hfm's reform readiness aha webinar

Is Your Hospital Ready for Healthcare Reform? Positioning Your Organization for Success

Featuring a case study by Holy Family Memorial Medical Center

November 19, 2009To access the audio portion of this webinar, please dial:

1 (866) 710-0179 Intl Callers should dial (334) 323-7224

When prompted by the operator, give the Passcode: 53939

Thank you for participating in today’s event!We’ll be starting shortly…

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Is Your Hospital Ready for Healthcare Reform? Positioning Your Organization for Success

Featuring a case study by Holy Family Memorial Medical Center

November 19, 2009To access the audio portion of this webinar, please dial:

1 (866) 710-0179 Intl Callers should dial (334) 323-7224

When prompted by the operator, give the Passcode: 53939

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Agenda and Speakers

• Introduction: AHA and AHA Solutions – Polly Mulford, Director, AHA Solutions• Strategic Challenges Facing Hospitals and Health Systems

- Mark P. Herzog, President and Chief Executive Officer, Holy Family Memorial, Inc.

- Mark E. Grube, Partner, Kaufman, Hall & Associates, Inc.

• Questions and Answers – moderated by Polly Mulford, Director, AHA Solutions

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Agenda• Strategic Challenges Facing Hospitals and Health Systems• Healthcare Reform/ New Era Discussion

– Required Provider Core Competencies• New Era Readiness Assessment – A Tool for Self Evaluation• Holy Family Memorial Hospital: Readiness Case Example

– Overview– Physician Integration– Care Coordination– Information Systems– Service Distribution Systems– Financial Position and Capital Capacity– Scale

• Moving from Assessment to Readiness• Questions and Discussion

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About AHA SolutionsAHA Solutions, Inc. is a resource to hospitals pursuing operational excellence. As an American Hospital Association (AHA) member service, AHA Solutions collaborates with hospital leaders and market consultants to conduct product due diligence and identify solutions to hospital challenges in the areas of finance, human resources, patient flow and technology. AHA Solutions provides related marketplace analytics and education to support product decision-making. As a subsidiary of the AHA, AHA Solutions convenes people with like interests for knowledge sharing, centered on timely information and research. AHA Solutions is proud to reinvest its profits in the AHA mission: creating healthier communities.

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Strategic Challenges Facing Hospitals and Health Systems

Mark P. Herzog, President and Chief Executive Officer, Holy Family Memorial, Inc. Mark E. Grube, Partner, Kaufman, Hall & Associates, Inc.

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Has your hospital started to prepare for reform and the new era?

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Please rate your organization’s reform/new era readiness as “weak” “medium” or “strong” in the following areas?

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Strategic Challenges Facing Hospitals and Health Systems (Right Now)

• Declining inpatient and outpatient volumes (in many markets) • Deteriorating payor mix• The rise of “super insurers” with 50%+ market share• Falling operating and EBIDA margins• Reduced liquidity• Financing problems for many and increased cost of capital• The growth and development of statewide and multistate systems• Significant capital needs related to physician, facility, and information technology

strategies• Uncertainty regarding healthcare reform

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Healthcare Reform/ New Era Discussion – Required Provider Core Competencies

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Healthcare Reform – The Ultimate Market Dynamic Proposed Legislation Is Uncertain, but Principles of Reform Have Been Articulated

• More stability and security for those who have insurance

• Expansion of the total population that is insured – insurance mandate, business mandate subsidies for the poor, excludes illegal aliens

• Budget neutral – $830 B to $1T price tag (over 10 years) covered through reduced costs/ elimination of waste

• Greater provider accountability with a focus on value

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Healthcare Reform – Key Potential Mechanisms to Achieve the Stated Cost Savings Goals

• Payment based on “best practice” levels of value (quality/ cost) • Bundled payments• Quality incentive payments• Reductions in readmission rates• Reductions in premium increases for Medicare Advantage plans• Reductions in home health, imaging, and other “high margin” service payments• Medicare drug discounts• Accountable care organizations

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Follow the Money – Industrial Organization Is a Function of the Underlying Economic Model: For Hospitals and Health Systems, the Business Model Is Driven by the Prevailing Reimbursement Mechanism

Prevailing reimbursement mechanism Industry reaction Government reaction

• 1960s – cost-based/ cost plus • Building boom • Health Systems Agencies (HSAs) and Certificate of Need (CON)

• Mid 1980s – discharge/ activity-based

• Drive admissions and outpatient procedures, manage length of stay (LOS)

• Modify payment levels

• Future? – outcomes-driven/ bundled payments/ accountable care organizations (ACOs)/ capitation-like structures

• Focus on care management capabilities, physician integration, information technology (IT)

• Modify outcomes targets?

