Bellin Health Improving Health & Lowering Cost April 10, 2014
Table of Contents I. Who We Are Bellin Health s Strategic Platform Organizational Structure and Organizational Chart Mission, Vision, Strategies with Scorecard Measures II. Utilization and Diversification III. Quality, Patient Satisfaction, and External Recognition IV. Strategies to Make Bellin Successful throughtransition Risk V. Breakthrough Initiatives 2
Strategic Initiatives Who We Are Bellin Health s Strategic Platform 3
4
Mission and Vision Mission Bellin Health is a community-owned not-for-profit organization responsible for the physical and emotional health of the people living in Northeast Wisconsin and the Upper Peninsula of Michigan. Directly, and in partnership with communities, employers, schools, and government officials, we guide individuals and families in their lifelong journey toward optimal health. We are committed to providing safe, reliable, cost-effective total health solutions with respect and compassion. Our innovative work will impact healthcare delivery in our region, as well as throughout the world. Vision The people in our region will be the healthiest in the nation. 5
Strategies Patient, Family and Customer-Centered Organization We will provide a positive patient experience for the population in all interactions, and will encourage and include the active participation of people and their families as we provide care. Everywhere in our region, we will know our customers, build relationships, and connect services at the right time and right way to meet their needs. Likelihood of Recommending BMG Panel Size Coordination of Care Pathways in Place Number of Strategic Partners Engaged Staff and Partners We will work with people directly associated with Bellin, and others critical to success in accomplishing our mission, and maintain a positive culture based on our values of: People; Superior Service; Continuous Improvement, Learning & Development; Innovative Thinking. Employee Engagement Overall Physician Engagement Measure Employee Safety-Workers Compensation Modification Rate Bellin Employee HRA Scores Overall 6
Strategies Improved Health of the Population We will provide superior healthcare products and services and at an affordable cost, which are of high quality, and offer a positive experience. Our focus will be on identifying and achieving individual health goals, providing a safe environment, attaining positive clinical outcomes, and continuously improving the overall health of our population. We will relentlessly improve and innovate. Risk-Adjusted Mortality Rate Hospital Clinical Quality Measures Primary Care WCHQ Ranking Avoidable Patient Harm Events Employer HRA Scores Community Poor or Fair Health 7
Strategies Growth & Prosperity We will continue to be a strong organization through innovation and expansion of our influence on the lives of the population. We will strive to lower the cost of healthcare services in our region to the lowest in the nation. At the same, time, we will maintain a bond rating at, or above, investment grade, which is a comprehensive and objective indicator of our financial strength. Total Revenue Cost to Produce Operating Margin Total Margin Value-Based Revenue Strategic Partner Healthcare Spend Per Capita Healthcare Costs 8
Strategic Measures Using Scorecards Bellin has a System Scorecard that is driven by individual Brand Scorecards to define and measure progress toward achieving our Strategies. The System Scorecard drills down to the department level to show clear accountability. 9
