Transcript Slide 1

UC Irvine Health
Institute for Clinical and Translational Science
Addressing unmet clinical needs
Terry A. Belmont
CEO, UC Irvine Medical Center
June 19, 2012
-1-
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Addressing unmet clinical needs
Will hospitals become extinct in 2050?
What would be the implications?
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An evolution is taking place in healthcare
Our changing needs will require innovation
Mainframe
Minicomputers
Desktops
Laptops
Smartphones
Tablets/iPads
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Mission – our purpose
An ever-present reminder of why our organization exists. In addition to
describing what we do, it centers us and serves as a foundation for our work,
plans and vision.
Discover  Teach  Heal
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Vision – our aspiration
Identifies the overall direction and long-term view of our organization. It is
visceral and inspiring and serves to differentiate and promote our aspirations to
all constituents.
To be among the best (top 20)
academic health centers in the nation in
research, medical education, and
excellence in patient care
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Core values
ARI2SE:
Accountability – We are each responsible for the achievements and successes of UC Irvine
Health.
Respect – We foster an environment of mutual respect and trust amongst ourselves and with
all whom we serve.
Integrity – We tell the truth and strive to earn the trust of those around us.
Innovation – We seek ideas and approaches that can change the way the world discovers,
teaches and heals.
Service through teamwork – As departments, units and individuals, we collaborate to
effectively and compassionately serve our patients, each other and our community.
Excellence – We are committed to achieving the highest level of excellence in patient care,
discovery and education.
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Our foundation
Combined, these elements represent the foundation of UC Irvine Health’s strategic
plan. They ensure that all strategies and actions within the strategic plan support
UC Irvine Health’s purpose and long-term direction.
Mission
Vision
Core
Values
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Strategic
themes
The seven strategic
themes represent
key areas of focus.
Each of these
themes has one or
more goals and
associated strategies
defining the actions
required to move
UC Irvine Health
closer to its vision.
Advance
clinical
excellence
Strengthen
image &
community
partnerships
Broaden the
impact of our
clinical
expertise
UC
Irvine
Health
Financial
sustainability
Foster an
outstanding
team
Advance
premier
research
Educate for
the future
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Where we are today
There are many external pressures / forces impacting UC Irvine Health today and in the future.
Purchasers /
Consumers
Payer (Gov’t or
Private)
Economic
Provider
(Hospital &
Physician)
Demographic &
Epidemiology
Legislative /
Policy
UC Irvine
Health
Teaching and
Research
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The long-standing, existing provider business model based on volume,
will be supplanted by a model based on the best possible quality at the
lowest possible price or “VALUE”
Current / Existing
Business Model
• Activity based reimbursement /
reward volume growth
• Emphasis on aggressive top line
/ revenue negotiations
• Consolidate for market /
negotiating power
• Indirect / minimal financial
incentives for quality, safety,
satisfaction etc.
• Minimal risk assumed by
hospitals
Future
Business Model
• Provider payment tied to quality,
outcomes, and cost
effectiveness
• Emphasis on cost control,
productivity, and efficiencies
• Consolidate to secure
“populations”, scale, and build
coordinated / aligned continuum
• Assuming / sharing risk (next
generation capitation)
• Pricing power tied to ability to
demonstrate “value”
Prepared by UC Irvine Medical Center Strategic Services Department
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Provider
(Hospital &
Physician)
The emphasis on “value” will require providers to re-evaluate their
clinical processes and infrastructure
Healthcare is rapidly moving from an activity-based model to a value-based care
delivery model
o Best possible quality at lowest possible price
o Away from fee-for-service model
o Community or population health models
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Performance categories for UC Irvine Medical Center’s
organizational goals are based on the value equation
Patient Experience +
Quality of Care
Patient
Experience
Quality
of Care
Service /
Patient
Experience
Quality /
Safety
I.T.
Cost of Care
Cost of
Care
Size /
Growth
Finance /
Cost
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Needs in patient care delivery.
Burning platform priorities and initiatives for FY2013
 Quality & Safety Outcomes
o Utilization Management /
Case Management
o Lean Sigma (SPI)
 Patient Experience (SPI)
 Cost Reduction
o Throughput Improvement
o Lean Sigma (SPI)
o Resource Opportunity
Improvement (ROI)
 Robust EMR/EHR
o QUEST implementation
*(SPI) = Strategic Plan initiative
 Delivery System / Network
Infrastructure
o Primary Care Strategy (SPI)
o Ambulatory Care Strategy (SPI)
 Market Essentiality
o Brand Strategy Development &
Implementation (SPI)
o Portfolio Analysis
(SPI)
o Cancer Center Clinical Strategic
Business Plan
 Funds Flow / SOM Deficit (SPI)
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10 value imperative issues
1. Quality Outcomes: Ability to demonstrate quality outcomes (outcomes of care, process of care, safety, etc.) that are
exceptional.
2. ALOS / Throughput: Reduction in ALOS and improvements in throughput (patient flow and reduced wait times once
in our system) that free up capacity, improve service, and reduce costs.
3. Cost Reduction (Make Margin at Medicare Rates): Reduce the cost of delivering care (both inpatient and
outpatient) at UC Irvine Medical Center to improve our value, enable competitive pricing and provide sustainable cash
flow and capital to the organization.
4. Payment Models (Taking Risk): Pilot, build infrastructure for and begin taking risk (capitation) for populations.
May include large populations (ACO), professional capitation (HMO), or target specific populations (bundled payments).
5. Primary Care: Develop a robust primary care network in key geographies to secure secondary referrals and prepare
for primary management of (select) patient populations.
6. Community Network of Care: Expand UC Irvine Health’s ambulatory footprint in the community including
specialty care and ambulatory care both on / off campus as well as implementation of other cost-effective care settings
(urgent care, retail, etc.).
7. Patient Experience: Ability to demonstrate and distinguish UC Irvine Medical Center through an exceptional patient
experience as measured by HCAHPS and other service measurements.
8. Senior / Medicare Opportunities: Implement strategies and programs to capture senior market share and
capitalize on the growing senior market. Includes dual-eligible strategy.
9. Health Insurance Exchanges: Implement strategies and programs to capture market share resulting from the
advent of the California Health Benefit Exchange.
10.Medi-Cal Eligibility Expansion: Implement strategies and programs to capture market share resulting from the
eligibility expansion of Medi-Cal.
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So, will hospitals become extinct in 2050?
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Rethinking the delivery of care
Outcomes vs.
Volume
Health vs.
Healthcare
Home vs.
Hospital
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Rethinking the delivery of care
Prepared by Geisinger Health System, Nov. 2011
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The implications
Will require us to continue leveraging technology.
The iPad iMedEd Initiative
• UC Irvine continues to lead in the development of a completely tabletbased medical school curriculum. It was the first in the nation to do so in
August 2010.
Diagnostic ultrasonography
• UC Irvine School of Medicine was the first medical school on the West
Coast and the second in the nation to introduce this into all four years of
medical school curriculum. The technology has the potential to improve the
quality of patient care.
Telemedicine
• Will provide greater access to quality healthcare. Used in medical
education and to consult with patients remotely. Home care is going to
become increasingly important in all aspects of medicine in the next
decade.
…and more from you
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Again, will hospitals become extinct?
Yes. In their present form.
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Thank you.
Questions?