Saturday, March 16, 2013
11:00 a.m. – 12:15 p.m.
Achieving Group Practice Initiatives with Physician Extenders [More Info]
Richard Baney, MD, MBA, Assistant Medical Director for Quality Improvement, and Debra Johansen, MBA, CMPE, Chief Operations Administrator, MIMA
| MIMA expanded their primary care department by hiring ARNPs and PAs, and found the use of physician extenders also supported practice initiatives related to quality, compliance, patient access, and operational efficiency. Members of MIMA’s administrative leadership will also review their experience developing compensation models for the extenders and their physician supervisors. |
| Upon completion of this activity, participants should be able to identify benefits to utilizing physician extenders to augment their group practice volumes, meet patient access needs, and to easily implement changes in work flows to meet quality, compliance, and operational efficiency goals; and design a physician extender compensation model that includes a variable factor to incite productivity and/or efficiency, depending on the practice revenue structure, and a supervising physician stipend model that encourages participation. |
Kenneth B. Robbins, MD, Chief Medical Officer, Hawai’i Pacific Health
| Physician leadership and a physician/administrative partnership are keys to success for high-performing organizations. This presentation will make the case for physician leadership training as a strategic imperative in your organization, discuss the challenges faced by physician leaders, and present the nuts and bolts of developing a successful in-house physician leadership training program. |
| Upon completion of this activity, participants should be able to articulate why physician leadership training is a strategic imperative for their organizations; describe the challenges faced by physician leaders; and describe how to develop an in-house physician leadership training program. |
Brian Rank, MD, Medical Director, HealthPartners Medical Group, HealthPartners; and Penny Ann Wheeler, MD, Chief Clinical Officer, AllinaHealth
| AllinaHealth and HealthPartners Medical Group, market competitors, have successfully partnered in an ACO model to achieve Triple Aim results with improvements in quality and the patient experience, and lower cost utilization. This real-world case study of an ACO includes three years of strong total cost of care trend results. |
| Upon completion of this activity, participants should be able to describe how two competitors were able to cooperate and achieve Triple Aim results through effective mission alignment, governance, and targeted clinical strategies. |
Margaret Head, RN, MSN, MBA, Chief Operating Officer and Chief Nursing Officer, and Danny Bonn, MMHC, Administrative Director, Vanderbilt Medical Group
| While the Vanderbilt University Medical Center had been using an EHR for several years, the tools did not meet HITECH/Meaningful Use certification criteria and were inconsistently utilized by providers. With a clearly defined governance structure and organized operational approach, VUMC was able to successfully certify and attest to HITECH/Meaningful Use within an aggressive time frame. The plan is to replicate this structure and organization to Phase II and other significant organizational changes. |
| Upon completion of this activity, participants should be able to describe the challenges that an academic medical center faced in achieving Meaningful Use; establish a methodology and operational plan to advance an organization in the path to earning the Meaningful Use incentives or other significant organizational initiatives; identify the benefits of using dashboards to track project progress, assist leaders in performance management, and manage to financial targets; and describe lessons learned from a successful transition to Meaningful Use. |
Jim Roxburgh, RN, MPA, Program Manager, and Alan J. Shatzel, Jr., DO, Chairman, Department of Medicine, Medical Director, Mercy Neurological Institute, and Medical Director, Mercy Telehealth Network
| Health systems across the country struggle with clinical integration, access, safety, and quality because fragmented care delivery has been rewarded. New economic drivers incentivize population management, quality outcomes, and better value which requires innovation and rapid adoption of technology for care delivery across the entire continuum. This presentation will highlight lessons learned and telehealth network development and implementation from seed money to reality. |
| Upon completion of this activity, participants should be able to describe the importance of healthcare systems redesign, clinical integration, care process improvement through telemedicine and deployment of telehealth technology; describe how leading with service drives quality; discuss the importance of physician leadership and how physician/administrative partnerships deliver results; describe the value proposition for telemedicine across the care continuum; and describe that delivering the right care at the right time aligns with payment reform. |
