ihi expedition 2 slides...ihi expedition expedition ... • front-line nurse(s) ... collecting data...
TRANSCRIPT
4/7/2015
1
IHI ExpeditionExpedition: Preparing Care Teams for Bundled Payments
Session 2: Building a Care Bundle
April 7, 2015
Nick Bassett, MBATrisha Frick, MS, RN Lucy Savitz, PhD, MBAMolly Bogan, MA
Begins at 1:00 PM ET
Today’s Host2
Akiera GilbertProject Office Assistant
Institute for Healthcare Improvement
4/7/2015
2
Phone Connection (Preferred)3
To join by phone:
1) Click on the
“Participants” and “Chat”
icons in the top right
hand side of your
screen.
2) Click the button
on the right hand side of
the screen.
3) A pop-up box will
appear with the option “I
will call in.” Click that
option.
4) Please dial the phone
number, the event
number and your
attendee ID to connect
correctly .
WebEx Quick Reference
• Please use chat to
“All Participants”
for questions
• For technology
issues only, please
chat to “Host”
4
Enter Text
Select Chat recipient
Raise your hand
4/7/2015
3
5
Chat
5
Name and the Organization you represent
Example: Sam Jones, Midwest Health
Please send your message to All Participants
Expedition Director6
Molly Bogan, MA
Director
Institute for Healthcare Improvement
4/7/2015
4
Expedition Objectives
At the end of this Expedition, participants will be able to:
Describe the benefit of transitioning to a value-based purchasing model
Understand and apply activity-based cost accounting methodology to at least
one care process
Demonstrate examples of how to engage stakeholders in building a bundle
Describe how to customize care team redesign to deliver optimum care
under value-based purchasing
7
Today’s Agenda8
Introductions
Session 1 Action Period Assignment Debrief
Building a Care Bundle
Action Period Assignment
Closing
4/7/2015
5
Expedition SessionsSession 1: Volume to Value; Describe the benefit of transitioning Value- Based Purchasing
Lead Faculty: Lucy Savitz & Trisha Frick
Session 2: Getting Started with Building a Care Bundle
Lead Faculty: Trisha Frick & Nick Bassett
Session 3: Collecting Data Using Activity-based Costing
Lead Faculty: Nick Bassett & Lucy Savitz
Session 4: Engaging Stakeholders in Bundle Design
Lead Faculty: Trisha Frick
Session 5: Care Team Redesign
Lead Faculty: Trisha Frick
Session 6: Case Study: CMS Bundled Payments for Care Improvement Experience
Lead Faculty: Trisha Frick & Kathy Luther
9
Action Period Assignment Debrief10
• What patient population, procedure, or episode of
care did you identify to test a bundled payment
design?
• What criteria did you use to select it?
• Share with others using the chat to All Participants
4/7/2015
6
11
Chat
11
Please chat in the population or procedure
you chose to test a bundled design & what
criteria you used to select it.
Please send your message to All Participants
Faculty12
Lucy Savitz, PhD, MBA
Director of Research and
Education
Intermountain Healthcare
Salt Lake City, Utah
Trisha Frick, MS, RN
Assistant Director of
Managed Care
Johns Hopkins
HealthCare LLC
Glen Burnie, Maryland
Nick Bassett, MBA
Healthcare
Transformation
Manager
Intermountain
Healthcare
Salt Lake City, Utah
4/7/2015
7
IHI Expedition: Preparing Teams for
Bundled PaymentsApril 7, 2015 Webinar
Trisha Frick, MS, RN
Nick Bassett, MBA
• Identify episodes to bundle
• Identify available clinical champions
• Identify payer partnersInitiate
• Flowchart the episode across the continuum
• Capture cost & revenue streams
• Identify potential areas to eliminate wasteCreate
• Run retrospective analysis to determine potential bottom-line impact
• Structure the feedback system for cost, quality and service metrics
Complete
Session 2
4/7/2015
8
Common Guiding Principles for Identifying the Bundled Procedure
• Balance: volume, cost and risk
• Large variability
• Acute vs. chronic episodes
• Clearly understood patient population
• Elective vs. emergent
• Accessible data
• Engaged providers
Identifying an Available Clinical Champion
• Practicing physician
• Respected by their peers
• Benchmark practice
• Analytically minded
• Early adopter
• Strong relationships with key stakeholders
• Passionate about their program David Jevsevar, MD, MBA
4/7/2015
9
Payer Partners
• Government programs (BPCI)
• Commercial Insurance
• Direct-to-employer contracts
• Claims data (data sharing agreements)
• Other contracted groups
4/7/2015
10
Initiators for Bundled Rates
• Physicians
• Managed Care
• Commercial Insurance
• Direct-to-employer contracts
• Government programs (BPCI)
Assemble the Team
• Clinical champion
• Administrator
• CMO
• Front-line nurse(s)
• Quality consultant
• CFO/Analyst
• Project Manager
4/7/2015
11
Components of Healthcare Costs
Cost per
Person
Cost
Process Episode
Processes
Person
Episodes
Costs for a
single lab test
# lab tests with
a TKR# TKRs
Flowchart the Processes in the EpisodeDetermine the scope of the bundle
BPCI Example
4/7/2015
12
Flowchart the Processes in the EpisodeBegin with front-line staff
Flowchart the Processes in the EpisodeEstablishing Baselines
• Create or refine the existing CPM (care delivery baseline)
• Identify and approve quality metrics
• Determine the costs associated with the outlined processes
4/7/2015
13
Various types of Data
• Claims data
• Clinical (EMR) data
• Manually collected data
• Costing (chargemaster) data (will be discussed next time)
Questions/Discussion26
Raise your hand
Use the chat
4/7/2015
14
Action Period Assignment
• Focus on population or episode of care
identified in Session One
• Assemble the team using the members
identified in slide 20
• Flowchart out at least one sub-process in the
episode selected.
Expedition Communications
• All sessions are recorded
• Materials are sent one day in advance
• Listserv address for session communications:
• To add colleagues, email us at [email protected]
28
4/7/2015
15
Session 3
Lucy Savitz, PhD, MBA
Director of Research and
Education
Intermountain Healthcare
Salt Lake City, Utah
29
Tuesday, April 21st, 1:00 – 2:00 PM ET
Collecting Data Using Activity-Based Costing
Nick Bassett, MBA
Healthcare Transformation
Manager
Intermountain Healthcare
Salt Lake City, Utah
Thank You!30
Director: Molly Bogan
Akiera Gilbert
Please let us know if you have any questions or
feedback following today’s Expedition webinar.