Implications for Providers: The Reform Continuum

Low High

Level of hospital/ physician integration and care management

capability

X X

Typical community hospital The Feds want you here

• Geisinger Health System• Mayo Clinic• Kaiser Permanente• Group Health of Puget

Sound• Cleveland Clinic

• Where are you on the reform continuum?• What more do you need to do?• What resources will you need to get there?• Do you have the size/ scale/ capital (human and financial) to move

along the reform continuum on its own?

Critical Questions that Need to Be Answered:

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Reform Readiness AssessmentTypical Community Hospital More Prepared

Employed physicians with “reform compatible” compensation models

Independent/ unaligned staff

Physician Integration

Extensive use of protocols/ EBM

Limited or no protocols/ EBM

Care Coordination Infrastructure

Strong historical care management orientation

Limited historical care management orientation

Care Coordination Culture

EMR, IT distributed throughout system, sophisticated care management and monitoring software

No EMR, limited connectivity

Information System Sophistication

Highly accessible primary care, rationalized upper-level care

Poor primary care access, extensive unnecessary service duplication

Balanced Service Distribution System

SufficientInsufficient

Capital Capacity

StrongWeak

Composite Position

Largest in MarketSmallest in Market

Scale

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Holy Family Memorial: Readiness Case Example

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HOLY FAMILY MEMORIAL

Medical Center – 87 Staffed beds, full range of acute care

Physician Network – 80 providers, 50% primary care, 50% specialists; Regional Orthopedic Program

Retail and Outreach Services – Wellness Center, pharmacies, DME, occupational health

• Highly competitive local and regional market

Sponsored by the Franciscan Sisters of Christian Charity, Holy Family Memorial (“HFM”) is an integrated delivery system including a hospital, a large employed

multispecialty group practice, and retail services

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MANITOWOC, WISCONSIN

Holy Family Memorial

City of Manitowoc41,066 people

(Level since 2000)

Manitowoc County 81,717 people

(Level since 2000)

80 miles north of Milwaukee

35 miles southeast of Green Bay

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TRUE VOLUME TRENDSGROSS REVENUE GROWTH

(PRICE ADJUSTED)

$0

$100

$200

$300

$400

INPATIENT OUTPATIENT CLINICS TOTAL

Mil

lio

ns

2009

2010

2011

Volume Trends 2009-2011

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Gross Revenue YTD 2012

24%

39%

4%

33%

IP

OP

Retail

Phys

Volume/ Revenue Breakdown 2012

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• Nationally recognized for extensive application of ambulatory/ hospital information technology (IT)

• Rapid adoption of clinical best practices and highly integrated inpatient/ outpatient quality improvement

• Ability to swiftly adapt to current and future business models due to complete integration of hospital with outpatient, clinic, employer-based, and retail business units

What’s Unique About HFM?

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Strategic Positioning 2001-2009• 2001-2005: Concentrated on building a strong foundation through a Strategy

and Facilities focus• 2005-2009: Shaped a cutting edge infrastructure through focus on Systems and

Processes (IT, LEAN, Innovation, Safety) and reconfirming HFM’s Mission, Vision, and Values

• 2009 and Beyond: – Expanding the high performance environment focus on cultural

transformation and innovation– Strategic Program Unit Review– Operations best practices benchmarking

Ready for the Future

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• Significant drop in patients with insurance

• Common knowledge: many are delaying needed care because of uncertainty

• Gross revenues down nearly 10%, net 12%

• Proactive leadership and shared sacrifice early on positioned HFM for third consecutive year of improved gain from operations

• For many organizations these pressures can create an unfortunate short-term search for relief…..