Robert W. Brenner, MD, MMM, Chief Medical Officer, and Jamie Reedy, MD, MPH, Medical Director of Practice Transformation, Assistant Medical Director of Quality, Department of Care Coordination/Utilization Management, Summit Medical Group
| It is clear that in order to remain financially solvent, medical groups must ready their organizations for success under value-based payment models. Summit Medical Group has approached this challenge by creating a Department of Practice Transformation. This presentation will overview this journey, describe the challenges and successes, and offer specific examples. |
| Upon completion of this activity, participants should be able to describe the reasons for developing a Department of Practice Transformation; delineate the roles and responsibilities of a Department of Practice Transformation and those of the individuals that staff this department; list the key success factors for transforming care; describe the stages of transformation and change management experienced by SMG; and cite specific examples of how the Department of Practice Transformation at SMG has managed to ensure continuous improvement in care for individuals and the health of populations at an appropriate cost. |
Barney Newman, MD, Medical Director, and Maura Del Bene, NP, Associate Director, Palliative Medicine, Palliative Medicine Service, WESTMED Medical Group
| The new frontier of palliative care is the outpatient setting when serious illness is present. The involvement of palliative care, from the time of diagnoses, has the highest impact potential for patient-centered, quality, and cost-effective care. This presentation will describe the principles, strategies, and tools employed to implement the program at WESTMED Medical Group. |
| Upon completion of this activity, participants should be able to define Palliative Care (from time of diagnoses through death, medical specialty for serious illness); differentiate between primary and secondary palliative care; differentiate between ambulatory versus hospital based palliative medicine services; understand the role/value of primary palliative care in a large outpatient medical system to potentially improve pain and symptom control, patient/family satisfaction, and cost savings for individuals diagnose with serious illness; describe three core components to a palliative medicine consultation; discuss effective strategies for the delivery of palliative care in diverse settings of integrated outpatient practice, long term care setting and hospitalist program; describe the capacity of the EMR to identify, clarify, and incorporate palliative principles/practices/screenings; and identify three-to-five tools specific to palliative care assessments, triggers, decisional aids, prognostication and generalist resources. |
Lee Sacks, MD, Executive Vice President, Chief Medical Officer, Advocate Health Care and CEO, Advocate Physician Partners; and Mark Shields, MD, Senior Medical Director, Advocate Health Care
| This presentation will outline the lessons learned over two years from one of the largest commercial ACOs that resulted in a Medicare Shared Savings Program. Presenters will describe how Advocate Physician Partners’ integrated model of care successfully transitioned to an accountable care-type model, explore how specific measures improve goals of accountable care, and outline how to modify it for Medicare beneficiaries. |
| Upon completion of this activity, participants should be able to describe a governance structure and physician alignment model supporting cultural change for thousands of independent and employed physicians that is successful for care of both commercial and Medicare patients; describe a model of care that integrates all stakeholders, physicians, patients and payers, with a common goal to improve quality and value of care; design an infrastructure with proven outcomes that impact clinical care, efficiency, medical and technological infrastructure, patient safety, and patient experience; establish a financial funding model which includes a pay-for-performance incentive, aligning physicians and improving clinical outcomes; describe the use of information technology to support all stakeholders in the delivery of care; describe how to take an existing infrastructure to the next level by incorporating Medical Home and Accountable Care guidelines; and develop a shared savings model for commercial and Medicare patients that reduces waste and improves care coordination throughout the continuum, resulting in lower costs and more appropriate and effective care for the patient. |
Robert Trenschel, DO, Senior Vice President Medical Operations, and Mary Beth McDonald, MBA, Senior Vice President Clinic Operations, Aurora Medical Group; and Karen Bowman-Dillenburg, MS, Operations Improvement Manager, Aurora Health Care
| This presentation will provide an overview of the process Aurora Medical Group is using to standardize physician schedule templates and scheduling processes using Lean methodologies. Areas of focus will include decreased complexity resulting in increased operational efficiencies, patient throughput, and overall satisfaction. The presenters will lead a discussion on challenges, lessons learned, and next steps, while providing concrete tactics and processes to achieve schedule optimization and physician/provider acceptance. |
