webinar: integrating physician practices into your network
DESCRIPTION
As the federal government and private payers move swiftly toward value-based care, hospitals and health systems are increasingly looking to clinical integration strategies as a way to coordinate care more easily across settings, manage the health of populations and take advantage of emerging payment models. Join us as we explore strategies for integrating physician practices and ambulatory care facilities. Our panel of experts will outline proven practices—and pitfalls to avoid—when it comes to growing your network and bringing new docs into the fold.TRANSCRIPT
Welcome...
Today’s topic
Integrating Physician Practices Into Your Network
During today’s discussion, feel free to submit questions at any timeby using the questions box. A follow-up e-mail will be sent to all
attendees with links to the presentation materials online.
Patricia RichesinVice president, Physician Strategies and Services, VHA,Irving, Texas
Christopher LloydCEO, Memorial HermannPhysician Network,Houston
Dr. Charles KellyPresident and CEO,Henry Ford PhysicianNetwork,Detroit
HousekeepingHousekeeping1. Viewer Window 2. Control Panel
Maureen McKinneyEditorial programs manager,
Modern Healthcare
Now speaking...Please use the questions box on your webinar dashboard
to submit comments to our moderator
Patricia RichesinVP, Physician Strategies and Services
VHA
Now speaking...Please use the questions box on your webinar dashboard
to submit comments to our moderator
************************************THE PATIENT****************************
Creating a Community of CareFundamentals of Integrated System Risk Management
Employers • Payers • Providers • Hospitals
Right Providers Right Specialties Right Access Right Services
Optimal Outcomes Optimal Utilization Optimal Cost
Big Data Effective Networks New Knowledge New Expertise
1 |
Value-based care is forcing more hospitals and health systems to explore clinical and physician integration strategies
2 |
Assessment
Acculturation
Alignment
Assimilation
Creating a Community of CareKey steps to successful integration
3 |
Assessment
Acculturation
Alignment
Assimilation
Creating a Community of CareKey steps to successful integration
Lack of due diligence to ensure a match between hospitals and physician networks can derail long-term strategy
Assess demand for services across continuum, primary care and specialists, as well as places of service
4 |
Assessment
Acculturation
Alignment
Assimilation
Creating a Community of CareKey steps to successful integration
Not being aligned upon entering an agreement might lead to misunderstanding of value proposition and expectations for the relationship
Align incentives for clinical quality, patient access, financial outcomes; create structures that fit including employment models
5 |
Assessment
Acculturation
Alignment
Assimilation
Creating a Community of CareKey steps to successful integration
Resistance to change may ultimately result in conflict and misalignment of long-term vision/goals
Decide if you’re going to build or adopt a culture; share best practices while moving from a team of individuals to individuals on a team
6 |
Assessment
Acculturation
Alignment
Assimilation
Creating a Community of CareKey steps to successful integration
Without strong network and physician leadership, systems break down and progress is slowed
Need a team approach to care – not only across providers (primary, specialists, hospitalists), but within a practice (providers, nurses, techs)
7 |
Assessment
Acculturation
Alignment
Assimilation
Creating a Community of CareKey steps to successful integration
SuccessfulIntegration
8 |
Physician Integration Strategies
Appendix
7 keys to creating an efficient onboarding process
As new physicians and practice groups join your organization, a thoughtful, standardized approach can make onboarding and orientation go more quickly and efficiently.
Below are seven keys to creating an efficient onboarding process that enables a smooth transition for physicians and staff joining the new organization and assimilating into the new culture.
1. Due diligence: Create a check list of items typically required for due diligence such as by-laws, articles of incorporation, shareholder or partnership agreements, real estate documents, an asset list, all contracts, insurance documentation, pending litigation, financial documents, employee roster and regulatory compliance documents.
2. Document exceptions: Develop a template to document exceptions to the standard agreement. These might include medical directorships, additional assets or monetary arrangements or anything that is not typically part of the standard agreement.
