Mid-Atlantic Permanente Medical Group Strategic Projects Implementation Team Summer Internship Johns Hopkins February 19, 2015
Introductions Katie Wilson, RD, MHSA Joined MAPMG in 2013 Previously worked at The Permanente Medical Group (KPNCAL) and consulting (Advisory Board Company, Sg2) Cabell Jonas, PhD Joined MAPMG in 2014 Previously a management consultant at The Advisory Board Company
Overview MAPMG Background Summer Internship Projects in Progress
Who We Are: Kaiser Permanente Mid-Atlantic States (KPMAS) Mid-Atlantic Permanente Medical Group Kaiser Foundation Health Plan Over 1,100 Physicians ~563,000 Members
Kaiser Permanente of the Mid-Atlantic States Cover much of Maryland, Washington, DC, and Northern Virginia ~563,000 members Over 1,100 Mid-Atlantic Permanente Medical Group physicians About 6,000 employees 30 medical facilities Hub and spoke system 5 hubs Core hospitals at which MAPMG physicians directly care for members 24 hours / 7 days / 365 days care available Fully supported by Comprehensive EMR 5
Demonstration of the superior value we deliver Access to Specialty Care Days Wait From Referral/Order Creation to First Appointment December 2014 50.00 External 45.00 Days Wait 40.00 35.00 30.00 e.g. it takes 18 days to get a dermatology appointment outside of KP, and only 8 days within MAPMG. 25.00 20.00 15.00 10.00 5.00 0.00 6
Demonstration of the superior value we deliver Overall Picture: National Committee for Quality Assurance (NCQA) annually rates nearly 500 Health Plans annually on clinical quality (using HEDIS) and consumer satisfaction (using CAHPS)* KPMAS has always been a local quality leader, but is now a national quality and service leader, outpacing all local health plans. Rank nationally among private (commercial) Plans** 1 500 #81 #73 #33 #15 In 2014, Next highest commercially available plan in DC, MD, or VA with over 100,000 members #16 Kaiser Foundation Health Plan of the Mid-Atlantic States #13 +68 Ranked #124 * NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA s Healthcare Effectiveness Data and Information Set (HEDIS ) is the most widely used performance measurement tool in health care. Consumer Assessment of Healthcare Providers and Systems (CAHPS ) is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). ** NCQA s Private Health Insurance Plan Rankings 2009 2013 33
Demonstration of the superior value we deliver Quality: Clinical Quality Metrics where plan achieved highest rate in MD, DC, VA* Count of Clinical Quality Metrics where plan achieved highest rate in MD, DC, VA* (Out of the 48 clinical measures that represent 60% of the 2014 NQCA Commercial Health Plan Ranking Methodology**) 34 * Highest rate means highest rate amongst plans with enrollment >100,000 members in DC, MD, and VA combined (as reported to NCQA in 2014) ** See http://www.ncqa.org/linkclick.aspx?fileticket=lmx7foxxbb8%3d&tabid=2144&mid=9626 for details on methodology (section 6.3.1) *** Refers to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (DC, MD, VA) (HMO) NOTE: The source for data contained in this publication is Quality Compass 2014 Commercial data and is used with the permission of the Committee for Quality Assurance (NCQA). Quality Compass 2014 includes certain CAHPS data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass is a registered trademark of NCQA. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
70% 60% Demonstration of the superior value we deliver Patient Experience: Service as measured by key CAHPS metrics Overall Health Care Rating** Kaiser Permanente Mid=Atlantic States CAHPS* Results: 2014 Private Plans (% scoring 9 or 10) 90% 80% Personal Doctor Rating Kaiser Permanente Mid=Atlantic States 80% Specialist Doctor Rating National Median Rate Kaiser Permanente Mid=Atlantic States 70% 70% 50% Other large Mid-Atlantic Health Plans** 60% Other large Mid-Atlantic Health Plans** 60% Other large Mid-Atlantic Health Plans** 40% 50% 30% 40% 2009 2010 2011 2012 2013 2014 2009 2010 2011 2012 2013 2014 * Consumer Assessment of Healthcare Providers and Systems (CAHPS) **Data CAHPS 2014 (percent of respondents scoring question a 9 or 10 on 10 point scale) *** Other large Mid-Atlantic health plans composed of plans with more than 150,000 members in DC, VA or MD 35 50% 2009 2010 2011 2012 2013 2014
Continually Building Our Capabilities 10 Major investment in delivery system beginning 2009 5 multi-specialty hubs, IT systems investment New health plan and delivery system leadership Over 600 board-eligible / board-certified physicians hired since 2009 Many of our physician are recognized as leaders in their field 154 top doctors in Northern Virginia Magazine 128 super doctors in Washington Post Magazine 86 rising star doctors in Washington Post Magazine 59 top doctors in Washingtonian Magazine 37 top doctors in Baltimore Magazine
Demonstration of the superior value we deliver Cost Effectiveness: Reducing hospital and emergency room utilization 24% reduction 2008-YE 2014 ER Rate/1000 24% reduction 2008-Sep 2014 11 Note: *Commercial with Psychiatry. ** Total ED Visits: just outpatient.
