Peer-to-Peer Sessions

Thursday, September 26, 2013

10:45 a.m. - 12:00 p.m.
Engaging Physicians to Achieve High-Value Health Care
Adrienne Boissy, MD, MA, Director, Center for Excellence in Healthcare Communication, Robert Coulton, MBA, Executive Director, Office of Professional Staff Affairs, Brian Donley, MD, Chair, Professional Conduct Committee, President, Lutheran Hospital, and Director, Foot and Ankle Program, and James Merlino, MD, Chief Experience Officer, Cleveland Clinic Health System
Physicians are a critical component in healthcare delivery and are essential partners for successful implementation of healthcare improvement strategies. In today’s environment, physicians have a responsibility to drive individual improvement and accountability, and to also participate in organizational initiatives to help drive operational efficiency. For organizational effectiveness, chief executive officers and other healthcare leaders must engage physicians and get them to partner in strategic initiatives to better enhance the value equation. These four senior leaders discussed successful strategies and offer the participants effective tactics hospitals can implement.

Analytics to Action: How to Stay Ahead of the Cost Curve
Wendy Oberdick, MD, Value Based Operations, Medical Director of Patient-Centered Medical Home, and Jason Tipton, MBA, Director of Analytics, Holston Medical Group
In this interactive presentation, Holston Medical Group will outline the transition from a reactive “sick” model―utilizing claims data based on past expenditures―to a proactive wellness model that began with a focus on gaps in care and benchmark goal-setting. The presenters described this paradigm shift as well as questions, hurdles, and lessons learned during the process. Topics discussed included: analytical and clinical transformation, stratification of patient need and resource allocation, affecting change with performance support, and facilitating compliance to drive the effectiveness of the Triple Aim.

Best Practices Panel: Lessons from AMGA’s Hypertension Learning Collaborative
Moderator: Jerry Penso, MD, MBA, Chief Medical and Quality Officer, American Medical Group Association
Panelists: Lori Arnoldussen, RN, Clinical Quality Coordinator, ThedaCare Physicians; Ashok Rai, MD, President and CEO, Prevea Health; and Elizabeth Ciemins, Research Director, Billings Clinic

High blood pressure (hypertension) is a leading risk factor for heart disease, stroke, kidney failure, and diabetes complications. Nearly one out of three American adults has high blood pressure and less than half of patients have their condition under control. AMGF’s national campaign Measure Up/Pressure Down seeks to mobilize medical groups, patients, and other stakeholders to address this health crisis. A panel of leaders from groups involved in the campaign discussed how they established successful processes to manage their patients with hypertension using team-based, coordinated care. 

2:00 p.m. - 3:15 p.m.
Best Practices Panel: Lessons from AMGA’s COPD Learning Collaborative
Chan Chuang, MD, Corporate Medical Director, and Janelle Howe, Director, Disease Management, HealthCare Partners; and Steven J. Bernstein, MD, MPH, Director, Quality Management Program, and DeAnn VanSickle, Performance Improvement Coordinator, University of Michigan Health System
Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease which is characterized by chronic airflow limitation and a range of pathological changes in the lung, significant extra-pulmonary effects, and important comorbidities which may contribute to the severity of the disease in individual patients. AMGA members have been participating in collaborative to develop best practices to improve the care of patients with COPD. A panel of leaders from groups involved in the learning collaborative discussed how they established successful processes to manage their patients with COPD.  Speakers examined the leadership support necessary, tools and systems required, and how care is managed within their patient populations by sharing an outline of their COPD chronic care models, intervention methods, outcomes, and lessons learned.

TEAMcare at The Polyclinic:  Multi-Condition Collaborative Care for Diabetes, Heart Disease, and Depression
Elise Ernst, MEd, MSW, MBA, Vice President of Practice Management, and Oren Townsend, MD, Medical Director of the Physicians Care Network, The Polyclinic; and Paul Ciechanowski, MD, MPH, Associate Professor, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Director, UW Training Xchange, Center for Commercialization
Attendees heard how, over the past year, The Polyclinic has implemented TEAMcare as part of transforming its primary care. It is a proven interdisciplinary approach to improving diabetes clinical outcomes by systematically assessing and treating depression as a comorbidity. In this innovative approach, they provided guideline-based, collaborative care management, with the goal of improving behavior change and controlling multiple disease risk factors. Presenters shared data on improved outcomes and lessons learned, and help you assess your organization’s readiness to implement TEAMcare.