10 |
7 keys to creating an efficient onboarding process
3. Develop a master onboarding list with a timeline. Identify responsible staff for each section and tie together sequential processes. Provide central access to the list so that each department can access it as needed.
4. Communicate. Communication and coordination is the key to ensuring that all items are completed prior to the provider beginning employment. Missing key deadlines can be costly to the organization. Setting up a realistic timeline, which is minimally 60 to 90 days is essential.
5. Appoint a project manager/owner. The project manager/owner serves as the key contact for administrators and practitioners to ensure the process goes smoothly and remains on schedule. Regularly scheduled meetings with key players helps keep the project moving and holds people accountable.
11 |
7 keys to creating an efficient onboarding process
6. Establish an orientation plan. During the first year of employment, assign a physician mentor and hold regular meetings with the medical director to ensure engagement and integration into the new group and culture.
7. Continually review the process. Create a physician survey related to the onboarding process as part of the master plan to help identify areas for improvement.
In our rapidly-changing environment, a well-planned onboarding process that serves as a structural compass before, during and after the partnership deal is done is critical to success. When a plan is in place, the organization as a whole benefits through improved employee morale and a vibrant culture that works together to put the needs of the patient first.
12 |
Dr. Charles KellyPresident and CEO,
Henry Ford Physician Network
Now speaking...Please use the questions box on your webinar dashboard
to submit comments to our moderator
Henry Ford Physician Network
• Clinically integrated as defined by FTC
• Operational April 2010
• Approximately 1700 physicians total– 1100 member Henry Ford Medical Group
– 100 non-HFMG, regionally employed physicians
– 500 private practice physicians
– Footprint in 3 county market, SE Michigan, 7 competitive Health Systems.
• Marketing as Narrow Network/Population Manager– Provider-owned Health Plan
– Direct to employer
• Application pending for CMS MSSP for 2015
On-boarding Process
• Practice Interest and Application completion
• 120 day period of pre-Qualification
membership
• Achieving Qualified membership
• Practice Orientation
Application period
• Clinical Integration is hard work and not for
everyone
• Initial contact regarding “interest” generally
triggered by news of peer receiving incentives
or desire to participate in a premium contract
• Little knowledge of the extra work and
commitment required of a CI Citizen
Application Period
• Following our notification, application and
copy of participation agreement forwarded
• If completed and returned within 2 weeks the
provider and practice enter a 120 day pre-
Qualification phase.
• We follow up with the practices in 2 weeks if
we have not received any information
• Status change to “ declined” and process ends
120 day pre-Qualification
• All the following elements must take place within
120 days or our agreement is void
– Establish data connectivity and continuous reporting
– W9 on file
– Approved credentials
– Executed participation agreement
• Your worst case scenario is having providers enter
into patient assignments without commitment to
CI process thus leading to beneficiary disruptions
Qualified Membership
• Orientation scheduled-designed for Office Mgr and key staff- helpful if physician attends– Actually begins during installment of data aggregator tool
– Physician portal registration/userID and password
– Metrics toolkits provided for appropriate specialty
– Contract summaries provided
– MSO offerings explained and process to acquire
– General overview of value of the Network and Clinical Integration
– Assist with practice workflow solutions
– Description of required coding and integrating with billing practices
– Leadership review, ie. Board members, Regional Medical Director and HFPN team.
• Physicians enrolled in all contracts
• Physicians achieve eligibility for incentives and benefits
• Office Manager Forum schedules and invitations
Metric Toolkits
• Essentially designed to inform participant on what they will be measured, what the source of data will be, how they will be informed of the outcomes and frequency of reports.– Press Ganey satisfaction surveys distribution by PN
– Data collection across ALL patients, not just contracted beneficiaries
• It also links these measures to our “Value Campaign” which also describes eligibility and scoring for earning incentives
• Introduction to the data dashboard that allows individual and specialty specific and regional comparisons.
• Choosing Wisely Campaign outline and requirements for members
MSO Offerings
• Subsidized IT offerings- supported by training, install and ongoing maintenance.
