Peer-to-Peer Breakout Sessions

Leaders from our prestigious member community will share innovative strategies and groundbreaking processes that are enabling them to successfully engage patients, manage wellness, build partnerships, employ emerging technologies, and transition to new payment models. Choose from five compelling tracks: Leadership and Governance, Technology and Data, Care Process Improvement, Practice Management, and Legislation and Regulation.

Interactive Discussion Groups
Taking place concurrently with the peer-to-peer breakout sessions, these highly interactive sessions allow participants to engage with each other around specific strategies they are using to confront common challenges.

DG    Interactive Discussion Group
LG    Leadership and Governance
TD    Technology and Data
CP    Care Process Improvement
PM    Practice Management
LR    Legislation and Regulation

Friday, March 24, 2:00 p.m. - 3:15 p.m.

CEO Strategies: What Will Be the Keys to Our Future Success?
Moderator: Howard Graman, M.D., Vice President, AMGA Consulting
Speakers: David R. Posch, Executive Vice President, Population Health, Vanderbilt University Medical Center;
Mark Mantei, Chief Executive Officer, The Vancouver Clinic; and
Mark Briesacher, M.D., Chief Executive Officer, Intermountain Medical Group

Our members are widely recognized as some of the preeminent organizations in the healthcare industry today.  Our groups have set the standard for physician leadership, innovative care practices, and award winning outcomes.  In this discussion group, three of our member leaders will engage the audience in a candid conversation and address forward looking thoughts such as:  What do they believe will be the keys to succeeding in this new age of health care? What necessary changes must groups be willing to make in order to be the system of choice in their communities? Where are their organizations focusing their resources to achieve the greatest impact?

Optimizing the Role of the Advanced Practice Clinician in a Large Multispecialty Medical Group
Donna E Forrest, N.P., M.S., APRN-BC, Chair Advanced Practice Clinician Advisory Council; and
Jaime E. Murillo, M.D., SMG-Cardiology Specialists, Sentara Medical Group

In 2015, Sentara Medical Group formed a special task force to address the role of advanced practice clinicians within the medical group, in response to growing concerns about patient access to care.  At that time, there were over 850 requests for new patient appointments weekly. 250 appointments could be made in the first seven days and another 550 spread out over two to eight weeks; however, it was estimated that between 5 and 15 new patients were being turned away every day. In this session, leaders from Sentara Medical group will detail their experience evolving the role of advanced practice clinicians and their impact on improving patient access, clinical quality, and patient experience. Hear the project deliverables, findings, accomplishments, and recommendations from their yearlong task force.
Upon completion of this activity, participants should be able to understand the value of the role of the APC in addressing the predicted future physician shortage; describe the role and scope of practice of the nurse practitioner and physician assistant; compare and contrast potential models of patient care delivery with full utilization of the APC, examine barriers to optimal utilization of APCs in a large physician group; develop internal and external marketing strategies to promote the role of the APC; and examine strategies to promote the physician-APC partnership in delivering quality patient care.

The Impact of a Weight Reduction Program at Aurora Healthcare:  Why Wait to Address Weight in Your Population?
Melanie Smith, D.O., Family Medicine Physician; and
Natasha Malesevich, Senior Project Manager, Aurora Health Care

As healthcare costs continue to escalate, one cannot overlook the impact of obesity on overall healthcare costs in patient and caregiver populations. Looking at historical data, Aurora estimated the total net amount spent on medical care and prescriptions for covered employees in 2011 was nearly $250 million In this session, the presenters will share their experiences measuring the impact of a weight management program on healthcare costs, which is enabling them to optimize and scale the delivery of an effective weight management program for both their caregivers and their patients.
Upon completion of this activity, participants should be able to understand the value of using existing data to project cost savings as a result of health program implementation; incorporate the use of internal metrics in the delivery and optimization of value-based care; and drive impact on healthcare costs through the delivery of an effective, lifestyle-based weight loss/weight maintenance program.

Partnering for Improved Health: Excela Health’s Implementation Journey
Robert Zimmerman, M.D., Assistant Medical Director;
John David Whatley, B.S., Client Relationship Manager; and
Donna Daniel, Ph.D., Senior Program Director, Continuum of Care, IBM Watson Health

In early 2016, Excela Health Medical Group (EHMG) joined AMGA’s Diabetes: Together 2 Goal® campaign to improve diabetes management across its population.  This session will demonstrate the effective use of partnerships and technology to support patient outreach and engagement, improve clinical quality measurement reporting, and manage large-scale improvement programs to prepare for value-based transformation.
Upon completion of this activity, participants should be able to showcase how a healthcare system used people, processes and technology to increase patient engagement and improve clinical quality care; demonstrate how Excela Health working with AMGA and IBM Watson Health assisted with the ease and accuracy of data reporting internally and externally for clinical quality improvement; and learn next steps for using data to further drive value-based transformation.

