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Session #21:Multicare: Organizing for Accountable Care

and Population Health

Christopher Kodama, MD Christi McCarren, RN, MBA

Pre-Session Poll QuestionOn a scale of 1-5, how would you rate your healthcare organization’s preparedness for accountable care and population health?

1) Not at all ready2) Somewhat ready3) Moderately ready4) Very ready5) Extremely ready6) Unsure or not applicable

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About the Organization

2

Not-for-profit healthcareorganization

Addressing accountable care and population health

10,000+ employees

500,000+ patients

1188 providers

1.4B revenue

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Once Upon a Time…

Delivery System

Value-based Reimbursement

Operational Efficiency

Consumer Expectations

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MultiCare Clinical Integration Network

RegenceContract

MultiCare Connected Care

NetworkPremera

Boeing

Contract

Contract

UnitedContract

Humana

Plan Sponsor

Contract

Contract

Value Creation

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Our Approachand Results

5

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Focus and Prioritization

Internal Opportunity

Existing VBP Obligations

Potential Purchaser Priorities

Collaboratives

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Clinical Collaboratives

Design and Deploy

Empower

Measure

Improve

Physician-led

Evidence-based

Multi-disciplinary

Dedicated resources

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The Collaborative Journey

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MultiCare Collaboratives

Systemwide Anesthesia Committee

(SWAC)

Medical Value Program(MVP)

Critical Care Collaborative

Women’s Collaborative

Surgery Collaborative

Medicine Collaborative

Cardiac Collaborative

Pediatric Collaborative

Sepsis Resp Proning Early Mobility

OB Gyn

Ortho Joints ColonSpine

(Surgical)Glycemic Control

Pneumonia COPD SpirometrySpine (Acute

BP)

Heart Failure AMI CAB

TBD TBD

Supported by Program Manager

Supported by Coordinator

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Sepsis – In Process Measures

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CHF– In Process Measures

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CHF– In Process Measures

By Provider Type

By Facility

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Poll Question #2

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On a scale of 1-5, how effectively is your organization using healthcare analytics to support accountable care and population health?

1) Not at all effective

2) Somewhat effective

3) Moderately effective

4) Very effective

5) Extremely effective

6) Unsure or not applicable

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Results

65%

Decrease in mortality rate from 15-17% to 7-8%

Sepsis

22% 37%

Heart Failure Pneumonia

Decrease in 30-Day all-cause CHF

readmission rate from 25.4% to 20-21%

Reduction in pneumonia

readmissions

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Results

50%

Labor and Delivery

71%

Total Joint SurgeryColon Surgery

21.8%

Reduction in median LOS for elective

colon surgery

Reduction below target in

readmission rates for elective colon surgery patients

18.8%

Reduction below target in

readmission rates for total joint

surgery patients

Elimination of vaginal deliveries with LOS > 4 days and reduction in

C-section deliveries with LOS > 6 days

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Future Plans

• Renew focus on service and cost, in addition to clinical improvement

• Develop a greater partnership with emergency services and the post-acute realm, in order to spread the effects of improvement efforts to impact more of the patient care continuum

• Increase MultiCare’s flexibility to respond to a rapidly changing market

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Lessons Learned

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1. Involve physicians early in the analytic design and implementation effort

2. Do not let a desire for perfection be the enemy of good; it will stand in the way of progress

3. Understand the importance of effective change management

4. Effective leadership from the top is critical

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Analytic Insights

AQuestions &

Answers

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Choose one thing…

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What one thing (or more) can you do differently after hearing this presentation?

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Thank You

20

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Session Feedback Survey

1. On a scale of 1-5, how satisfied were you overall with this session?

1) Not at all satisfied

2) Somewhat satisfied

3) Moderately satisfied

4) Very satisfied

5) Extremely satisfied

2. What feedback or suggestions do you have?

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Upcoming Sessions

Breakout Sessions – Wave 4 (1:15 PM – 2:00 PM)

26) Panel – How Community Hospitals Thrive with AnalyticsJohn Wadsworth, Vice President, Technical Operations, Health Catalyst

27) Quality Improvement in Healthcare: An ACO Palliative Care CaseDr. Robert Sawicki, MD, Senior Vice President, Supportive Care, OSF HealthcareRoopa Foulger, Executive Director, Data Delivery, OSF HealthcareLinda Fehr, RN, Division Director, Supportive Care, OSF Healthcare

28) Clinical Standards Work To Improve Evidence-Based Care Delivery: A How-To WorkshopCharles Macias, MD, MPH, Chief Clinical Systems Integration Officer, Texas Children’s HospitalTerri Brown, MSN, RN, CPN, Assistant Director, Clinical Outcomes & Data Support; Research Specialist, Center for Research and EBP, Texas Children’s Hospital

29) Five Months to Improvement: How Stanford Built an Improvement Program the Gets ResultsSpencer H. Kubo, MD, Associate Professor of Radiology (Pediatric Radiology), Stanford University Medical Center

30) Breaking Down Silos: Resolving Academic, Medical, and Research Interests Once and for AllSamuel L. Volchenboum, MS, MD, PhD, Assistant Professor of Pediatrics, Director, Informatics Program, The University of Chicago Medicine)

Location

Imperial Ballroom B

Imperial Ballroom A

Grand Salon

Murano

Venezia