Strategic Projects Implementation Summer Internship Interns will support a team of senior Strategic Project Implementation Consultants and engage directly with the physician executives they support. The internship is designed to provide a wide array of experiences that traverse the areas of consulting, analytics, project management, strategy, communications, marketing and executive leadership. Ideal interns are self-starters, energized by a fast-paced work environment, exercise exceptional judgment, enjoy working on teams, have excellent attention to detail and are interested in improving health care delivery. Submit Resume and Cover Letter by March 1
Projects Interns Will Support High-profile projects include, but are not limited to: Coordinating key elements for implementation of new Telemedicine programs Enhancing clinical care pathways Ensuring medical group policies align to legislative changes Soliciting feedback from members to guide marketing efforts Implementing physician engagement initiatives and patient outreach programs Details: Submit Resume and Cover Letter by March 1 to Cabell.Jonas@kp.org 8-10 weeks Flexible start and end dates Competitive stipend Based in Rockville, MD (10 minutes north of DC; off Metro Red Line) and local clinics
Project in Progress: Telemedicine Bringing health care to you
APC Telemedicine What is Telemedicine? Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology. - American Telemedicine Association 15
KPMAS Telemedicine Telemedicine is on the brink of a boom 140 VIRTUAL VISITS (in millions) (Park Associates 8/29/2014) 130 120 100 80 60 40 20 16 5.7 0 2014 2015 2018 16
KPMAS Telemedicine Why KPMAS Telemedicine? CARE CONVENIENCE COST CARE DELIVERY MODEL 17
KPMAS Telemedicine Current KPMAS Telemedicine Endeavors HouseCalls (MOB-to-Home) Pediatric Subspecialties (MOB-to-MOB) Endocrinology, Neurology, Heme-Onc, Cardio, Developmental, GI TeleSpine TeleDerm TelePsych TeleNutrition CDU-to-CDU Movi 18
Projects in Progress: Hepatitis C Screening Pathway Redesign New USPSTF Recommendations for Hepatitis C Screening Best Practice Alert: The USPSTF now recommends offering one-time screening for Hepatitis C to adults born between 1945 and 1965 Persons at high risk for infection should be screened (past/present substance abusers, men who have sex with men) New Clinical Technology Fibroscan Fibroscan uses transient elastography to measure liver stiffness fibrosis score indicates the severity of disease progression; non-invasive test Located in the GI clinic
A Broad Scope of Responsibility Leadership Engaging clinical leadership to support the redesign Labs Creating new lab orders Automating labs to streamline pathway for patients Reporting results to the right teams Clinical Technology Implementing Fibroscan in 5 clinics Training staff on machine and EMR Primary Care Educating physicians about the new pathway Creating, distributing patient educational materials Encouraging compliance Specialty Care (GI, ID teams) Outlining clinical result interpretation processes Educating physicians about the new pathway Encouraging compliance Producing, managing data reports IT, Medical Record Coordinating the IT support across entire pathway Continuous quality improvement of the pathway Staff Support Creating training curriculum for new Coordinator Education Create educational video for patients Create educational videos for physicians and staff Create 1-pager cheat sheets for staff
Other National Projects We Support PCORnet, the National Patient-Centered Clinical Research Network, is an innovative initiative of the Patient-Centered Outcomes Research Institute (PCORI). The goal of PCORnet is to improve the nation s capacity to conduct comparative effectiveness research efficiently by creating a large, highly representative network for conducting clinical outcomes research. Kaiser Permanente Research Bank National project from all 7 KP regions Program aggregates biological samples and health information from consenting participants Researchers will apply to use samples and health information to conduct clinical and epidemiological research Patient Outcomes Research to Advance Learning (PORTAL) network is a collaboration between Kaiser Permanente (several regions), Group Health, Denver Health, HealthPartners and SmartPatients
Benefits of Our Role Kaiser Permanente and MAPMG are elite health care organizations Culture that supports continual innovation and improvement Interesting and impactful work Constant learning and growth High degree of ownership over work Unmatched executive and physician exposure Making a difference in patient care and patient lives Strong and supportive team
Challenges of Our Role High degree of ambiguity MAPMG runs lean like a startup company Physicians and staff have many competing priorities Responsibilities cut across many disciplines
Strong Candidates: Enjoy ambiguity and thrive under pressure Are energized by challenges Are consistently professional; have strong presence Are ready to do whatever it takes to get a job done Are good communicators Are flexible and hardworking Enjoy working with physicians Have a passion for improving patient care
Questions? To apply, send your resume and cover letter expressing interest to Cabell.Jonas @kp.org by March 1. Details: Submit Resume and Cover Letter by March 1 to Cabell.Jonas@kp.org 8-10 weeks Flexible start and end dates Competitive stipend Based in Rockville, MD (10 minutes north of DC; off Metro Red Line) and local clinics