HFM 2009: A Preview of Health Reform

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http://z.about.com/d/politicalhumor/1/0/A/t/2/healthcare-valium.jpg

Holy Family Memorial’s Response• HFM board, executive, and physician leadership anticipated these challenges and

did not seek medication!• A 12-month planning process in 2008 produced a new strategic plan and an

updated Mission and Vision; in 2009 senior leadership was reorganized around this new vision

• To “stress test” HFM’s strategic and organizational positioning, Kaufman Hall was retained in July 2009 to conduct a financial and operational analysis, and assess our “readiness for reform”

• Overall, a much more proactive approach than the other option…

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Preparing for Healthcare Reform: The “Wait and Hope” Option

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A Readiness Assessment Framework

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Reform Readiness AssessmentTypical Community Hospital More Prepared

















Capital Capacity

StrongWeak

Composite Position


Scale

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What Is Physician Integration?• Physician integration is defined as having a collaborative relationship between the

hospital and the medical staff supported along multiple dimensions:– Organizational structure and governance– Citizenship and leadership from broader medical staff– Medical staff support infrastructure– Financial incentives

• Physician employment does not beget physician integration; integration does not necessarily require employment (though it can be difficult to achieve without)

• Through proper integration, physicians and the hospital work together toward common goals and objectives– The biggest challenge will be integrating independent physicians under future

reimbursement conditions

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• Not all physicians are seeking employment• Though the market is driving employment, hospital systems can take advantage of

physician independence by structuring pluralistic alignment models

• Maintaining this hybrid strategy gives hospitals time to build capital and adequate practice management capabilities

The Path to Physician Integration Will Require a Pluralistic Physician Model

Independent physicians Clinically integrated physicians Employed physicians• Independent physicians will

likely continue to practice through a transition period

• Hospital systems will seek to partner with independent physicians to drive quality and effectiveness through a series of partnerships, particularly clinically-focused co-management and contracting strategies

• Multispecialty groups organized around driving highest quality healthcare

How Well Positioned Is HFM’s Physician Workforce and Management Capability?IntegrationAttributes Key Elements of Most Prepared Current

Capabilities

Organizational Structure and Governance

• Physician led councils/committees that report to senior leadership or the board

• Significant physician membership on the board• Physician involvement in service line planning and

management

Citizenship and Leadership from Broader Medical Staff

• A proactive physician community that is able to share concerns and drive organizational initiatives

• Independent physicians aligned through clinical integration models

Practice Management

• Strong, physician-led practice management and leadership• Seamless provision of billing/contracting/other back-office

functions• Transparent reporting of outcomes and business decision

making

Compensation Models• Clear and transparent expectations and incentive structure• Multidimensional incentives (including production,

outcomes, citizenship, cost management, and others)

Lower Higher

• Structure supports growing physician involvement in HFM direction

• Greater physician leadership in service planning and development needed

• Within the employed group many relationships are fragmented; more a “confederation of practices” than one large medical group

• Strong and trusted physician group leadership; need for enhanced empowerment and development

• HFM exposed to erosion of specialty breadth as physicians retire/succession plans challenging

• Production-based compensation ensures group performance

• Citizenship incentive system in place, but needs more sophistication

• Opportunity to improve group incentives

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Care Coordination Infrastructure and Culture

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What Is Care Coordination?• Established protocols for procedures

• Established protocols for chronic disease

• Protocol adherence, monitoring and accountability mechanism

• Formalized mechanisms for coordinating care though physician-directed management of patients

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More Than Semantics: Case Management vs. Care Coordination

Case Management Care Coordination

Objective Contain cost Facilitate access/ deliver value

Target Population High cost/ high use patients High-risk populations

Functional Orientation Prior authorization Problem solving and process improvement

Context Incident Longitudinal

Nature of Coordination Work within a single organization providing medical care

Work across various organizations/ providers providing care

Note: Adapted from Colorado Department of Public Health; Kaufman Hall analysis.