| Upon completion of this lecture, participants should be able to identify the Lean methodology to optimize physician schedule design; develop effective scheduling processes that maximize patient throughput, reduce patient wait times, enhance patient and staff satisfaction, and improve physician satisfaction; and implement monitoring techniques to assure sustainability of results. |
David L. Knocke, FACHE, President, BJC Medical Group; and Lori Schutte, MBA, President, Cejka Search
| This presentation will apply the trends reported in the annual Retention Survey to real-life challenges. Participants will learn about balancing growth and efficiency through BJC Medical Group’s recruitment, acquisition, and retention model for a diverse group of 10 community hospitals, operating in highly competitive markets within a system that includes a top academic medical center. |
| Upon completion of this activity, participants should be able to identify key turnover benchmarks and retention trends as highlighted by the Cejka Search and AMGA 2010 Physician Retention Survey; describe how to minimize turnover during transitions in compensation and incentive models; evaluate the elements of efficient, scalable acquisition and recruitment processes; implement an efficient marketing strategy featuring a strong internet and social media presence; and avoid the high costs caused by lack of alignment, “internal” recruitment competition, prolonged vacancies and inefficient recruitment processes. |
Saturday, March 16, 2013
The Merger of Gundersen Clinic and Lutheran Hospital: Struggles and Successes [More Info]
Jeff Thompson, MD, Chief Executive Officer, Gundersen Health System; and Daniel K. Zismer, PhD, School of Public Health, University of Minnesota
| Drs. Thompson and Zismer will do an analysis of the 15-year process of combining a major clinic system and tertiary hospital system into an integrated health system. Emphasis will be on governance, physician engagement, and utilizing the new structure to improve the functioning of the system. |
| Upon completion of this activity, participants should be able to describe the governance structure of the new entity; delineate physician involvement in leadership in the new entity; name several cultural and structural barriers that need to be overcome; and define the 10 major principles that need to be committed to make such a merger work. |
Bernadette Loftus, MD, Associate Executive Director for the Mid-Atlantic States, The Permanente Medical Group
| Kaiser Permanente Mid-Atlantic States has rapidly become a top national performer in quality and service. Much of this success is a result of strides made in physician leadership and engagement. The recipe for success includes communicating a clear strategy, setting bold goals, designing an organizational structure for accountability, and providing tools. |
| Upon completion of this activity, participants should be able to enhance physician leadership and engagement. |
Kate Elizabeth Koplan, MD, MPH, Director of Medical Management, Atrius Health
| Very few medical groups have shared cost data at point-of-care electronic order entry with their clinicians in order to educate clinicians about the relative costs of ordered items such as laboratory tests and procedures. Atrius Health is at the cutting edge of this exploration with its addition to its EMR of relative costs of laboratory tests at the point of care. The emphasis in this interactive presentation is to share how the group practically approached the problem of cost education within the EMR in real time order entry and how it evaluated this program as being successful, both quantitatively and qualitatively (including clinician engagement). |
| Upon completion of this activity, participants should be able to describe the background of limited experience with making cost data transparent to ordering clinicians at the point of care; describe the importance of cost containment and how a culture of cost transparency further engages and educates clinicians in this current environment of cost containment activities; delineate how one large EMR-based medical group implemented a wide-reaching and controversial cost transparency program at the point-of-care; and describe the results of the program listed above in terms of changes in lab ordering patterns and also in terms of a qualitative analysis of beliefs and attitudes about cost in clinical care. |
Gregory A. Spencer, MD, FACP, Chief Medical Officer, Crystal Run Healthcare
| Crystal Run Healthcare’s CMO discusses how it became one of the nation’s first Medicare Shared Savings Program ACOs—and examines the lessons learned in its first year of the program. Dr. Spencer will discuss how to assess an organization’s strengths and weaknesses, and how to build a leadership team to oversee the transition to value-based care. He will offer guidance on how to establish the clinical infrastructure needed to effectively use embedded care managers to help build medical neighborhoods and how an EHR can be the backbone for an enhanced data warehouse to create more effective clinical dashboards and identify patient care gaps. |
