• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
HFM's Reform Readiness AHA Webinar
 

HFM's Reform Readiness AHA Webinar

on

  • 317 views

AHA Solutions Webinar Jointly presented by KaufmanHall and Holy Family Memorial outlined a reform preparedness framework applicable today!

AHA Solutions Webinar Jointly presented by KaufmanHall and Holy Family Memorial outlined a reform preparedness framework applicable today!

Statistics

Views

Total Views
317
Views on SlideShare
317
Embed Views
0

Actions

Likes
0
Downloads
2
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    HFM's Reform Readiness AHA Webinar HFM's Reform Readiness AHA Webinar Presentation Transcript

    • Thank you for participating in today’s event! We’ll be starting shortly…Is Your Hospital Ready for Healthcare Reform? Positioning Your Organization for Success Featuring a case study by Holy Family Memorial Medical Center November 19, 2009 To access the audio portion of this webinar, please dial: 1 (866) 710-0179 Intl Callers should dial (334) 323-7224 When prompted by the operator, give the Passcode: 53939 1
    • Is Your Hospital Ready for Healthcare Reform? Positioning Your Organization for Success Featuring a case study by Holy Family Memorial Medical Center November 19, 2009 To access the audio portion of this webinar, please dial: 1 (866) 710-0179 Intl Callers should dial (334) 323-7224 When prompted by the operator, give the Passcode: 53939 2
    • Agenda and Speakers• Introduction: AHA and AHA Solutions – Polly Mulford, Director, AHA Solutions• Strategic Challenges Facing Hospitals and Health Systems - Mark P. Herzog, President and Chief Executive Officer, Holy Family Memorial, Inc. - Mark E. Grube, Partner, Kaufman, Hall & Associates, Inc.• Questions and Answers – moderated by Polly Mulford, Director, AHA Solutions 3
    • Agenda • Strategic Challenges Facing Hospitals and Health Systems • Healthcare Reform/ New Era Discussion – Required Provider Core Competencies • New Era Readiness Assessment – A Tool for Self Evaluation • Holy Family Memorial Hospital: Readiness Case Example – Overview – Physician Integration – Care Coordination – Information Systems – Service Distribution Systems – Financial Position and Capital Capacity – Scale • Moving from Assessment to Readiness • Questions and Discussion 4
    • About AHA Solutions AHA Solutions, Inc. is a resource to hospitals pursuing operational excellence. As an American Hospital Association (AHA) member service, AHA Solutions collaborates with hospital leaders and market consultants to conduct product due diligence and identify solutions to hospital challenges in the areas of finance, human resources, patient flow and technology. AHA Solutions provides related marketplace analytics and education to support product decision- making. As a subsidiary of the AHA, AHA Solutions convenes people with like interests for knowledge sharing, centered on timely information and research. AHA Solutions is proud to reinvest its profits in the AHA mission: creating healthier communities. 5
    • Strategic Challenges FacingHospitals and Health SystemsMark P. Herzog, President and Chief Executive Officer,Holy Family Memorial, Inc.Mark E. Grube, Partner, Kaufman, Hall & Associates, Inc. 6
    • Has your hospital started to prepare for reform and thenew era? 7
    • Please rate your organization’s reform/new era readinessas “weak” “medium” or “strong” in the following areas? 8
    • Strategic Challenges Facing Hospitals and Health Systems(Right Now) • Declining inpatient and outpatient volumes (in many markets) • Deteriorating payor mix • The rise of “super insurers” with 50%+ market share • Falling operating and EBIDA margins • Reduced liquidity • Financing problems for many and increased cost of capital • The growth and development of statewide and multistate systems • Significant capital needs related to physician, facility, and information technology strategies • Uncertainty regarding healthcare reform 9
    • Healthcare Reform/ New Era Discussion– Required Provider Core Competencies 10
    • Healthcare Reform – The Ultimate Market DynamicProposed Legislation Is Uncertain, but Principles of Reform HaveBeen Articulated • More stability and security for those who have insurance • Expansion of the total population that is insured – insurance mandate, business mandate subsidies for the poor, excludes illegal aliens • Budget neutral – $830 B to $1T price tag (over 10 years) covered through reduced costs/ elimination of waste • Greater provider accountability with a focus on value 11
