Peer-to-Peer Learning

Networking Discussion Groups
Join your peers from medical groups and health systems of similar type and size for structured networking and discussions on Friday, March 9. Participants in these popular sessions will be part of lively and free-flowing discussions, share common experiences, and find new solutions to challenges. Due to the intimate nature of these meetings, participation is open only to medical group and health system participants.

Peer-to-Peer Breakout Sessions
Discover innovative strategies and groundbreaking processes from AMGA members that enable you to successfully engage patients, manage wellness, build partnerships, employ emerging technologies, and transition to new payment models. In addition to lectures and case studies, many of this year’s breakout sessions feature interactive discussions, group exercises, and problem solving to catalyze change.

Leadership and Culture

Leadership and Culture

Technology and Innovation

Technology and Innovation

Care Redesign and Patient Experience

Care Redesign and Patient Experience

Efficent Operations and Finance

Efficient Operations and Finance

 

Governance and Strategic Planning

Governance and Strategic Planning

Health Care on the Hill

Health Care on the Hill

Interactive Session

Interactive Session

Chief Executive Officer / President Presentation

Chief Executive Officer / President Presentation

 

Friday, March 9, 2:00 p.m. - 3:15 p.m.

Leadership and Culture

Engaging Physicians: Increasing Trust, Strengthening Culture, and Building Resilience through a Multi-pronged Approach
Susan Rehm, M.D., Executive Director, Physician Health, and Michael Michetti, J.D., Executive Director, Office of Professional Staff Affairs, Cleveland Clinic
In 2015, Cleveland Clinic embarked on an effort to increase physician resiliency in response to national burnout rates and rapid industry change. Using engagement survey data and town halls, Cleveland Clinic developed a Staff Experience framework with over 30 programs in five focus areas: outreach, clinical enhancements, professionalism, well-being, and professional growth.

Since implementation, Cleveland Clinic’s engagement survey data has demonstrated positive movement in every metric. During this engaging session, leaders from Cleveland Clinic will share the history and supporting data, review key programs, and conduct multiple audience exercises on effective engagement.

Upon completion of this activity, participants should be able to:

  • Describe key elements that make up a physician’s employee experience
  • Identify multiple programmatic strategies that enhance the physician experience, decreasing burnout and increasing engagement and well-being
  • Employ reframing strategies to identify positive intent and engage in meaningful discourse
  • Create a coach approach to engagement

 

Leadership and Culture

Chief Executive Officer / President Presentation

Strategies to Engage Employees, Improve Internal Communication, and Develop Future Leaders
Daniel M. Duncanson, M.D., CPE, Chief Executive Officer, and Susan K. Knowles, M.B.A., Executive Chief of Staff, Southeastern Integrated Medical
Recognizing the important role of employees in the journey to improve the patient experience, Southeastern Integrated Medical (SIMED) launched a series of programs to engage more than 100 providers and 350 staff members across its 11 locations in north central Florida. With challenges in employee engagement, recruitment talent pools, and employee turnover, SIMED launched a system-wide initiative to improve communication across levels and to develop leaders from within.

Beginning in 2014, SIMED launched a leadership academy, revamped its new employee orientation, emphasized employee communication, offered new recognition opportunities, and established a physician development group. Together, these efforts helped SIMED achieve CAHPS results in the 90th percentile in a number of patient/caregiver experience categories, improve employee retention by 11%, and advance 78% of Leadership Academy participants to higher responsibility positions.

In this session, leaders from SIMED will provide brief case studies of their programs and lead an interactive discussion with participants.

Upon completion of this activity, participants should be able to:

  • Determine if the employee engagement strategies presented are applicable to their environment in order to improve engagement and retention
  • Evaluate tactics to develop future manager and physician leaders
  • Identify metrics to measure employee engagement and retention

 

Technology and Innovation

Chief Executive Officer / President Presentation

Improving the Safety of Prescribing for a Medicare Advantage Population: Is There a Role for Genomics?
Francis R. Colangelo, M.D., M.S.-HQS, FACP, Chief Quality Officer, Robert A. Crossey, D.O., President, and Jennifer Obenrader, Pharm.D., CDE, Supervisor of Clinical Interdisciplinary Team, Premier Medical Associates, P.C.
Adverse drug reactions and interactions contribute to nearly 800,000 annual deaths and injuries, despite the availability of computerized drug-drug interaction (DDI) software in electronic health records. Premier Medical Associates (PMA) launched a clinical pharmacist-led pilot project to improve prescribing safety among 3,000 Medicare Advantage patients who take five or more medications.

Understanding the impact of genetic variations on individual responses to medications and how these variations can lead to adverse health outcomes, the Pittsburgh-based multispeciality medical group incorporated a proprietary program to explore drug-drug-gene interactions (DDGIs) using pharmacogenetic screening.

Leaders from PMA will summarize pilot project findings, including the most commonly identified DDIs and DDGIs, describe patient and provider acceptance of genetic testing, and highlight the impact of more precise prescribing on utilization and costs using claims data.

Upon completion of this activity, participants should be able to:

  • Determine if an investment in an enhanced DDI software program and/or a pharmacogenetic testing program led by clinical pharmacists will improve the safety of provider prescribing
  • Explain the ways that genetic variation can account for individual responses to medications and how such individual variations can lead to adverse health outcomes
  • List the most commonly identified DDI that were previously overlooked and drug-drug-gene interactions

 

Technology and Innovation

Chief Executive Officer / President Presentation

ACO Collaboration: Driving Value through the Development of a National, Clinically Integrated Research Network
Jeff James, M.B.A., CPA, Chief Executive Officer, Wilmington Health; and Kenny Bilger, Chief Executive Officer, Christie Clinic
Clinical research can dramatically impact an ACO’s triple aim aspiration as well as its bottom line. In 2013, Wilmington Health and Christie Clinic formed a collaborative that has since grown to six ACOs nationwide. Learn how AMGA members Wilmington Health and Christie Clinic introduced a clinical research program as part of their revenue diversification strategy, while using the program as an ACO counter measure to improve outcomes, increase engagement, and lower costs for the healthcare system.

The organizations have since established a clinically integrated national research network, in partnership with one of the world’s largest contract research organizations, to continue to reduce the time it takes to conduct clinical trials and reduce the cost of therapeutic development. Enabled by clinically integrated electronic medical records, their study recruitment is now eight times more efficient than the industry average.

A recent diabetes study spearheaded by the clinical research program illustrates dramatic improvement in patient satisfaction, reductions in A1c levels at the 13-visit mark, and significantly lower costs per Medicare beneficiary ($354 per month) after study enrollment.

