healthcare leadership network of the delaware valley: physician alignment june 2015 christine winn,...
TRANSCRIPT
Healthcare Leadership Network of the Delaware Valley:
Physician Alignment
June 2015Christine Winn, FACHE
Senior Vice President, MD Anderson Cooper Cancer Institute and Cooper Physician Alignment
Overview
• Why is this important?• What has happened in the past?• Variety of Physician Alignment Models and
Preparation Tactics– Local Impact
• Necessary items for your “journey”
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Why is this important
• Operating costs will need to be reduced by 15 percent to 25 percent to ensure continued viability in the value environment
• Physicians are a driver of costs and are THE major partner needed to reduce those costs
• Current alignment activities can prepare Healthsystems to be cost competitive in new models
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ACHE Focus on Physicians• New Physician Executive Forum• Physician Leadership “Boot Camp” Pilots • Career Development Task Force
– Physicians as members• New Strategic Plan – Desired Outcomes
– Increased membership and participation across the spectrum of healthcare leadership
– Higher levels of member engagement and satisfaction– Increased brand awareness and perceived value among
members and key constituents– Greater impact in advancing effective and efficient healthcare
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What has happened in the past with our physician colleagues?
• BUYING SPREE• Not what we expected….loyalty cant be
bought?• Healthsystem and physician alignment
– Co Management– Gainsharing
• Value Based Collaboration Models
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VARIETY OF ALIGNMENT MODELS AND PREPARATION TACTICS
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Building a Successful Physician Alignment Strategy
Source: Healthcare Strategy Group
Mutual Success
Clinical Integration
Building Common Vision and Culture
Physician Employment Strategy
Economic Alignment Options
Medical Staff Growth and Development
Physician Manpower Planning
Strategy
Planning
Alignment
Integration
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Kurtsalomon, 2013
Focus Areas for Alignment Activities
• Volume Based Care– Focused on Employment – Fixed Compensation– Committee Service
Compensation– Defend Market– Competitive Advantage
with subspecialists
• Value Based Care– Promotes Integration
and alignment of incentives
– Focus on quality across continuum
– Need for common IT platforms
– Preparation for Bundled Payments and ACO’s
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What are key Physician/Healthsystem Collaboration Forces Now?
• Pay for performance reimbursement approaches • Regulatory requirements are increasing • Migration of physicians from inpatient to outpatient settings (loss of
connection)• Need to recruit additional physicians places a risk on existing
physicians • Newer physicians want predictable hours and an income guarantee • Practice expense stress financial viability of independent practices• Large employers and Medicare are moving to bundled payments,
single price contracting, and pay-for-performance • Long-term success of the healthcare system
Source: Nick Fabrizio, PhD, FACMPE, FACHE, MGMA consultant 11
LOCAL IMPACTS – COOPER EXPERIENCE
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Employees4,666 full-time, 1,337 part-time
6,003
Patient encounters 1.3M+
Admissions 26,624
ED visits 81,075
Outpatient visits 1.2M
Medical Staff 1,004
Employed physicians 541
Community physicians 266
Allied Health professionals 197
Residents and Fellows 313
Licensed bedsIncludes 35 NICU and Transitional Newborn Bassinets
635
Cooper Fast Facts
Cooper Medical School of Rowan University
• Opened in 2012 on the Health Sciences Campus in Camden, New Jersey.
• The first new medical school in New Jersey in over 35 years and the only four-year MD-granting medical school in South Jersey.
• CMSRU has quickly become a sought after medical school in the country because of its focus on community.
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• CMSRU addresses the physician shortage locally and nationally, and its students and faculty continually work to find innovative improvements to health care throughout the region.
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The need to meet our academic mission remains while we strive to address the triple aim
High competition for fixed population
Amidst a cultural shift
The Delaware River
Partnerships
beyond
M&A
Industry is
in flux
Academic mission:Education & research
QUALITYImprove the health of the population
COSTReduce the
cost of care per capita
SERVICEEnhance the patient
experience
Triple Aim
1 2
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Academic Medical Centers like Cooper walk afine line to strike a balance between volume and value
The Balancing Act COMMODITIZED CAREDESTINATION CARE
VOLUME (Old Order) VALUE (New Order)
• Health system business models focused on high margin, high-tech inpatient care
• Fee-for-service payment for activity volume and “carve outs”
• Advanced subspecialty care for the complications of advanced disease
• Specialty focus on care innovation
• Health system business models focused on quality and efficiency of care management across the full continuum
• Bundled/global payments and incentives for outcomes
• Proactive health management• Innovation around process
integration across providers
Product & Services Differentiation
Operational EfficiencyCustomer Service
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Health System Trends: Volume to Value
Timing Matters
Premature Well-Timed LaggingContracts before sufficient
capabilities to be successful on new arrangements
Transition contracts strategically while building capabilities.
Delay building capabilities andfocus on fee for service – and risk
being caught unprepared
Capabilities for Value-Based Care
Value-Based Contracts
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Cooper aims to be the partner of choice
Making Cooper the partner of choice….
…allows us to pursue a range of collaboration options
Cost Advantage
Efficient Product
Quality Outcomes
Payor Contracts
Tertiary Care Capabilities
Service excellence
1. Clinical affiliation
2. Regional collaborative
3. Accountable Care Organization
4. Clinically integrated network
5. Merger or acquisition Ri
sks
and
rew
ards
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iOnly Academic Med Ctr (AMC)
in South NJ
Programs of Distinction
Supportive partnership
position
Building relationships
with community hospitals
Expense reduction
Improved quality Transforming
the culture
Focus on quality and access
Cost advantage among peers
Payor contracts
Shifting improvement
focus to Ambulatory
COMMODITIZED CARE
Product & Services Differentiation
Operational EfficiencyService Excellence
DESTINATION CARE The Balancing Act
Cooper continues to position itself for the future
Checklist for Necessary Physician Alignment Items
MapMenuStopwatch“Spidy Sense”TeamCatcherYoga MatWatering Can
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