confidential and proprietary – unitypoint health “end zone”: care model transformation erick...
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Confidential and Proprietary – UnityPoint HealthConfidential and Proprietary – UnityPoint Health
“End Zone”: Care Model Transformation
Erick Laine, MD, EVP/COO, UnityPoint ClinicAric Sharp, VP, UnityPoint Health Partners
Confidential and Proprietary – UnityPoint Health
Quality
Patient Access/Patient Experience
Cost-of-Care*
Transparency*
Market Drivers
… Decades …
… last 10 years …
Now
Now
“Triple-Aim” Performance
New Differentiators
Time Course
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Clinical Transformation
OperationalTransformation
Business Transformation
OrganizationalTransformation
Quality
Patient Access/Patient Experience
Cost-of-Care*
Transparency*
Marketplace Changes
( “T.H.E. Care Model” )
External EnvironmentInternal Environment
“End Zone” Transformation
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T.H.E. Care Model
Medicare Medicaid
Commercial Payers
Other Payers
Illinois
FFS
MSSP
MedicareAdvantageIowa
Wisconsin
Care Model Applications
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T.H.E. Care Model…. Starts with the Person
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T.H.E. Care Model Organizes Our Approach
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TRIPLE AIM: BIG OPPORTUNITY
T.H.E. Care Model: Governance
CEO Forum
Population Health
End Zone Steering
Recommendations from PHSC requiring CEO approval Provide Resources Implementation toward standard care model
Review, set, and approve standards across the system Removal of any duplication across regional initiatives Approve recommendations to CEO Forum per charter
Facilitation of issue resolution Ensure alignment with other strategic initiatives Communication Ensure quality of deliverables
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BROAD ENGAGEMENT
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24 month Development Process
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PHASE I
Functional Definitions Regional Assessment Playbook Scorecard End Zone Scorecard
PHASE II
Operational Plans Regional Summaries 2015/2016 System
Summary
PHASE IV
Performance (Measure Against Scorecard)
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Functional Definitions Resolve Interdependencies
Business Requirements
Operational Plan Development
• Resolved 55 Interdependencies
• Assigned Ownership to Key Team
• Several Subgroups Formed
• Added MTM as a Core Competency
• Identify Requirements for each Competency
• Collate all requirements
• Find best solutions to meet requirements
• Coordinate solutions and assign ownership
• Operational Plans being developed
• Resource requirements for implementation
• Ownership during and after implementation
• Sequencing and prioritization
• Define a standard that all can converge towards
• Distill definitions down into functional components
• Identify most important components
• Survey to determine gaps
Phase I drill-down …. Phase II….
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CORE COMPETENCY WORK TEAM MEMBERS
ADVANCED CARE Exec Sponsor: Monique Reese C.N.P, Team Lead: Marie Kayser R.N., Team Members: Dianna Nunn, John Ubben, Jennifer Federspiel, Jean Duncan, John L’Estrange, Lori Bishop R.N., Jennifer Kownanacki, Patricia Newland M.D., Vicki Wildman, Cincy Eggleston, Dawn Welling, Theresa Lewis, Tammy Duvendack
ATTACHMENT & RETENTION Exec Sponsor & Team Lead: Brian Jones, Team Members: Shari Naughton, Megan, Maher, Ann Petersen, Jeri Spaur, Laura Smith, Sid Ramsey, Dan Allen M.D., Lori Weih, Della Guzman, Julie Zuber, Bill O’brien, Chris Mcmillan, Keith Seashore
CALL CENTER ACCESS Exec Sponsor: Erick Laine M.D., Team Lead: Kathy Cunningham, Team Members: Karri Drabik, Jeri Spaur, Laura Hahn, Audrey Vaughn, Tammy Duvendack, Dawn Welling, Raedean VanDenover, Theresa Lewis
CLINICAL CARE PATHWAYS Exec Sponsor: David Williams M.D., Team Lead: Wendy Mortimore M.D., Team Members: Megan Maher, Gary Kimberlin, Linda Wendt, Jeff Reininga, Kendra Gustafson, Rhiannon Harms, Patricia Newland M.D., Marcel Devetten M.D., Ryan Walsh M.D, Elizabeth Lane, Derek Clevidence M.D.
