Peer-to-Peer Sessions
Routes to Tomorrow's Health
Care
Successful Models of Accountable
Care
IQL 2012 Annual Conference, October 3-5,
2012
Gaylord National Harbor Resort &
Conference Center, National Harbor,
Maryland (Washington, DC Metro Area)
Thursday, October 4,
2012
10:30 a.m. - 12:00 p.m.
Creating Accountable
Physician Leadership: Essential to the
Successful ACO
Mark J. Werner, MD, CPE, Senior Vice
President and Chief Clinical
Integration Officer, and David W. Moen, MD,
President, Fairview
Physician Associates and Fairview Health
Network, Fairview Health
Services
The presenters will discuss Fairview's use of
design criteria-based
approaches to care innovation and the means
to engaging accountable
physician leaders. They will share their
efforts in building culture,
developing clinical leaders, optimzing dyad
leadership models in a
multispecialty group, setting expectations
for physician "owner
operators," evolving the role of an
independent physician association
board, moving service lines beyond an
academic center across community
hospitals, deploying care transition, and
patient navigation programs.
Upon completion of this activity,
participants should be able to
describe key attributes of culture and design
criteria within an
accountable physician network, describe the
design criteria for their
particular envisioned organization and the
essential physician
leadership needed for success, describe
strategies for developing,
deploying and supporting accountable
physician leaders, and develop a
gap analysis of physician leadership needs
within their organization and
identify approaches to addressing those
needs.
You Can't Eat
an Elephant in One Bite: Bending the Cost Curve
in a Multispecialty Practice
Scott Hines, MD, Clinical Transformation
Officer, and Jonathan Nasser, MD,
Internal Medicine and Pediatrics, Crystal Run
Healthcare LLP
This interactive presentation will outline
effective techniques employed
by a multispecialty group to re-engineer the
care team and reduce the
cost of care. Examples will include a PCP
clinical management
enhancement series, the implementation of a
home care program, and the
utilization of the process of variation
reduction. An interactive
demonstration of Crystal Run Healthcare's
variation reduction platform
will be included.
Upon completion of this activity,
participants should be able to
identify the unique challenges facing a
multispecialty group ACO,
describe the emerging role and importance of
the primary care physician
in controlling healthcare cost and identify
mechanisms for enabling PCPs
to do this successfully, describe how a home
care program can be used to
reduce the cost of health care, articulate
how the process of variation
reduction can be used to standardize work and
control utilization of
resources, and participate in a variation
reduction project and
implement this project at their
organization.
Post-Acute Care
Transitions: An Essential Component of
Accountable Care
Bruce C. Smith, MD, Associate Medical
Director, Strategy Deployment,
Group Health Physicians
In 2009, Group Health embarked on a
comprehensive program to re-design
patient care before, during, and after
hospitalization using a Lean
management model to improve patient
satisfaction and quality of care
while reducing overall costs of care. This
presentation will provide an
overview of this extensive initiative with
important take-home lessons
for other practices involved in coordinating
overall costs of care and
improved care quality.
Upon completion of this activity,
participants should be able to
improve the quality of post-acute care
transitions, reduce avoidable
costs during and after care transitions, and
reduce avoidable hospital
admissions, readmissions, and ER
visits.
How Care Teams Are Using
Predictive Analytics and Comparative
Data to Optimize Interventions for High-Risk
Patients
Stephen A. Morgan, MD, Vice President of
Medical Informatics, and
Marcus Speaker, MD, Medical Informaticist,
Carilion Clinic; John
Cuddeback, MD, PhD, Chief Medical Informatics
Officer, Anceta; and Mary
Lantin, MPH, Director of Operations, Provider
Markets, Humedica
Participants in AMGA's Anceta collaborative
will share how they are
using Humedica MinedShare® clinical
intelligence to target timely
interventions aimed at reducing hospital
admissions and ED visits in
patients with congestive heart
failure. Employing predictive analytics
in the context of a patient-centered medical
home, care teams are
identifying patients who are likely to be
admitted to the hospital or ED
with a CHF-related condition. This session
will explore PCMH work flows
and protocols that take advantage of
predictive models.
Thursday, October 4,
2012
1:45 p.m. - 3:15 p.m.
Medical
Group Leadership: Transitioning from Popularity to
Performance
Jeffrey Bailet, MD, Executive Vice
President, Aurora Health Care and
President, Aurora Medical Group, and Brent R.