Reducing Unnecessary Admissions from the Emergency Department through Henry Ford’s New Emergency Disposition Support Program
Bruce Muma, M.D., FACP, Chief Medical Officer, Henry Ford Physician Network, Henry Ford Health System; and
Michelle Slezak, M.D., Senior Staff Physician, Henry Ford Hospital, Associate Medical Director Quality, Henry Ford Department of Emergency Medicine, Henry Ford Hospital

Learn how Henry Ford employed an innovative new model for reducing unnecessary admissions to the ED by coordinating the delivery of appropriate resources in safe, lower-acuity settings. In this transformative session, leaders from Henry Ford will identify the key metrics used to evaluate the program, explore challenges the program has encountered, and identify the factors that were critical to its success.
Upon completion of this activity, participants should be able to describe an effective model for reducing unnecessary admissions from the ED and reducing total costs of care accordingly; and identify critical factors that enabled a new program to better coordinate transitions of care from the ED while engaging many diverse stakeholders across a health system.

Ensuring a Remarkable Patient Experience Is Delivered in Every Dimension, Every Time
Mimi Helton, Senior Director, Clinic Services,
Marty Lambeth, Vice President, Clinic Services, and
Karen Nichols, B.S., Senior Director, Clinic Services, Novant Health Medical Group

Learn how Novant Health has strategically developed a clinic services team, comprised of leaders and team members who provide operational and optimization support for over 450 clinics across a 3-state footprint, to ensure each clinic is delivering on its promise to provide the most remarkable patient experience in every dimension, every time. In this session, leaders from Novant will discuss the lessons they learned while developing this team, what challenges the road ahead holds, and, most importantly, how the team has been able to execute its clinic services strategy without ever wavering from its primary goal.
Upon completion of this activity, participants should be able to identify the significant benefits that a strategically developed clinic services team can bring to a medical group; identify any services they may be lacking; discuss how to outline recommendations for improvement; and create effective tracking tools and measure the successful completion of operational improvements.

Retail Medicine Sustainability: A Synchronized Model of Urgent and Primary Care Serving Multiple Generations of Healthcare Consumers
David Brash, M.H.A., FACHE, President and Chief Executive Officer;
Stephen P. Combs, M.D., CPE, FACFE, FAAP, Chief Executive Medical Officer; and
Karen Williams, M.B.A., M.P.H., MGCHA Executive Director of Operations, Wellmont Medical Associates

Access to care is important for improved outcomes and medical care cost containment. With the increased prevalence of high-deductible plans and PCMH, the challenge is to serve patients at their convenience, not ours. Wellmont Medical Associates (WMA), a 2014 Acclaim Award Honoree, developed cost-effective urgent care centers that have allowed them to coordinate the right care at the right place at the right time for their patients. Learn how WMA, through their Epic EMR, was able to pair physician leaders with advanced practitioners at multiple locations to deliver quality, coordinated, and timely care in a financially sustainable model.
Upon completion of this activity, the participant should be able to describe a methodology to replicate a standardized, financially sustainable model for access to care that supports the primary care PCMH model and satisfies multiple generations of patients.

What Medicine Can Learn from Marketing: Re-Branding Primary Care
Zeev E. Neuwirth, M.D., Senior Medical Director for Population Health, Carolinas Healthcare System Medical Group
In health care, we continue to deploy interventions focused on “supply side” improvement―improved product/service features. In this presentation, Dr. Neuwirth will introduce the concept of a “Marketing Mindset,” which shifts the focusl to “demand-side” improvement and innovation―that is, focused on understanding and solving the needs of the customer (patient) and improving their “performance.” Carolinas Healthcare System has begun to deploy a set of methodologies (tools) that will allow them to shift from supply-side to demand-side thinking. This interactive presentation will introduce the conceptual frame of a Marketing Mindset, review the various methodologies from the literature case studies, and explore the experience of Carolinas Healthcare System.