| Upon completion of this activity, participants should be able to identify organizational strengths and weaknesses in preparing for the ACO model; assemble a leadership team to help patients and providers make the transition to a value-based system; and describe the lessons Crystal Run has learned during its first year of ACO operation. |
Beth Averbeck, MD, Associate Medical Director, Primary Care, and Joan Flaaten, Regional Clinic Director, NEST Region, HealthPartners
| HealthPartners has taken team-based care to the next level through a framework of population health. Based on HealthPartners’ care design principles of reliability, customization, access, and coordination, the organization has redesigned care team roles to maximize productivity, connected with partners to improve coordination, and developed innovative ways to access care. |
| Upon the completion of this activity participants should be able to describe using resources effectively and efficiently to serve high-cost or high-utilization populations; and how HealthPartners has worked across its system and community to meet the mission of better health, better experience, and lower cost for the patient. |
Kenneth E. Berkovitz, MD, System Medical Director, Summa Cardiovascular Institute, and Chair, Department of Cardiovascular Disease, Summa Akron City and St. Thomas Hospitals, Summa Physicians Inc.; Robert A. Gerberry, JD, Associate General Counsel, and Robert Hunter, MBA, MA, System Administrative Director, Summa Cardiovascular Institute, Summa Health System
| This session will explore the collaboration between Summa Physicians and the Summa Cardiovascular Institute to innovate care delivery, drive higher quality, and lower costs. To achieve these goals, Summa implemented a multifaceted strategy including participation in an accountable care organization, a clinically integrated network, and in the CMMI Bundled Payment Care Improvement Initiative (BPCII). The presentation will highlight the care redesign process necessary to deliver the highest quality care at the lowest cost for patients seeking cardiovascular care. |
| Upon completion of this activity, participants should be able to define criteria to evaluate organizational readiness to participate in initiatives such as bundled payment programs, accountable care organizations or other value-based purchasing programs with governmental and commercial payers and employers; design and implement evidenced-based clinical guidelines to reduce care variations and lower costs for cardiovascular services across multiple system hospitals, including high-cost conditions focused on by ACOs and participants in bundled payment programs; build upon prior Physician-Hospital partnerships to engage physicians in collaborative efforts to reduce fragmented care and delivering a more coordinated product through aligned financial incentives; and identify the legal and regulatory issues applicable to health systems and their physicians related to gainsharing, shared savings distributions, and other mechanisms to reward physicians for both clinical production and achievement of quality and cost outcomes. |
Kenneth Ashley, MD, FAAP, FACPE, Medical Director, Primary Care, Sutter Medical Group; Theresa Frei, RN, BSN, MBA, Chief, Patient and Client Services, Sutter Physician Services; and Jennifer K. Gingrass, MS, Principal, ECG Management Consultants, Inc.
| This presentation will describe the partnership between Sutter Medical Group (SMG) and Sutter Physician Services (SPS) to develop an off-site, integrated patient service center intended to function as a single point of contact for after-hours nurse advice, patient scheduling, and billing services. The goal was to provide 24-by-7 patient access. The presenters will describe the design and implementation processes, results, as well as ongoing enhancements and use of technology. |
| Upon completion of this activity, participants should be able to review the impetus and goals behind the development of an integrated patient service center; describe how patient service center operations were structured, what services are provided, and how they were implemented; identify the challenges associated with physician and patient adoption; and communicate the results, including the impact on point of service operations, costs, and patient satisfaction. |
Patrick F. Garrett, MD, MMM, FACP, Vice President Physician Relations, St. Anthony’s Medical Center; and Dave Hinkle, CMPE, Executive Director, St. Anthony’s Physician Organization
| This presentation will navigate participants through the process of moving from a fee-for-service model to a full risk payer model. Different initiatives such as Patient-Centered Medical Home, IOCP, and Meaningful Use will be discussed. |
| Upon completion of this activity, participants should be able to describe the practical steps to assist a practices transition from a traditional fee-for-service payment model to risk models that support population health management; and describe the necessary steps to provide a value-based product by modifying the payer contract(s), modifying the physician compensation plan, modifying the operational methods, and engaging physicians to manage through the entire process. |