Moving from Volume to Value: Building an Organizational Framework for Transformation
Ballroom G
Kari Bunkers, MD, Mayo Clinic Health System CMIO and Medical Director, Office of Population Health Management, Robert Stroebel, MD, Medical Director, Midwest Office of Population Health Management, and James Yolch, Administrator, Office of Population Health Management, Mayo Clinic

“Business as usual” is unacceptable in the age of healthcare reform. Beginning with the launch of CMS Accountable Care pilot projects, organizations have been scrambling to respond to new requirements, future state ground rules, and uncertain payment models. In response to this enormous change, Mayo Clinic created a new coordinating office to respond to uncertain times, develop a framework for population health management, and implement a value-based model of care. This presentation provided an overview of Mayo Clinic’s approach including their organizational framework, operational strategy, and lessons learned.

When It Comes to Value, Variety Is NOT the Spice of Life: Using the Process of Variation Reduction to Engage Physicians in the Pursuit of Value
Scott Hines, MD, Co-Chief Clinical Transformation Officer, Division Leader Medical Subspecialties, Crystal Run Healthcare
The process of variation reduction aims to standardize care and eliminate waste in an organization through the development of best practice guidelines and engaging physicians in sharing their personal practice patterns. This presentation outlined the evolution of Crystal Run Healthcare’s variation reduction program, from the diabetes pilot to the current program consisting of quarterly variation reduction meetings with every department in the practice. Presenter shared outcomes data illustrating cost savings and displayed the internally developed automated tool that creates the necessary data for these exercises.

Friday, September 27, 2013

8:30 a.m. - 9:45 a.m.
Determination of Primary Care Panel Size in a Value-Based Compensation Healthcare Delivery Environment
Dale Eric Green, MD MHA, Chief Medical Information Officer, Cornerstone Health Care
With the advent of new payment models, new panel configurations have arisen. This presentation will examine physician panel size definitions and panel size calculations, and a variety of potentially deterministic variables including patient panel risk profiles, physician training and experience, practice style, advanced practice practitioners, team-based care models, and the availability of specialists. Presenters shared an algorithm developed at Cornerstone to calculate primary care panel sizes, including calculated panel sizes in comparison to actual Cornerstone physician panels. They also discussed the potential pros and cons of using panel size as elements of compensation formulas as well as the use of balancing measures.

Decoding Healthcare Babel: How to Evaluate Data Aggregation and Analytic Vendors and Solutions
Robert E. Matthews, Vice President, PriMed Physicians
As groups prepare for and enter value-based contracts, the need for improved data integration and analytics becomes more urgent. Health data is notoriously difficult to aggregate and analyze. Over 40 vendors have entered this space, but many impose significant limitations to what the customer can expect based upon the technologies they use or their approaches to solve the problem. This presentation is designed to help medical groups to better evaluate their needs―and the vendor’s solutions. The presenter created definitions and descriptions for the essential elements of an aggregation and analytic product and provide a framework that can be used for future product evaluations.

Best Practices Panel: Provider Satisfaction and Engagement
Kevin McCune MD, Chief Medical Officer, Advocate Medical Group; Cheryl Magnuson-Giese, MSW, MPH, SPHR, Senior Director of Physician/Clinician Services, HealthPartners; and Craig Best, MD, MPH, Chair of OB/GYN, Reliant Medical Group
One of your biggest challenges is creating a culture where providers feel appreciated and are engaged in improving the quality patient care and the success of the organization. By targeting provider satisfaction and engagement, medical group leaders can create a roadmap to organizational excellence. In this panel presentation, participants heard best practices from AMGA member groups who described how they use the data and reports from the AMGA Patient Satisfaction Benchmarking Survey to evaluate areas for improvement, promote successful changes within identified problem areas, and design processes and strategies to continually improve provider satisfaction and engagement.   

Best Practices Panel: Shared Decision Making
Richard Wexler, MD, Director of Patient Support Strategies, Informed Medical Decisions Foundation; David McCulloch, MD, Medical Director, Clinical Improvement, Group Health Cooperative; and Karen Sepucha, Health Decision Sciences Center, Massachusetts General Physicians Organization
Practice variation can have an enormous impact on quality, efficiency, and financial stability. This panel discussion examined how shared decision making (SDM) can address this problem. The session explored benefits to patients, providers, and systems of care; differences between patient education and decision aids; and strategies for successful implementation. Presenters focused on SDM implementation as a tool for addressing practice variation and share strategies for successfully implementing SDM, supported by decision aids.

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