Agenda: Friday, October 1

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 Exhibitors

8:00 a.m. – 9:00 a.m. General Session: Payment Reform and the Future of the ACO Model
Lawrence Casalino, M.D., Ph.D., Chief, Division of Outcomes and Effectiveness Research, Weill Cornell Physician Organization; Martin Hickey, M.D., M.B.A., Chief Accountable Care Officer, Alegent Health Clinic; Richard A. Maturi, Senior Vice President, Health Care Delivery Systems, Premera Blue Cross; and Nicholas Wolter, M.D., Chief Executive Officer, Billings Clinic
In this interactive panel discussion, the speakers will discuss the implications of the Patient Protection and Affordable Care Act on reimbursements to medical groups and ACOs, touting the benefits of the ACO model. Panelists will share their views on payment reform and their possible effect on healthcare delivery. In addition, the audience will hear about edPAC deliberations, decisions, and the political dimensions of the process.

9:00 a.m. – 10:00 a.m. Peer-to-Peer Track Sessions

Governance

The Importance of Governance in Leading the ACO Vision
Mark C. Rumans, M.D., Physician in Chief, and F. Douglas Carr, M.D., M.M.M., Medical Director, Education and System Initiatives, Billings Clinic
Like most physician/hospital integrations, Billings Clinic experienced significant challenges due to cultural differences between the clinic and hospital that almost defeated the plans to merge the clinic and its partner hospital. What saved the merger was a reorganization of their governance into a physician-led, professionally managed community healthcare system. With hospitals and physicians again considering various levels of integration in order to qualify as an ACO, Billings Clinic’s successful governance model presents a roadmap for other physician group and hospital alignment strategies. Dr. umans and Dr. Carr will discuss lessons learned in translating the governance model into a new reality, an “emergent” approach to a merger, and the critical issue of trust in the development of culture.

Aligning Incentives

University of Utah Health Care: Utah Demonstration Project and How We Aligned with the Principles of Accountable Care Organizations
Robin L. Lloyd, M.P.A., Executive Director, Ambulatory Services & Community Clinics; and Julie Day, M.D., Medical Director for Quality, University of Utah Health Care: Community Clinics
Presenters describe participation in the development of a multi-stakeholder, statewide demonstration project; and the process and challenges involved in creating a broad-based project that is aligned with the principles driving Accountable Care Organizations.
Upon completion of this activity, participants should be able to describe the nature of a collaborative demonstration project that aligns payment models with Accountable Care Principles and delineate how specific Accountable Care Elements can be developed within a Group Practice.

Care Coordination

Advocate Health Care: Developing the ACO Infrastructure Uniting Employed, Independent and Large Group Practices
Lee Sacks, M.D., Executive Vice President, Chief Medical Officer, Advocate Health Care and President, Advocate Physician Partners; Mark Shields, M.D., Senior Medical Director, Advocate Health Care
The presentation will focus on the infrastructure necessary to unite primary and multi-specialty, employed and independent physician practices of all sizes. The information provided is derived from a proven model of care developed and managed by Advocate Physician Partners. The session will include details on structure, governance, pay-for-performance and technology.
Upon completion of this program, the participants should be able to design an infrastructure supporting a clinical integration program for independent and employed providers; including physician membership requirements and techniques for managing change within the physician practices; understand the regulatory issues impacting program design; identify key clinical issues, describe various techniques for their improvement, and understand their application and the synergies they create; negotiate pay-for-performance incentives to support their clinical improvement efforts, aligning incentives and maximizing reimbursement; and understand the impact of the clinical integration program as a chassis for an Accountable Care Organization.

Organizational Structure

Western Washington Medical Group: Establishing a Strategic Path for Partnering
Jerry Tillinger, M.B.A., M.H.A., CEO, Western Washington Medical Group; and Max Reiboldt, CPA, President/CEO, Coker Group
Proper planning is necessary to ensure the success of any alignment. New models are surfacing to support these newly aligned physician-hospital relationships. However, choosing and adapting the most appropriate alignment model that encourages the full and successful continuum care for your patients is imperative. In light of the need for long-term planning and integration strategies, this session embraces compensation and fair market value, “employment lite,” viable equity models, equity joint venture structure, and related compliance issues specifically focused towards the concept of accountable care organizations.
Upon completion of this activity, participants should be able to investigate regulatory/legal trends in employment including contractual issues; explain the correlation between compensation and practice valuation and define fair market value and the fair market value opinion process.

10:00 a.m. -10:30 a.m. Refreshment Break in Exhibit Hall

10:30 a.m. -11:30 a.m. Peer-to-Peer Track Sessions

Aligning Incentives

Lessons Learned as a CMS Group Practice Demonstration Project Group Leader
Barbara A. Walters, D.O., M.B.A., Senior Medical Director, Southern NH Community Group Practices, and Sheila Johnson, R.N., M.B.A., Director of Clinical Performance, Dartmouth-Hitchcock Clinic
The CMS Physician Group Practice Demonstration Project is regarded as the model for a successful ACO program and believed to be the driving force behind ACO legislation being included in health reform. This presentation will apply best practices from one of the participants in the demonstration project. Dr. Walters will discuss the improvements in care coordination, quality of care and financial savings that have been achieved in the demonstration project that could be applied in creating an ACO, as well as lessons learned on reimbursement methodologies and aligning incentives from a five-year project that would cement the link between compensation and results.