Upon completion of this activity, participants should be able to:

  • Describe the importance of clinical research in a value-based health system
  • Outline the value of clinical research as a revenue diversification strategy and as providing better outcomes, higher engagement, and lower costs for the healthcare system
  • Identify the added value of being associated with a network of integrated clinical research sites

 

Technology and Innovation

Chief Executive Officer / President Presentation

Innovative Care Models: Mitigating Downside Risk with Virtual Care Centers
Randall S. Moore, M.D., M.B.A., President, Mercy Virtual
Leaders today increasingly discuss moving their organizations into value- and risk-based contracts, and the required components of care management and delivery. An often unspoken concern centers on how to migrate from current, dominant, volume-driven fee-for-service to value, without an end-of-term obligation to write a large check for failure to effectively manage utilization and costs.

Discover how Mercy’s extensive Virtual Care Center, described as a “hospital without beds,” allows the 330-person care team to use highly sensitive two-way cameras, online-enabled instruments, and real-time vital signs to monitor patients wherever they are—hospital, physician office, or home. Leaders will share how the world’s first facility dedicated to telehealth mitigates downside risk while delivering market-differentiated clinical, operational, and financial performance.

Upon completion of this activity, participants will be able to:

  • Explain how the use of virtual technology for patient care is relevant in value-based healthcare delivery
  • Identify current practices to find opportunity to involve expanded virtual care practices

 

Care Redesign and Patient Experience

The Path to High Performance at CHRISTUS Trinity Clinic: AMGA’s 2018 Acclaim Award Recipient
Steve Keuer, M.D., President and Chief Medical Officer, Scott Smith, M.D., Senior Vice President and Institute Chair of Primary Care, David Gano, M.S.O.D., Regional Director of Ambulatory Performance Improvement, Janet Hurley, M.D., Medical Director of Population Health, Andrea R. Anderson, M.H.A., M.B.A., Administrative Director of Population Health and Ambulatory Quality, and Annamari Dietrichson, Regional Director of Professionalism and Patient Experience, CHRISTUS Trinity Clinic
Since 1999, the Acclaim Award, supported by AMGA Foundation, has recognized medical groups and other organized systems of care that are bringing the American healthcare system closer to the ideal delivery model―one that is safe, effective, patient-centered, timely, efficient, and equitable. Each year, AMGA honors members that have demonstrated successful system-wide change, delivered better patient outcomes, and embraced continuous learning and innovation that has led to improved quality and value-driven patient care.

This session will spotlight the powerful initiatives of CHRISTUS Trinity Clinic, our 2018 Acclaim Award recipient. Leaders from the group will describe their journey and explore their award-winning initiatives, highlighting how AMGA’s High-Performing Health System™ attributes, along with their core mission principles, guide their physicians, advance practice providers, clinical staff, and support staff to provide the highest quality, compassionate care.

Upon completion of this activity, participants will be able to:

  • Describe the initiatives of the 2018 Acclaim Award recipients
  • Evaluate whether elements are replicable at their organization

 

Care Redesign and Patient Experience

Built to Last: University of Utah’s Population Health Model
Julie Day, M.D., Medical Director, Quality Improvement and Population Health, and Annie Mervis, M.S.W., Director of Quality Improvement and Population Health, University of Utah Community Physician Group
Population health management requires a comprehensive approach to successfully advance healthcare quality, access, and outcomes. Speakers from the University of Utah Community Physician Group will detail the various aspects of their population health model, including two meeting structures (quality improvement project meetings and monthly care conferences), multidisciplinary team structures (with on-site pharmacists and embedded social workers), risk stratification, centralized care navigation center, community collaboration with their state-wide Clinical Health Information Exchange, and contracting for value-based payments.

The approach, which can be adopted by other organized systems of care, has substantially decreased emergency department utilization, managed 77% of crisis interventions without higher level of care, and nearly tripled the number of quality measures meeting the goal.

Upon completion of this activity, participants should be able to:

  • Articulate the elements a working population health management infrastructure
  • Describe the elements of a successful integrated behavioral health model
  • Identify useful measures of success within a population health integrated model and how to work with the community to build reporting capability
  • Outline the steps and approach to creating a value-based model contract

 

Care Redesign and Patient Experience

Chief Executive Officer / President Presentation

Acute Care Clinic: Alternative to Extensivist Model
David F. Moulton II, M.D., Medical Director, Clinical Integration, and Richard Panek, ACMPE, Chief Executive Officer, State of Franklin Healthcare Associates, PLLC
Meeting the triple aim of health care and improving performance under value-based payer agreements are key objectives for the successful medical group in today’s healthcare environment. Payers are looking to providers to generate and deploy creative solutions which result in improved patient experience, increased efficiency, and effectiveness of care, and provide a benefit for the plan and employer in terms of better employee health care at a lower cost.

Enabling patients with acute clinical conditions who would previously have generated a visit to the ED and possible hospitalization in the outpatient setting was the inspiration for State of Franklin Healthcare Associates to create its Acute Care Clinic (ACC). SoFHA initiated the ACC as an alternative to the extensivist clinic model due to the lack of hospitalists to cover this service as well as the ability of internal medicine physicians with extensive hospital medicine experience to staff the clinic. To date, the ACC has treated more than 600 patients with a 30-day hospital admit rate of less than 20%, significantly improved patient experience while reducing ED visits and facility spend, and provided a nearly $2.2 million lift to value programs in less than a year.

Upon completion of this activity, participants should be able to:

  • Describe the specific patient population/demographic that would benefit from the ACC by improving patient care experience, lowering out-of-pocket cost, and avoiding hospitalization
  • Identify the data needed to develop proforma for the ACC as well as determine provider and clinical staff and systems/facility resources needed to safely provide this service in the ambulatory care setting
  • Explain how an ACC can be developed, established, run, and maintained with a reasonable amount of financial investment and provider time
  • Articulate the impact of an ACC on value-based contracts, such as MSSP and Medicare Advantage

 

Efficent Operations and Finance

Creating an Advanced Post-Acute Care Network Using Relationships, Tools, and Data
Chris Butters, M.S., R.N., Manager, Post Acute Care Services, Bryan Sanders, R.N., B.S.N., Director of Network Development, and Megan Romine, D.O., M.H.A., FACP, Medical Director, UnityPoint Health Accountable Care, Internal Medicine Provider, UnityPoint Clinic
Developing a high-performing post-acute care network that will contribute to better outcomes and efficiencies requires significant coordination within an ACO network. Leaders from UnityPoint Accountable Care, L.C.(UAC)—one of the largest ACOs in the nation with more than 200,000 patients covered in value-based arrangements and more than 5,000 participating physicians—will describe its structure, focusing on UAC’s post-acute care network which includes more than 80 skilled nursing facilities across Iowa and Illinois. The presentation will detail the network build, strategy, network criteria, resource structure, tools, dashboard utilization, and performance.

Significant improvements in outcomes, savings, and care coordination will be highlighted, including its $50 million in shared savings and quality incentives. Learn how UnityPoint Accountable Care, L.C. decreased length of hospital stays and cost per stay, lowered re-hospitalization rates by 15%, and established a foundation for risk-based agreements.