Utilization Data Beds in Service Fiscal Year Ended September 30, 2009 2010 2011 2012 2013 Bellin Hospital 173 172 175 176 176 Bellin Psychiatric Center 53 53 53 60 60 Bellin Health Oconto Hospital 4 4 4 10 10 Inpatient Admissions Bellin Hospital 8,159 8,361 8,508 8,401 8,421 Bellin Psychiatric Center 1,994 2,021 1,891 1,882 1,696 Bellin Health Oconto Hospital 22 21 36 44 158 Inpatient Days Bellin Hospital 31,689 33,109 33,434 31,030 31,465 Bellin Psychiatric Center 8,882 8,270 7,716 7,351 6,860 Bellin Health Oconto Hospital 62 84 139 185 359 Average Length of Stay Bellin Hospital 3.9 4.0 3.9 3.7 3.8 Bellin Psychiatric Center 4.4 4.1 4.1 3.9 4 Bellin Health Oconto Hospital 2.8 2.5 1.7 2.4 2.3 Average Daily Census Bellin Hospital 86.8 90.7 90.8 85.0 86.2 Bellin Psychiatric Center 24.3 22.7 21.1 20.1 18.8 Bellin Health Oconto Hospital 0.2 0.2 0.4 0.5 1 Outpatient Visits Bellin Hospital 371,612 399,426 404,848 440,679 496,221 Bellin Psychiatric Center 17,856 19,131 19,473 21,708 21,909 Bellin Health Oconto Hospital 6,380 6,691 6,864 7,141 10,877 Other Statistics Inpatient Surgery 3,699 3,839 3,743 3,664 3,856 Outpatient Surgery 9,111 9,324 9,806 10,032 9,768 Emergency/Urgent Care Visits 27,573 29,150 28,322 32,881 33,465 Newborn Births 1,261 1,233 1,268 1,264 1,231 Bellin Primary Care Clinic Visits 379,755 405,704 388,790 414,009 442,038 Inpatient admissions at Bellin Hospital increased in 2013. Outpatient visits continue to increase. Primary Care clinic volumes continue to grow. Specialty Group clinic volumes increased substantially due to acquisitions of general surgeons, allergists, OB/GYN, and cardiothoracic surgeons. Case mix index continues to increase and is expected to move upward with better documentation through Epic. Bellin Specialty Group Clinic Visits 0 22,185 32,305 32,164 58,798 Psychiatric Visits 39,148 38,728 40,165 42,884 36,574 Case Mix Index 1.50 1.54 1.53 1.57 1.58 10
Strategic Initiatives Quality/Patient Satisfaction Results and External Recognition 11
Readmission Rates 30-day All Cause Readmission Rate is better than All Wisconsin Rate 253 days since the last Central Line Associated Blood Stream Infection (CLABSI) 971 days since last Ventilator Acquired Pneumonia (VAP) 12
Patient Experience Results 13
Patient Experience Results Data collection period: 4/1/2012-3/31/2013 14
15
16
Quality Recognition at National Headlines 17
Strategic Initiatives Strategies to Make Bellin Successful through Transition Risk 18
Business Case 19
Medicare Pioneer Year 1 - Results 20
2 Hospital Systems 700 Physicians Population 1,000,000 SYSTEM RESOURCES 715 Physicians 57 Primary Care Locations 3 Tertiary Hospitals 4 Critical Access Hospitals 1 Psychiatric Hospital with full-service Behavioral Health Clinic Hospice & Palliative Care Services Skilled Nursing Facilities (1 systemowned) 21 POPULATION SEGMENTS Employees, Children & Families 540,000 people Medicare160,000 people Medicaid 180,000 people Uninsured 120,000 people Total Population 1,000,000 people
Final Numbers Pioneer ACO PY1 (2012) Actual Base Base Target 4.6% Savings 22 $5.3M take home @ 70%)
PY1 Pioneer ACO Performance Bars represent annualized PY1 PBPY expenditures Green represents gain, red represents loss when compared to benchmark 23 Baseline to 2012 Trend ACO Ref. Pop. Difference -8.5% -1.7% -6.8% -5.4% 1.1% -6.5% -5.6% 0.5% -6.0% -2.8% 3.5% -6.3% -4.4% -0.6% -3.8% -1.9% 2.7% -4.5% -4.6% 0.3% -5.0% -3.6% 0.5% -4.1% -1.0% 2.6% -3.6% -6.4% -1.7% -4.8% 3.7% 6.7% -3.0% 0.1% 1.4% -1.2% -1.5% -0.5% -1.0% 0.7% 1.5% -0.9% 2.2% 2.5% -0.3% 0.7% 0.8% -0.1% 2.0% 1.9% -0.1% 1.0% 1.0% 0.0% 0.2% 0.0% 0.2% 0.3% 0.0% 0.3% 0.2% -0.3% 0.5% 0.7% 0.0% 0.6% -1.4% -2.0% 0.7% 2.2% 1.0% 1.3% 4.4% 1.8% 2.6% 5.0% 2.6% 2.3% 5.7% 3.6% 2.1% 2.2% 0.0% 2.2% 2.0% -0.6% 2.6% 8.2% 3.7% 4.5% 4.2% -0.2% 4.5% 7.4% 2.1% 5.3%
24
25
Value-Based Revenue Value Based Revenue as a Percent of Operating Income 9.82% 10.0% 9.0% 8.0% 7.0% 6.0% 5.0% 4.0% 2.81% 3.0% 2.0% 1.0% 0.0% 0.11% 0.22% 2009 2010 2011 2012 2013 26
Bellin Health s Breakthrough Initiatives 27
Aim Achieve an annual 4% operating margin to fund continued investment in technology, staff, and facilities to improve the health of the region. 28
Bellin s Approach 29
2013 Results 30
Cost to Produce 31
Breakthrough Initiatives 32
Eliminate Cost, Waste & Variation Driver Diagram 33
Manage Populations to Achieve the Triple Aim Driver Diagram 34
Business Development & Growth Driver Diagram 35