richard m. hamrick iii, md, mba hca capital division, chief medical officer june 6, 2013 payment and...
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Richard M. Hamrick III, MD, MBAHCA Capital Division, Chief Medical Officer
June 6, 2013
Payment and Delivery Reform:Building a Bridge to the Future
HCA Virginia:Healthcare Provider
HCA Virginia:5th Largest Private Employer
Our Employees
• Over 30,000 covered lives
enrolled in our medical
benefit plans
• $77.8 million in annual
medical spend
HCA Virginia
• Healthcare-Associated Infections are a leading cause of preventable illness and death
• 43 HCA hospitals participated in a cluster-randomized trial to determine the best protocol to decrease MRSA healthcare-associated infections in the ICU – over 73,000 patients
• Trial resulted in identifying protocol that significantly reduces the rate of MRSA positive cultures by 37% and bloodstream infections by 44%.
Bloodstream infections are usually
serious infections typically causing
•Prolonged hospital stay•Increased Cost and
•Risk of mortality.
Targeted versus Universal Decolonization to Prevent ICU Infection
Jonathan B. Perlin, MD, PhD
Edward Septimus, MDJulia Moody, M.S., Jason Hickok, M.B.A., R.N.,
Employer Observations
Access“Help us increase the % of our
covered lives who have a primary care physician relationship”
ChronicDisease
“The minority of our covered lives drive the majority of our employee
benefit plan cost”
Costs “A well managed covered life is less costly to our employee benefit plan”
Over 900 Physicians in Central VA
Holding Each Other Accountable
to a Clinical Quality Program
Supported by IT Infrastructure
A Clinically Integrated Network
How HCA is Managing Their Own Covered Lives
16,000 covered lives Central VA
Economic incentives to utilize VQCP
Began
January 1, 2013
Embedded in all 3 HCA
benefit plans
How HCA is Managing Their Own Covered Lives
GENERAL STATS
15,321 members62% Female (Avg. 37 Yrs Old)38% Male (Avg. 34 Yrs Old)
HEALTH STATUS
76% Healthy10% Episodic14% Chronic
HIGH COST MEMBERS
10% of Population70% of Total Spend
747 Diabetics115 COPD
85 CHF116 Morbid Obesity
482 Asthma
CENTRAL VIRGINIA
ONLY
Biometric Screenings
H2UHealth
Coaching
Physician Led
RN Care Managers
Employer Solutions
Employer Claims
Analysis
Tailored Care Management
Better Quality, Lower Costs.
Increased Productivity
Building a Bridge
Data transparency
New payment models based on quality and cost
Personal performance improvement