Upon completion of this activity, participants should be able to:

  • Delineate the steps and resources needed to develop a post-acute care network that achieves improved outcomes and efficiencies in patient care
  • Explain different models used to engage skilled nursing facilities and the tools used to improve performance and monitor outcomes
  • Describe the risk-sharing financial model being used by UnityPoint Accountable Care within its network

 

Health Care on the Hill

AMGA Federal Legislative and Regulatory Update
Chet Speed, J.D., LL.M., Vice President, Public Policy, Grant Couch, Director, Government Relations, Darryl Drevna, M.A., Director, Regulatory and Public Policy David Introcaso, Ph.D., Senior Director, Regulatory and Public Policy, Christina Lavoie, J.D., Assistant Director, Public Policy and Operations, and James Miller, M.B.A., Director, Government Relations, AMGA
What are the latest updates on CMS payment models, including MACRA? What’s happening with the Affordable Care Act, Medicare, and Entitlement reform under the administration and Congress? Join AMGA’s expert advocacy team as they highlight key items on AMGA’s 2018 healthcare agenda for Congress and other regulatory agencies, as well as the critical need-to-know items that will affect your medical group in both the legislative and regulatory arenas.

Upon completion of this activity, participants should be able to:

  • Describe AMGA advocacy efforts on behalf of medical groups and other organized systems of care
  • Identify how they can participate in AMGA’s advocacy efforts

 

Friday, March 9, 3:45 p.m. - 5:00 p.m.

Leadership and Culture

Chief Executive Officer / President Presentation

“Accidental” Leadership: Leveraging Personal Perspectives
A. Marc Harrison, M.D., President and Chief Executive Officer, Intermountain Healthcare
A self-proclaimed “accidental leader,” Dr. Harrison has traveled the globe to lead teams in transforming healthcare delivery. Previously the CEO of Cleveland Clinic Abu Dhabi, Dr. Harrison became president and CEO of Intermountain Healthcare in October 2016.

Hear firsthand how his personal experiences as a distinguished pediatric critical care physician and as an oncology patient have shaped his leadership and desire to carry out Intermountain’s mission of helping people live the healthiest lives possible. Dr. Harrison will share how this mission carries into safety, quality, patient experience, access, stewardship, and engaged caregivers across its 22 hospitals, 180 clinics, and 37,000 employees in Utah and Idaho.

Upon completion of this activity, participants should be able to:

  • Describe how an organization’s mission can affect safety, quality, patient experience, access, and quality
  • Promote stewardship through effectively communication their mission
  • Promote caregiver and employee engagement in their organization’s mission

 

Leadership and Culture

Developing a Comprehensive One-Year Clinician Onboarding Program
Sherry Dunevant, M.S.N., Senior Director of Physician Services Education and Training, and Victoria Kline King, M.D., Clinical Physician Executive Clinician Onboarding and Engagement, Novant Health
To succeed as a high-performing healthcare system, strategic onboarding of physicians is paramount. No longer viewed as basic orientation, onboarding is a strategic endeavor for assimilating new providers into the organization’s culture and ensuring engagement and alignment. Learn how a medical group with over 470 clinics and 1,500 physicians across three states launched a one-year onboarding model to accelerate cultural alignment and empower a resilient physician team.

Leaders from Novant Health will describe how this comprehensive program, built by physicians for physicians, transforms organizational culture and sets the course for Novant’s future. The presentation will feature the transition from a one-day, computer-based orientation to a year-long onboarding model and the many benefits, including positive outcomes from participant surveys, feedback from practice and market leadership, and evidence of organizational engagement.

Upon completion of this activity, participants should be able to:

  • Describe how onboarding can be a vehicle for cultural immersion and a catalyst for cultural shift
  • Identify the benefits and components of a comprehensive one-year onboarding program for a medical group
  • Delineate the significance of curriculum design and delivery by physicians
  • Address the impact of early engagement with executive leaders
  • Explain the interconnection between recruitment, onboarding, and retention to drive achievement of organizational strategic goals and imperatives

 

Leadership and Culture

Chief Executive Officer / President Presentation

Passion, Purpose, and Joy: Sentara Medical Group’s Journey to High Performance
Robert “Doug” Culling, D.O., M.S., CPE, Corporate Vice President, Sentara Healthcare, President, Michael G. Charles, M.D., FAAFP, Medical Director – Clinical Quality, Michael Holtz, D.P.M., FACFAS. Clinical Chief, Musculoskeletal, Board Member & Chair of Compensation Committee, Donna E. Forrest, R.N., M.S., N.P.-C, Board Member, and Mary Sue Easmeil, Director, Patient Experience, Sentara Medical Group
All large medical groups are facing similar challenges in determining how to navigate the complex and sometimes chaotic environment in health care today. Provider organizations must simultaneously develop the competences to be successful in value-based programs, while sustaining productivity and financial success in a heavily fee-for-service payer environment. Leaders from Sentara Medical Group will articulate the specific and actionable strategies used to create a culture of high performance in clinical quality, service quality, employee and provider engagement, and mitigation of provider burnout.

The presentation will feature four sections, based on the quadruple aim: (1) MACRA quality and cost management, (2) “I am Incredible” recognition program focused on improving patient, provider, and staff satisfaction, (3) population management of high-risk patients using advanced practice clinicians and extensivists, and (4) mitigation of provider burnout with short- and long-term strategies as part of its RENEW program.

Upon completion of this activity, participants should be able to:

  • Reduce per capita costs through improved quality and cost management in the world of MACRA
  • Describe ways to improve patient experience by implementing programs similar to Sentara Medical Group’s “I am Incredible” initiative
  • Improve the health of high risk populations via an APC and extensivist model
  • Address the well-being of their providers while helping to prevent burnout

 

Technology and Innovation

Building a Winning Collaboration Between an ACO and Its Technology Partner
David Swieskowski, M.D., M.B.A., President, Mercy ACO, Iowa
As risk-based contracts become more prevalent in the market, medical groups and health systems must evaluate if their current IT systems will fully support the needs of managing an at-risk population. When the Mercy ACO launched in 2012, technology was a key priority to optimize the network and care management practices as well as to identify and reduce the amount spend on high-cost patients in its network of more than 300,000 managed patients.

Dr. Swieskowski will describe their step-by-step process to collaborate with a technology partner to implement a system that can risk-stratify patients, identify and coach low-performing providers, measure efficiency of all care operations, enable near real-time reporting, as well as significantly reduce staff time previously spent on manual data efforts.