AMGA Federal Legislative and Regulatory Update
Chet Speed, J.D., LL.M., Vice President, Public Policy;
Grant Couch, Director, Government Relations;
Darryl Drevna, M.A., Director, Regulatory and Public Policy;
David Introcaso, Ph.D., Senior Director, Regulatory and Public Policy;
Christina Lavoie, J.D., Assistant Director, Public Policy and Operations; and
James Miller, M.B.A., Director, Government Relations, AMGA

What are the latest updates on CMS payment models, including MACRA? What’s happening with the Affordable Care Act, Medicare and Entitlement reform under the new Administration and Congress? Join AMGA’s expert advocacy team as they highlight key items on AMGA’s 2017 healthcare agenda for Congress, as well as the critical need-to-know items that will affect your medical group in both the legislative and regulatory arena.
Upon completion of this activity, participants should be able to describe AMGA advocacy efforts on behalf of medical groups and other organized systems of care.

Friday, March 24, 3:45 p.m. - 5:00 p.m.

When It Seems Like Everyone Is Merging:  Remaining an Independent Group
Moderator: Pete Johnson, Western Regional and Workshop & Retreat Director, AMGA
Speakers: Jeff James, M.B.A., Chief Executive Officer, Wilmington Health;
Scott Barlow, M.B.A., Chief Executive Officer, Revere Health (invited); and
Michael Kasper, M.H.A., Chief Executive Officer, DuPage Medical Group

Market forces are driving more and more practices into considering consolidation and integration with hospitals and health systems. But, what if hospital ownership/integration isn’t the right decision for your group? In this session, hear from leaders from some of our foremost independent groups and learn what makes them think they can and should buck the trend.

How to Create a Culture of Continuous, Sustainable Improvement
Christopher Kodama, M.D., M.B.A., FAAP, President of MultiCare Connected Care/MultiCare Health System
Transforming the culture of an integrated delivery system to one of continuous, data-driven improvement isn’t easy—but MultiCare Health System has done it. MultiCare built a culture of continuous improvement through collaboratives (multidisciplinary, clinically focused teams) that have achieved measurable quality improvements and contributed to $100 million in cost reductions. In this powerful session, leaders from MultiCare will address how you can create and sustain a culture of continuous, data-driven improvement within your organization; champion system-wide change initiatives using a mixture of top-down and bottom-up leadership approaches; build teams for effective change management; and implement sustainable, enterprise-wide improvement initiatives.
Upon completion of this activity, participants should be able to outline the governance and function of organizational structures called Collaboratives, which are dedicated to improving outcomes across the continuum within a specific clinical area; describe how Collaboratives develop evidence-based guidelines and pathways; and explain the optimal way for Collaboratives to use analytics in their efforts to improve outcomes.

The Power of Culture
Warner L. Thomas, President and Chief Executive Officer, Ochsner Health System
In an environment where change is the only constant, understanding the role culture and communications play in achieving results is critical. Hear lessons learned from President and CEO Warner Thomas regarding Ochsner's work to transform communications to employees, physicians, and leaders to focus on their purpose: patients. This work, at every level of the organization, has resulted in a strong culture deeply rooted in Ochsner's mission, vision, and values that has driven employee engagement results >90th percentile.
Upon completion of this activity, participants should be able to assess their own communication strategies and identify significant areas of opportunity; describe how simple patient-centered language changes can drive results; and renew focus on purpose across their organization to amplify engagement.

Population Health Accountability: Promoting Organizational Process Standards and Dashboards
Michael Sheinberg, M.D., Medical Director, Medical Informatics, Lehigh Valley Health Network; and
Jennifer Schlegel, M.S.N., R.N., Senior Business Analyst, Enterprise Analytics

Improving the health outcomes of an entire population is no easy endeavor. Among the many challenges is the goal of transforming millions of individual patient encounters and service at a micro level to an organizational standard that aims to positively affect outcomes at a macro level. In this session, leaders from Lehigh Valley Health Network will focus on addressing the operational and technical knowledge gap that exists for efficiently translating individual patient encounters to large scale population health promotion, as well as the standard processes, electronic tools and accountability needed to provide operational tactics used to successfully and rapidly transition.
Upon completion of this activity, participants should be able to describe the important standard operational processes necessary to care for populations down to the patient level and translate that data back for population health management; list the enhanced electronic tools used to help aid staff and clinicians in translating patient encounter data to affect larger accountable care goals; and discuss the accountability strategy and matrix needed to improve quality with the use of standard processes and tools.