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How Well Positioned Is HFM to Support Care Coordination?Program Attribute Key Elements of Most Prepared Current

Capabilities

Patient Centeredness

• Patient navigation through nurse navigators and social workers

• Alignment of downstream services to expedite treatment (e.g., PT after surgery)

Harnessing Technology

• IT connectivity across provider spectrum (i.e., MD offices to all HFM sites)

• Patient-facing accessibilityIntegration of Capabilities and Communication

• Physician communication (e.g., tumor boards)• Consistent care protocols across sites

Measurement• Quality and Outcomes Measurement• Analysis to identify readmission drivers (such as

poor prescription management)

Cost Management

• Care directed to the lowest cost setting possible with consideration to quality and access

• Supply chain management

Lower Higher

• Patient centeredness is a goal for the organization, but incompletely practiced

• Downstream navigation/ guidance through system can be strengthened

• IT connectivity exists; integrating it into the care coordination culture is the next step

• Limited patient access to medical records/ IT platform; though improving

• Physician communication has improved; but coordination across the continuum can improve

• Care protocols in place and expanding

• Process improvement initiatives have been successful

• Standing admission orders and measurement through CPOE

• Good physician accountability

• Physicians are accountable for practice costs• Utilization management and cost controls are

strong• Opportunity to improve supply chain

management

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Information Systems

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Information Technology Infrastructure• Having integrated, sophisticated IT systems will become increasingly important for healthcare providers• Organizations that invest not only in the actual hardware and software, but also in staff development and

expertise are more likely to use their system(s) effectively and to maximum potential• IT across the spectrum of health system functions will be necessary for HFM to actively manage its business

and remain competitive

Clinical Care Disease Management Organization Operations Finance

Electronic Medical RecordCPOEPACSClinical Info. Mgmt.Protocols/ EBMTelemedicine

Physician Practice Management

Budgeting Systems

Ability to communicate among patients, physicians, and hospital (e.g., schedule tests, make appointments online, receive test results, etc.)

Clinical Non-ClinicalIT Solutions

Planning Accounting

Program/ Service Performance Management

Patient Billing Systems

Sam

ple

IT S

olut

ions

Note: Bold font denotes historical HFM emphasis; regular font denotes future emphasis.

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How Well Positioned Is HFM’s Information Technology?IntegrationAttributes Key Elements of Most Prepared Current

Capabilities

Clinical Care Coordination and Disease Management

• Electronic Medical Record (EMR)• Computerized Physician Order Entry (CPOE)• Picture Archiving and Communication System

(PACS)• Post-discharge Disease Management System

Organizational Operations and Planning

• Physician Practice Management Systems• Program/ Service Line Performance

Management• Capital Planning Systems

Accounting and Finance

• Patient Billing Systems• Budgeting Systems

• Near complete adoption and integration of IT into clinical workflow

• Telemedicine used for home health; opportunity to expand outpatient disease management systems

• IT based and operational process improvements underway

• Service line performance management systems and processes not fully implemented

• Implementation of centralized billing in process

• Inadequate analysis of true costs• Difficult to identify profitability trends for

services across the networkLower Higher

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Service Distribution System

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Characteristics of a Well-Organized Service Distribution System• Ready access (in person, by phone, online) to care coordinators (PCPs, NP/ PAs)

• Distributed ambulatory capacity (primary care, specialty care, outpatient diagnostic and testing services)

• Concentration of highly specialized technologies and clinical resources (e.g., super specialists) to support quality and cost considerations

• Effective linkages and transfer protocols with “downstream” providers (Home Health, SNF, Rehab, etc.)

• Strong communication connectivity across the entire delivery spectrum

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Holy Family Memorial Service Distribution

Orthopaedics Clinic Family Practice Clinic PT and Wellness Walk-in Care Lab Nutrition Counseling Well Spa

ENT Clinic Pediatrics Clinic

Chiropractic Clinic Podiatry Clinic Endocrinology Clinic Women’s Health Clinic Pediatric Therapy Lab

Behavioral Health Clinic Neurology Clinic Dialysis

GI Clinic Internal Medicine Clinic Urology Clinic Lab

Family Practice Walk-In Care Pediatrics Clinic Orthopaedics

PT and Wellness Pharmacy

Inpatient Services Diagnostic Center of Excellence Cancer Care Center Heart and Vascular Center Pain Center General Surgery Wound Clinic Sleep Lab Main Laboratory

Orthopaedics Clinic in Sheboygan (20 mi south)

Studying clinic expansion to Kewaunee (20 mi NE)

Studying clinic expansion to Chilton (20 mi SW)

Pharmacy HME Diabetes

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How Well Positioned Is HFM Delivery System?ProgramAttribute

Key Elements of Well Prepared Small/ Rural Providers

Current Capabilities

Accessible Primary Care

• Physicians• Mid-level providers• Urgent Care, Retail, etc.