COMMON CARE PLAN Exec Sponsor: Mark Purtle M.D., Team Lead: Mary Ann Osborn R.N., Team Members: Jeff Jutting, Tiffani Heaberlin, Misty Rauch, Jim Bell M.D., Lori Bishop R.N., Deb Shriver R.N., JoEllen Frommelt, Janna Emick, Tammy Duvendack, Dawn Welling
CONNECTION TO COMMUNITY RESOURCES
Exec Sponsor: Aric Sharp, Team Lead: Pam Halvorson, Team Members: Dianna Nunn, John Ubben, Darren Clark, Kari Prescott, Tammy Duvendack, Mike Issacson, Dennis Duke, Sarah Brown, Dawn Palmer
NEXT GEN HOSPITALIST Exec Sponsor & Team Lead: Mark Purtle M.D., Team Members: Jeff Jutting, Rhiannon Harms, Kathy Brandow, Carmen Buchman, Theresa Lewis, Dustin Arnold M.D., Mark Willis, Tray Ekhardt M.D., Dan Sullivan M.D., Chad Wolbers, Julie Harris, Elizabeth Day M.D., Nadine Schlienz, Jeremy Jaskunas M.D., Heather Certain M.D., Tammy Duvendack, Todd Baker, Marty Dorgan, Laurie Brown, Paul, McLoone M.D.,Toyosi Olutade M.D., Stephanie Burns, Wendy Lindley, Lynn Wold, Jenni Friedly
HOSPICE Exec Sponsor: Monique Reese C.N.P., Team Lead: Leanne Burrack M.D., Team Members: Megan Maher, Cory Reuter, Lynn Steffen, Heather Vandewater, Crystal Franke, Joyce Bianchi, Patti Fallert, Jean Walker
PALLIATIVE CARE Exec Sponsor: Monique Reese C.N.P., Team Lead: Lori Bishop R.N., Team Members: Megan Maher, Lynn Steffen, Heather Vandewater, Jennifer Federspiel
PCMH 2.0 Exec Sponsor: Erick Laine, M.D., Team Lead: Linda Wendt, Team Members: Megan Maher, Lauren Hardison, Sean Liddell, Patricia Newland, M.D., Dawn Welling, Lori Weih, Tammy Duvendack, Ray Seidelman, Jennifer Federspiel, Lori Bishop R.N., Kevin Carroll, Craig Logemann
RISK STRATIFICATION Exec Sponsor: Betsy McVay, Team Lead: Lillian Dittrick, Team Members: Jeff Jutting, Kevin Allen, John Ubben, Jeryl Janson, Lance Lisk, Amber Lenhardt
TRANSITIONS IN CARE Exec Sponsor & Team Lead: Monique Reese C.N.P, Team Members: Dianna Nunn, Jeff Jutting, Rhiannon Harms, Dianna Burnett, Pat Grunwald, Lori Bishop R.N., Deb Moyer R.N., Peg Bradke, Dawn Welling, Kami Petitgoue
UTILZATION and REFERRAL MANAGEMENT
Exec Sponsor & Team Lead: Aric Sharp, Erick Laine M.D., Team Members: Jeff Jutting, John Ubben, David Williams M.D., Larry Kay M.D., Sabra Rosener, Carol Brockmiller, Greg Johnson M.D.
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Each Clinical Core Competency
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• Standard Functional Definition
• Paragraph and Checklist Format
• Communicates the standard where we will converge in the near term
• Points to when we will be able to begin to evolve such standards
• Provides clear articulation of the way we will provide value to the marketplace
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Regional Gap Analysis: Initial Findings
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Triple Aim Scorecard Metrics
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CLINICAL CORE COMPETENCY PHASE II ESTIMATED HOURS
Common Care Plan (estimate includes Assessment Toolkit) 2,365*
Risk Stratification 205
Transitions In Care 4,552*
Advanced Care 228
Attachment & Retention 460
Call Center Access 506*
Clinical Care Pathways 467
Connection To Community Resources 850
Hospice 131
Medication Therapy Management 232
Palliative Care 416
PCMH 2.0 254
Utilization Management / Referral Management 285
TOTAL 10,951
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Phase II Work: Conceptual Design Operational Planning
ADDITIONAL COMMENTS1) Top 4 Priorities are highlighted in RED: 1) Common Care Plan, 2) Assessment Toolkit, 3) Risk Stratification, 4) Transitions in
Care2) Next Generation Hospitalist Clinical Core Competency Team is a separate work stream and is in progress. The estimated hours for this
team are not represented in the Total Hours.3) End Zone Scorecard is a Phase II Deliverable and estimated hours are not included in the Risk Stratification Phase II Estimated Hours.
The estimated hours for this work is 250 resource hours.4) * Represents Clinical Core Competency Teams requesting additional physicians to be added to the team The Physician resource needs
are being shared with Dr. Erick Laine to determine available resources.
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What Comes Next
• Key Milestones– March 12 Phase II Launch– March 12 – April 29 Core Competency Operational Plan Development– April 30 End Zone Steering Committee Review Operational Plans– May 5 Pop Health Approve Operational Plans– May 5 – May 22 Regional Summary Development and Signoff– June 2 Pop Health Steering Committee Review End Zone / Playbook
2015 / 2016 System Summary– June 11 CEO Forum Presentation 2015 / 2016 System Summary
• TARGET: Deliverables In Advance Of Budget Cycle
Q1 Q2 Ongoing
Phase I Phase II Phase III Phase IV
01/01/17
Nov/Dec
Planning
Q3-Q4 FY 2016
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T.H.E. Care Model
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ORGANIZATIONAL COMMITTMENTS
1. This is T.H.E. CARE MODEL we are transforming toward.
2. Every region is represented.
3. We understand this won’t be perfect, it will evolve over time.
4. We will align our future initiatives to T.H.E. Care Model
5. We will dedicate key individuals and others’ time for completion of Phase II planning.
6. We will develop an organized standard communication plan
7. We will remain committed to development and deployment regardless of when risk bearing contracts come into play.
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QUESTIONS
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