Using Machine Intelligence to Reduce Clinical Variation
Todd Stewart, Vice President, Clinical Integrated Solutions, Clinical Informatics, Mercy; and
Francis X. Campion, M.D., FACP, Internal Medicine Physician, Harvard Vanguard Medical Associates / Atrius Health, and Chief Medical Officer, Ayasdi

Mercy sought to forge a new path for one of its most critical initiatives, the development of clinical pathways, as an approach for standardizing evidence-based best practices to optimize care quality and outcomes while reducing costs and care variation. In this transformative session, leaders from Mercy and Atrius Health will illustrate the application of machine intelligence for optimizing care for total joint replacement and laparoscopic surgery patients at Mercy, using EHR data from 10 hospitals. This unbiased approach of machine intelligence for pattern identification unlocks valuable insights into practice variation for improving clinical pathways and population management.
Upon completion of this activity, participants should be able to contrast traditional, hypothesis-driven inquiry with “unsupervised” learning using machine learning and topological data analysis; outline strengths and weaknesses of large datasets from EHRs, claims and genetic analysis related to variation and anomaly detection; demonstrate the use of topological data analysis for surgical pathway optimization; and demonstrate new methods for understanding illness patterns in chronic disease populations using machine learning for claims data study and biomarker analysis.

Improving Outcomes:  Systemic Approaches to Dementia Detection, Diagnosis, and Care
Elizabeth Madison, Neuroscience Program and Operations Manager, Allina Health;
Terry Barclay, Ph.D., LP, Research investigator, Center for Memory & Aging, Regions Hospital, HealthPartners Medical Group; and
Michelle Barclay, Executive Co-Lead, Act on Alzheimer's, The Barclay Group, LLC

In an era where healthcare providers are increasingly recognized and rewarded for delivering value, Alzheimer’s disease and related dementias can and must be managed to reduce the severity of the disease, avoid unnecessary hospitalizations, and improve quality of care and life for those affected. With no cure or preventive treatment, we are even more compelled to address this issue head on. This powerful session will present the tools and practical approaches used by three large healthcare systems seeking to improve the quality of care for their patients with cognitive impairment and dementia.
Upon completion of this activity, participants should be able to review best practices in detection, diagnosis, care, and management of patients with Alzheimer’s and related dementias; share systematic approaches to dementia care that have been implemented in multiple health systems; highlight evidence and consensus based tools to simplify workflows; and discuss the rationale/case for strategic optimization of dementia management in health care systems.

Realizing the Value of Annual Wellness Visits
Daniel B. Hager II, M.H.A., Program Manager, Physician & Ambulatory Services, and Kyle P. Moore, CPA, View President, Ambulatory & Home Care, Bon Secours Health System, Inc.
In 2013, Bon Secours Health System, Inc. (BSHSI) embarked on a culture change initiative and made preventive services an equal priority with medical management of acute and chronic illnesses by holding executives accountable for completion rates of the Medicare Annual Wellness Visit (AWV) over multiple states. By applying a people, process, and technology approach to clinical transformation, BSHSI has achieved performance of over 50% of Medicare beneficiaries completing AWVs (far outpacing national averages at 16.7%) and is leveraging that success to drive quality and financial performance.   Learn how you can identify strategies and tactics for leveraging the AWV to achieve system goals and elite performance.
Upon completion of this activity, participants should be able to understand how an integrated healthcare delivery system demonstrate the value of Annual Wellness Visits in improving preventive health screening and improve patient engagement and loyalty in the process; learn how a 50% completion rate for Annual Wellness Visit was achieved; and identify strategies and tactics for leveraging the AWV to achieve system goals and elite performance.

No Appointment, No Problem:  Evolution of the Walk-in Clinic
J. Stephen Jones, M.D., President, Regional Hospitals and Family Health Centers; and
Renee Kolonick, M.H.A., Senior Director, Family Health Centers, Cleveland Clinic

Access can be challenging in a reactive healthcare environment, diagnosing and treating problems as they occur. It’s further complicated in a proactive population health environment, when visits may be more frequent and patient compliance is critical. This presentation will show how an extension of primary care through the use of walk-in clinics can not only provide a low-cost access point for the same-day acute need, but also open the PCP schedule to improve access for the chronic disease, and use this model to build practices of new physicians.
Upon completion of this activity, participants should be able to understand the advantages of walk-in access; improve access for low acuity care as well as chronic disease; discuss the transition of PCP to team based care; and describe a best practice staffing model for low cost care.