Logical Grouping of Highly Interrelated Services

• Imaging and Lab• Cardiology, CVS, Pulmonary• Medical/ Radiation/ Surgical Oncology and

others

Single Site Acute Care Center

• Concentration of higher cost acute care services; geographic footprint based on lower acuity services and diagnostics

Strong Referral Relationships

• Well established and coordinated referral relationships with tertiary providers, SNF, rehab and home health

Contemporary Facilities and Equipment

• “Clean”, modern, contemporary physical plants• Competitive diagnostic technology and service

portfolio

• Aged main inpatient plant• Clinical technology and diagnostics very

competitive for the market• Facility master plan being updated to show

replacement options

• Coordination of referrals through network generally smooth

• Very little telemedicine or outreach from tertiary centers in Green Bay to supplement current specialists

• Significant facility consolidation efforts under way

• Outreach based on clinics; though there is some redundancy of clinic space within local region

• Minimal redundancy of diagnostics or other high capital services across local service area

• Relatively large number of employed primary care physicians

• Very accessible care locations and schedules• Market slow to respond to innovative care

delivery mechanisms (i.e., retail clinics)

Lower Higher

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Financial Position and Capital Capacity Assessment

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How Well Positioned Is HFM Financially?

ProgramAttribute

2009 Position Relative to Medians

Profitability

Liquidity

Leverage and Capital Capacity

• Relative to equity and cash, HFM is leveraged slightly higher than “BBB+” medians • Debt service coverage has remained relatively consistent and is currently in line with “BBB+”

medians• HFM is anticipating approximately $40.6 million in building, MIS, contingency, and equipment

capital expenditures from FY2010-2014 • HFM has no major projects planned requiring access to the debt markets. However like most

smaller healthcare organizations, HFM will have difficulty in accessing debt in the current lending environment at favorable rates

• HFM’s liquidity decreased significantly in 2008, most likely due to the high level of capital spending and negative performance from the investment markets

• As such, cash to debt levels remain below targets• Projected days cash on hand of 135 days for 2009 are in-line with appropriate credit median

levels

• Moderate growth in net patient service revenue (3.6% compounded annual growth) from 2005 to 2009; however consistent year to year margin improvements despite national trend

• Operating performance has varied greatly over the last five years, from a $1.7 million loss in 2006 due to employee health claims to a projected high point of $6.1 million in 2009

• The variability in operating performance has lead to variability in underlying operating EBIDA margins, from a low point of 7.9% in 2006 to a projected high point of 13.5% in 2009

Lower Higher

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Scale

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Organizations that attain a greater scale can better leverage their fixed cost base, deliver higher quality care, achieve variable cost efficiencies, build

market leverage, diversify risk across markets or a broader base of programs/ services, preserve long-term access to capital, and ensure ongoing viability though the attraction and recruitment of top talent.

Scale: A Requisite for Success in the Future Healthcare Market?

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• HFM has been able to retain talent• HFM has a highly tenured work force

and a typical hospital culture. An intentional culture shaping process is in place to spur innovation and change capacity

• Opportunity exists to encourage risk taking within the organization

• Membership in GPOs are the extent to which HFM can leverage scale in purchasing

• Evaluating leverage options with potential regional strategic partners

• Major competitors are large players in the broader regional market

• Ability to draw patients to Manitowoc limited by HFM’s size relative to others in the market

• HFM market influence has pockets of strength, especially with employers and regional orthopedics

• Organization size challenges R&D resource investment to optimally support innovation

• Limited capital excess given current system position

How Well Positioned Is HFM in Terms of Scale?IntegrationAttributes Key Elements of Most Prepared Current

