visioning for collaboration & risk-takingtransforming lives, erasing boundaries macro-strategies...

A d v a n c i n g t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g

Sponsored by

Visioning for Collaboration &

Risk-Taking October 19th, 2014 / 9:00 AM

Visioning for Collaboration and Risk-Taking Sunday, October 19th, 2014 / 9:00 AM


Moderator: Lisa McCracken Senior Vice President of Senior Living Research, Ziegler

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Presenters: Rocklon Chapin President and CEO, Benedictine Health System

Scott LaRue President and CEO, ArchCare

Jesse Jantzen CEO, Elder Care Alliance

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§  To discuss the growing importance of collaboration and partnerships and how that is being shaped by the external factors shaping our sector.

§  To have attendees learn about how to effectively integrate collaboration into strategic planning and visioning for the future of the organization.

§  To highlight three providers who have effectively developed external relationships to advance their organizations forward.

Session objectives:

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Presentation outline: Section 1: A Look at Partnerships & Collaboration

Section 2: Overview of Three Provider Organizations

Section 3: Facilitated Discussion

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Section 1: A Look At Partnerships

& Collaboration

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“Coming together is a beginning, staying together is progress, and working together is success.”

~Henry Ford

Collaboration Does Not Happen Overnight

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§  The external environment is playing a significant role in shaping who are partners are and need to be

§  Partnerships and collaborations need to be deliberate and strategic §  How does it fit your vision for the

future? §  How can this serve to enhance your

mission?

Big-picture Thoughts On Collaboration

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Section 2: An Overview of Three

Provider Organizations

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Catholic Leadership Symposium October 2014

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No

Elder Care Alliance - A Little History

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Elder Care Alliance – Structure

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Vision Engaging Hearts, Transforming Lives, Erasing Boundaries §  Enriching human relationships, connecting people and

community, providing environments that foster independence, allowing people to flourish and where there is joy.

§  Partnering to create communities where people are empowered, engaged, and have a voice and a vocation.

§  A key contribution we make to the field of aging is in developing leaders with a calling to deliver person-centered, high quality services in support of holistic wellness.

§  We strive to transform ourselves, the lives we touch, the field of aging, and society’s view and value of older adults.

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Mission – Who We Are Expressing our faith heritage, Elder Care Alliance is an integrated system committed to serving and enriching the holistic wellness of older adults

and those who care for them through education, innovation and a network of professionals, care communities and partners.

Vision – The Future State

Engaging hearts, Transforming lives, Erasing boundaries

Macro-Strategies – What We Will Do Approach for all we do: Holistic Wellness. Research, Creation, Innovation Robust Leadership Development Focused Growth and Diversification of Service Mix

1 2 3

Values – How We Live Out The Mission

Dignity Caring Excellence Prudent Stewardship

Collaboration Learning

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Healthcare Reform Impact

§  Strategic partnerships §  Employer mandate §  Squeeze on reimbursement rates §  Consolidation

= Pressure: financial, legal, governance

The World is Changing

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Consolidation / Strategic Partnerships …burning platform or strategic imperative?

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§  Sophisticated business §  Set vision and strategy §  Evaluate risks and mitigate liabilities §  Govern effectively/

staff oversight

The Importance of Governance

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Measuring Success

§  Exponentially grow mission impact §  Obtain access to greater resources §  Economies of scale §  Ability to offer greater benefits/

programs/services

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A d v a n c i n g t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g P A G E 19



“The Mission of ArchCare, the Continuing Care Community of the Archdiocese of New York is to foster and provide faith based holistic care to frail and vulnerable people unable to fully care for themselves. Through shared commitments, ArchCare seeks to improve the quality of the lives of those individuals and their families.”

ArchCare’s Mission

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ArchCare’s Vision “ArchCare is the healthcare ministry that

individuals, families, parishes and others turn to for the highest quality care coordination and post-acute services as well as information and decision support. As a valued and innovative partner, ArchCare ensures access to a broad array of integrated, holistic services for frail and vulnerable individuals throughout the Archdiocese of New York.”