MACRA: Navigating a Path Toward Increased Risk Beyond 2017
Mark DeRubeis, M.B.A., Chief Executive Officer, Premier Medical Associates; Marc Gunter, MD, Co-Chief Operating Officer, Mercy Clinic; Jeffrey W. Bailet, M.D., Executive Vice President, Healthcare Quality and Affordability, Blue Shield of California; Erik Johnson, M.B.A., Vice President, Network and Population Health, Optum; and Chet Speed, J.D., LL.M. Vice President, Public Policy, AMGA
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) changes how Medicare pays physicians and other clinicians. The implications of the law extend beyond revenue throughout the health care system. The Centers for Medicare and Medicaid Services (CMS) is driving these changes in Medicare today, but most commercial payers are in quick pursuit in the hopes of containing costs. The Merit Based Incentive program (MIPS) is the most lucrative option in MACRA for maximizing Medicare payments¸ particularly for high-performing health care systems. Still, as the bar for performance rises, it will become more and more difficult to achieve the same results in future years. This is when groups are likely to transition over to the advanced Alternative Payment Model (advanced APM) to obtain greater stability in finances. But if they are not taking steps now to adjust for this transition, they’ll be unprepared for the financial risk associated with an advanced APM. Speakers will look at short and long term implications of MACRA and how it can serve as a catalyst enabling groups to improve care; grow provider capacity; foster collaboration and succeed in a new and uncertain health care economy. The panelists will describe how health systems and medical groups can make informed choices now to increase their financial stability as they are taking on more risk.
Upon completion of this activity, participants should be able to describe the essential tools needed to weather financial risks and strengthen market position in the near, medium, and long term implementation of MACRA and the Quality Payment Program (QPP); describe the importance of data, clinical analytics and predictive modeling in managing population health, improving care for high-risk patients, and driving down costs; explore the human, operational, and technological (e.g., actuarial, financial, and health analytic) expertise needed to predict and manage risk for stronger, more predictable performance; understand the importance of access to industry benchmarks to target resources and coordinate care for increased value across the care continuum (e.g., ambulatory, acute, post-acute, rehab, etc.); and explore the value of collaborative relationships in maximizing skills, maintaining a standard for the highest quality care, and accumulating the scale needed to succeed and advance in MACRA.

Saturday, March 25, 11:00 a.m. - 12:15 p.m.

The Dynamics of a Medical Group Inside a Health System: Leadership Challenges
Moderator: Howard Graman, M.D., Vice President, AMGA Consulting
Speakers: James C. Farley, Former Senior Vice President, MedStar Medical Group;
Michael Bukosky, MSHA, FACMPE, President, PPM, COO of USMD Holdings, USMD Health System; and
T. Clifford Deveny, M.D., Interim President and Chief Executive Officer, Summa Health System

As the integration trend continues, there are inevitable and natural tensions in the evolving dynamic of a medical group inside a health system.  In this session, three executives that have extensive experience with this dynamic will share their leadership lessons and initiate a discussion of the changing role of the medical group enterprise within the system.

Approaching the Triple Aim through Creation of a Motivational Workplace
Scott Rathgaber, M.D., Chief Executive Officer, Gundersen Health System
Creating a motivational workplace is of great importance to Gundersen Health System, and will be both transformational and critical to our future success. It fuels progress toward achieving the triple aim and goals of population health. This requires a comprehensive transformation of how we envision care delivery, community health, leadership, and staff development. It touches all parts of the organization.
Upon completion of this activity, participants should be able to evaluate care teams; create a motivational culture and environment; and determine how to improve their current workplace environment.

The Evolution from Retail Clinics to Medical Neighborhoods
James Bleicher, M.D., M.H.C.M., Regional President, SSM Health St. Louis Physician Organization & Ambulatory Services; and
Margaret Head, R.N., M.S.N., M.B.A., Vice President, Operations, SSM Health St. Louis Medical Group

Retail clinics have become a common outlet of care; however, In 2015, Walgreens approached SSM Health with a ground-breaking proposition in which SSM Health would assume operations of the 26 St. Louis metropolitan area Take Care Clinics. The critical strategic concept of the transaction was to take advantage of the geographic reach provided by the retail outlets and create Medical Neighborhoods, designed to provide the most convenient access and the right level of service to their patients. In this innovative session, leaders from SSM Health St. Louis Medical Group will present performance metrics and lessons learned from their pioneering journey.
Upon completion of this activity, participants should be able to understand the strategic value of retail services in the current health care environment; design a strategic and an operational plan to incorporate retail services as an extension of primary care physician practices; and evaluate the effectiveness of retail programs through objective metrics and subjective feedback.

Creating a Successful Medical Group Culture and Well-Being Plan
Peter Valenzuela, M.D., M.B.A., Chief Medical Officer, Sutter Medical Group of the Redwoods
As more physicians transition from private practice to employed models, incorporating them into organizations has proven challenging.  Despite recruiting excellent providers in the past, Sutter Medical Group of the Redwoods struggled to incorporate them into their group in a meaningful way. In addition, many of their physicians struggled with work-life balance due to long periods of time spent on electronic charting at home, leading to record levels of burnout. With this in mind, they set a goal to strengthen their group culture and improve the work life of their providers. Learn how Sutter Medical Group of the Redwoods, was able to increase provider retention rates, patient satisfaction scores, and provide EHR optimization support that led to a dramatic improvement in e-messaging turnaround and chart closure.
Upon completion of this activity, participants should be able to understand the importance of provider well-being; list key aspects to include in a group culture and well-being plan; and establish metrics to track group culture and provider well-being.

Developing a Virtual Scribe Program with Full EMR Integration
Kevin Conroy, Chief Financial Officer, Chief Population Health Officer;
Lewis Kohl, D.O., M.B.A., Chief Medical Information Officer, Senior Medical Director; and
Thomas J. Lester, M.D., Chief Medical Officer, CareMount Medical PC

Physician morale is at an all-time low, as many Physicians have come to feel that they are working for their EMR.  In response, CareMount Medical considered going to a scribe program to reduce the burden on physicians and to improve their satisfaction. However, unlike live scribes who add cumbersome technology, take precious exam room space and interfere with the privacy of the doctor/patient interaction, CareMount Medical utilized remote, asynchronous, clinical scribes and integrated the Virtual Scribe System in to their EMR. In this innovative session, leaders from CareMount will review the benefits of the program and discuss the equipment and technology requirements necessary to implement successful virtual scribe program.
Upon Completion of this activity, participants will be able to understand ow use of a virtual scribe can reduce the burden of an EHR upon a clinician; explain the advantages and disadvantages of a virtual versus a live scribe; describe how the use of a virtual scribe can increase provider satisfaction and engagement in quality programs and organizational initiatives; describe the steps required, options to consider, and the process by which to integrated the scribe program in an EMR; outline how this tool assists in meeting Meaningful Use, ACO, PCMH and other quality requirements; describe the technology required to record and manage the patient/physician interactions; and understand the physician training requirements.

Innovative Medical Group Approaches to Palliative Care
Elizabeth Glazer, MD, Medical Director for Palliative Care, WellMed Medical Group;
Dana Lustbader, M.D., FCCP, FAAHPM, Chair, Department of Palliative Care, ProHEALTH Associates;
James Mittelberger, M.D., M.P.H., FACP, FAAHPM, Director and Chief Medical Officer; and
Mitchell Mudra, M.B.A., National Program and Product Director, Optum Center for Palliative and Supportive Care

The most vulnerable and costly populations are those facing serious illness. Numerous studies demonstrate gaps in care for this high-need, high-cost group. To address this issue, leaders from WellMed, ProHEALTH, and OptumCare will describe their collaborative interventions to drive system changes that transform care for patients facing serious illness. Medical group leaders and palliative care experts will share their approaches, including use of data to identify patients, challenges in outcome assessment, and other key challenges faced.
Upon completion of this activity, participants should be able to recognize the large opportunities for medical groups to drive major outcome improvements and generate cost savings associated with serious illness care; define the key process and outcome metrics needed to improve serious illness care; understand the key data needed to identify patients for whom palliative care should be considered; access and use key tools and resources available to medical groups for improvement of serious illness care; and initiate a systematic medical group program to improve serious illness care.

Improving Care Delivery: Assessing and Addressing the Risk of Cardiovascular Disease for Patients with Diabetes
Robert A. Crossey, D.O., President;
Francis R. Colangelo, M.D., Chief Quality Officer; and
Holly Kern, R.N., Director of Quality Care, Premier Medical Associates

Through assessment of both Together 2 Goal ® and local Medicare Stars data, Premier Medical Associates (PMA) recognized that their practice was not attaining high performance levels for rates of prescribing of statins for adult patients with Type 2 diabetes. In this session, leaders from PMA will describe the interventions that led to dramatically improved adherence to evidence-based guidelines.
Upon completion of this activity, participants should be able to return to their practices with ideas to improve prescribing rates for statins for patients with diabetes.

Innovative Care Models:  Mercy’s Virtual Care Center
Randy Moore, M.D., President of Mercy Virtual
In 2015, Mercy invested $54 million to design an extensive virtual care center, with the capacity to allow the 330-person care team to monitor patients wherever they are―hospital, physician office, or home. By using technology to bring caregivers to the bedside instantly, care to patients and outcomes have improved dramatically. In this presentation, the speakers will share real-time examples of how this telemedicine model of care has saved costs to patients and the system over time, and has resulted in improved health outcomes to patients served by this technology.

Warning: Some Forms of Value Contracts Can Be Hazardous to Your Group’s Health
Robert E. Matthews, Vice President for Quality, PriMed Physicians, and President and Chief Executive Officer, MediSync
In the majority of markets, the payers are just starting to proffer value agreements. Many of the initial contracts on offer are bad for the medical group and unreasonably skewed towards the payer. There have now been several examples of organizations going broke while making care better.  Many medical groups are deeply concerned about their ability to improve the quality and cost-effectiveness of care successfully and in a manner that they can afford. This presentation outlines ways to improve contracts to allow the group to pace improvement with the availability of monies to support the costs of improvement.
Upon completion of this activity, participants should be able to understand several models of risk or value agreements in order to estimate both the costs and likely revenue results of different models to redesign care; describe a basic model for estimating revenue from value based contracts; and identify at least three negotiating strategies with payers.

Saturday, March 25, 2:00 p.m. - 3:15 p.m.

Who is Your Strategic Partner?  Why Your Choice and Process Matter
Moderator: Pete Johnson, Western Regional and Workshop & Retreat Director, AMGA
Speakers: C. Todd Staub, M.D., Chairman of the Board, ProHealth Physicians, Inc.;
Mark A Derubeis, Chief Executive Officer, Premier Medical Associates, PC; and
Christopher J. Knapp, Chief Executive Officer, The Everett Clinic

Medical groups are experiencing changes in the way health care is financed and practiced at breakneck speed. How groups navigate and ultimately engage in these new strategic partnership models may be the most important challenge we as provider organizations collectively face. In this discussion group, you will hear from three different non-affiliated medical groups on their experience engaging in new collaborative models. Learn how they were able to identify strategic partners that would provide not only capital, but also complementary competencies that could further advance their organization’s strategic goals.

Managing Change as Change Becomes the Norm: The Vancouver Clinic’s Medicaid Strategy
Alfred Seekamp, M.D., Chief Medical Officer; 
Sharon Crowell, M.D., Chair, Board of Directors, The Vancouver Clinic; and
Linda Carpenter, Ph.D, President, Carpenter Smith Consulting

In 2013, The Vancouver Clinic (TVC) estimated that it lost $13.5 million caring for its Medicaid patients.  In 2014, there were more patients and reimbursement was cut by the State yet again. This created a crisis of access for their patients, placed undue strain on providers and staff, and placed the organization in jeopardy financially. In this powerful session, leaders from TVC will outline how they are using a novel engagement strategy to help manage the monumental change within their organization, outlining their recent efforts to reduce Medicaid numbers and lead community efforts to care for these patients.
Upon completion of this activity, participants should be able to describe a unique and powerful approach to engaging physicians in responding to a financial crisis; understand the importance of physician engagement in developing organizational goals; describe a process that promotes local decision making to support organizational objectives; and apply strategies to be able to successfully manage challenging change.

Create a Bigger Bang: Learn How We Activated 100,000 Patients on our Portal in the First Year
Michael Sheinberg, M.D., Medical Director, Medical Informatics; and
Lindsay Altimare, M.P.A., Project Manager, Lehigh Valley Health Network

The digital revolution has spread widely and rapidly so that anyone with access to technology can engage and be engaged in almost any facet of their day to day life. Surprisingly, within the healthcare industry, this pace and scope lags behind. Yet it is healthcare delivery and patient engagement and demand that call for the most widespread, rapid and innovative leveraging of the digital revolution. This presentation walks through Lehigh Valley Health Network’s patient portal (MyChart) journey, highlighting milestones and critical success factors for reaching 100,000 activated patients in its first year. You will come away from this session with a roadmap for implementation, strategies on goal setting, lessons learned in pilot applications, how to develop workflow algorithms, tips on a patient marketing campaign, concepts for future applications, and lessons learned.
Upon completion of this activity, participants should be able to break down critical milestones achieved to accelerate patient portal activation; identify stakeholders’ roles and responsibilities required to deliver consistent, targeted message to broad audience; formulate detailed workflows to support portal enrollment in the physician practice setting; employ strategies to involve colleagues in cultural transformation to support patient engagement and enroll in the portal themselves; and gain an understanding of new targeted, digital marketing strategies to enroll patients.

Managing Patients for Performance under BPCI Total Hip and Knee Replacements
Kristen Daley, Director of Value-Based Programs, Centura Health – South Denver Operating Group; and
Ryan Walker, LSSBB – Orthopedic Service Line, Porter Adventist Hospital

As a part of Colorado’s largest integrated healthcare system, Centura Health Physician Group and Centura Health – Porter Adventist Hospital, partnered to engage in the Bundled Payment for Care Improvement (BPCI) Initiative sponsored by the CMS. In this session, leaders from Centura will share the story of their first year in BPCI for total joints replacement, including best practices driving program success and the lessons learned on the journey. This session is perfect for those who are unsure if their organization is ready for bundled programs.
Upon completion of this activity, participants should be able to assess their organizations readiness for bundled programs; experiment with approaches to assessing patient risk; begin assessing their post-acute partners to develop a preferred network; and know how to approach direct cost reduction.

The Extensivist Clinic: “Disruptive Innovation” Healthcare Delivery Model
Christopher Neglia, D.O., Lead Extensivist and Hospitalist, Holston Medical Group
The Extensivist Clinic of Holston Medical Group opened to patients in May 2013 to provide better care to the frail elderly population who would traditionally require hospitalization. In this session, Dr. Neglia will describe Holston’s innovative extensivist program and include a discussion on Post-Hospital Syndrome and the pitfalls of hospitalization―especially in the frail elderly population. By allowing patients to recover at home, HMG has been able to reap extreme cost savings and achieve high patient satisfaction scores.
Upon completion of this activity, participants should be able to identify the roles and functions of our version of an Extensivist Program; understand how quality of care improves and how health care costs are reduced; and acquire the tools to begin implementing an Extensivist Program.

Developing a Strategy to Address Opiate Use Disorder in Our Communities
Dan Cole, CMPE, Assistant Vice President, Medical Specialty;
Teresa Koeller, M.D., Board Certified Addictionologist, Medical Director, Addiction Medicine; and
Ashel Kruetzkamp, R.N., M.S.N., Nurse Manager Emergency Department, St. Elizabeth Healthcare Edgewood, St. Elizabeth Healthcare

In 2013 the Emergency Rooms of St. Elizabeth Healthcare began to experience an increase in overdoses relating to heroin and other opiates. At first glance the trend between the departments comprising the system was not considerable enough to warrant immediate action. However, that all changed in 2014 when the Emergency Rooms experienced a 36.70% when overdoses reached 745 from 545 in 2013. This was followed by 55.18% increase in 2015 when overdoses reached 1,156. In this session, leaders from St. Elizabeth Healthcare will provide a comprehensive framework of the opioid epidemic, treatment options, how to build relationships throughout the community and the necessary steps to help the community recover. Learn how to identify the signs and symptoms of the issues and how a healthcare community can form alliances within their medical community to support the social agencies, law enforcement, and the recovery community.
Upon completion of this activity, participants should be able to understand the complexity of the issues, examples of the types of the relationships they need to form, and the methodologies of how to create them; describe treatment options and how their medical group can part of the community solution; understand how opiate use disorder will lead to long-term complex health problems and what needs to be in place now to limit the impact; and review the impact of a well-organized community response and how these results can help the community recover.

Co-located, Integrated Community Specialists in the Primary Care Medical Home at Mayo Clinic: Maximizing Value Utilizing Curbside, Electronic, Triage, and Traditional Consultations
Muhamad Y. Elrashidi, M.D., M.H.A., Senior Associate Consultant and Assistant Professor of Medicine in the Division of Primary Care Internal Medicine, Department of Medicine;
Paul M. McKie, M.D., Senior Associate Consultant and Assistant Professor of Medicine in the Division of Cardiovascular Diseases, Department of Medicine; and
Nathan P. Young, D.O., Senior Associate Consultant and Assistant Professor of Neurology in the Department of Neurology, Mayo Clinic

Healthcare delivery in the US continues to present challenges to practitioners and healthcare institutions given the complexities of providing care to an increasingly aging, multi-morbid population across multiple care settings and amid significant changes to patterns of reimbursement and increased focus on delivering high value care. As a result, there is a critical need for development and dissemination of novel, high value care delivery models that can overcome these challenges. This session will empower attendees by highlighting these key issues and presenting Mayo Clinic’s experience with the development and impact of the Integrated Community Specialist (ICS) care model as a component of the patient-centered, primary care medical home (PCMH).
Upon completion of this activity, participants should be able to review salient healthcare trends underscoring imperative for integrated care delivery models; describe the co-located integrated community specialist care model; recognize co-located specialty care in the medical home as a way to improve primary and specialty care communication, collaboration, and care delivery value; and identify opportunities to adopt integrated specialty care models to improve high value care delivery for audience members’ organizations.