    • Healthcare Reform– Key Potential Mechanisms to Achieve the Stated Cost Savings Goals • Payment based on “best practice” levels of value (quality/ cost) • Bundled payments • Quality incentive payments • Reductions in readmission rates • Reductions in premium increases for Medicare Advantage plans • Reductions in home health, imaging, and other “high margin” service payments • Medicare drug discounts • Accountable care organizations 12
    • Follow the Money– Industrial Organization Is a Function of the Underlying Economic Model:For Hospitals and Health Systems, the Business Model Is Driven by thePrevailing Reimbursement Mechanism Prevailing reimbursement Industry reaction Government reaction mechanism • 1960s – cost-based/ cost plus • Building boom • Health Systems Agencies (HSAs) and Certificate of Need (CON) • Mid 1980s – discharge/ activity- • Drive admissions and outpatient • Modify payment levels based procedures, manage length of stay (LOS) • Future? – outcomes-driven/ • Focus on care management • Modify outcomes targets? bundled payments/ accountable capabilities, physician care organizations (ACOs)/ integration, information capitation-like structures technology (IT)
    • Implications for Providers: The Reform Continuum Typical community hospital The Feds want you hereLow X Level of hospital/ physician X High integration and care management • Geisinger Health System capability • Mayo Clinic • Kaiser Permanente Critical Questions that Need to Be Answered: • Group Health of Puget • Where are you on the reform continuum? Sound • What more do you need to do? • Cleveland Clinic • What resources will you need to get there? • Do you have the size/ scale/ capital (human and financial) to move along the reform continuum on its own? 14
    • Reform Readiness Assessment Typical Community Hospital More Prepared Independent/ Employed physicians with unaligned staff “reform compatible” compensation models Physician Integration Limited or no Extensive use of protocols/ EBM protocols/ EBM Care Coordination Infrastructure Limited historical care Strong historical care management orientation management orientation Care Coordination Culture No EMR, limited EMR, IT distributed throughout system, sophisticated connectivity care management and monitoring software Information System Sophistication Poor primary care access, extensive Highly accessible primary unnecessary service duplication care, rationalized upper-level Balanced Service care Distribution System Insufficient Sufficient Capital Capacity Smallest in Market Largest in Market Scale Weak Strong 15 Composite Position
    • Holy Family Memorial: Readiness Case Example 16
    • HOLY FAMILY MEMORIAL Sponsored by the Franciscan Sisters of Christian Charity, Holy Family Memorial (“HFM”) is an integrated delivery system including a hospital, a large employed multispecialty group practice, and retail servicesMedical Center – 87 Staffed beds, full range of acute carePhysician Network – 80 providers, 50% primary care,50% specialists; Regional Orthopedic ProgramRetail and Outreach Services – Wellness Center,pharmacies, DME, occupational health • Highly competitive local and regional market 17
    • MANITOWOC, WISCONSIN Holy Family Memorial City of Manitowoc 41,066 people (Level since 2000) Manitowoc County 81,717 people (Level since 2000) 80 miles north of Milwaukee 35 miles southeast of Green Bay 18
    • Volume Trends 2009-2011 TRUE VOLUME TRENDS GROSS REVENUE GROWTH (PRICE ADJUSTED) $400 Millions $300 $200 $100 2009 2010 $0 2011 INPATIENT OUTPATIENT CLINICS TOTAL 19
    • Volume/ Revenue Breakdown 2012 Gross Revenue YTD 2012 24% 33% IP OP Retail Phys 4% 39% 20
    • What’s Unique About HFM? • Nationally recognized for extensive application of ambulatory/ hospital information technology (IT) • Rapid adoption of clinical best practices and highly integrated inpatient/ outpatient quality improvement • Ability to swiftly adapt to current and future business models due to complete integration of hospital with outpatient, clinic, employer-based, and retail business units 21
    • Ready for the Future Strategic Positioning 2001-2009 • 2001-2005: Concentrated on building a strong foundation through a Strategy and Facilities focus • 2005-2009: Shaped a cutting edge infrastructure through focus on Systems and Processes (IT, LEAN, Innovation, Safety) and reconfirming HFM’s Mission, Vision, and Values • 2009 and Beyond: – Expanding the high performance environment focus on cultural transformation and innovation – Strategic Program Unit Review – Operations best practices benchmarking 22