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Overview of ArchCare

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2008: ArchCare began to transform the Healthcare Ministry to expand services op?ons for frail elders and

other vulnerable popula?ons.

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2014: The ArchCare Ministry offers a broad array of programs to serve diverse needs

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Environmental Context for Change

& Collaboration

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§  NYS Public Policy Direction: Care Management for All

§  Drivers of Policy Changes – Move toward managed care to create

§  Accountability

§  Budgetary predictability

§  Minimize unnecessary utilization & reduce costs

§  Optimize quality

§  Focus on high-cost, high-need Medicaid populations: dual eligibles

§  Mandatory enrollment in Managed Long Term Care Plans (MLTCPs) of individuals ≥ 21 years of age requiring > 120 days of community long term care.

§  The policy changes threatened the future financial viability of many community based organizations without managed care experience.

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§  NYS decided to participate in the federal demonstration program to create integrated Medicare and Medicaid Plans, or Fully Integrated Duals Advantage (FIDA) plans.

§  NYS viewed MLTCPs as the foundation for transitioning into FIDAs.

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Fee For

Service

Medicaid Managed Care

_________________

Medicare FFS

Integration of Medicaid &

Medicare Managed Care

State and Federal Policy Shifts

2012 2015

MLTCP FIDA

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Delivery System Reform Incentive Payment (DSRIP) Program §  $6.4 billion to create Integrated Delivery Systems, and improve

the care coordination of all Medicaid recipients & reduce avoidable hospitalizations by 25%.

§  Will become operational April 2015 and continue through December 2019.

§  DSRIP has become a catalyst to spur the development of organized collaborative arrangements among providers with shared and measurable goals.

§  The Integrated Delivery Systems will crystallize referral patterns.

§  It is critically important for providers participate in these networks.

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Fee For

Service

Integrated Delivery Systems (IDSs)

Health Care Providers

Health Homes

Community Based Orgs

Other Providers

MCO

NYS

•  IDSs will be a “new provider type”

•  “permanent” structural change in healthcare delivery

Future State in 5 Years Envisioned by NYS

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Examples of Partnerships & Collaboration

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Key elements to successful collaborations: §  Identify partners with mutual interests

and goals. §  These can be other health care providers,

health plans, community-based organizations and governmental agencies.

§  Based on the mutual goals, develop win-win arrangements.

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Education & Sharing of Ideas Given the sweeping State & Federal policy changes

§  Carmelite Sisters for the Aged and Infirm §  Cabrini Eldercare §  ArchCare

§  Founded in June 2011 the Catholic Providers Forum to identify ways to ensure a continuing Catholic presence in caring for the elderly & disabled and to create a venue for open dialogue, creative exchange of ideas and exploring collaborative opportunities

§  Forum brought together > 80 representatives from 26 Catholic service providers and religious orders caring for their own aging members, and has continued to hold gatherings to fostered collaborative initiatives such as: §  Working with religious communities to develop care arrangements for their elders to

leverage their Medicaid & Medicare benefits without further erosion of community assets. §  Avila Institute of Gerontology providing educational programs for providers.

§  Care coordination and service arrangements.

§  Creation of Cardinal Health Partners IPA, LLC.

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§  Given its managed care expertise, ArchCare developed care coordination arrangements with other providers that helped the providers transition into the managed care market. §  At the same time, the continuity of care by the providers to their patients was

preserved.

§  The Board of a stand-alone home care agency realized the need for an alliance with a larger system, and sought ArchCare sponsorship which has yielded many synergies (e.g., lower expenses due to economies of scale, broader geographic scope and service offerings).

§  ArchCare has collaborated with housing providers to §  Transition plan members from SNFs to community housing. §  Expand access by elders in housing complexes to coordinated long term care

services.

Combining Organizational Strengths

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Mutual Goals §  ArchCare and its major referring hospitals share the goal

of optimizing transitions of care across settings to enhance patient experience and reduce unnecessary re-hospitalizations. §  Regular meetings to review performance metrics,

collaborate on protocols, and engage in collective problem-solving.

