consumer and physician engagement during a major hospital ...€¦ · specialists launched first in...

PRESENTED BY

Consumer and Physician Engagement During a

Major Hospital Affiliation

Lisa Neveling, VP, Program Development Nur M. Nur, Business Development Associate

Lahey Health, Business Development

Lahey Health

Overview

2

© Copyright 2016 Healthgrades Operating Company, Inc. All Rights Reserved. May not be reproduced or redistributed without the express permission of Healthgrades Operating Company, Inc. 3

1888 Beverly Hospital, Beverly MA Founded

1889 Addison Gilbert Hospital, Gloucester MA Founded

1912 Winchester Hospital, Winchester MA Founded

1923 Lahey Clinic, Boston MA Founded

1980 Lahey Clinic Moves to Burlington MA

1994 Lahey Clinic, Peabody MA Opens Beverly and Addison Gilbert Merge

1995 Northeast Health System Forms (Beverly/Addison Gilbert, Behavioral Health, Senior Health)

2012 Lahey Health System Forms (Lahey Clinic and Northeast Health System)

2014 Winchester Hospital Joins Lahey Health VNA Middlesex East Joins Lahey Health

History of the Lahey Health System

Massachusetts Health Care Landscape

Rising Costs, Unique Utilization

5


Academic Medical Center Utilization

The Massachusetts delivery system uses major teaching hospitals for far more of its inpatient care than the rest of the nation.


State Budget Consequences

Lahey Health Model of Care

Keeping Care Local

8


Right-Sized Inpatient Capacity

Ability to Keep Care Local

Lahey Health’s Unique Advantage

© Copyright 2016 Healthgrades Operating Company, Inc. All Rights Reserved. May not be reproduced or redistributed without the express permission of Healthgrades Operating Company, Inc.

Overall Hospital Case Mix Index Benchmarked against Median Teaching Hospital

10

1.77

1.78 1.79 1.84

1.87

1.82

1.80

1.86 1.84

1.82 1.84

1.89

1.63

1.63 1.64

1.66

1.64

1.70 1.66

1.70

1.69 1.69

1.71 1.75

1.30

1.40

1.50

1.60

1.70

1.80

1.90

2.00

2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q4 2014 Q1 2014 Q2 2014 Q3 2014 Q4

LAHEY Median Teaching Hospital 75th Percentile Teaching Hospital 25th Percentile Teaching Hospital

Source: AAMC•COTH Quarterly Survey of Hospital Operations & Financial Performance Note: recent survey n=147 Overall Hospital Case Mix Index = Overall Hospital Case Mix Index

Higher is Better


CMI Adjusted Expense per Adjusted Discharge Benchmarked against Median Teaching Hospital

11

$7,609 $7,424

$8,351

$7,492 $7,900

$7,165 $7,529

$7,173 $7,607 $7,726 $7,764

$7,555

$9,577

$9,438 $9,660

$9,533 $9,422

$9,177 $9,593

$9,841

$9,936 $9,492 $9,480

$9,651

$5,400

$6,400

$7,400

$8,400

$9,400

$10,400

$11,400

$12,400

2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q4 2014 Q1 2014 Q2 2014 Q3 2014 Q4

LAHEY Median Teaching Hospital 75th Percentile Teaching Hospital 25th Percentile Teaching Hospital

Lower is Better

Source: AAMC•COTH Quarterly Survey of Hospital Operations & Financial Performance Note: recent survey n=147 CMI Adjusted Expense per Adjusted Discharge = (((Total Operating Exp - Total Other Operating Rev) * (Inpt Gross Rev/ Total Gross Rev) / Total D/Cs) / Overall Hospital CMI


Lahey Hospital & Medical Center – A Top Performer Among Peers on Quality Measures COMPARED TO US NATIONAL RATE

12

Hospital Overall Nurses Doctors Responsive

ness Pain

controlled

Explanation about

medicines

Lahey Hospital & Medical Center(MA)

Massachusetts General Hospital (MA)

Brigham & Women’s Hospital (MA)

The Johns Hopkins Hospital (MD)

Cleveland Clinic Foundation (OH)

Hospital of University of Pennsylvania (PA)

Source: Hospital Compare - 7/1/2014-6/30/2015


Economic Savings to the Payers and Commonwealth


Lahey Health Competitive Vision

Cost, Quality, Access = Value

Lahey Health Patient Direct Connect

Experience

15


Eastern MA: Competitive Spending

16

$0

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

$6,000,000

2012 2013 2014

Lahey Health

Key Competitor


Emerging Points of Disruption to Healthcare’s Business Model

Payer shift from volume to value

Emergence of “care anywhere”

Entrance of new, innovative, well-financed competitors Health care as a “retail good”, consumer price sensitivity


Lahey Health and Healthgrades

• Customer Relationship Management and Call Center since 2009

• Patient Direct Connect program since 2014

• Quality Achievement online messaging

• Marketing Automation

• Expansion of CRM database with Lahey Health data in progress


Lahey Health Patient Direct Connect (PDC) Objectives

• Capture new business for Lahey Health primary care/specialist care

• Enhance Lahey Health profile among women (45 to 64 yrs)

• Increase commercial payer mix

• Enhance physician alignment/engagement

• Engage in measurable growth activity


Lahey Health PDC Phased Implementation

• Employed Lahey Health primary care providers and specialists launched first in September 2014 – Creation of Central Physician Database

– Quality Control of Data – Met minimum physician profile data requirements to

launch program

• Next wave captured newly-affiliated, employed Winchester Hospital PCPs and specialists in October 2015


Sustaining PDC in Lahey Health

Educate and partner with

system program

stakeholders Continuous

evaluation of performance

Ensure high physician fill

rate Frequent update of physician

roster

Identify PDC tools to help

build on existing

successes of the program

Create program standardization by centralizing

ownership


Lahey Health PDC Results

23

Program to Date totals from September 2014 forward

March 2016 Contract to Date Program to Date Searches 60,371 273,266 602,975 Calls 1,656 8,204 15,372 Referrals 1,612 7,895 14,650 Transfers 780 3,911 6,980 Conversion Ratios Call/Search 2.7% 3.0% 2.6% Referral Transfer Rate 48.4% 49.5% 47.7%


Lahey Health PDC Call Volume

24

43% 50% 55% 55% 53% 51% 56% 52% 57% 61% 56% 59%

0%10%20%30%40%50%60%70%

Apr2015

May2015

Jun2015

Jul2015

Aug2015

Sep2015

Oct2015

Nov2015

Dec2015

Jan2016

Feb2016

Mar2016

% New Patient callers by month

* New Patients are self-reported at the time of call

3720

2922

338

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

6,980 Transferred Callers

OTHER

EXIST

NEW

89 80 94 154

* 261 298 260

+ 458

395 462

0

100

200

300

400

500

Apr2015

May2015

Jun2015

Jul2015

Aug2015

Sep2015

Oct2015

Nov2015

Dec2015

Jan2016

Feb2016

Mar2016

Number of New Patient Callers

* Moved to HG call center + Added Winchester and increased competitive search


Lahey Health New Patient Projected ROI

25

*ROI Estimated based on average encounters per call and historic reimbursement rates for encounters

-0.53 -0.18

0.33

0.98

1.73

2.53

3.39

4.33

-2.00

-1.00

0.00

1.00

2.00

3.00

4.00

5.00

Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16

New Patient ROI


PDC: Reflection

• Identify active champions from across the organization

• Create seamless coordination between internal access center and Healthgrades call center

• Engage Finance/IT to ensure timely ROI measurement

• Centralize PDC program management

• Create and launch internal communication plan early on


PDC: Future Goals

• Determine program ROI

• Expand PDC program to include private practice primary

care providers and specialists

• Enhance patient access through online appointment scheduling

• Continue to enhance and hone provider profiles

Questions?

28

Thank You

consumer and physician engagement during a major hospital ...€¦ · specialists launched first in...

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