Agenda: Thursday, September 30

Institute for Quality Leadership Annual Meeting
September 29 - October 1, 2010 | Westin Diplomat, Hollywood, Florida

7:00 a.m. – 8:00 a.m. Continental Breakfast with the Exhibitors

8:00 a.m. – 10:00 a.m. General Session: Leading the Journey to an ACO
Robert E. Nesse, M.D., Chief Executive Officer, Mayo Health System; John H. Cochran, M.D., FACS, Executive Director, The Permanente Federation, Kaiser Permanente; Mark Werner, M.D., Chief Medical Officer, Carilion Clinic; and Karl Ulrich, M.D., President and Chief Executive Officer, Marshfield Clinic
In this interactive panel discussion, participants will hear leaders of some of the nation’s foremost ACOs describe their specific organization’s journey to become an ACO. Panelists will highlight their experiences with governance, aligning incentives, patient care coordination and how organizational structure was necessary to their success as an ACO.

10:00 a.m. - 10:45 a.m. Refreshment Break in Exhibit Hall

10:45 a.m. - 11:45 a.m. Peer-to-Peer Track Sessions

Governance

Lehigh Valley Physician Group: Redesigning Organizational Structure for Optimal Patient Care
Mark Wendling, M.D., Associate Medical Director, Performance Improvement; and Michael Sheinberg, M.D., Associate Medical Director, Medical Quality, Lehigh Valley Physician Group
The drive for optimal patient care results is challenged by internal and external forces. Lehigh Valley Physician Group has gone through a series of steps to redesign their organizational structure to optimize patient care while remaining financially vital. Operationally, they have partnered director-level physician leaders with administrative leadership in all clinical departments. The strength of this dyad of management extends throughout the organization to the practice level. Changes have allowed the group to expand its previously developed registries from PQRI reporting to patient population management at the practice level.
Upon completion of this activity participants should describe how our organization faced internal and external challenges to redesign our organizational structure promoting optimal patient care results.

Aligning Incentives

WellStar/Humana Patient-Centered Medical Home Pilot: Accelerating Improved Patient Outcomes through Key Stakeholder Partnerships and Collaboration
Jacqueline R. Hayes, R.N., B.S.N., Executive Director of Clinical Services, WellStar Physicians Group; Marcia L. Delk, M.D., M.B.A., Senior Vice President Medical Affairs, Chief Quality Officer, WellStar Health System; and Christopher Corbin, M.B.A., Program Manager, Clinical Guidance Organization, Humana
The session is a case study describing how WellStar, working collaboratively with Humana and other key healthcare industry partners, leveraged their diabetes quality improvement initiatives to transform two busy primary care offices into patient-centered medical homes that are well positioned for transition to an ACO. Highlights will include practical lessons learned of how to improve patient care and gain improved outcomes through this unique collaboration.
Upon completion of this program, participants will gain insight into innovative ways to leverage community partners to achieve improved patient care and health outcomes; learn practical ways to use Quality Goals and Outcomes to secure physician engagement in quality improvement initiatives; learn about opportunities to expand data capabilities and perspectives through payer collaboration; increase understanding of how to successfully transition practice quality programs to a full Patient Centered Medical Home Model concept; and gain insight into the use of the EMR in measuring quality outcomes.

Care Coordination

Virginia Mason Medical Center: Team Medicine Begins a Transformative Journey to Becoming an Accountable Care Organization
Ingrid Gerbino, M.D., FACP, Section Head, Virginia Mason Medical Center, Lynnwood; and Carolyn Cone, Program Manager, Virginia Mason Medical Center
This presentation will describe how VMMC primary care teams have been on a journey to transform their practices into an efficient, effective, high-quality and sustainable delivery system within a large, multispecialty, vertically integrated organization. The elements of this transformation will be described, and participants we will be challenged to articulate and assess the milestones in their own transformational journeys.
Upon completion of this activity, participants should be able to recognize some of the elements required of an Accountable Care Organization; understand how the VMMC primary care delivery system has utilized an agreed upon management method and other tools to transform itself into an essential part of an Accountable Care Organization; and articulate both the precipitators as well as the barriers to becoming an Accountable Care Organization which may exist in one’s home organization.

Organizational Structure

Delivering Value: How Integration Can Position Your Practice for Long-Term Success
John M. MacKeigan, M.D., Chair of the Board/Chief Medical Officer, Spectrum Health Medical Group; and Joshua D. Halverson, M.H.A., Senior Manager, ECG Management Consultants, Inc.
Organizations that coordinate decisions across specialties and services have the greatest potential for delivering value to purchasers of health care. In an environment where value is rewarded, high-functioning multispecialty practices are positioned for a strategic advantage. This presentation provides a detailed case study of how a large multispecialty practice transformed itself to an integrated practice and the benefits to patients and to the organization’s viability from the transition.

11:45 a.m. – 12:45 p.m. Lunch with Exhibitors

1:00 p.m. – 2:00 p.m. Peer-to-Peer Track Sessions

Governance

Holzer Clinic and Charis Healthcare: Why Align with a Hospital?
G. Patrick Connors, FACHE, CEO, Holzer Clinic; and Craig Anderson Sr., Senior Partner, and Craig Anderson Jr., Senior Manager, Charis Healthcare
This presentation will explore the lessons learned in evaluating strategic options to improve the delivery of healthcare across the care continuum. Holzer Clinic and Holzer Health Systems agreed to create a physician-led, integrated, foundation model organization. The presenters will explain the process and lessons learned during the transitional period starting in May 2008. Today, the organizations have developed a functional transition model while it seeks financial funding to finalize the foundation model.
Upon completion of this activity, participants should be able to describe local and national healthcare trends and reform impacting group practice alignment with hospital systems; discuss alignment models and their advantages and challenges; describe lessons learned by Holzer Clinic in evaluating and negotiating the creation of a physician- led foundation with a hospital system; delineate critical success factors in aligning two organizations; describe how to lead 100 physicians in support of a significant strategic change and describe the legal, economic and change management critical success factors.

Aligning Incentives

Geisinger Health System: Payment Reform and Setting a Course for Success with Accountable Care Organizations
Seth Frazier, Vice President, Transformation, Geisinger Health System; and Mike Nugent, Director, Navigant Consulting, Inc.
Here are the greatest opportunities/risks for medical practices in a payment reform environment and how practices need to prepare. The presentation will consist of three sections, with questions welcomed throughout, followed by a panel discussion with Q&A: (1) state by state payment reform inventory and common themes; (2) worst/best case scenarios by type of practice; and (3) how practices need to prepare now (first movers, fast followers, wait-and-see strategy).
Upon completion of this activity participants should be able to understand what federal and state public payers are doing in the professional & facility payment reform arena (e.g., new value based fee schedules, pay for performance initiatives, ACOs) and lessons learned; understand what commercial payers (e.g., BCBS, others) are doing in the professional & facility payment reform arena (e.g., new value based fee schedules, pay for performance initiatives, ACOs) and lessons learned; recount case studies of how large physician groups are preparing for payment reform and ACOs―including ACO pilots, bundling demonstrations, compensation model design changes.

Care Coordination

PriMed Physicians: Achieving Breakthrough Chronic Disease Outcomes
Robert E. Matthews, Executive Director; Douglas Romer, M.D., Family Practice Physician and Chairman of the Board, PriMed Physicians
National outcomes reveal that many medical groups achieve moderate success in, for example, disease management outcomes, but only a very few achieve breakthrough success rates. The presenters will discuss the features of PriMed’s approach to quality improvement that have led to its higher success rates as compared to the efforts from highly respected medical groups around the country; discuss the challenges that medical groups experience in engaging their physicians in an effort to achieve breakthrough experience across many diseases; and examine some of the unforeseen challenges that they are experiencing as they roll out additional quality processes related to chronic diseases and wellness/prevention objectives.
Upon completion of this activity, participants should be able to define characteristics of medical group efforts that achieve modest performance improvement versus those efforts that achieve breakthrough performance improvements; identify the cultural challenges that occur when medical groups attempt to achieve breakthrough performance as compared to moderate performance improvements; identify the major challenges posed when attempting to “spread” breakthrough performance to additional medical quality projects (i.e., additional disease states).

Organizational Structure

Northwest Physicians Network and Physician Health Partners: Implementing a Virtual Accountable Care Organization
Rick MacCornack, Ph.D., Chief Systems Integration Officer, and Scott Kronlund, M.D., Chief Medical Officer, Northwest Physicians Network; and Jay Want, M.D., Chief Executive Officer, Physician Health Partners
The basis of ACO thinking is rooted deeply in managed care logic which developed over 25 years ago. Added to this are the capabilities of health information technology, an accruing experience in managing populations of people living with chronic conditions, and the renewal of interest in a well-developed primary care system as the center of the care process. This session will apply ACO principles as a virtual model, illustrating the work of Northwest Physicians Network and Physician Health Partners in making a virtual model a reality.
Upon completion of this activity, participants should be able to describe the emergence of ACO thinking out of managed care logic; define the functional elements of an ACO; describe key elements of a virtual ACO and identify critical elements of long term financial and operational sustainability that need to be resolved; distinguish between an ACO’s structural functions and the behavioral requirements of its participants; describe why an ACO structure may be of benefit to improving patient care; describe the potential problems of institutionalizing the ACO model; describe the opportunities to improve the quality of patient care using the ACO model without increasing the cost of care.