Care Coordination

ACO in Action: Care Coordination at the Intermountain Medical Group
Linda Leckman, M.D., FACS, Vice President, Intermountain Healthcare and CEO, Intermountain Medical Group
One of the administration’s goal with health reform legislation over time is to encourage organizations to go to the Accountable Care Organization concept, meaning physicians and hospitals and other caregivers working together to meet the needs of the patient. Intermountain Healthcare has been recently touted by President Obama and for years by many others as an industry leader in coordinating care to meet the needs of patients. In this presentation, Dr. eckman will discuss Intermountain’s care coordination processes and how incorporating them into your DNA is a key component to achieving recognition as an ACO.

Organizational Structure

Putting “Accountable” into Accountable Care Organization
David L. Bronson, M.D., FACP, President, Cleveland Clinic Regional Hospitals
The Cleveland Clinic is known as one of the nation’s leading integrated systems of care, often cited by President Obama as an example of his vision for healthcare reform. Dr. Bronson will describe how the clinic's governance and organizational structure supports a system of operational accountability that drives improved performance and puts value as its top priority.

11:30 a.m. – 12:30 p.m. Networking Lunch with Exhibitors

12:45 p.m. – 1:45 p.m. Peer-to-Peer Track Sessions

Regulatory Issues

AMGA ACO Regulatory and Legislative Update
Chester A. (Chet) Speed, J.D., LL.M., Vice President, Public Policy; George H. Roman, Senior Director of Health Policy; and Karen S. Ferguson, Associate Director of Regulatory Affairs
AMGA policy staff will present a town hall discussion with participants to review up-to-date regulatory and legislative activity from within the nation’s capital. At the conclusion of this discussion, members of the audience will be well informed about the regulatory process and its elevated importance in the health reform advocacy realm, and be provided an overview of AMGA’s legislative priorities and regulatory strategic plan.

Legal Issues

Legal Issues and Answers
C. Frederick (Fred) Geilfuss, J.D., Partner, Foley & Lardner LLP; and Martin Hickey, M.D., M.S., Chief Accountable Care Officer, Alegent Health Clinic
While the ACO provisions were included in the Patient Protection and Affordable Care Act (PPACA), there is still much to be determined regarding the definition and legal framework actually governing the establishment and operation of ACOs. In your organization’s journey to an ACO, you’ll need to carefully navigate a variety of legal and governance issues, including antitrust law, antifraud law, governance and organizational structure requirements related to exempt organizations, as well as a cadre of compliance and state licensure requirements. This presentation will address the practical and legal challenges to implementing ACOs and detail the steps your organization should take to prepare for this process.

Aligning Incentives

Leveraging Analytics and Comparative Data to Position Your Organization as an Accountable Care Organization and to Succeed Under a Value-Based Purchasing System
A.G. Breitenstein, J.D., M.P.H., Vice President & General Manager, Provider Markets, Humedica; John Cuddeback, M.D., Ph.D., Chief Medical Information Officer, Anceta; and Abe Levy, Chief Medical Services Officer, Mount Kisco Medical Group
Ultimately, umedica MinedShare™ Ambulatory and the Anceta Comparative Data Warehouse (CDW) will help AMGA members to become high-performing care organizations and qualify as ACOs by allowing AMGA organizations to: analyze comparative data to identify opportunities to deliver improved patient care, i.e. identify opportunities to lower the hospital readmission rates for Type II diabetes patients; use comparative data to propose value sharing arrangements with payers; structure reports to measure and monitor targeted improvement; and use ongoing reports to maximize improvement and report results for enhanced payment. Mount Kisco Medical Group will discuss why their organization signed on to participate in the Anceta CDW, what they hope to gain from participation, what they have seen so far and how they hope to use Humedica MinedShare™ Ambulatory most effectively to improve care delivered in and the financial performance of their organization.

1:45 p.m. – 2:00 p.m. Refreshment Break

2:00 p.m. – 3:00 p.m. General Session: Expanded Roundtable Discussion on ACOs
Robert E. Nesse, M.D., Chief Executive Officer, Mayo Health System; Mark Werner, M.D., Chief Medical Officer, Carilion Clinic; and Karl Ulrich, M.D., President and Chief Executive Officer, Marshfield Clinic
In the tradition of the IQL, the conference will conclude with an open-mike discussion of the implications of ACOs and their impact on the healthcare industry. The panelists from the earlier general session will return to offer their thoughts and to lead a discussion on the conference’s presentations as well as a look ahead at a world in which ACOs are the leading model for healthcare delivery.

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