Transcript VHA Quarterly Business Review Template

Engaging Physicians in the Transition from
the Volume to Value-based Care Model
Lani Berman
VHA Vice President Performance Services
Richard D. Parker, MD
Professor of Surgery, CCLCM
Chairman, Department of Orthopaedic Surgery
Orthopaedic Rheumatologic Institute
Cleveland Clinic Foundation
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Disclosures
Lani Berman, MBA, MPH, VP, VHA has nothing to disclose
I, Richard D. Parker, MD have relevant financial relationships
to be discussed, directly or indirectly, referred to or
illustrated with or without recognition within the presentation
as follows:
• Smith & Nephew: Consultant/Education
• Zimmer: Consultant/Royalties
• Cleveland Clinic: Chairman, Orthopaedics
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About VHA
Member-based, national network of 5,100 not-for-profit
health systems and affiliates—representing both
traditional acute-care hospitals and a diverse mix of
providers that operate as extensions of the health system
Help hospitals reduce costs through group purchasing
contracting across their hospital or health system
Highly focused on clinical improvement and Member
collaboration
Leader in consulting in the areas of clinical, operational,
supply chain and financial performance for health systems
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About Cleveland Clinic
• Became a hospital system in 1990s
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Mantra is “Patients First”
“To Act as a Unit” and “All for One”
Physician-led
Culture of leadership
• 60% employed physicians and 40% private practice
physicians
• Physician employment contract is for one year
– Annual Professional Review
– Each Staff has a different “formula”
• Patient Care – Research - Education
– Salary is adjusted each year
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Department of Orthopaedic
Cleveland Clinic Foundation:
Department of Orthopaedics
Ranked #3 for Orthopaedics
by U.S. News & World Report magazine
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Department of Orthopaedic
CCF Department of Orthopaedics:
Patient Care/Research/Education
• Two Orthopaedic Residencies
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Allopathic
Osteopathic
• One Podiatry Residency
• Eight Clinical Fellowships
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Hand/UE
Adult Reconstruction
Sports & Exercise Medicine
Sports Ortho
Spine Ortho/NS
Pediatric Ortho
Foot/Ankle
Shoulder
• Research Fellows
• CCLCM (32 Medical Students/year)
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Department of Orthopaedic
Orthopaedic Locations
“More than Main Campus”
24 Locations in
Northeast Ohio
CCF Florida
CCF Canada
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Department of Orthopaedic
Reality of Being An Orthopaedist:
“It doesn’t suck to be us!”
• We improve quality of life
• We provide “Episodic Care”
• Baby Boomers
• Orthopaedics is fun!
• Innovation
• We make a great living
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Department of Orthopaedic
Bridging the Divide Between Physician
Alignment and Clinical Integration
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The New Era of Health Care
Volume – Based
►
Value Based
Payment
Fee-for-Service
Outcome Based
Incentive
Volume
Outcome/Cost
(Value)
Focus
Acute Episodes
Populations
Role of the
Provider
Single Episodes
Care Continuum
Information
Retro/Prospective
Real-time & Predictive
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Three Areas of Critical Focus for Health Systems
During Transition to Value Based Care Model
Optimize cost and
quality to remain
competitive in
current acute care
model
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Engage and align
physicians to new
value-based care
model
Assess and stage the
transformation to
integrated care across
the continuum
Equation for a Value-Based Model
Value
=
Quality (Outcomes)
We are here
Cost
Physicians
Cost
Where
we need
to be
Quality (Outcomes)
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Department of Orthopaedic
How Will Physicians be Valued in the
Equation?
Value =
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Quality (Outcomes)
Cost
x Engagement
Department of Orthopaedic
Components of Physician Engagement
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Track Outcomes (OrthoMiDas)
Cost Effective (Care Path)
Appropriateness of Care
Comparative Effectiveness
Professionalism
Efficiency
Skill
Lifelong Learner
Malleable (Cooperation)
Participation
Leadership
Department of Orthopaedic
Components of Physician Alignment
• Communication
– Financial ROI
– Dashboards (SSI, SCIP, HCAPS, etc.)
• EMR/Outcomes (OrthoMiDas)
• Care Path (TKRA and THRA)
• Physician meetings with Supply Chain
– EMB driven
– PPI (Physician Preference Items)
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Quality & Patient Focus
Transparency (COI)
Vetted
Examples: (Total joint/Spine/Trauma/Bone Graft)
• RFP (ACT AS A UNIT) with Vendors
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Department of Orthopaedic
Summary: Achieving Physician Engagement
and Alignment Requires…
Shared
goals
Transparent
data sharing
Ongoing
education
Adaptability
Open
communication
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Contact Lani Berman ([email protected]) or Dr. Richard Parker
([email protected]) for more information
This VHA Inc. information is proprietary and highly confidential. Any unauthorized dissemination,
distribution or copying is strictly prohibited. Any violation of this prohibition may be subject to penalties
and full recourse under law. Copyright 2014 VHA Inc. All rights reserved.
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