BOARD STRATEGIC & FACILITIES PLANNING COMMITTEE MEETING AGENDA

Transcription

1 BOARD STRATEGIC & FACILITIES PLANNING COMMITTEE MEETING AGENDA Monday, January 15, 2018 Palomar Medical Center 12:00 p.m. Raymond Family Conference Center Buffet lunch for board members & invited guests 2185 Citracado Parkway, Escondido, CA PLEASE TURN OFF CELL PHONES OFF OR SET THEM TO SILENT MODE UPON ENTERING THE MEETING ROOM Form A Time Page Target CALL TO ORDER 12:00 Public Comments :15 *Information Item(s) 1. *Approval: Minutes Monday, October 16, 2017 (ADD A Pp4-19) :17 2. Board Meeting Follow Up :32 3. Strategic Plan Review (ADD B Pp21-49) :12 Public Comments :27 ADJOURNMENT 1 1:28 **Doug Moir, M.D., Chair Della Shaw, EVP Strategy Hugh King, IEVP Finance **Jerry Kaufman, PTMA, Director Alan, Conrad, MD, EVP Physician Alignment Frank Beirne, EVP Operations ** Ray McCune, RN, Director Maria Sudak, RN, MSN, CCRN, NEA-BC, VP PMCE **Hans Sison, LVN, 1 st Alternate Jeannette Skinner, RN, MBA, FACHE, VP PMCP **Diane Hansen, Interim President and CEO Foundation Philanthropy Officer Daniel Steeber, General Counsel **Franklin Martin, M.D., CoS PMCE PH Foundation Board Member Dan Farrow, AVP Hospitality & Facilities **Charles Callery, M.D., CoS PMCP Pam Sime, IEVP Human Resources NOTE: If you have a disability, please notify us by calling hours prior to the event so that we may provide reasonable accommodations Asterisks indicate anticipated action. Action is not limited to those designated items. 1 5 minutes allowed per speaker with a cumulative total of 15 minutes per group. For further details & policy, see Request for Public Comment notices available in meeting room

2 Minutes Board Strategic & Facilities Planning Committee Monday, October 16, 2017 TO: Board Strategic & Facilities Planning Committee MEETING DATE: Monday, January 15, 2018 FROM: Debbie Hollick, Committee Secretary Background: Budget Impact: The minutes from the Board Strategic & Facilities Planning Committee meeting held on Monday, October 16, 2017 are respectfully submitted for approval (Addendum A). N/A Staff Recommendation: Staff recommends approval of the Monday, October 16, 2017 Board Strategic & Facilities Planning Committee meeting minutes as presented. COMMITTEE RECOMMENDATION: N/A Motion: Individual Action: Information: Required Time: 1

3 Strategy Update Della Shaw, EVP Strategy TO: Palomar Health Board of Directors Strategy and Facilities Committee MEETING DATE: January 15, 2018 BY: BACKGROUND: Della K. Shaw, Executive Vice President Strategy Chairman Moir requested that the committee undertake a review of the Strategic Plan over the next months. The January presentation will include review of two key Strategic Priorities, Population Health and Strong Physician Alignment and Networks. It will also include discussion of the Clinically Integrated Network (CIN) in relation to both Strategic Initiatives. BUDGET IMPACT: STAFF RECOMMENDATION: COMMITTEE RECOMMENDATIONS: MOTION: INDIVIDUAL ACTION: INFORMATION: REQUIRED TIME: 2

4 ADDENDUM A 3

5 BOARD STRATEGIC & FACILITIES PLANNING COMMITTEE MEETING MINUTES MONDAY, OCTOBER 16, 2017 AGENDA ITEM CONCLUSION/ACTION FOLLOW UP / RESPONSIBLE PARTY FINAL? DISCUSSION CALL TO ORDER The meeting held in the Palomar Medical Center Raymond Family Conference Center, 2185 Citracado Parkway, Escondido, CA was called to order at 12:00 p.m. by Committee Chair McCune ESTABLISHMENT OF QUORUM Quorum comprised of Directors McCune, Kaufman, Czerwonka Excused Absences: None NOTICE OF MEETING Notice of Meeting was posted at the Palomar Health Administrative office; also posted with full agenda packet on the Palomar Health website on Thursday, October 12, 2017, which is consistent with legal requirements PUBLIC COMMENTS There were no public comments *INFORMATION ITEMS 1. * Board Strategic & Facilities Planning Committee Meeting Minutes Monday, September 18, Board Strategic & Facilities Planning Committee Minutes 4

