crafting strategic relationships - becker's hospital review · 1 crafting strategic...
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Crafting Strategic Relationships
“One Size Does Not Fit All” Ann Huston
Chief Strategy Officer
Josette Beran
Executive Director
Strategic Partnering & Network Integration
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• $7.6B in Annual Revenues; Not-for-Profit
• Academic Medical Center
• Medical Group that Runs a Health System
• 47,000 Caregivers
• >3,400 Employed Physicians & Scientists
• >1,700 Independent Physicians
• 6.2 Million Total Annual Patient Visits
• Global
Cleveland Clinic Today
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Cleveland Clinic Roles
Specialty care referral center
Community care and population
manager
Innovative Academic Medical
Center
Services provider “CC Inside”
Our partnership activities serve our
strategies
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Two Aspects of Our Agenda
INTERNAL
Transform our
care model and
organization to value
EXTERNAL
Grow organically and
through strategic
relationships
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Cleveland Clinic Integrated Care Model
Retail Virtual
CC Clinic Community - Based
Organizations
Ambulatory D&T Independent Physicians
Hospitals
Rehab
Skilled Nursing Facilities
MyChart
Emergency Post Acute
Care System
Self/
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• Jointly-established quality standards
• Reward for quality and efficiency
• Drive to better outcomes
• Drive to improve value for patients,
providers and payers
Employed Physicians Independent Physicians
Data/
Analytics
Health
Plans
Physician Alignment Through
the Quality Alliance
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Integrating a Post-Acute
with Select Medical
Develop world
class post-acute
care delivery
Expand post-
acute access in
NE Ohio
Leverage capital
and capabilities
Post-Acute Provider
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Training the Next Generation
with Ohio University
Innovation in
patient-centered
medical care
New model of
community-based
care for NE Ohio
Competency-based
medical education
focused on primary
care delivery
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Two Aspects of Our Agenda
INTERNAL
Transform our
care model and
organization to value
EXTERNAL
Grow organically and
through strategic
relationships
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Framework for Growth
Engineer growth in
core
Enter new geographic
markets
Preserve revenue
through
contracting
Diversify thru new
businesses
& models
Lead with consumer-focused products with
demonstrably differentiated value
Strategic Partnerships
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Hospitals
Ambulatory Sites of Care
• Network
products
• Innovations
Cooperative
• Joint
management of
populations
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• Clinical expertise
• Physician/clinician integration
• Outcomes-based sourcing
• Track record
• Analytics
• Strong member networks
• Contracting expertise
• Track record
FEATURES
• Analytics
• Provider-centric model
• Physician/clinician integration
• Evidence-based health sourcing
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Extending System of Care
Through Cardiac Network
Specialty Network of Affiliated Hospitals and Alliances • Clinical expertise and infrastructure
• 25 affiliates
• 7 members in national network
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Objectives
• Grow volume/lives
- Service area share
- Complex cases
• Attain necessary capabilities
• Realize benefits of scale
• Minimize capital outlay and risk
• Extend and differentiate our brand
• Leverage and monetize value we create
• Leadership – care and model
• Advance the strategy
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Key Considerations
• Care delivery remains local
• Regional, integrated systems as
core functional unit
• Unrealized advantages of scale
• Mergers difficult to realize
• Culture and values trump all
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Strategic Relationships
Consulting
Service
Agreements
Affiliations
& Alliances
Joint Ventures
Enterprise Joint
Operating Agreements
Member Substitutions
& Mergers
LOOSE
TIGHT
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Making It Work
• Cultural fit
• Sufficient mutual value
• Clear, shared objectives
• Sustained effort and management
• Commitment to relationships and
the work
Mindfulness in every interaction
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Acquisition of Akron General
• $700M health system
• Adjacent and important market
• Financially challenged
• Initial minority position
• 6-year call right
• Exercised full member at 1 year
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Integration Process
• Effective November 2015
• 18-month phase-in
• Driving to full integration, N.B., not
homogeneous
• Position AGMC as hub of southern region
- Drive clinical intensity
- Draw to CCAG from southern region
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Functional Integration
Approach
• Wholesale change – move out, we own you!
