Milestones. Milestones. Marshfield Clinic Who We Are, What We Do, and How State Policy Impacts Us

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Marshfield Clinic Who We Are, What We Do, and How State Policy Impacts Us Robert E. Phillips, M.D. Medical Director, State Government Relations Wisconsin Rural Health Summit Chula Vista Resort, Wisconsin Dells May 24, 2011 Milestones 1916 Founded by Six Physicians One of First Group Medical Practices in US 1926 UW Madison Medical Preceptor Program 1959 Marshfield Medical Research Foundation formed 1971 Greater Marshfield Community Health Plan (became Security Health Plan) Milestones 1991 Lawton Center Dedicated 1997 Laird Center for Medical Research 1998 Personalized Medicine Project 2003 Monkeypox Virus Identified 2007 UWSMPH Academic Campus 2008 Laird Center Expansion 1

Marshfield Clinic System Marshfield Clinic -- Clinical Care 54 Regional Centers Family Health Center Diagnostic & Treatment Center Flambeau Hospital Lakeview Medical Center 7 Dental Clinics (and 1 more opening in 2011) Primary Service Area 28 Counties Marshfield Clinic Today 780 Physicians 85 Medical Specialties 6,680 Staff 374,468 Patients 3.8 million Patient Encounters From Every Wisconsin County Every State in the US Nearly 30 Foreign Nations 2

Expansion West/Northwest Divisions New Primary Care Centers in: Cumberland Bloomer Lake Hallie Elk Mound Arcadia Hayward Menominee Center Addition Marshfield Clinic System Marshfield Clinic Research Foundation Marshfield Clinic Education Foundation Security Health Plan Marshfield Labs Applied Sciences Marshfield Food Safety CattailsMD Medical Research Largest Private Medical Research Facility in Wisconsin 450 Active Research Projects 180 employees, 30+ MD/PhD Scientists 150 Clinicians involved in active research FY 2007 -- $10 Million in Grant Awards FY 2008 -- $14 Million in Grant Awards 3

Medical Research Five Research Centers Clinical Research Center Marshfield Epidemiology Research Center Center for Human Genetics National Farm Medicine Center Bioinformatics Research Center Electronic Medical Record Internally Developed More than 30 Years of Medical History Completely Paper-less in 2007 Connects all 54 of our Centers Deployed Wireless Tablets for Point of Service Care of Patients CMS Demonstration Project 1 of 10 National Participants 4-year Project Impressive Results in First Two Years Improved Patient Health, Lowered Costs 4

Personalized Medicine Use Genetic Data and Health Information to Improve Patient Care Largest Population-Based Bio-Bank in US 20,000 Adult Participants Access to More than 30 Years of Electronic Medical History Information Biomedical Informatics Biomedical Informatics Research Center formed 2005 Use Information to Improve Health Care Manage Large Amounts of Medical Information Support Medical Decisions Usability Laboratory Human Computer Interaction Wisconsin Genomic Initiative Use Genetic Data, Health History and Environmental Factors to Predict and Prevent disease, Personalize Treatments Partnership Between Marshfield Clinic, UWSMPH, MCW, UW-Milwaukee Each Partner Brings Capabilities, Resources Can Only Be Done in Wisconsin Initial Results in Two Years 5

Our Mission: The mission of Marshfield Clinic is to serve patients through accessible, high quality health care, research and education. Our Vision: Marshfield Clinic will be the preferred system of cost-effective, evidence-based, quality health care. Through research, education and standardization of quality, we will reduce the burden of disease, disability and cost for our patients and communities. Marshfield Clinic Health Policy Agenda: Access Quality Cost-control Future of Health Care (HC) 1. HC will focus on patient need. 2. HC complexity mandates integration. 3. HC providers accountable for value of care, results 4. Decreased dollars for HC with expansion of population need. 5. Reimbursement for value. 6. Providers will assume more financial risk. 7. HC organizations will have incentives for greater: Integration Consolidation Patient centered care Basics of New Model Delivery System 1. New reimbursement terms 2. Share responsibility for value not volume a) Alignment of community, patients, providers b) Transparency of quality and service data 3. Seamless integration of care 4. Aligned governance and financial systems 6

Principles for Planning 1. Care for all 2. Chronic disease drives 75% of cost 3. Integrated models more efficient 4. Payment for quality - outcomes 5. Cost transparency 6. Quality Value = Quality Cost Wisconsin State Health Information Network (WISHIN) 1) Marshfield Clinic connectivity standards, data governance 2) Transparency 3) Key stakeholders input 4) Interoperability standards 5) HIT dissemination for patient safety and efficiency of care Insurance Exchange 1) WI Model 2) Governance Board Public/private partnership 3) Web portal vs. expanded functions 4) Regional vs. statewide 5) Maintain private sector options 7

Marshfield Clinic 1) Aligned with need for cost control 2) Quality outcomes based metrics 3) Access pure cost reduction may impair access 4) Equal share of patients with limited resources Resource-delivery issue Cost Patient responsibility Affects Quality Uneven reimbursement Access State Legislative Agenda 2011-12 Preserve MA/BC Health Insurance Exchange Security Health Plan payment reform, evidence-based and QOL HIT Dental Access and Education Marshfield Clinic Federal Health Policy Agenda 2011-2012 Value-based purchasing in health care Reduce geographic disparity in Medicare reimbursement to WI PGP Demo chronic disease care for all MC patients shared savings pilots Studying ACO rules Implementing Meaningful Use PCMH Pilots Primary care focused 8

Contacts Dr. Karl Ulrich, President/CEO Dr. Douglas Reding, Vice President Dr. Robert Phillips, Medical Director, State Government Relations Ryan Natzke, Director, State Government Relations Thank You! 9