2013 Annual Conference

Practice Management

Friday, March 15, 2013
2:00 p.m. - 3:15 p.m.

Provider Approachability: A Look in the Mirror
Mark Deyo-Svendsen, MD, Medical Director and Family Practice Physician, Michael Phillips, MD, Associate Medical Director and Family Practice Physician with Obstetrics, and Karl Palmer, RN, MS, Quality Nurse Specialist, Mayo Clinic Health System - Red Cedar
This presentation will describe the successful use of a survey-resurvey method to assess staff and provider perceptions of individual provider approachability and safely share transparent results and improvement resources. It will also share results of the program, including that the resurvey showed improved perceptions, reports of providers making improvement efforts, and a perception that the survey process made the culture safer.
Upon completion of this activity, participants should be able to describe the importance of approachable behaviors by medical staff and their impact on patient safety; delineate how approachability feedback as a crucial component of medical staff professional development; delineate how a transparent, all-staff survey approach was used and the potential and actual pros and cons of this approach in one practice setting; describe the key principles and process steps required to implement a successful approachability survey process; and perform a professionally safe provider approachability survey at their home site.

Transitioning Reimbursement from Volume to Value:Performance-based Contracting Using a Shared Savings Model
Michael J. Tronolone, MD, MMM, Chief Medical Officer, The Polyclinic
In 2010, The Polyclinic and Premera Blue Cross implemented a three-year performance-based contract that allows both parties to share in savings. This presentation will focus on the crafting of a shared savings agreement, while touching on issues such as patient attribution, the selection of an appropriate control group and comparison methodology, and transitioning from an Episode Treatment Group (ETG)- based methodology to measure cost to adopting the Total Cost of Care as the measurement system.
Upon completion of this activity, participants should be able to describe the key elements that should be part of any shared savings agreement; describe the critical importance of patient attribution and risk adjustment in a shared savings reimbursement model; and assess their organization's readiness for entering into a shared savings agreement.

Reducing Medical Cost Trend in ACO/AQC Environments: AnInnovative Approach to Physician Engagement
Sandhya K. Rao, MD, Associate Medical Director for Quality Improvement, and Megan R. Renfrew, MA, Senior Project Manager, Performance, Analysis & Improvement, Massachusetts General Physicians Organization
Constraining the growth of healthcare costs is a national priority. New payment mechanisms and risk- and reward-sharing contracts are focused on managing medical expense trend. This presentation will detail how Massachusetts General Hospital developed a Trend Management Tool that provides cost and utilization data to specialists and engages leaders in trend reduction initiatives.
Upon completion of this activity, participants should be able to explain the importance of monitoring cost trends under new payment and delivery models; describe "phases of design and implementation" for employing a trend management tool; illustrate common or expected barriers and solutions to implementation; and list concrete next steps on how to implement a trend management tool in their institution.

Friday, March 15, 2013
3:45 p.m. - 5:00 p.m.

Right-sizing Staff: Managing Costs More Effectively
Loretta Swan, CPC, Vice President/Operations, Trinity Clinic, Trinity Mother Frances Hospitals and Clinics
In today's economy the pressure continues to grow for medical practices to reduce costs in order to meet the healthcare challenges ahead. In an effort to find the best-use staffing model, Trinity Clinic implemented a strategy to identify the appropriate staff complement and determine just how many employees were required to support the activity produced. This presentation outlines successful steps to right-sizing staff as a cost containment strategy.
Upon completion of this activity, participants should be able to describe the process of implementation for "right-sizing" staff; analyze the use of staffing benchmarks compared to physician/midlevel productivity to help identify areas for improvement and promote peak performance; describe staffing strategies to improve the physician practice's daily operations and reduce cost; and assess whether an opportunity exists to optimize clinic support staff based on specialty specific volume and per provider benchmarks.

Integrated Delivery Systems: A Cure for the Healthcare Delivery Crisis
Donn Sorensen, MBA, FACMPE, President, East Communities, and Fred McQueary, MD, President, North Central Communities, Mercy; and Amy Fore, MHSA, FACMPE, Director of Operations, St. John's Clinic
Want to become an ACO? It starts with integration. This session provides tools needed to develop an integrated delivery system that serves the organization's unique patients, physicians, and communities. The presenters offer practical guidance for successfully integrating hospitals and group practices with strategies for shared leadership, cultural alignment, and more.
Upon completion of this activity, participants should be able to describe the elements that comprise an integrated delivery system; describe elements that are commonly mistaken as integration, but are not adding value to the organization (the myths of integration); and take recommendations, adapt, and apply to their own organization in order to establish a successful integrated delivery system that meets the requirements of an accountable care organization.

Unifying Compensation: The Lehigh Valley Physician GroupCompensation Plan Experience
Edward R. Norris, MD, Chair, Compensation Committee, and Michael A. Rossi, MD, MBA, Physician Executive Director, Lehigh Valley Physicians Group
Lehigh Valley Physician Group has undertaken a multi-year and multispecialty process to implement a uniform compensation model that accounts for provider productivity, administrative and education needs, and citizenship requirements to align a large multispecialty group of more than 700 providers. The compensation plan also addresses and contributes to budget and financial integrity for the Lehigh Valley Physician Group. The process of implementing this compensation plan will be presented.
Upon completion of this activity, participants should be able to describe the process and challenges of implanting a compensation plan for a large physician group; and discuss strengths of integrating a compensation plan with accurate accounting for budget, work production prediction, advanced practice providers and citizenship needs.

Saturday, March 16, 2013
11:00 a.m. - 12:15 p.m.

A Lean Approach to Physician Schedule Optimization
Robert Trenschel, DO, Senior Vice President Medical Operations, and Mary Beth McDonald, MBA, Senior Vice President Clinic Operations, Aurora Medical Group; and Karen Bowman-Dillenburg, MS, Operations Improvement Manager, Aurora Health Care
This presentation will provide an overview of the process Aurora Medical Group is using to standardize physician schedule templates and scheduling processes using Lean methodologies. Areas of focus will include decreased complexity resulting in increased operational efficiencies, patient throughput, and overall satisfaction. The presenters will lead a discussion on challenges, lessons learned, and next steps, while providing concrete tactics and processes to achieve schedule optimization and physician/provider acceptance.
Upon completion of this lecture, participants should be able to identify the Lean methodology to optimize physician schedule design; develop effective scheduling processes that maximize patient throughput, reduce patient wait times, enhance patient and staff satisfaction, and improve physician satisfaction; and implement monitoring techniques to assure sustainability of results.

Life Lessons: Building an Efficient Medical Staff Engine Serving 10 Diverse Hospitals
David L. Knocke, FACHE, President, BJC Medical Group; and Lori Schutte, MBA, President, Cejka Search
This presentation will apply the trends reported in the annual Retention Survey to real-life challenges. Participants will learn about balancing growth and efficiency through BJC Medical Group's recruitment, acquisition, and retention model for a diverse group of 10 community hospitals, operating in highly competitive markets within a system that includes a top academic medical center.
Upon completion of this activity, participants should be able to identify key turnover benchmarks and retention trends as highlighted by the Cejka Search and AMGA 2010 Physician Retention Survey; describe how to minimize turnover during transitions in compensation and incentive models; evaluate the elements of efficient, scalable acquisition and recruitment processes; implement an efficient marketing strategy featuring a strong internet and social media presence; and avoid the high costs caused by lack of alignment, "internal" recruitment competition, prolonged vacancies and inefficient recruitment processes.

Saturday, March 16, 2013
2:00 p.m. - 3:15 p.m.

Physician Practice Redesign: Implementing an Integrated Patient Service Center
Kenneth Ashley, MD, FAAP, FACPE, Medical Director, Primary Care, Sutter Medical Group; Theresa Frei, RN, BSN, MBA, Chief, Patient and Client Services, Sutter Physician Services; and Jennifer K. Gingrass, MS, Principal, ECG Management Consultants, Inc.
This presentation will describe the partnership between Sutter Medical Group (SMG) and Sutter Physician Services (SPS) to develop an off-site, integrated patient service center intended to function as a single point of contact for after-hours nurse advice, patient scheduling, and billing services. The goal was to provide 24-by-7 patient access. The presenters will describe the design and implementation processes, results, as well as ongoing enhancements and use of technology.
Upon completion of this activity, participants should be able to review the impetus and goals behind the development of an integrated patient service center; describe how patient service center operations were structured, what services are provided, and how they were implemented; identify the challenges associated with physician and patient adoption; and communicate the results, including the impact on point of service operations, costs, and patient satisfaction.

From Volume to Value: Moving from a Fee-For-Service Model to a Population Management Model
Patrick F. Garrett, MD, MMM, FACP, Vice President Physician Relations, St. Anthony's Medical Center; Robert Curtin, MD, President, Dave Hinkle, CMPE, Executive Director, St. Anthony's Physician Organization
This presentation will navigate participants through the process of moving from a fee-for-service model to a full risk payer model. Different initiatives such as Patient-Centered Medical Home, IOCP, and Meaningful Use will be discussed.
Upon completion of this activity, participants should be able to describe the practical steps to assist a practices transition from a traditional fee-for- service payment model to risk models that support population health management; and describe the necessary steps to provide a value-based product by modifying the payer contract(s), modifying the physician compensation plan, modifying the operational methods, and engaging physicians to manage through the entire process.

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