Transcript Slide 1

Change is Inevitable…Are we Ready?
The Impact of National
Health Care Reform
Presentation to:
20th Annual Education Session
Health Care Quality Institute
Marco Island, FL
June 27, 2014
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Presentation Objectives
• Discuss the impact national health care reform is having
on care delivery models, patient experience, and public
health financing;
• Share strategies for addressing the rapid change and
uncertainty health care; and
• Address the need to bring more value at a lower cost
without jeopardizing quality.
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ABOUT AHS
Our Mission
Caring, Healing, Teaching, Serving All
Excellence for All
Safety Net
Provider
Alameda Health
System
Integrated Regional
Network
H
E
J
F
W
… 2012
Assess and
Plan
2013-2017
Build, Adapt,
Transform
2022…
Sustain system
& manage pop
Our Vision
AHS is recognized
as a world-class
patient and family
centered system of
care that promotes
wellness, eliminates
disparities and
optimizes the health
of our diverse
communities
Organizational Overview
1864
Alameda County Infirmary opened on the Fairmont Campus
1927
Highland Hospital opened in Oakland
1960s
Ambulatory health care services launched
1992
John George Psychiatric Pavilion opened
1990s
Alameda County Medical Center (ACMC) was formed by merging Fairmont Hospital with
Highland Hospital and John George Psychiatric
1998
Alameda County Hospital Authority was created
2012
Adopted 10 year Financial Plan and 5 year Strategic Plan
2013
ACMC renamed and rebranded to Alameda Health System (AHS)
Expanded Ambulatory – Same Day Services; San Leandro Hospital acquired
2014
Alameda Hospital affiliation completed
Organizational Overview
Nationally recognized
public health system
849 licensed beds, 4,545 employees, 1000+ MDs, 5 acute
hospitals, 3 SNFs and 4 Wellness centers
Average Daily Census: 411; Discharges: 20,461, ED Visits:
146,932
OP Clinic Visits 312,465 ; Surgeries: 9,176; Births: 1,080;
Operating budget: $805M
Training tomorrow’s
doctors (160/year)
Training students/
providers
Emergency Medicine, General Surgery, Internal Medicine,
Orthopedics, Oral Maxillofacial Surgery, Podiatry
Nurses, allied health professionals, pre-doctoral psychology
interns
Market Presence
Eastmont Wellness
Highland Hospital & Wellness
John George Psych Hospital
Fairmont Hospital
San Leandro Hospital
Hayward Wellness
Newark Wellness
Alameda Hospital
Change
Hard
Inevitable
Unavoidable
Transformation
The nation is experiencing the most significant
TRANSFORMATION of the health care delivery system
since the launch of Medicare.
• Successful transformation is dependent on our
ability to CHANGE.
HITEC
PPACA
PCMH
2009
2010
2011
ACO
HBE
VBP
2012
2013
2014
Patient Protection and
Affordable Care Act
January 1, 2014 Changes
• Guaranteed Issue – Preexisting condition clause
• Minimum health insurance
standards
• Individual mandate
• Health Insurance Exchange
• Federal Subsidies for
individuals, families, and small
employers
• Medicaid expansion
• Medicare shift from FFS to
bundled payments
• Employer mandate
Alameda Health System
Strategic Goals
1
ACCESS
3
Effective physician and
hospital partnership that
supports clinical integration
leading to improved quality
SUSTAINABILITYand experience for patients
Market competitive standard
for access in the communities
we serve that supports
organizational growth
2
INTEGRATION
Financial sustainability that
supports growth and
reinvestment to sustain
our mission
4
5
EXPERIENCE
Patients feel valued, cared
for and continue to choose
us as their medical
home/provider of care
5
NETWORK
Community engagement and
external partnerships that
align resources necessary
for a sustainable clinically
integrated network of care
6
WORKFORCE
Culture of excellence in the
workforce that empowers
staff to embrace and lead
transformation to a high
performance health system
2010 Federal Spending: $3.5T
Education, 3%
Transport, 3%
Research, 2%
Employee
Benefits, 7%
National Debt, 6%
Other, 3%
Defense,
20%
Social
Safety-Net,
Security,
14%
20%
Medicare,
Medicaid,
CHIP, 21%
Federal goal is to shrink that
number year after year after year
Patient Experience
National Health Care Reform
• Accountable Care Organizations
• Medicare Innovation Projects
• Administrative Simplification
• Anti-Discrimination
• Provider Profiling
Change
Hard
Inevitable
Unavoidable
Implementing a Turn Around
Build
Excellence
Board
Alignment
Financial
Focus
Goal
Alignment
Performance
Improvement
Focus on
Culture
1: Recognize MegaForces
•
•
•
•
•
•
•
•
•
Demographic Shifts
Technology Changes
Workforce Shortages
Economy
Accountable Care
Payment Reform
Health Care Consumerism
ICD-10
Changing Regulations/Compliance
2: Prepare and Empower
3: Don’t Wait
4: Plan, Do, Check, Act
5: Influence Consumer
Decision Making
The Consumer Decision Model
Changing the Face
of Health Care
Access
Sustainability
Experience
Looking to the Future
The Four Agreements: Miguel Ruiz
Don’t make
assumptions
Don’t take anything
personally
Be impeccable
with your word
Always do your best
Issues Before Us!
THANK YOU!
Carladenise A. Edwards, Ph.D.
CHIEF STRATEGY OFFICER