Peer-to-Peer Sessions

Developing Paired Leadership
Paul Sternberg, Jr., M.D., G.W. Hale Professor & Chair, Vanderbilt Eye Institute, Assoc. Dean for Clinical Affairs, Vanderbilt School of Medicine, Asst. Vice Chancellor for Adult Health Affairs; and Brian R. Carlson, M.H.S.A., M.B.A., Department Administrator and PCC Director, Vanderbilt Eye Institute, Vanderbilt Cosmetic & Plastic Surgery; Vanderbilt University Medical Center and Vanderbilt Medical Group
Using actual business scenarios and examples, the presenters will lay out the process by which they were able to develop a paired leadership model that has moved Vanderbilt Eye Institute forward on all relevant metrics for success.
Upon completion of this activity, participants should be able to describe the concept of paired leadership; explain how to develop a paired leadership model including the personal attributes it takes to have paired leadership; and describe a framework for decision making and accountability in paired leadership.

Medical Group Transition: Steps to Success
Scott Griffin, Former President and Chief Executive Officer, Reading Hospital Medical Group; and Michael Soisson, Healthcare Practice Leader, Pinstripe Healthcare
Given the current changes in healthcare market, many physicians and medical groups are moving towards an employment or acquisition strategy within larger hospitals or healthcare systems.  This presentation will present a case study of how the physicians in the Reading, Pennsylvania area transitioned their practices to a larger, multispecialty group practice that is owned and operated by the Reading Hospital and Medical Center.
Upon completion of this activity, participants should be able to describe key factors that have proven successful in the transition of a number of physician practices into a hospital-based group.

Advanced HIE Technologies Improve Medical Adherence and Quality Management
Tom Deas Jr., M.D., Board Member, North Texas Specialty Physicians
Discover how a physician organization implemented the three essential HIE technology elements to improve care coordination and quality management through clinical decision support, advanced quality measures, and EMR interoperability and to pave the way to becoming an accountable care organization.
Upon completion of this activity, participants should be able to describe the three essential technology elements for quality and medical adherence management; delineate examples of a CCR document, data from a secure web portal, and quality reports (e.g., PQRI, HEDIS) produced by the HIE, highlighting the advantages of reports from the interoperable HIE comprehensive EHR platform; discuss how the independent practicing physicians use the HIE's clinical decision support quality application at the point of care to track care quality measures which meet the EHR meaningful use criteria; and determine strategies to leverage the HIE and lessons learned into its Accountable Care Organization design and development.

The Physician Group Practice Transitions Demonstration Program
Frederick J. Bloom Jr., M.D., M.M.M., Assistant Chief Quality Officer, Geisinger Health System
The Physician Group Practice (PGP) demonstration program successfully showed CMS that large group practices could improve the quality of care provided and reduce the overall cost of care. When demonstration ended, the 10 participating groups negotiated a three-year PGP Transitions demonstration to provide them an incentive to continue improving the quality and efficiency of care provided to Medicare patients while transitioning to Accountable Care Organizations in the Medicare Shared Saving program.
Upon completion of this activity, participants should be able to describe the evolution of the CMS Physician Group Practice demonstration program into the PGP Transitions demonstration program; identify design aspects of the PGP demonstration program that have been corrected in the PGP Transitions program; explain the significance of different models of patient attribution, risk adjustment, and savings corridor calculation; and identify the quality criteria used in the PGP Transitions program and the additional bonus offered for reporting as bundled measures and reporting a patient experience measure.

Chronic Disease Toolkits: Spreading Quality Outcomes Simply
Steve Sarette, Process Improvement Specialist; and Gerald H. Angoff, M.D., FACC, M.B.A., Chair of the Quality and Outcomes Improvement Committee , Dartmouth-Hitchcock Clinic
Dartmouth-Hitchcock Clinic's toolkit to maximize outcomes for chronic disease management uses common business process improvement tools and can be replicated for multiple chronic disease conditions.  The presentation will show how to use such toolkits to spread best practice across the Medical Home departments with the support of trained coaches and minimal training for existing clinic staff.
Upon completion of this activity, participants should be able to describe the DHC approach to chronic disease management and the value of the toolkit format for quality improvement.