6 BOARD STRATEGIC & FACILITIES PLANNING COMMITTEE MEETING MINUTES MONDAY, OCTOBER 16, 2017 AGENDA ITEM CONCLUSION/ACTION FOLLOW UP / RESPONSIBLE PARTY FINAL? DISCUSSION There was no discussion MOTION: by Director Kaufman, 2 nd by Director Czerwonka and carried to approve the Monday, September 18, 2017 Board Strategic & Facilities Planning Committee meeting minutes as presented. All in favor. None opposed. No abstentions N/A Y 2. Board Meeting Follow Up Information only Board Committee Follow Up Tracking Tool Executive Vice president Della Shaw noted that, per request of Board Chair Czerwonka, a perpetual follow up tracking tool has been created for this and the Board Community Relations committee, which will facilitate follow up on requests from the board members for each committee meeting 3. Balanced Score Card: FY2018 Brand Goals Exception Report Information only Utilizing the attached presentation, Ms. Shaw reported out on the latest data for the Brand Pillar, noting that they are currently rounding as to what methodology to use for the Balanced Score Card. The data being shared in this report is from the Studer Leader Evaluation Manager (LEM), which automatically rounds points to the closes whole number; based on rounding outcome, this format may change in the future 4. Strategic and Business Planning Update Information only Utilizing the attached presentation, Ms. Shaw provided a strategic and business planning update, noting that Next Steps were to move to a Strategic Management System ADJOURNMENT TO EXECUTIVE SESSION 1. Report involving Hospital Trade Secret Per Health & Safety Code concerning potential new service or program Estimated disclosure date TBD RE-ADJOURNMENT TO OPEN SESSION Board Strategic & Facilities Planning Committee Minutes 5 2

7 BOARD STRATEGIC & FACILITIES PLANNING COMMITTEE MEETING MINUTES MONDAY, OCTOBER 16, 2017 AGENDA ITEM CONCLUSION/ACTION FOLLOW UP / RESPONSIBLE PARTY FINAL? DISCUSSION ACTION RESULTING FROM CLOSED SESSION, IF ANY - MOTION: by Director Czerwonka, 2 nd by Director Kaufman and carried to recommend full board approval of transaction. All in favor. None opposed. No abstentions Board of Director s to review transaction for potential approval N PUBLIC COMMENTS There were no public comments ADJOURNMENT Meeting adjourned at 1:27 p.m. by Chair McCune COMMITTEE CHAIR Doug Moir, M.D. SIGNATURES: COMMITTEE SECRETARY Debbie Hollick Board Strategic & Facilities Planning Committee Minutes 6 3

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21 ADDENDUM B 20

22 Passion. People. Purpose. TM Board of Directors Strategy and Facilities Planning Committee Strategic Plan Review Della K. Shaw EVP Strategy & Interim Chief Philanthropy Officer January 15,

23 Strategy Palomar Health will be recognized as the dominant provider of integrated health services as measured by market position and value-based metrics of care. People Process Outcomes Mission Sustaining Financial Performance Customer Value Quality Cost Experience Brand Operational Excellence Clinical Integration Efficiency & Effectiveness Hassle Free Experience Consumerism Organizational Capabilities World-class Workforce Technology Patient First Culture 2

24 Strategic Priorities Effective and Efficient Care Develop effective and efficient systems that support achievement of the Quadruple Aim to enhance patient experience, improve population health, reduce costs, and improve the life of health care providers, including clinicians and staff. Create and Maintain Customer Value Attract, create, and retain loyal customers where customers are defined as our patients and their families, physicians, payers, and our community by achieving the Triple Aim initiatives of enhancing customer experience, improving population health, and reducing costs. Strong Physician Alignment and Networks Build physician-hospital alignment and physician engagement as the foundation of a high-value network that will meet the Population Heath Management needs of our community and ensure that Palomar Health is the preferred provider of care in North County. Population Health We will serve as providers, coordinators, collaborators, and aggregators in population health and population health management for our employees and the communities we serve our population. North County Network Collaborations, Partnerships and Alignments Through collaborations, partnerships, and affiliations in the region, Palomar Health will build aligned networks that ensure community access to comprehensive, clinically integrated, value-based care that will meet the needs of the population we serve for generations to come.