Phillips, FACMPE, Senior
Vice President, Medical Group Operations,
Aurora Medical Group
As medical groups prepare for an uncertain
future, the need for
performance-based physician leadership is
critical. The selection
process must shift from a popularity vote to
ensure success in a rapidly
changing environment. Aurora Health Care has
successfully implemented a
new process and will share the transition,
job descriptions, and lessons
learned.
Upon completion of this activity,
participants should be able to
articulate the value of a performance based
leadership selection
process, organize and implement this new
selection process while
enhancing the buy in and engagement of the
physicians, ensure alignment
with overall strategic goals and changing
healthcare environment,
determine physicians with the greatest
leadership potential, and
strengthen the physician/administrator dyad
model to ensure greater
overall performance and success.
HealthPartners' National Quality Forum-endorsed Measure of Total Cost of Care
Sue Knudson, MA, Vice President, Health
Informatics, and Beth
Averbeck, MD, Associate Medical Director,
Primary Care, HealthPartners
HealthPartners received NQF-endorsement for
its measure of Total Cost of
Care. This complements existing quality
measures to provide a common
reference point supporting the development of
accountable care
organizations and payment reform models.
Providers, insurers, employers,
consumers and others can use this to manage
costs, drive affordability,
and improve healthcare.
Upon completion of this activity,
participants should be able to
describe how HealthPartners' NQF-endorsed
Total Cost of Care Measure was
developed and how HealthPartners uses it, and
identify how their system
could apply Total Cost of Care to provide
better health, better
experience, and lower cost for their
patients.
Value-Based Ambulatory Operations
at the Cleveland Clinic:
Linking an Accountable Population Health
Model with Business
Intelligence Analytics
Brian Harte, MD, Director, Business
Intelligence/Medical Operations,
President, South Pointe Hospital, and Meghan
Snow, MHA, Administrator,
Medicine Institute, Cleveland Clinic
Cleveland Clinic has embarked on an ambitious
program to implement and
study various models to primary care practice
redesign, as preparation
for Accountable Care. The presenters will
explore the steps of the
development, execution, and measurement of
these pilots, and review the
investments needed to successfully execute
this strategy.
Upon completion of this activity,
participants should be able to
describe the efforts in the past year in
aligning Cleveland Clinic
senior leadership around developing a
strategy for accountable care,
describe several proposed models of primary
care delivery and elaborate
on the decision-making process that resulted
in a business plan to test
multiple models simultaneously, including the
challenges and unique
opportunities of each, demonstrate the
challenges in providing the data
necessary to study and support these models
of care, and the forum and
structure in which performance is reviewed,
describe the substantial
staffing and technological investments
required to successfully execute
an ACO strategy and practice redesign, and
explain how an effective
group practice model in a patient-centered
environment can lead to
innovation and uncover opportunities for
improving quality of care while
increasing safety and lowering
costs.
Changing
Directions: Planning and Executing the Shift
from a "Fee-for-Service" to a "Pay for Value"
Medical Group
Robert E. Matthews, Vice President for
Quality, PriMed Physicians
and President and CEO, MediSync; and Douglas
Romer, MD, Family Practice
Physician, Chairman of the Board, PriMed
Physicians
Most medical groups' revenues have been based
solely on volumes of
services provided. As medical groups are
contemplating or are actually
engaging in the shift to value based revenue,
leaders must plan and
execute a massive change in their group
infrastructure, operational
practices and culture. This presentation will
feature some of the key
elements in the change strategy from the
perspective of PriMed
Physicians, a group that has been undertaking
this transition for a
decade.
Upon completion of this activity,
participants should be able to
identify and define five major areas of
change that must occur in a
major organizational transformation, describe
the elements of "change
management" especially as they apply to a
medical groups, and describe
the need for physician leaders to
simultaneously have both a "big
picture" perspective of the changes that they
are planning and a
detailed list of change projects.
From Transaction to Total Value Care: Geisinger's Transformation Roadmap
Maria Susan Kobylinski, M.D., Department
Director, Community
Practice Service Line, Geisinger Health
System; and Lisa Cone-Swartz,
Vice President of Product Management, Press
Ganey Associates
The shift from volume to value will be a
transformative experience for
healthcare providers, and as an early adopter
of value-based care
delivery, Geisinger Health System is in a
unique position to share
lessons learned through this process. This
presentation will focus on
how effective redesign and care coordination
can deliver rapid and
long-term impact on clinical quality measures
and cost of care.
Recommendations on how to ensure that the
voice of the patient and
provider are both drivers and evaluators of
these changes will be
detailed, including results from a newly
designed Care Coordination
survey.
Upon completion of this activity,
participants should understand
Geisinger's process to effectively redesign
their organization to focus
on care coordination; describe key
initiatives, processes, and results;
explain specific tactics they can employ
within their own organizations;
and utilize expert advice on how to ensure
that they include the patient
and provider voice in change
initiatives.
Friday, October 5,
2012
8:30 a.m. - 10:00 a.m.
Practice Operations Coaching: Supporting Physicians to Improve Care Results
Kevin McCune, MD, Chief Medical Officer,
Advocate Medical Group;
Judith Miller MHSA, RHIA, CHP, Vice
President, Medical Services, Scott
Kent, MA, Hospital and Health Administration,
Vice President, Field
Operations; Janet Skoda, MBA, Vice President,
Field Operations, Richard
Bobos, MBA, Practice Operations Coach, and
Katherine Kalthoff, MBA,
Practice Operations Coach, Advocate Physician
Partners
This presentation will explore tactics and
organizational changes
Advocate Physician Partners and Advocate
Medical Group implemented to
support practice improvements necessary to be
successful in an
accountable care world. Practice methods,
analytic data systems and
tools for evaluating and assessing practice
operations, key metrics, and
coaching techniques will be discussed.
Upon completion of this activity,
participants should be able to
describe an organizational model for
providing feedback and practice
coaching to independent and employed
physician practices, design an
infrastructure for providing data, feedback,
and methods for
improvement to physicians about key
metrics important to the goals of
the larger organization, and delineate the
use of information technology
in providing useful and actionable data to
physicians on their
performance meeting key targets.
Who Needs The
Hospital? Hardwiring Clinical Pathways
for Ambulatory Care Coordination Improves
Quality, Efficiency, and
Outcomes
Arthur L. Forni, MD, MMM, Associate
Medical Director, and Barney D.
Newman, MD, Medical Director, WESTMED Medical
Group
WESTMED is implementing Ambulatory Care
Pathways to optimize treatment
of many common conditions. This presentation
will explore how structured
care coordination is expected to limit
unnecessary variation in clinical
practice (especially overutilization),
prevent medical errors, provide a
more comfortable experience for the patient,
and ultimately decrease
cost by reducing unnecessary ER visits and
hospitalizations.
Upon completion of this activity,
participants should be able to
describe the rationale for standardization
and coordination of care for
"ambulatory sensitive" conditions, describe
the development and
implementation of ambulatory pathways to
structure care in a
multispecialty group practice, and discuss
the need for physician
engagement and analysis by appropriate
metrics to guide the use of
ambulatory pathways and their ongoing
refinement.
Engaging
the Patient and Family to Improve Health Care
Outcomes
Amy Compton-Phillips, MD, Associate
Executive Director of Quality,
The Permanente Federation, and Doug Bonacum,
Vice President of Safety
Management, Kaiser Permanente
Partnering with patients and families is the
key ingredient to
transforming the healthcare system and
improving patients' health,
health outcomes, and care experience. This
session will describe how
partnerships with patients are formed and
result in improved care, and
provide specific tools and case study
examples from Kaiser Permanente.
Upon completion of this activity,
participants should be able to
describe Kaiser Permanente's holistic and
universal approach to
including the patient and their family in the
care model, explain why
patient- and family-centered care can help to
improve quality, safety,
service, and affordability, apply core
components of patient- and
family-centered care in their own
organizations, and describe tools or
tactics to increase partnerships with
members, patients, and families.
Physician Incentives,
Unbundling of Payments and the "C"
Word: Facing the Impending Realities of
Healthcare Payment Reform
Jennifer Close, Vice President of
Operations, Dean Health System
As healthcare providers seek to redefine
themselves as accountable care
organizations, it will be crucial that
delivery systems master the
ability to design incentive models that align
physicians, to craft
mechanisms to un-bundle payments, and to bear
risk via capitation or
other evolving reimbursement strategies. This
presentation highlights
Dean Health System's experience in all three
domains.
Upon completion of this lecture,
participants should be able to
discuss the array of future payment-reform
models that CMS and other
payers will likely develop to reward
physicians and hospitals for
delivering value-based and accountable care;
describe Dean's experiences
in designing primary care and specialty
physician incentive models aimed
at maximizing the delivery of high-quality
and efficient care; and
explain the complexities of bundled payments,
by reviewing Dean's
experience with bearing risk and with the
"unbundling" of gain-sharing
between physicians, hospitals, and other
care-givers.