CMS Meaningful Use and Beyond
Aman Bhasin, Chief Information Officer, Orlando Internal Medicine, and Steve Vicker, Chief Information Officer, Manhattan Physicians Group
Successful adoption of the CMS meaningful use measures can significantly affect an organization's financial viability. This session will explore the measures and how to formulate a robust quality program that meets the criteria while remaining aligned with organizational priorities and goals.
Upon completion of this activity, participants should be able to discuss CMS Meaningful Use, define the stages of adoption and appreciate the importance of group participation; identify opportunities to align CMS Meaningful Use program initiatives with other pay of performance initiatives and well as their own organizational goals; describe the value of defining quality metrics in the early stages of EHR implementation; and build an EHR based quality program using Meaningful Use measures via a successful collaboration between their clinical leaders, quality and information technology.

Developing Accountable Care Networks
Michael Boguszewski, M.B.A., Director of Strategy and Growth, Park Nicollet Health Services; and Ross A. Armstrong, M.S.H.A., M.B.A., Manager, ECG Management Consultants
Hospitals and physician groups now realize they must develop integrated networks of accountable care that span geographies and the service continuum to significantly enhance the quality and decrease the cost of healthcare in the U.S. The speakers will address options and priorities for managing the complicated pathway to accountable care network formation, as well as share the experiences of Park Nicollet related to its own "work in progress" development.
Upon completion of this activity, participants should be able to delineate the necessary components required to develop a network of accountable care.

Creating and Implementing a Physician Compensation Plan in the Patient-Centered Medical Home
Christine Griger, M.D., M.B.A., President, Affinity Medical Group;  and  Ed Scanlan, M.D., Medical Director, Network Health Plan
This interactive discussion describes the steps Affinity Medical Group took to transform a productivity-based primary care physician compensation plan into an innovative hybrid model that takes physicians off the proverbial treadmill and directs practice pattern changes by aligning compensation with organizational and medical home goals featuring productivity, cost, access, quality, satisfaction, panel size, and off-line work.
Upon completion of this activity, participants should be able to describe how to create and implement a physician compensation plan that aligns with organizational goals and with the objectives of the patient-centered medical home; discuss the process of engaging physicians within an integrated healthcare organization in the process of developing their compensation plan within these parameters; and explain how a properly constructed compensation plan can help position an integrated delivery system to accept risk as an accountable care organization.

Value of Detailed Comparative Data in Understanding Variation in Process of Care and Designing Strategies to Improve Population Health and Optimize Resource Use
John Cuddeback, M.D., Ph.D., Chief Medical Informatics Officer, Anceta; A.G. Breitenstein, J.D., M.P.H., Vice President, Provider Markets, and Mary Lantin, M.P.H., Director of Operations, Humedica
Variation from evidence-based guidelines reveals only part of the opportunity that medical groups have to improve care. Guidelines are of little value in prioritizing potential interventions for high-risk, high-cost patient populations, who fall outside the scope of typical guidelines. The Anceta collaborative data warehouse, developed in partnership with Humedica, contains longitudinal EHR, e-prescribing, and administrative data on more than 10 million patients of participating medical groups, normalized and mapped to provide meaningful comparisons of care process and outcomes at a medical group and clinician level. Through direct access to detailed internal and comparative data and the Anceta collaboratives, medical groups are learning how other groups are treating patients with similar combinations of clinical comorbidities and sociodemographic factors, their relative resource use, and the outcomes they're achieving. The presenters will provide examples of Anceta participants' identification of under-treated, high-risk patient populations and variation in care approaches, outcomes, and cost using the detailed comparative data.
Upon completion of this activity, participants will be able to explain how Anceta and Humedica enable AMGA members to under­stand variation in practice and its impact on quality and cost; and to discuss the use of comparative data for measuring clinical performance and identifying high-risk patients with diabetes and other chronic conditions.


Being Accountable for Healthcare Delivery in Central Ohio
Thomas D. Thompson, M.B.A., Vice President of Business Development;  and James Dougherty, M.D., Chief Medical Officer, The Medical Group of Ohio (MGO)
This presentation will describe the new and necessary structure that MGO put in place that resulted in committed leadership from the physicians and the health system to accomplish clinical integration and successful contracting with two of the four largest payers in Central Ohio.  Presenters will share demonstrated results and interactions with the commercial payers, discuss the necessary investment, processes, and tools, and explore how this effort positions the group in pursuit of being an ACO.
Upon completion of this activity, participants should be able to describe how an IPA can be instrumental in developing a clinically integrated system of care delivery including independent physicians and a hospital system; discuss how using results from pilot programs that includes a pay for quality component, becomes a model adaptable to the commercial payers; explain how the IPA has been able to demonstrate the improvement of quality and value of healthcare services to the purchasers in Central Ohio; and explain how a clinically integrated network and related infrastructure can be a spring board to an Accountable Care Organization.

An Integrated Framework for Reducing Health Disparities
Beth Averbeck, M.D., Associate Medical Director, Primary Care, HealthPartners Medical Group
Disparities are evident in nearly all facets of our healthcare system.  With technological advances, leaders have the opportunity to focus on populations that persistently experience lower levels of satisfaction and worse health outcomes.  Learn how to utilize a data-driven approach for reducing disparities and improving global performance.
Upon completion of this activity, participants should be able to design a data driven approach for achieving equity; articulate the advantages of integrating disparities reduction goals into annual planning processes and accountability mechanisms; develop plans for involving diverse communities in designing tests of change; discuss how technology can support systematic care customization; and describe why health care leaders should consider disparities reduction as a key part of an organization's strategic imperative.

Ready? Triple Aim! Align!  Taking Steps Toward an Accountable Care Organization
Scott Hines, M.D., Endocrinologist, and Jonathan Nasser, M.D., Internist and Pediatrician, Crystal Run Health Care
This interactive presentation will outline the processes employed to align physicians to an accountable care model of healthcare delivery. Application of IHI's Triple Aim will be demonstrated, with specific examples of changing physician evaluation, defining quality measures, improving patient experience, creating local best practice standards, and measuring and reducing cost.
Upon completion of this activity, participants should be able to describe the tenets of the triple aim and understand their applicability to the pursuit of accountable care; describe how these tenets can be applied to a physician performance matrix in an effort to align physicians toward a goal of accountability; explain a process for developing department specific quality measure in both primary and specialty care; and articulate how creating practice standards can be used to standardize work, analyze utilization and control cost of care.

Aligning with Physicians to Improve Care and Create Value
Marty Manning, President, and Mark Shields, Senior Medical Director, Advocate Physician Partners
The presentation focuses on an integrated model of care developed by Advocate Physician Partners that aligns physicians, patients, and payers.  It will explore how infrastructure, technology, financial models, evidence-based medicine, and other measures improve clinical outcomes.
Upon completion of this activity, participants should be able to describe a governance structure and physician alignment model that supports cultural change for thousands of independent and employed physicians; develop a model of care that integrates all stakeholders, physicians, patients and payers, with a common goal to improve the quality and value of care; articulate the impact of information technology in streamlining the care delivery process and uniting physicians; design an infrastructure with proven outcomes that impacts clinical care, efficiency, medical & technological infrastructure, patient safety and patient experience; establish a financial funding model which includes a pay-for-performance incentive, aligning physicians and improving clinical outcomes; and advance their existing infrastructure by incorporating Medical Home and Accountable Care guidelines.

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