25 Focus Population Health & Physician Networks Population Health We will serve as providers, coordinators, collaborators, and aggregators in population health and population health management for our employees and the communities we serve our population. Strong Physician Alignment and Networks Build physician-hospital alignment and physician engagement as the foundation of a high-value network that will meet the Population Heath Management needs of our community and ensure that Palomar Health is the preferred provider of care in North County. 4

26 Setting the Stage 2016 Community Health Needs Assessment (CHNA) 5

27 2016 CHNA Designed to provide a deeper understanding of barriers to health improvement in San Diego County. Report included an analysis of health outcomes and associated social determinants of health which create health inequities the unfair and avoidable differences in health status seen within and between counties and communities with the understanding that to the burden of illness, premature death, and disability disproportionately affects racial and minority population groups and other underserved populations. Insights were meant to help hospitals identify effective strategies to address the most prevalent and challenging health needs in the community. 6

28 2016 CHNA San Diego Statistics Nearly 15% of San Diegans live in households with income below 100% of the Federal Poverty level Almost 15% of San Diegans aged 25 and older have no high school diploma or equivalency Greater proportion of Latinos, African Americans, Native Americans, and individuals of other race live in poverty compared to the overall San Diego population. Approximately 46% of households in San Diego have housing costs that exceed 30% of their income. Approximately 1 in 7 San Diegans are food insecure. Approximately 10% of San Diegans aged 5 and older have limited English proficiency and 8.5% are linguistically isolated. 7

29 2016 CHNA San Diego Geographic Regions 2013 Community Need Index Scores 4.2 to 5.0 = High Need Central Min 3.0 Max 5.0 East Min 2.6 Max 4.8 North Central Min 2.0 Max 4.4 North Coastal Min 1.8 Max 4.6 North Inland Min 2.4 Max 4.4 South Min 2.2 Max 5.0 8

30 2016 CHNA San Diego Geographic Regions North County 2013 Community Need Index (CNI) Scores Zip Codes with a Score of 4.2 or Higher Escondido 92025, North Coastal Oceanside Pala Vista 92083, San Marcos

31 Behavioral Health North Inland

32 Behavioral Health North Coastal

33 Cardiovascular Disease North Inland

34 Cardiovascular Disease North Coastal

35 Diabetes Mellitus North Inland

36 Diabetes Mellitus North Coastal

37 CHNA San Diego Top Community Health Needs (alphabetical) 1. Behavioral Health 2. Cardiovascular Disease 3. Diabetes (Type 2) 4. Obesity 16

38 CHNA Ranking Results 17

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40 Who Takes Which Group? Segmenting Patients and Interventions Managing Three Distinct Patient Populations High- Risk Patients 5% of patients; usually with complex disease(s), comorbidities Trade high-cost services for low-cost management Rising-Risk Patients 15-35% of patients; may have conditions not under control Avoid unnecessary higher-acuity, highercost spending Low-Risk Patients 60-80% of patients; any minor conditions are easily managed Keep patient healthy, loyal to the system 19

41 What Do you Really Want to Own? Defining our Core Competencies Bricks and Mortar Components of Population Health Prevention Worksite Clinics Schools Primary Care Retail Clinics Pharmacy Medical Home Primary Care Urgent Care Acute Care Emergency Care Urgent Center Long-Term Management Post-Acute Care Hospital Freestanding Acute Care Hospitals Affiliate Hospitals Palliative Care Ambulatory Care Surgery Post-Acute Care Home Health Primary Care Acute Care Long-Term Management SNF Hospice Long-Term Care LTAC Source: Population Health Advisor interviews and analysis. 20

42 The First Line of Tactical Management Contact Center Functions Supporting Population Health Source: Population Health Advisor interviews and analysis. 21

43 Care Management as Connective Tissue of Population Health Physician Practice Medical Home ACO ED Acute Care Home Health SNF Nursing Home LTAC Problem: Care management models are developed independently, resulting in conflicting approaches and gaps in care Question: Do we have an overarching care management model to control how methodologies are deployed in each area of the health system? Need: A strong, centrally-managed, and continuum-wide care management structure. Case Management Discharge Planning Patient Placement PCP Follow-up LT Care Planning Transitional Care System Navigation 22

44 Organizing the Basket of Community Assets Surfacing, Addressing Social Needs Critical to Care Social and Environmental Social, Environmental Factors Influencing Health: Individual Behaviors 40% 20% 10% Health Care Income and employment status Housing and transportation Literacy and language Hunger and access to healthy food options 30% Genetics Social integration and support Safety 80-90% Health status attributed to non-clinical care factors 85% Physicians reporting unmet social needs lead directly to poorer health outcomes 20% Physicians who believe they have the ability to address social needs Source: Powering Healthier Communities: Community Health Centers Address the Social Determinants of Health, National Association of Community Health Centers, 2012, B Booske et al, Different Perspectives for Assigning Weights to Determinants of Health, University of Wisconsin Population Health Institute, 2010, Population Health Advisor research and analysis. 23

45 Drivers of High-Risk MediCal Healthcare Costs Based on results of over 4,000 assessments of high-risk patients conducted at Montefiore CMO 24 24

46 Passage to Population Health Management Sustainable, Population-Centered, Data-Driven, Coordinated Care Network Assemble a strong provider network aligned with system-wide performance goals and engaged in health care improvement Care Model Establish ambitious clinical standards for delivery system redesign and care management resources Economics Craft a sustainable valuebased payment strategy with a solid financial foundation for profitability and growth Technology that supports delivery system redesign, provider accountability, value-based quality monitoring, and patient engagement Advisory Board Company content 25

47 One-Stop Call Centers Co-locate Patient Information Central Platform Coordinates, Personalizes Care Linking CRM and EMR Systems to Resolve Multiple Needs in One Call Physician office Diagnostic testing Emergency department Care coordination platform Health Information Exchange Urgent care clinic Pharmacy Platform offers comprehensive patient information; nurses triage care, make appointments Encounter triggers alert for nurse to follow up Case in Brief: Centura Health 16-hospital health system based in Englewood, Colorado Moved multidisciplinary navigators to single CenturaConnect platform to manage care coordination pathways and increase collaboration across care sites Worked with Salesforce and TriageLogic to document every patient interaction in centralized EHR/CRM platform and offer seamless triage Platform includes all patient information, including non-clinical factors related to health Source: Centura Connect, available at: Rogers J, Working on the Edge: Integrating New Technology and Communication Platforms into Your Call Center, CenturaConnect Virtual Resource Center, 2015; TriageLogic Call Center Software Integrates with Centura Connect s Salesforce 26 Platform, PRweb, Dec 2014, available at: Source: Population Health Advisor interviews and analysis.

48 Technology Platforms and Capabilities Data Sources EMRs, Payer Claims, Patient-Reported Data Reporting and Analytics Required Measures Costs/Utilization Predictive Analytics Quality Improvement Practice Management Program Measures ACO, HEDIS, MACRA, MU Specialty Registry, etc. Contract Alignment (Current & Potential) Provider Analytics Hierarchical Condition Category (HCC) Analytic 27

49 Patient Activation Wellness P O P U L A T I O N M A N A G E M E N T Patient-Centered Medical Homes Referral Management Utilization Management Person, Patient, Member P 2 + M Provider Insurance Product Commercial Self Insured Employers Community Health Needs Assessment Member Experience Payor Our Own Employees Enterprise Unified Strategy Care Management & Coordination Clear Transitions Disease Management Medicare/MediCal Acute Ambulatory Behavioral Health Urgent Care CMS Retail MIPS and APM Regulatory Clinical Integration State Compliance P4P Governance Skilled Nursing Home Health Rehab Bundled Payments ACO Long Term Care Infrastructure Organization Leadership At-Risk Contracting Capitation Culture Enhanced Practices EDW Operations Margin Enhancement Business Model Shift Quality Reporting Resource Utilization Interoperability Technology evisits Operational Efficiency Centers of Excellence Physician Alignment Programs Telehealth Analytics Solutions Rural Outreach Mission Vision Strategic Planning Market Position Recruiting Relationship Managment Financial Model Disbursement Pool Funding Contract Management Provider Reimbursement Performance Improvement Clinical Decision Support Patient Portal Serivce Line Optimization Descriptive Predictive Prescriptive Registries Care Management Contract Management Lean Six Sigma Operational Transformation

50 Questions & Discussion 29