• Access to Group Purchasing discounts
• Affordable Malpractice coverage
• Privacy and security compliance for the practice
• Ford X Plan and other employee discounts offered to HFHS workforce
• Revenue cycle assistance with private vendor that generates robocalls and securely stores credit info
Christopher LloydCEO,
Memorial Hermann Physician Network
Now speaking...Please use the questions box on your webinar dashboard
to submit comments to our moderator
Complexion of the Physician Network
• MHMD
– 4000 practicing physicians
• 1950 CI physicians in MHACO (single signature representation)
• 300 Advanced Primary Care Practices (PCMH)
• 250 additional PCPs
• Evolving High Performance Specialty Physicians (500)
• 200 are employed (MHMG)
• University of Texas Physicians
– 800 physicians
– CI and ACO affiliates
– Some UT faculty participate in advanced and high performance practices
Memorial Hermann Corporate Structure
Memorial
Hermann Health
System
Children’s
Governance
Audit
System Quality
Finance
Physician Council
Corporate
Members
Memorial
Hermann
FoundationMHMDHePIC
MH Medical
Group
MH Health
Solutions, Inc.
MH Community
Benefit Corp.
MH Accountable
Care
Organization
MH Information
Exchange
CPCs: Connecting to the System Board and the Hospital Medical Staffs/MECs
MH Hospital Board
System Quality Committee
MHMD Board of Directors
Clinical Programs Committee
H&V Neuro
Woman/ Child
Surgery
Medicine Oncology
Path/Rad Primary Care
Nursing Councils
Operating Councils
Executive Liaisons
Service Lines
HOSPITAL MECs
Katy MEC MC MEC
NE MEC NW MEC
SE MEC SW MEC
SL MEC TMC MEC
TWL MEC
MH Medical Staffs (MHMD Members)
MHMD Clinical Programs Committees Physician Governance of Quality and Safety
MHMD Board of Directors
Clinical Programs Committee
H&V
Cardiology
CV Surgery
Neuro
Neurology
Neurosurgery
Woman/Child
Neonatal
OB/Gyn
Surgery
Anesthesia
Bariatrics
Orthopedics
ENT
Allergy
Medicine
Critical Care
Emergency
Ad hoc
Hospital Medicine
Post Acute
Oncology
Oncology
Contract
Imaging
Pathology
Primary Care
Adult PCP
Peds
Peer Review
Clinical Ethics & Palliative Care
Order SetEditorial Board
Informatics
Acute Surgery
DVT/PE JOC
End of Life Care JOC
Pediatric Head CT JOC
Surgical Home JOC
4
Memorial Hermann
Regional Medical Home Structure
Central Region• Hospitals - 4 (CMHH, TMC, TIRR, NW)• ASC - 3• MHDL PSC - 6
204 PCPs
•51 APCP (11 MHMD, 7 MHMG/Phytex, 33 UT)
•9 APP (5 MHMD, 4 MHMG/Phytex) •144 CI PCPs (inc UT)
757 Specialists• 21 MHMG/Phytex• 736 CI Specialists (inc UT)
• OPID - 7• SMR - 4
Northeast Region• Hospitals - 1 (NE)• ASC - 2• CCC - 1
33 PCPs
•20 APCP (15 MHMD, 4 MHMG/Phytex, 1 UT)
•0 APP•13 CI PCPs (inc UT)
73 Specialists• 4 MHMG/Phytex• 69 CI Specialists (inc UT)
• MHDL PSC - 1• OPID - 3• SMR - 2
North Region• Hospitals - 1 (TWL)• ASC - 4• FSER - 1
91 PCPs
•47 APCP (36 MHMD, 11 MHMG/Phytex, 0 UT)
•0 APP•44 CI PCPs (inc UT)
229 Specialists• 9 MHMG/Phytex• 220 CI Specialists (inc UT)
• MHDL PSC - 3• OPID - 3• SMR - 6
West Region• Hospitals - 3 (KT, KT Rehab, MC)• ASC - 4• MHDL PSC - 6
163 PCPs
•64 APCP (48 MHMD, 15 MHMG/Phytex, 1 UT)
•2 APP (2 MHMD, 0 MHMG/Phytex) •97 CI PCPs (inc UT)
283 Specialists• 15 MHMG/Phytex• 268 CI Specialists (inc UT)
• OPID - 8• SMR - 5
Southeast Region• Hospitals - 1 (SE)• ASC – 2• MHDL PSC – 3