    • HFM 2009: A Preview of Health Reform • Significant drop in patients with insurance • Common knowledge: many are delaying needed care because of uncertainty • Gross revenues down nearly 10%, net 12% • Proactive leadership and shared sacrifice early on positioned HFM for third consecutive year of improved gain from operations • For many organizations these pressures can create an unfortunate short-term search for relief….. 23
    • 24
    • Holy Family Memorial’s Response • HFM board, executive, and physician leadership anticipated these challenges and did not seek medication! • A 12-month planning process in 2008 produced a new strategic plan and an updated Mission and Vision; in 2009 senior leadership was reorganized around this new vision • To “stress test” HFM’s strategic and organizational positioning, Kaufman Hall was retained in July 2009 to conduct a financial and operational analysis, and assess our “readiness for reform” • Overall, a much more proactive approach than the other option… 25
    • Preparing for Healthcare Reform:The “Wait and Hope” Option 26
    • A Readiness Assessment Framework 27
    • Reform Readiness Assessment Typical Community Hospital More Prepared Independent/ Employed physicians with unaligned staff “reform compatible” compensation models Physician Integration Limited or no Extensive use of protocols/ EBM protocols/ EBM Care Coordination Infrastructure Limited historical care Strong historical care management orientation management orientation Care Coordination Culture No EMR, limited EMR, IT distributed throughout system, sophisticated connectivity care management and monitoring software Information System Sophistication Poor primary care access, extensive Highly accessible primary unnecessary service duplication care, rationalized upper-level Balanced Service care Distribution System Insufficient Sufficient Capital Capacity Smallest in Market Largest in Market Scale Weak Strong 28 Composite Position
    • Physician Integration 29
    • What Is Physician Integration? • Physician integration is defined as having a collaborative relationship between the hospital and the medical staff supported along multiple dimensions: – Organizational structure and governance – Citizenship and leadership from broader medical staff – Medical staff support infrastructure – Financial incentives • Physician employment does not beget physician integration; integration does not necessarily require employment (though it can be difficult to achieve without) • Through proper integration, physicians and the hospital work together toward common goals and objectives – The biggest challenge will be integrating independent physicians under future reimbursement conditions 30
    • The Path to Physician Integration Will Require aPluralistic Physician Model• Not all physicians are seeking employment• Though the market is driving employment, hospital systems can take advantage of physician independence by structuring pluralistic alignment models Independent physicians Clinically integrated physicians Employed physicians• Independent physicians will • Hospital systems will seek to • Multispecialty groups likely continue to practice partner with independent organized around driving through a transition period physicians to drive quality and highest quality healthcare effectiveness through a series of partnerships, particularly clinically- focused co-management and contracting strategies• Maintaining this hybrid strategy gives hospitals time to build capital and adequate practice management capabilities
    • How Well Positioned Is HFM’s Physician Workforce and Management Capability? Integration Current Key Elements of Most Prepared Attributes Capabilities • Physician led councils/committees that report to senior • Structure supports growing physician leadership or the board involvement in HFM directionOrganizational • Greater physician leadership in serviceStructure and • Significant physician membership on the board planning and development neededGovernance • Physician involvement in service line planning and management • Within the employed group many • A proactive physician community that is able to share relationships are fragmented; more aCitizenship and concerns and drive organizational initiatives “confederation of practices” than one largeLeadership from medical groupBroader Medical Staff • Independent physicians aligned through clinical integration models • Strong and trusted physician group • Strong, physician-led practice management and leadership leadership; need for enhanced empowerment and development • Seamless provision of billing/contracting/other back-office • HFM exposed to erosion of specialty breadthPractice Management functions as physicians retire/succession plans • Transparent reporting of outcomes and business decision challenging making • Clear and transparent expectations and incentive structure • Production-based compensation ensures group performanceCompensation Models • Multidimensional incentives (including production, outcomes, • Citizenship incentive system in place, but citizenship, cost management, and others) needs more sophistication • Opportunity to improve group incentives Lower Higher 32
    • Care Coordination Infrastructure and Culture 33
    • What Is Care Coordination? • Established protocols for procedures • Established protocols for chronic disease • Protocol adherence, monitoring and accountability mechanism • Formalized mechanisms for coordinating care though physician- directed management of patients 34
    • More Than Semantics: Case Management vs. Care Coordination Case Management Care Coordination Objective Contain cost Facilitate access/ deliver value Target Population High cost/ high use patients High-risk populations Problem solving and process Functional Orientation Prior authorization improvement Context Incident Longitudinal Work across various Work within a single organization Nature of Coordination organizations/ providers providing medical care providing careNote: Adapted from Colorado Department of Public Health; Kaufman Hall analysis. 35
    • How Well Positioned Is HFM to Support Care Coordination? Program Current Key Elements of Most Prepared Attribute Capabilities • Patient centeredness is a goal for the organization, but incompletely practiced • Patient navigation through nurse navigators and • Downstream navigation/ guidance throughPatient social workers system can be strengthenedCenteredness • Alignment of downstream services to expedite treatment (e.g., PT after surgery) • IT connectivity exists; integrating it into the care coordination culture is the next step • Limited patient access to medical records/ IT • IT connectivity across provider spectrum (i.e.,Harnessing MD offices to all HFM sites) platform; though improvingTechnology • Patient-facing accessibility • Physician communication has improved; but coordination across the continuum can improveIntegration of • Physician communication (e.g., tumor boards) • Care protocols in place and expandingCapabilities andCommunication • Consistent care protocols across sites • Process improvement initiatives have been • Quality and Outcomes Measurement successful • Standing admission orders and measurementMeasurement • Analysis to identify readmission drivers (such as through CPOE poor prescription management) • Good physician accountability • Care directed to the lowest cost setting possibleCost with consideration to quality and access • Physicians are accountable for practice costs • Utilization management and cost controls areManagement • Supply chain management strong • Opportunity to improve supply chain Lower Higher management 36
    • Information Systems 37
    • Information Technology Infrastructure • Having integrated, sophisticated IT systems will become increasingly important for healthcare providers • Organizations that invest not only in the actual hardware and software, but also in staff development and expertise are more likely to use their system(s) effectively and to maximum potential • IT across the spectrum of health system functions will be necessary for HFM to actively manage its business and remain competitive Clinical IT Solutions Non-Clinical Clinical Care Disease Management Organization Operations Planning Accounting FinanceSample IT Solutions Electronic Medical Record Physician Practice Program/ Service Patient Billing Budgeting Systems CPOE Management Performance Systems PACS Management Clinical Info. Mgmt. Protocols/ EBM Telemedicine Ability to communicate among patients, physicians, and hospital Note: Bold font denotes historical HFM emphasis; regular font denotes (e.g., schedule tests, make appointments online, receive test results, etc.) future emphasis. 38
    • How Well Positioned Is HFM’s Information Technology? Integration Current Key Elements of Most Prepared Attributes Capabilities • Electronic Medical Record (EMR)Clinical Care • Computerized Physician Order Entry (CPOE) • Near complete adoption and integration ofCoordination and IT into clinical workflowDisease • Picture Archiving and Communication System • Telemedicine used for home health;Management (PACS) opportunity to expand outpatient disease • Post-discharge Disease Management System management systems • Physician Practice Management Systems • IT based and operational processOrganizational • