engaging physicians in the transition from the volume to value-based care model
DESCRIPTION
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. - PowerPoint PPT PresentationTRANSCRIPT
1| VHA Inc. Confidential information.
Engaging Physicians in the Transition from the Volume to Value-based Care Model
Lani BermanVHA Vice President Performance Services Richard D. Parker, MDProfessor of Surgery, CCLCMChairman, Department of Orthopaedic SurgeryOrthopaedic Rheumatologic InstituteCleveland Clinic Foundation
2| VHA Inc. Confidential information.
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
Disclosures
3| VHA Inc. Confidential information.
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
About VHA
Department of Orthopaedic Surgery
About Cleveland Clinic
• Became a hospital system in 1990s – 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
4
Department of Orthopaedic Surgery
Cleveland Clinic Foundation: Department of Orthopaedics
Ranked #3 for Orthopaedics by U.S. News & World Report magazine
5
Department of Orthopaedic Surgery
CCF Department of Orthopaedics: Patient Care/Research/Education• Two Orthopaedic Residencies
– Allopathic – Osteopathic
• One Podiatry Residency • Eight Clinical Fellowships
– Hand/UE– Adult Reconstruction – Sports & Exercise Medicine – Sports Ortho – Spine Ortho/NS – Pediatric Ortho – Foot/Ankle – Shoulder
• Research Fellows• CCLCM (32 Medical Students/year)
6
Department of Orthopaedic Surgery
Orthopaedic Locations“More than Main Campus”
24 Locations in Northeast Ohio
CCF FloridaCCF Canada
7
Department of Orthopaedic Surgery
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
8
9| VHA Inc. Confidential information.
Bridging the Divide Between Physician Alignment and Clinical Integration
10| VHA Inc. Confidential information.
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
11| VHA Inc. Confidential information.
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
Engage and align physicians to new value-based care
model
Assess and stage the transformation to
integrated care across the continuum
Department of Orthopaedic Surgery
Value = Quality (Outcomes)
Cost
Cost
Quality (Outcomes)
We are here
Where we need
to be
Physicians
Equation for a Value-Based Model
12
Department of Orthopaedic Surgery
Value = Quality (Outcomes)
Costx Engagement
How Will Physicians be Valued in the Equation?
13
Department of Orthopaedic Surgery
Components of Physician Engagement
• Track Outcomes (OrthoMiDas)• Cost Effective (Care Path)• Appropriateness of Care• Comparative Effectiveness• Professionalism• Efficiency • Skill• Lifelong Learner• Malleable (Cooperation)• Participation• Leadership
14
Department of Orthopaedic Surgery
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)– Quality & Patient Focus– Transparency (COI)– Vetted– Examples: (Total joint/Spine/Trauma/Bone Graft)
• RFP (ACT AS A UNIT) with Vendors
15
VHA Inc. Confidential information.
Summary: Achieving Physician Engagement and Alignment Requires…
16 |
Opencommunication
Sharedgoals
Transparentdata sharing Adaptability
Ongoingeducation
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.
VHA Inc. Confidential information.
Contact Lani Berman ([email protected]) or Dr. Richard Parker ([email protected]) for more information
17 |