• Umbrella – Name and logo over both but
operations remain separate
• Balanced – CCHS aligned; Integration well-
paced yet prudent
- Systematic and well-managed
- Collaborative
X
X
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Integration Principles
• Patients First
• Ensure integrity of Enterprise
– finance, legal, compliance
• Expand synergies / efficiencies
• Achieve strategic positioning
• Align with IT implementation
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Integration Timeline
Wave
I
Wave
II
Wave
III
Wave
IV
Wave
V
Wave
VI
Wave
VII
11/1 -
12/31
Q1
2016
Q2
2016
Q3
2016
Q4
2016
Q1
2017 4/17
18 Months
Fully in CCHS
18 Month Integration Timeline
Integration Roadmap
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Connected Partial Full
EVS
Nursing
Call Center
Revenue Cycle
Supply Chain
EPIC
Clinical
Programs
Integration Framework
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Functional Integration
• Quality & Safety
• Patient Experience
• Clinical Transformation
• Compliance
• Finance
• Government Relations
• Human Resources
• Information Systems
• Legal
• Marketing
• Communications
• Medical Operations
• Nursing
• Support Services
• Facilities
• Supply Chain
• Physician Alignment
• Planning
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Clinical Services
• Unified CC clinical programs
• Clinical leadership alignment
• Flexible approaches
• Initial focus: cancer, cardiac, post-acute
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Integration Management
Process
• Formalized infrastructure
• Defined priorities
• Work teams in cadence
• Strong collaboration
• Ongoing issues resolution
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Management System
Integration Council
Regional
Governance Council
• Set strategy for region and CCAG
• Hospital Presidents & Institute Chairs
• Meets Monthly
• Oversee integration plan
• Functional Area Stakeholders
• Meets Weekly
• Drive day-to-day operations
• CCAG management
• Meets Weekly
CCAG
Management Team
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CC-CCAG Touch Points
• Governance – joint board members
• CCHS Leadership
• Physician Alignment
• Regional Planning
• Regional Operations
• Medical Operations
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Finance
AGHS Integration Objective
Scope Document
Wave I & II (11/2015- 3/2016)
GOAL: Integration of key financial business operations
for gained efficiencies, standardization, and
overall integration
Key Considerations: Phased approach for understanding current
state, and building to desired state
Team Leads: CC: Steve Glass, Tony Helton
CCAG: Dave Frigo
Initiatives: 1. Financial Accounting
2. Revenue & Reimbursement
3. Tax & Compliance
Timeframe: 11/2015 – 3/2016
Issues/Risks: Competing priorities (EAS approved projects,
workday, CTMS, Medina) , and cross-
department dependencies (ITD, HR, SCM)
Measures: # facilities integrated into rev cycle, etc.
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Prospects will be managed in a pipeline portfolio, once they
are categorized as good candidates to further develop,
they will be migrated to its own “deal”
The Integration phase will be composed of
Objectives -> Initiatives -> Project Plan (task)
Objectives
Objectives
Objectives
Initiatives
Tasks
AGHS Integration Tasks
IBMA
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Integration Council Status Report
Progress Review
Risks Issues Key Next
Steps Successes
Targ
et
Co
mp
leti
on
2015 2016
Q
4
Q
1
Q
2
Q
3
Q
4
Objective 1: Finance
1.1 Initiative: Financial Accounting
a.
Phase I-
Crosswalk
Analysis
12/
2015 *
Additional $
efficiencies identified
b.
Phase 2-
Develop
interface
03/
2016 *
Anticipate
>$500K investment
c.
Phase 3-
Myanalytics
planning
Q1
2016 *
d.
Phase 4-
Myanalytics
implementatio
n
Q2
2016 *
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Critical Success Factors
• Align with the strategy
• Find the right partner
• Carefully select priorities
• Put hard issues on the table
• Actively manage work
• Mindfulness in every interaction
• Celebrate successes
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How’s it Going?
• Mutually positive
• 300+ caregivers involved
• >$20M in savings to date
• Managing “on diversion”
• Having fun!
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Success Video
External Link:
https://www.youtube.com/watch?v=BjK-uW6GTCQ