Capabilities

Talent• Broad and deep clinical and management talent from a variety of

backgrounds• Empowerment throughout a large part of the organization to take risks; ability

to absorb impact from those risks

Purchasing Power

• Ability to leverage scale (in terms of facilities and volume) to reduce variable costs and efficiently deploy routine capital

– Shared purchasing– Lab– Back office

Market Influence

• Sustained negotiating ability with payors• Ability to drive change in the market

– Advancement of technology (e.g., drive adoption of 64-slice CT)– Advancement of service models and expectations within market (e.g.,

emergency room wait guarantees/ transparency)

Innovation• Clinical• Operational• Technological

Access to Capital

• Cost advantage• Favorable terms and conditions• Flexibility

Lower Higher

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Conclusions and Summary

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Reform Readiness AssessmentTypical Community Hospital Most Prepared Organizations

















Capital Capacity

StrongWeak

Composite Position


Scale

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Summary of Key PointsCare Coordination Infrastructure

HFM has the pieces in place for sophisticated care management (especially for its size). A broad array of protocols and information systems, as well as clinical leadership in decision making allows the Network to adequately track and audit its care processes and errors.


The culture of independence in physician practice at HFM will be among the largest hurdles for the organization. Historically, physician practice patterns have complicated the management of downstream and post-discharge care. Additionally, the physician culture’s risk averse nature can limit empowering physician extenders to fullest potential.


Past physician employment initiatives have paid off for HFM. Despite a lack of depth in some specialties, HFM’s physician workforce is more aligned than most comparable hospitals. Opportunities to improve alignment lie in continued development of physician leaders and greater alignment of compensation systems and incentives.

Information Systems

A full complement of clinical IT systems position HFM for success in this respect. HFM has an opportunity to be a regional leader. Quick and efficient IT planning, implementation, and adoption show that the Network can adapt to change with strong leadership.

Service Distribution System

Balanced service distribution system in the local market. Despite this, HFM is weighed down by legacy assets and is under increasing competitive pressures. Opportunities exist to better leverage clinical outreach sites. Additionally, a lack of clinical scale (i.e., volume) limits HFM’s ability to fully leverage efficiencies and demonstrate quality.

ScaleHFM faces significant challenges from its limited size and scale. In addition to challenges identified in other areas of the report, lack of scale limits its ability to control the market and maintain the breadth and depth of top management and clinical talent to serve in the challenging reform environment

Capital Capacity

Limited capital capacity. Like most similar organizations, HFM must focus on improving operating performance to continue its growth and maintain its leadership position related to physician integration and information systems.

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Key Takeaways• The old business model is “dead” regardless of the reform outcome

• Early movers will be rewarded

• An incremental approach to change and adaptation is not sufficient in the new era

• Effective physician integration and care management capabilities will define future success for hospitals and health systems

• More than one success model will emerge – not all organizations can evolve into a Mayo, Geisinger, or Kaiser type of provider

• Evaluate and “grade” your readiness right now

• Start taking the required steps toward success

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Moving from Assessment to Readiness• Size alone is insufficient• Start building the systems and programs for success• The emerging success model requires:

– Scale– A strong position in the geographies served– Multiple operations in a connected geography– A solid, integrated physician platform– A care, cost, and quality management culture– Sophisticated IT and care management infrastructures– Acute attention to operations and business portfolio management

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Question & Answer SessionTo submit a question via your phone, please dial *1 on your keypad.

You will be placed in queue, your phone line will be opened by operator when it’s your turn. (To be taken out of queue, press *1 again.)

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Upcoming: AHA Solutions Signature Learning SeriesWebinars:

HIE: Assimilating Patient Data to Leverage Your Technology and Applications to Meet “Meaningful Use” Requirements

Featuring a case study by West Tennessee HealthcareThursday, December 10 1 - 2pm Eastern Time

Creating Quality Initiatives through Policies & Procedures: Best Practices for Adherence and Management

Featuring Eastern Idaho Regional Medical Center Tuesday, December 15 3 - 4pm Eastern Time

To learn more or to register, call 1.800.242.4677 or visit aha-solutions.org

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About This Webinar• This educational webinar has been developed by AHA Solutions in partnership with

Kaufman, Hall & Associates, Inc.• Kaufman Hall has the exclusive endorsement of The American Hospital Association for its

Integrated Planning and Capital Markets Solutions.

2009. Kaufman Hall has been ranked #1 for the sixth consecutive year by Thomson Reuters as the country’s top financial advisor to healthcare providers.

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Contact Information

Mark P. Herzog President and Chief Executive OfficerHoly Family Memorial, [email protected]

For more information on AHA Solutions or Kaufman Hall

please visit www.aha-solutions.org

Mark E. GrubePartner Kaufman, Hall & Associates, Inc. [email protected]

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mailto:[email protected]

http://www.aha-solutions.org/

mailto:[email protected]

Featured SpeakerMark P. Herzog

Mark P. Herzog has served as President and CEO of Holy Family Memorial, Inc. (HFM) since 2001. Prior to this, Mr. Herzog served as EVP/COO for 10 years at two hospitals in northwest Indiana. His 25 years of experience also include leadership roles in health systems in Ohio and Pennsylvania. He was awarded an MHSA degree from the University of Michigan, and is an ACHE Fellow.

HFM is a small-market, tightly integrated health delivery system located in Manitowoc, WI, serving a population of nearly 100,000. It includes a hospital, an employed 80-practitioner multispecialty group practice, a comprehensive outpatient campus (“healthcare village”) and a wide range of prevention-focused retail services. HFM was an early adopter of clinical information systems and care management tools. During the past five years, HFM has been named Solucient Top Performance Improvement Leader, has received a Premier/ CareScience Select Practice National Quality Award, and has been recognized twice nationally for Patient Safety Excellence, with designation in 2009 as a Top 25 Most Wired Small Hospitals, and a Stage 6 EMR Adopter by HIMSS.

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Featured SpeakerMark E. GrubeMark Grube, Partner, leads Kaufman Hall’s integrated strategic advisory practice. This practice provides strategic and financial planning and implementation assistance related to enterprise-level strategies, clinical programs and service lines, physicians, health facilities planning, competitive markets, joint ventures, mergers and acquisitions, and overall organizational growth.Mr. Grube has more than 25 years of experience in the healthcare industry, as a consultant and as a planning executive with one of the nation’s largest healthcare systems. He has worked extensively with a broad range of healthcare providers, including community hospitals, specialty hospitals, regional and national health systems, and academic medical centers. Mr. Grube is a frequent speaker and author on healthcare topics, including strategy development, sustainable revenue growth, replacement facility development, and mergers and acquisitions. Over the past five years, Mr. Grube has published more than two dozen articles and white papers. He received the Helen Yerger/L.Vann Seawell Best Article Award from the Healthcare Financial Management Association (HFMA) in 2007 for his cover story in the May 2007 issue of hfm magazine titled “Growing the Top Line: 5 Strategies to Expand Your Business,” and in 2009 for the article he co-authored in the May 2009 issue of hfm titled “Ensuring Affordability of Your Hospital’s Strategies.” Mr. Grube has presented at national meetings of the American College of Healthcare Executives (ACHE), The Governance Institute, HFMA, and the Society for Healthcare Strategy and Market Development (SHSMD). Reflecting his serious commitment to healthcare management and governance education, Mr. Grube presents frequently at hospital/health system retreats and university graduate programs in health administration. He is a member of ACHE, HFMA, SHSMD, and the Leaders Board for Healthcare Strategy and Public Policy. Mr. Grube received an M.B. A. from the University of Chicago Graduate School of Business and a B.S., magna cum laude, in Economics from Bradley University.

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Kaufman Hall: Who We Are• Kaufman Hall is an independent consulting firm that offers integrated strategic,

capital, and financial advisory services and software to healthcare organizations of all types and sizes

• National practice established in 1985• Clients throughout the United States• Offices in Chicago, Atlanta, Boston, Los Angeles, New York, and

San Francisco• Impeccable industry credentials and national “gold standard” hospital and health

system client base• To learn more visit http://www.kaufmanhall.com.

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http://www.kaufmanhall.com/

Thank You

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hfm's reform readiness aha webinar

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