Upon completion of this activity, participants should be able to:

  • Choose an appropriate IT engagement model
  • Explain the phase-wise IT implementation strategy
  • Optimize the network and care management practices through analytics
  • Identify and reduce the high cost drivers in the care network

 

Technology and Innovation

Leveraging Technology Infrastructure in the Transition to Value: Key Learnings from a Multispecialty Physician Group
Hank Kerschen, M.H.S.A., Assistant Vice President, Clinical Transformation, and Barry Wendt, M.D., Chief Medical Information Officer, and Assistant Vice President, Clinical, St. Elizabeth Physicians
Balancing competing priorities in a challenging payer environment where value and volume are both rewarded is a constant challenge for medical groups and health systems. Leaders from St. Elizabeth Physicians will demonstrate how its people, processes, and technologies—including EMR algorithms, integrated care coordination, population outreach, and alignment of clinical and financial data—were used to achieve success while managing their transition to value.

The presentation will feature its many successful outcomes in meeting the charge of the quadruple aim, including provider satisfaction data, quality metrics, and significant cost savings. Its efforts have contributed to $2.2 million in shared savings on a 6,000 Medicare Advantage population in 2016, as part of a two-system, multi-state ACO.

Upon completion of this activity, participants should be able to:

  • Identify the leadership structure, operational processes, and aligned incentives necessary to balance system success in competing reimbursement models
  • List the people, processes, and technologies that can be used to achieve success
  • Describe key attributes that helped St. Elizabeth Physicians transition to value-based reimbursement

 

Care Redesign and Patient Experience

Transforming Healthcare Delivery and the Patient Experience: Lessons Learned from 90,000 Shared Appointments
Marianne Sumego, M.D., Medical Director, Shared Medical Appointment Program, Cleveland Clinic
In its current state, the national healthcare system is ill-equipped to meet the demands of patient care and access. Care models, such as shared medical appointments (SMAs), require medical groups and health systems to reevaluate care delivery, organizational culture, and patient interactions. Though SMAs demonstrate significant clinical, operational, and financial outcomes, the unique nature of the model is frequently a barrier to its application.

During this interactive session, Cleveland Clinic will showcase its nearly two decades of experience with SMAs by explaining benefits and critical workflow elements. The presentation will also highlight best practices and lessons learned, drawing on the impact of Cleveland Clinic’s 90,000 SMAs.

Participants will depart with worksheets and handouts developed by Cleveland Clinic for use in their own organizations.

Upon completion of this activity, participants should be able to:

  • Describe an SMA and benefits of the care model
  • Delineate the SMA team members, roles, and workflow needed to conduct a successful SMA
  • Utilize practical tools, handouts, and lessons learned used by Cleveland Clinic

 

Care Redesign and Patient Experience

Practice Transformation: Beyond PCMH
Fran Ganz-Lord, M.D., FACP, Deputy Chief Medical Officer, Chief Medical Value Officer, and Christopher Sclafani, P.E., M.B.A., Chief Operating Officer, CareMount Medical, P.C.; and Melissa Stratman, Chief Executive Officer, Coleman Associates
Increasing administrative burden and payment reform has unintended consequences for many practices, resulting in pressure to focus on tasks and paperwork instead of patients. Leaders at CareMount Medical, P.C., a Level III Patient-Centered Medical Home (PCMH) and Medicare ACO, recognized the need for a dramatic practice transformation—not for a certification, but for their patients, staff, and providers.

Participants will learn about CareMount’s practice transformation journey and discover a framework for the dramatic and rapid overhaul of practice operations. Data and outcomes, including improved access, no-show rates, quality of care, and satisfaction, will be presented.

Upon completion of this activity, participants should be able to:

  • Describe a model for rapid and dramatic practice improvement
  • Identify strategies to improve intra-office communication
  • Describe how improved practice operations can lead to decreased call volume
  • Share insights from CareMount’s experience transforming practices and identify key metrics used to track progress

 

Care Redesign and Patient Experience

Taking Action against the Opioid Epidemic: Making a Difference through Research and Best Practice
Molly Jeffery, Ph.D., Scientific Director of Emergency Medicine Research, Mayo Clinic; and Darshak Sanghavi, M.D., Chief Medical Officer, OptumLabs

To practically address the opioid crisis, healthcare organizations need a comprehensive method to assess causes and impacts within their population. National data reveal wide variation across communities in safe prescribing practices and access to medication-assisted treatment. This session presents a new framework to measure performance and highlights needs in four areas: prevention of opioid addiction, pain management, treatment for opioid use disorder, and maternal and child health. Leaders from Mayo Clinic will illustrate their work with emergency medicine and post-operative prescribing examples. Participants will leave the session equipped to adapt these metrics to prioritize interventions and track progress at their own medical group or health system.

Upon completion of this activity, participants should be able to:

  • Apply a proven framework to measure the impact and understand the root causes of the opioid epidemic in their patient population
  • Assess the four components of the epidemic that can be addressed by provider organizations: prevention of opioid addiction, pain management, treatment for opioid use disorder, and maternal and child health
  • Use their own data to prioritize interventions and track progress

 

Efficent Operations and Finance

Medicare Annual Wellness Visits, Proactive Risk Adjustment Initiatives, Coding, and Your Bottom Line
Kimberly Kauffman, M.P.H., Chief Value-Based Care Officer, Summit Strategic Solutions, and Clyde Worley, M.D., Summit Medical Group
Medicare annual wellness visits (MAWVs) offer significant return on investment that often goes unrealized due to the perceived complexities of capturing information from the face-to-face encounter and challenges related to proactively engaging patients in wellness. When properly implemented, MAWVs can improve quality of care, enhance patient experience, decrease utilization of unnecessary services, increase quality scores, enhance patient attribution, improve fee-for-service revenue, and support accurate risk adjustment.

Discover how Summit Medical Group’s three-pronged approach of provider education, pre-visit planning, and coding support (used to accurately and consistently capture the entire disease burden of patients) is achieving an 85% completion rate with MAWV. Timelines, lessons learned, quality scores, utilization, and the bottom line results will be included. Summit Medical Group’s MAWVs have resulted in tens of millions of dollars in the medical service pool to pay for indicated medical services for 30,000 Medicare Advantage patients; improved patient satisfaction scores; and helped outperform market and national rates for ER utilization and hospital admission and readmission rates.

Upon completion of this activity, participants should be able to:

  • Delineate the impact Medicare Annual Wellness Visit completion has on quality initiatives under MACRA
  • Identify how a successful Medicare Annual Wellness Visits Program impacts fee-for-service revenue for immediate return on investment
  • Explain the relationship that Medicare Annual Wellness Visits have on the risk-adjustment factor
  • Explain how Medicare Annual Wellness Visits positively impacts patient attribution
  • Describe the three-prong approach to a successful risk-adjustment program: provider education, pre-visit planning, and coding support
  • Identify steps needed to implement a successful risk-adjustment program

 

Governance and Strategic Planning

The Strategic Benefits of an Affiliation Model
Eric Crockett, M.B.A., FACMPE, Vice Chair of Provider Relations, Mark V. Larson, M.D., Consultant, GI and Hepatology, and Georg von Bormann, Assistant Professor of Health Care Administration, Mayo Clinic
Clinical care networks can enhance patient care by sharing clinical knowledge, promote engagement and alignment by fostering provider interaction, and keep appropriate care close to home. Recognizing these benefits, the Mayo Clinic Care Network aims to help provide the benefits of best-in-class clinical expertise without necessarily having to travel to a tertiary or quaternary care facility.

This presentation will show medical groups and health systems how to achieve this goal by developing closer relationships with community medical providers through formal collaboration and tools and services that promote information sharing—a unique alternative to a merger or acquisition. Participants will gain an understanding of this unique affiliation model and identify strategies to align with partners to improve patient care.

Upon completion of this activity, participants should be able to:

  • List attributes of a clinical care network
  • Compare and contrast collaborations versus mergers and acquisitions
  • Identify and implement strategies to develop a similar community-based network care model

 

Saturday, March 10, 11:00 a.m. - 12:15 p.m.

Leadership and Culture

Chief Executive Officer / President Presentation

The Virginia Mason Production System: More than a Quality Improvement Approach
Suzanne Anderson, President, Virginia Mason Medical Center and Executive Vice President, Virginia Mason Health System
Many medical groups and health systems across the nation incorporate Lean methodology to improve patient quality and safety, yet few are able to effectively implement the concepts organization-wide. Virginia Mason Medical Center was among the first American healthcare systems to adopt Lean through the Toyota Production System, introduced as the Virginia Mason Production System (VMPS), nearly two decades ago. Session participants will learn how the group has ingrained VMPS into the fabric of its organizational culture and management, and its impact on care delivery, patient experience, finance and operations, and other areas.

Please note, this session has replaced Gary Kaplan, M.D.’s session entitled “Lessons from a Hardware Store: How Hammers and Nails Apply to Medical Group Leadership and Management.”

Upon completion of this activity, participants should be able to:

  • Identify the key decisions that have contributed to the success of the Management System at Virginia Mason Medical Center
  • Delineate other key components of a comprehensive system including, innovation, talent review/development, Respect for People behaviors, and the Patient Family Partner program
  • List current challenges and how they might be addressed using the Management System

 

Leadership and Culture

Building and Sustaining High-Functioning Care Teams
Beth Averbeck, M.D., Senior Medical Director, Primary Care, and Leslie Dockan, R.N., M.H.A., Vice President, Primary Care and Clinic Operations, HealthPartners
Building and sustaining high-functioning care teams requires a culture of continuous improvement and innovation, and consistent attention from clinician and administrative leaders. With high retention and satisfaction of clinicians and staff, top quality and experience results, and lower-than-average total care of care, HealthPartners continuously works to optimize performance and sustain high-functioning care teams to deliver on its vision of health as it could be.

This presentation will examine efforts to optimize care team efficiency and reduce time spent working through process improvement, EMR optimization and automation tools, and patient inputs. HealthPartners’ methods, results, and tips and resources on how to initiate optimizing care team efficiency to reduce time spent working and sustain high-functioning care teams will be covered. Topics highlighted in-depth may include medication refills, patient communication, pre-visit planning, documentation efficiency, and quick wins.

HealthPartners’ successes include overall provider satisfaction at the 84th percentile according to the AMGA Provider Satisfaction Benchmarking Survey, a total cost of care 10% below the statewide average, and recognition as one of six “High Performing Medical Groups in 2016 (Primary Care)” out of over 260 medical groups as reported by Minnesota Community Measurement, among many others.

Upon completion of this activity, participants should be able to:

  • Identify strategies, practical tips, and tools for building and sustaining high-functioning care teams
  • Articulate the roles of process improvement, EMR optimization and automation tools, and patient inputs
  • Evaluate your organization’s current methods to optimize performance

 

 

Technology and Innovation

Innovative Technologies in Diabetes Care
Philip M Oravetz, M.D., M.P.H., M.B.A., Medical Director, Accountable Care, and Susan Montz, B.S.N., M.B.A.,
Director, Performance Improvement, Accountable Care, Ochsner Health System

AMGA Foundation’s Diabetes: Together 2 Goal® campaign empowers AMGA members to advance management of type 2 diabetes. Learn how participating member Ochsner Health System improved A1c control by 10% through the use of innovative technology, expansion of treatment options, and implementation of non-traditional treatment methods. Presenters will describe the role of population health platforms, registries, bulk orders, virtual visits, risk stratification, engagement programs, and outreach efforts in improving care for patients with type 2 diabetes.

In addition to A1c control, these efforts resulted in significant increases in A1c testing and patient outreach and engagement.

  • Describe the impact technology can have on patient engagement and outcomes
  • Explain different and effective methods to manage diabetes
  • Provide examples of ways to leverage technology to achieve better outcomes

 

Leadership and Culture

Engaging Physicians for Successful Cultural Transformation
Scott Nygaard, M.D., M.B.A., Chief Medical Officer for Physician Services and Network Development, and Becky Pollins, ‎System Director, Culture Transformation at Lee Memorial Health System, Lee Memorial Hospital, Lee Health; and Mohamad S. Kasti, M.S., M.B.B., M.C.A., Chief Executive Officer, CTI
Both institutional and frontline clinical leaders are critical to navigating through times of uncertainty to ensure quality of care and organizational success. By engaging physicians as partners, involving them in mission-critical strategic projects, and outlining a clear plan for success, Lee Health has truly transformed their culture.

This session demonstrates how adopting best practices and processes for engaging dyad and triad leadership teams will help organizations achieve significant and sustainable clinical transformation. Learn how eight projects at Lee Health—from standardizing evaluation and treatment for admission of pediatric respiratory patients to improving communication between providers and patients—resulted in tangible improvements in physicians’ ability to effectively lead by example, drive results, develop internal teams and collaboration, lead change and foster innovation, think strategically and make sound decisions, and manage conflict in a constructive manner. Participants will leave this session with a physician engagement framework that can move your organization from its current state to the desired goal.

Upon completion of this activity, participants should be able to:

  • List symptoms of cultural weakness commonly affecting physicians
  • Describe why it is essential for physicians to participate as institutional, service-line, and frontline clinical partners
  • Explain the difference between alignment and engagement and why both are essential
  • Accurately assess the current level of engagement in their own organizations and recognize the gaps between current state and desired state
  • Follow a practical road map to engaging and motivating the right people at the right time
  • Employ best practices and processes for engaging dyad and triad leadership team

 

Technology and Innovation

MIPS Optimization for Medicare ACOs: Experiences and Best Practice
Jason Hirsbrunner, M.B.A., Chief Operating Officer, Christie Clinic, LLC; and Tom S. Lee, Ph.D., Chief Executive Officer and Founder, SA Ignite
MACRA has changed Medicare’s physician financing model in the most significant and far-reaching way since the program’s inception in 1965. This legislation will have a profound impact on healthcare financing in all sectors of our industry. Through a case study, Christie Clinic and SA Ignite will explore the drivers, experiences, and best practices of a Medicare ACO in optimizing for value-based programs, particularly the Merit-Based Incentive Payment System (MIPS), which scores ACO clinicians on a competitive 100-point performance score, impacting Medicare Part B payments and the public reputations of clinicians.

Upon completion of this activity, participants should be able to:

  • Identify MIPS performance and reporting obligations of Medicare ACOs, such as MSSP Track 1 ACOs
  • Apply knowledge of MIPS requirements, shared experiences, and best practices to draft a MIPS-optimization action plan for Medicare ACOs
  • Educate ACO leadership about the financial and reputational impacts of MIPS and operational requirements for performing well under the program
  • Inform decisions the ACO may need to make regarding future participation in Medicare ACO programs or other alternative payment models

 

Technology and Innovation

Reducing Avoidable ER Visits and 911 Transports Using Mobile Integrated Health Care
Phil Mitchell, M.D., Vice President, Medical Affairs, Medical Staff President, Centura Health - Parker Adventist Hospital; and Renae Pemberton, Executive Director CHN Provider Partnership & Network Innovation, Centura Health
Inefficiency, waste, and patient dissatisfaction are often created through inappropriate utilization of 911 transports and a burgeoning number of emergency room visits. Redefining healthcare through a unique mobile acute care delivery model that is high-tech and convenient for patients alleviates the burden on primary care providers, urgent care facilities, emergency rooms, and emergency medical services

Centura Health Physician Group partnered with a mobile and virtual healthcare company to provide an innovative 911 alternative to EMS/fire agencies, collaborate with senior living communities, integrate with nurse advice lines, and supplement care management resources available to managed/risk populations, such as ACOs and MSSPs. This presentation will focus on implementation, potential benefits for medical groups, and intricacies of mobile integrated healthcare for medical groups and health systems. To date, this approach has impacted thousands of patients in Colorado while generating over $6 million in healthcare cost savings from avoidable ER visits and 911 transports.

Upon completion of this activity, participants should be able to:

  • Explain the differences between mobile integrated healthcare, community paramedicine, home-based primary care, home health, and other similar models.
  • Describe how these models are financially sustainable and how they could potentially incorporated into medical group risk models
  • Articulate the options for clinical integrations into health systems, medical groups, clinically integrated networks, and health information exchanges
  • Detail the potential value of mobile integrated healthcare to a medical group (specialty referrals, advanced imaging, managing ED utilization, platform for in-home care, etc.)
  • Describe the paradigm shift from 911 response to MIH response to citizens through community education

 

Care Redesign and Patient Experience

SwedishAmerican’s Journey in Implementing a Pneumococcal Vaccination Program to Increase Quality While Reducing Costs
Jennifer Kuroda, Quality Improvement Manager, and Thomas Schiller, M.D., Chief Clinical Integration Officer, Chief Quality Officer, SwedishAmerican Health System – A Division of UW Health; and Elizabeth Ciemins, Ph.D., M.P.H., M.A., Director, Research and Analytics, AMGA
While vaccinations in the U.S. are low for pneumococcal pneumonia, incidences of the disease are not: nearly one million adults contract the disease every year. A pneumococcal vaccination program can yield many positive results, enabling organizations to provide preventive care and lower costs. In addition to the benefits for patient health, these vaccinations are a high-profile CMS, NQF, and NCQA HEDIS quality measure for senior adults.

This presentation will highlight successful adult immunization program strategies, quantitative/qualitative results, and a case example from SwedishAmerican Health System that may help other organizations achieve positive results in a pneumococcal vaccination program. Interventions at SwedishAmerican increased pneumococcal vaccinations in the 65+ population by over 20%.

Upon completion of this activity, participants should be able to:

  • Identify patient populations appropriate for the pneumococcal vaccination
  • List benefits of pneumococcal vaccinations from the perspectives of patient health and quality measures
  • Utilize the tools and knowledge to implement an adult immunization program for pneumococcal vaccines
  • Describe the barriers and facilitators to a successful adult immunization program

 

Care Redesign and Patient Experience

Patient-Reported Outcomes: Engaging Patients with RA to Improve Health
Ronald L. George Jr., M.D., Ph.D., Rheumatologist, Wilmington Health; Jo Ellen Feugate, M.D., Ph.D., Rheumatologist, Mercy; and Catherine Espy, Director, Provider Programs, Optum Analytics
Engaging patients in the management of chronic illness is a key component to success in risk-based contracting. Many organizations are turning to patient reported outcomes (PROs) to create a more complete view of patient progress and help patients better manage their conditions. Over the past two decades, clinicians have made dramatic improvements in rheumatoid arthritis (RA) treatment, with disease remission now considered a realistic goal for many. Understanding whether and how well treatments are working requires regularly disease activity monitoring, but most providers have infrequent office visits with their patients.

This presentation will showcase how Wilmington Health and Mercy used patient-reported outcomes to manage chronically ill patients with RA. Data-enabled technology and a standardized survey instrument (RAPID3) helped provide a more complete picture of a patient’s functional status and disease activity over time, allowing participating providers to support better care, more efficiently. Leaders will also highlight key learnings for a successful PROs initiative.

Upon completion of this activity, participants should be able to:

  • Discuss the challenges of implementing a large-scale patient engagement program
  • Delineate key elements in enabling automated collection of patient reported outcomes
  • Explain the value of a systematic approach to collecting and maximizing providers’ use of patient-reported data
  • Identify the data-related challenges of managing RA
  • Describe how the RAPID3 survey, one of six disease activity and functional status assessment instruments endorsed by the American College of Rheumatology, aids in clinically managing RA and meeting eligibility requirements for earning Medicare’s merit-based incentives

 

Efficent Operations and Finance

Transforming Operations and Physician Engagement in an Academic Outpatient Practice: Four Years of Lean
Lee McHenry, M.D., Medical Director, Medicine Outpatient Clinics, Indiana University Health Physicians , Co-chair IUHP Operations and Practice Standards Committee, Michael Ober, M.D., Vice Chair of Clinical Affairs, Department of Medicine, Indiana University School of Medicine, and Brian Kremer, M.B.A., Vice President, Practice Operations, Indiana University Health Physicians, Co-chair IUHP Operations and Practice Standards Committee; and Paul DeChant, M.D., M.B.A., Deputy Chief Health Officer, Simpler Healthcare
Have you struggled with overcoming physician entitlement to achieve significant improvement in a faculty practice? Driven by the realization that differing processes across locations, service lines, and physician practices impacted both patient care and the bottom line, Indiana University Health Physicians leadership committed to Lean process improvement. Leaders from the outpatient academic clinic will share the keys to their success in moving from chaos to quadruple aim performance by pursuing Lean transformation, based on the principles of respect for people and relentless continuous improvement.

Learn how in just a little over three years Lean transformation efforts doubled the clinic’s new patients per month, cut average visit duration in half, and improved NRC Picker overall rating of care from the 35th to the 66th percentile nationally. To date, more than 90% of clinic physicians have participated in rapid improvement event workshops and completed Lean green training.

Upon completion of this activity, participants should be able to:

  • Detail the leadership behaviors and attributes that are key to moving from physician resistance to engagement
  • Identify key factors in driving meaningful change to clinical operations in an academic outpatient subspecialty clinic
  • Implement processes for metric-driven workflow redesign with a principle-based Lean management approach

 

Efficent Operations and Finance

Generating Value Revenues at a Price Your Group Can Afford
Robert E. Matthews, Vice President for Quality, PriMed Physicians
For many groups and health systems, preparing for value care is daunting work. The costs and financial outcomes of various improvement methods can vary enormously. Group leaders are faced with the task of creating and executing a plan for value that is affordable, likely to achieve success, and capable over time of producing more revenue than it costs. Many groups that are journeying from volume to value are uncertain about what kinds of value revenue they can achieve and what methods to improve performance will work well.

This session will emphasize the importance of volume-to-value planning with the goal of finding the best revenue opportunities and the least-expensive, most-effective methods. Various methodological options will be categorized to help you achieve success on a budget you can afford. Participants will depart equipped to evaluate, select, and develop effective methods to achieve carefully defined goals.

PriMed Physicians has, from the start, been able to generate value income in excess of its costs to implement improvement programs. In PriMed Physician’s first year of value contracts, total revenues for value (above fees) was $4.3 million, of which more than 25% was net profit. Its quality programs have shown tremendous success; PriMed ranks as the top performer for Measure Up/Pressure Down®, Together 2 Goal®, and the American Academy of Pediatrics’ asthma campaign.

Upon completion of this activity, participants should be able to:

  • Identify several models of quality improvements and to match such models with the appropriate goals
  • Organize a planning process to plot their health system’s journey from volume to value
  • Break cost and quality improvement into segments that make the planning of value care more manageable

 

Saturday, March 10, 2:00 p.m. - 3:15 p.m.

Leadership and Culture

Improving Provider Communication: Lessons from the Creation of a Coaching Network
J. Scott Taylor, M.D., Medical Director of Service Excellence, MultiCare Health System; and Mike Nelson, M.D., Physician Coach, Studer Group
For a large, integrated healthcare system, making improvements to patient experience system-wide can be a challenging and seemingly impossible task. Effective physician/advanced practice provider communication is critical to safety, quality, and patient experience. While new graduates receive training and competency testing for patient communication skills, most experienced physicians have limited training, if any.

This session explores MultiCare Health System’s journey to create a successful Provider Coaching Network. Participants will learn how to build a network of coaches, train coaches, and develop strategies to reach frontline providers. The presenters will also share steps to success, identify real-world pitfalls to avoid and how to empower coaches to succeed and frontline clinicians to improve, and provide tools and resources to leverage within your organization.

Upon completion of this activity, participants should be able to:

  • Describe the essential elements needed to create a physician/APP coaching network
  • Verbalize two strategies for training effective physician/APP coaches
  • Identify two of the most important components of great physician-patient communication

 

Technology and Innovation

Reducing Clicks to Combat Provider Burnout: Strategies for EHR Efficiency
Michael Sheinberg, M.D., Medical Director, Medical Informatics, and Jennifer Schlegel, M.S.N., R.N., Senior Business Analyst, Enterprise Analytics, Lehigh Valley Health Network
While the EHR has revolutionized the quality of care delivery, its contribution to the growing provider burnout epidemic in our country is well documented. Optimizing the utilization of the EHR by using standard work, efficient processes, and automated data capture can significantly impact provider satisfaction and associated workload.

Lehigh Valley Health Network will detail how it has heavily leveraged analytics to drive both system and individual focus for change and adaptation. Informatics experts will explore the link between EHR efficiency/satisfaction and provider burnout, highlight data analytics used to measure provider competence and productivity, and discuss effective countermeasures. Participants will learn standard processes, electronic tools, and governance strategies that can be employed by your organization to successfully maximize provider efficiency and reduce burnout associated with the EHR.

These efforts have significantly improved time saved by providers, as well as provider and patient satisfaction.

Upon completion of this activity, participants should be able to:

  • Describe the associations linking use of the electronic health record (EHR) to provider burnout and inefficiency
  • List the data and reporting analytics that are effectively used to measure provider competence and productivity in the EHR
  • Discuss the standard processes, optimization tools, and accountability strategy needed to improve provider efficiency and decrease burnout

 

Technology and Innovation

Driving with a Dashboard: Engaging Providers with Actionable Data for Population Health Performance
Dan Hager, M.H.A., Director, Clinical Performance and Integration, Kyle Moore, C.P.A., Vice President, Ambulatory & Home Care, and Ronnie Oestreicher, Enterprise Director, ConnectCare (Epic) Design/Build, Bon Secours Health System, Inc.
Like many healthcare systems, Bon Secours Health System, Inc. struggled with engaging its employed providers in driving population health performance, due in large part to the significant variations in the measurement and communication of provider performance. The variability limited achievement of population health outcomes due to a lack of easily accessible information and actionable tools for clinicians.

Learn how Bon Secours created the Ambulatory Four Quadrant Dashboard, a dynamic tool within the EMR that displays key performance indicators in clinical quality, patient experience, access, and cost, with the ability to drill down to actionable levels of detail in three clicks or fewer. The indicators align with the system’s strategic quality plan and annual board-approved goals, as well as pay-for-performance commitments, including MIPS.

Built through a rigorous clinician-led process, the dashboard has experienced high use—provider dashboard utilization nearly tripled in its first month of implementation—and is helping leaders drive system success. Practice- and executive-level visualizations enable other care team members and all levels of leadership to be engaged in driving population health performance within a common performance measurement ecosystem.

Upon completion of this activity, participants should be able to:

  • Apply best practices for engaging providers through performance measurement and communication via performance-enhancing tools
  • Organize technical development activities that optimize provider utilization upon implementation
  • Drive performance through identification of connections between quality strategies, clinical workflow, and technical tools to drive performance

 

Care Redesign and Patient Experience

Interactive Session

Improving Patient-Centered Communication When HIPAA Regulations Won’t Allow Lapel Cameras
Hilary Hoekenga, M.B.A., M.H.A., Director Clinic Operations, and Gregory Carlson, MD, Medical Director, UCHealth Medical Group; and Shay Bright-Mouttet, Ph.D., Senior Organizational Development Consultant, University of Colorado Health
In order to make meaningful improvement to any dataset, medical groups and health systems must provide the tools and sustain their commitment to improvement, not just measure and re-measure. In a strategic effort to improve patient satisfaction scores, providers requested lapel cameras for individualized, interactive feedback. With concerns around HIPAA regulations, the compliance team rejected the idea.

In response, University of Colorado Health launched a successful pilot patient-centered communication program (PCCP), in which patient-provider interactions were observed and providers received significant feedback, including metrics and recommendations for improvement. Presenters will highlight program details, lessons learned, and outcomes, and lead an interactive patient appointment scenario.

Patient satisfaction scores improved, as did individual provider performances in categories including listening, understandable answers, respect, and knowledge of medical history. The pilot was so successful that University of Colorado Health will have an employed resource to perform these observations and expand the programs.

Upon completion of this activity, participants should be able to:

  • Identify communication behaviors to utilize during patient appointment
  • Implement the behaviors in future appointments
  • Create a tangible resource to refer back to for improvement
  • Establish a patient-centered communication program in their medical group or health system

 

Care Redesign and Patient Experience

Interactive Session

Opioid Safety: How to Improve Opioid Prescribing at Your Organization
Kent Hu, M.D., M.P.H., Associate Medical Director of Quality and Patient Safety, and Dianna Chamblin, M.D., Facility Medical Director Comprehensive Pain Center, The Everett Clinic
In 2015, opioids killed more than 33,000 people across the nation, averaging nearly 100 deaths per day. The rate has nearly quadrupled since 1999. Medical groups and health systems have the unique ability to influence the safe prescribing of opioid medications and impact patients who may suffer from addiction, reducing overdoses and death. Located within an epicenter of the opioid epidemic in Washington, The Everett Clinic will describe its journey to improve the safety of chronic opioid therapy. The presentation will feature the three-pronged approach of appropriate pain control, safe opioid prescribing, and identification and management of high-risk groups.

Significant improvements in opioid prescribing since the program launched in September 2016 will be highlighted. Only 1.3% of patients at The Everett Clinic are on chronic opioids, among the lowest rates reported by other area multispeciality groups. Patients managed by pain specialists have doubled, while rates for walk-in clinic opioid prescribing and opioid prescriptions by surgeons have declined by 26% and 27%, respectively.

Following the lecture, session participants will brainstorm barriers and solutions and identify concrete action items to catalyze change.

Upon completion of this activity, participants should be able to:

  • Describe the role of providers and healthcare leaders in solving the opioid epidemic
  • Promote key strategies to moving forward with safe opioid prescribing within their organizations
  • List actionable next steps to improve opioid prescribing
  • Maintain focus on culture and systems

 

Care Redesign and Patient Experience

Interactive Session

Transitioning to Value-Based Care Through System-Level, Evidence-Based Guidelines
Elizabeth Crabtree, Ph.D., M.P.H., Director, Clinical Integration and EBP, Assistant Professor, Department of Medical Informatics and Clinical Epidemiology, and Thomas Yackel, M.D., M.S., M.P.H., Chief Value-Based Clinical Officer, and Professor, Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University
Patient safety and quality initiatives based on the best available advice are driving factors for academic medical center designations. Ideally, patient care decisions are always based on the best available scientific evidence; in reality, however, this is not the case. Scientific evidence often takes 15 to 20 years to be widely accepted and incorporated into routine patient care. Applying principles of evidence-based care into everyday practice can be challenging in the workflow of busy clinicians. Equally challenging to practitioners in the burgeoning information age is the need to quickly and efficiently locate information through health information technology and appraise and apply it to patients in a rigorous, valid, and reliable manner.

Presenters will describe how Oregon Health and Science University , an academic medical center, partnered with community hospitals to create a value-based care organization, and how the development and implementation of system-level, evidence-based guidelines is supporting this effort. Implementation efforts include: Adult Cystic Fibrosis Pain and Anxiety Management; Adult Safe Opioid Prescribing for Chronic, Non-End-of-Life Pain; Supplemental Feeding in Healthy, Term Neonates; Colorectal Cancer Screening; Heart Failure; Low Back Pain; and Dialysis.

Participants will learn best practices for defining criteria for prioritizing topics for guideline development and in forming practice recommendations and consensus statements based on synthesized evidence, clinical expertise, and patients’ values and preferences. A hypothetical team-based exercise during the session will highlight how patients’ values and preference, local data, and clinical expertise are used in shaping practice recommendations and consensus statements.

Upon completion of this activity, participants should be able to:

  • Explain strategies to prioritize topics for guideline development
  • Describe the essential steps in creating a clinically integrated health system with system-level, evidence-based guidelines
  • Discuss the challenges and barriers in transitioning from a volume-based to value-based organization
  • Identify how to apply evidence tables, patient population and local data, practice setting information, patients’ preferences and values, and clinical expertise to develop clinical practice recommendations

 

Efficent Operations and Finance

Aligning Provider Incentives in Risk-Bearing, Value-Based Contracts
Amber Lenhardt, C.P.A., Executive Director, Finance and Network Development, and John Ubben, Manager, Network Services, UnityPoint Accountable Care
Recognizing that current fee-for-service reimbursement models were on an unsustainable path, UnityPoint Accountable Care (UAC) sought to engage payers in value-based contracts that rewarded providers for activities that improve the quality of patient care, yield better patient experiences, and reduce per capita healthcare costs. Learn about UAC’s Funds Flow Model, launched in early 2016, which provides for distribution of shared savings and allows providers to assume a tolerable amount of risk in value-based contracts. The model encourages higher performance in focused areas of opportunity and puts UAC on the path to more continued success in value-based contracts.

In its first performance year distributing Global Incentive Funds and Shared Savings/Losses, UAC has seen a 20% increase in the use of Participant Provider Skilled Nursing Facilities and witnessed increased efforts from providers to improve performance on the quality and utilization measures that comprise the FFM.

Upon completion of this presentation, participants should be able to:

  • Identify the process UAC followed to engage physicians in creating a risk sharing model with an acceptable amount of risk
  • Describe initial pitfalls and points of consideration made during the development stages
  • List creative ideas on how to balance the financial risk in value-based contracts with new financial reward systems introduced under the Advanced APM designation within MACRA

 

Governance and Strategic Planning

Under Siege: Preparing an Academic Medical Center for Population Risk
Mark Behl, M.H.A., M.B.A., Chief Operating Officer, Clinical Practice Organization, UC San Diego Health
In the face of growing pressure to deliver value-based care, academic medical centers (AMCs) must redesign their delivery model to address consumerism, risk-based contracts, and shrinking funding sources. Healthcare payers, employers, and consumers are no longer willing to absorb the higher cost structures built within AMCs.

This presentation by UC San Diego Health highlights the journey of one organization to transition from a traditional AMC to a high-performing, clinically integrated, and team-based delivery model that is responsive to the external realities, while preserving the tripartite mission of delivering outstanding patient care, education, and research. Learn how UC San Diego Health is addressing funds flow, governance, Lean process improvement, and strategic planning to become a strong system positioned for the future of health care.

Upon completion of this activity, participants should be able to:

  • Identify the perceived strengths and challenges of the traditional AMC model
  • Create a roadmap to transition from the traditional AMC model to a new organizational model prepared for the future
  • Involve physicians, staff, and patients in the development of a primary care strategic plan
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