97 PCPs
•38 APCP (15 MHMD, 16 MHMG/Phytex, 7 UT)
•0 APP•59 CI PCPs (inc UT)
141 Specialists• 7 MHMG/Phytex• 134 CI Specialists (inc UT)
•OPID - 6• SMR – 8
Counts as of 7/22/2014Physician counts do not include physician extenders *Includes UT Pediatricians, some specialty Pediatricians, and some IM and FP’s with a secondary subspecialty
Southwest Region• Hospitals - 2 (SL & SW)• ASC - 4• MHDL PSC - 6
174 PCPs
•73 APCP (34 MHMD, 33 MHMG/Phytex, 6 UT)
•4 APP (0 MHMD, 4 MHMG/Phytex) •97 CI PCPs (inc UT)
277 Specialists• 38 MHMG/Phytex• 239 CI Specialists (inc UT)
• OPID - 5• SMR – 8 (add’l 1 pending)
1 Additional SMR in Nederland
3 Additional MDs in Bay City: 1 MHMG PCP, 1 MHMG Specialist, 1 CI Specialist.
5
PCP Regional Leaders
Dr. Jeff Sweeney
Medical School
at USC and
residency at Kaiser
Permanente
Captain in
medical corps
Board certified in family medicine
North Northeast West Southwest Southeast Central
Dr. TejasMehta
Temple University School of Medicine
Residency at Penn State
College of Med
Board certified in Internal
medicine and
primary care
Dr. AnkurDoshi
University of Texas Medical
Branch Med
School
Board certified in Internal
Medicine
Founder of Prime Care Medical
Group
Dr. John Vanderzyl
University of Texas Health
Center – Houston
Board certified in family medicine
Named “Top Doctors in
America”
Dr. Adnan Rafiq
St. George
University
Medical School
and University of Medicine – New
Jersey
Board Certified in internal
medicine
Physician of the Year 2012
Dr. Kevin Giglio
UT Health
Houston medical
school
Residency at MH Family medicine program
Board certified family medicine
The MHACO
� Shared Savings and Aligned Incentives
� More flexibility in ACO “related” quality,
safety and efficiency program incentives
� MHMD contracting capability
MHACO
Promoting Evidence Based Medicine
Promoting Beneficiary Engagement
Internally Reporting On Quality And Cost Metrics
Promoting Care Coordination
POPULATION MANAGEMENT
Quality Assurance And Improvement Program Processes
Commercial Medicare
7
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Today’s panelists...Integrating Physician Practices Into Your Network
During today’s discussion, feel free to submit questions at any time by using the questions box.
Maureen McKinneyEditorial programsmanager,Modern Healthcare
Christopher LloydCEO,
Memorial Hermann Physician Network,
Houston
Dr. Charles KellyPresident and CEO,
Henry Ford PhysicianNetwork,
Detroit
Patricia RichesinVice president, Physician Strategiesand Services,VHA,Irving, Texas
TODAY’S MODERATOR
Thank you...
... for attending today’s editorial webinar on integrating physician practices into your provider network.
We also thank our panelists, Dr. Charles Kelly, president and CEO of Henry Ford Physician Network, Detroit;
Christopher Lloyd, CEO of Memorial Hermann Physician Network, Houston;
and Patricia Richesin, vice president of physician strategies and services, VHA, Irving, Texas.
Expect a follow-up e-mail within two weeks. For more information,
send an e-mail to [email protected]
Our next editorial webinar, “Patient Engagement: A Key Strategy for Population Health Management,”
is set for Wednesday, Sept. 17. For more information, please visit modernhealthcare.com/webinars