2:00 p.m. – 2:30 p.m. Refreshment Break in Exhibit Hall

2:45 p.m. - 3:45 p.m. Peer-to-Peer Track Sessions

Governance

The Road to Integration and an ACO: Leveraging Culture & Leadership
Donn E. Sorensen, M.B.A., FACMPE, Executive Vice President, St. John's Health System
High cost, limited access, sub-optimal quality outcomes, and physician workforce shortages are but a few of the challenges facing the healthcare industry today. One response has been to integrate large multispecialty group practices with hospitals, but few have been able to achieve the full potential of this relationship. This session will educate participants on the driving market forces behind integration, and the key characteristics of an effective and synergistic model to better serve and provide value to the community, patients, physicians, and health system. Ranked as one of the top three integrated health systems in the nation, St. John's Health System has built a strong physician-led and professionally-managed integrated system comprised of a 550-physician multispecialty medical group, 1 tertiary and 5 regional hospitals, and a health plan. Learn how application of these integration principles took this organization from a failed model of integration in the 1990s to a nationally recognized leader in large multispecialty group practice/hospital integration positioned for full participation as an ACO.

Aligning Incentives

The Everett Clinic: Our Journey toward an Accountable Care Organization
Albert W. Fisk, M.D., Chief Medical Officer, and Jennifer L. Wilson-Norton, Director of Pharmacy, The Everett Clinic
This presentation will outline The Everett Clinic’s path toward becoming an ACO, including its experience with the CMS Physician Group Practice Medicare Demonstration Program. It will also describe a pilot program with the Boeing Corporation which lowered that employer’s cost of care for the pilot population, as well as using lean principles and key lessons from these programs to produce a standard approach to adding value in the care of complex patients.
Upon completion of this activity, participants should be able to describe key lessons learned in improving quality, cost effectiveness and patient satisfaction for complex patients in a model that prepares an organization for success as an ACO.

Care Coordination

Geisinger Health System: Engaging Hospital, Physician, and Community Partners
Frederick J. Bloom Jr., M.D., M.M.M., Assistant Chief Quality Officer; and Thomas R. Graf, M.D., Chairman, Community Practice Service Line, Geisinger Health System
Geisinger Health System has implemented a successful Patient-Centered Medical Home model at 30 Geisinger sites and 5 non-Geisinger practices, improving the care of more than 200,000 patients. In addition, they functioned as an accountable care organization in the five-year Medicare Physician Group Practice demonstration project. These experiences have resulted in a clear understanding of the issues of importance to both PCMH and hospital partners in an ACO. Successful implementation of the new model has required using these lessons learned to engage and support the 14 community hospitals in its rural service area.
Upon completion of this activity, participants should be able to describe the organization of a Patient Centered Medical Home (PCMH) and the differences of an accountable care organization (ACO); identify the issues of importance to both PCMH and hospital organizations in forming an ACO; leverage the tactics of successful medical home interventions at the local level to drive hospital organizational change; list the specific activities that will drive quality improvement, patient engagement, and reduce cost in an ACO; develop other important partners beyond the primary care office and hospital with specialty physicians, nursing homes and home health agencies to expand the ACO structure; utilize performance compensation methods to support the new organizations from pilot stage to full implementation; discuss the unique challenges of various practice environments―integrated health system, community hospital, non-integrated physician partners―and methods to overcome these challenges.

Organizational Structure

Dean Health System: Leveraging Clinical Integration to Create Value in a Virtually Integrated Delivery System
Craig Samitt, M.D., Chief Executive Officer, Dean Health System; and Carole Black, M.D., Valence Health and Karen Hohenstein, Directors, Navigant Consulting, Inc.
Dean Health System/SSM-Wisconsin, a virtually Integrated Delivery System/ACO, embarked on a successful journey to Excel at Value-Based Care. Presenters will describe the Medical Cost Trend Initiative to identify opportunities for improving care efficiency/effectiveness, and to implement systematic interventions for “bending the trend” while enhancing care delivery that saved approximately $10 million in one year. The presentation will also describe Dean’s strategic imperative to improve efficiency and effectiveness of operations and care delivery programs, and the opportunity assessment process; the improvement framework; the implementation of care coordination best practices; and lesson learned.
Upon completion of this activity participants should be able to understand a systematic approach for identifying and assessing opportunities to improve Medical Cost Trend by enhancing care efficiency and effectiveness; demonstrate a successful strategy for implementing multiple simultaneous system-wide clinical improvement projects in a virtual IDS/ACO, driving to results; specify key elements of clinical integration for productively engaging physicians and executing value-based initiatives.

4:00 p.m. - 5:00 p.m. General Session: 2010 Acclaim Award Winner
This presentation will feature the recipient of the 2010 Acclaim Award, AMGA's most prestigious quality award, presented annually by the American Medical Group Foundation, honoring physician-directed organizations that bring the American healthcare system closer to a delivery model in which patients experience care that is safer, more reliable, more responsive, more integrated, and more readily available.

5:00 p.m. - 6:00 p.m. Happy Hour with the Exhibitors

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