§  During Superstorm Sandy, many vulnerable older adults were left homeless. ArchCare partnered with New York State to provide assisted living accommodations and to protect the safety and well-being 59 elders who have opted to remain with ArchCare on a long term basis. §  Sharing mutual goals and mission can result in innovative

service arrangements.

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§ Mission § Structure § Governance § Services

BHS Overview

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“The Benedictine Health System is a Catholic organization entrusted with advancing the health care ministry of the Benedictine Sisters of Duluth, Minnesota. Our mission is to witness to God's love by providing compassionate, quality care with special concern for the underserved and those in need.”

Mission Statement

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Core Values

§  Hospitality §  Stewardship §  Respect §  Justice

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Vision Statement

“We create Benedictine Living Communities where health, wellness

and choice come to life.”

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The Structure

Benedictine Health System

Associate Organizations

Ministry Partners

Member Organizations

Communities Served by Benedictine Health System & Related Facilities

Benedictine Sisters Benevolent Association

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§  BHS owns and/or manages more than 70 long-term care facilities, on 39 campuses across 6 states

§  Bed complement §  3300 Long-Term Care §  2500 Housing with

Services/ Assisted Living Facilities

§  Staff §  6000 total employees

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BHS Service

Area

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BHS Top 5 Strategic Challenges §  We must re-set our fundamental business model and

practices to be efficient, effective and innovative and thereby lead the transformation of healthcare

§  We need to recruit, engage and develop a workforce motivated, skilled and trained to meet the needs of those we serve across the continuum and at all locations

§  We must create or adapt existing partnerships to extend and advance all aspects of our care

§  We need to focus on creating a distinctly BHS experience that encourages a memorable, trusted relationship with those we serve

§  We need to fund mission growth and depth by generating a sustainable operating margin

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§  80+ LTC facilities…70 campuses/communities §  3,000 Nursing Facility Beds…focus on post-acute

care, aligned with integrated hospital/health care systems

§  5,000 Housing with Services/Assisted Living Units §  Care at Home – 4,000 served

§  Model…strong care coordination, aligned with Diocese/Parish Model of informal care support

§  Specialized care – §  End-of-Life Care §  Memory Care §  Therapy

Profile of BHS 2020

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§  At Risk/Integration of Payment §  Medicare/Medicaid dual eligibles…various state-based

programs §  Accountable Care Organization partnerships (ACOs); CMS

Model 3 Demonstration §  Subcontracting of risk as post-acute/LTC partner

§  Enhanced Partnerships; hospital/health systems; Catholic Health Care providers; Catholic Diocese

§  Capital Formation/Financial Sustainability §  Sustained system financial performance required §  Strategic Capital Fund & Strategy

§  Equity Pool §  Philanthropy §  Debt/Leverage

Profile of BHS 2020

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Sponsor/Partnering Model (Catholic/non-Catholic sponsors)

HEALTHEAST 45%

School Sisters of St. Francis

10%

CERENITY CARE CENTERS

BHS Management

5 LTC Campuses

BHS 45%

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Sponsor/Partnering Model (Freestanding Catholic facility)

Benedictine Sisters of Sacred Heart

Monastery BHS

50% 50%

BHS Management

Villa St. Benedict CCRC

LTC Campus

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Interlude Restorative Suites Model

Allina Health 1/3

BHS 1/3

Presbyterian Homes & Svcs

1/3

Interlude Locations = BHS or PHS – 90/10% LLCs

6 Metro facilities on Allina sites

BHS Management

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§  Are there opportunities for existing sponsors with a strong commitment to Senior Care to partner in strengthening our Senior Care ministry?

§  Should Catholic Senior Care come together, “consolidate,” as Catholic hospitals/health systems have done?

§  Are there new models of collaboration/sponsorship that could be lifted up and explored by interested CHA members?

Future Direction for Catholic Sponsorship of Senior Care?

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Section 3: Facilitated Discussion

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Questions & Answers

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Thank you. Rocklon Chapin President & CEO Benedictine Health System [email protected]

Scott LaRue President & CEO ArchCare [email protected]

Jesse Jantzen CEO Elder Care Alliance [email protected]

Lisa McCracken SVP of Senior Living Research Ziegler [email protected]

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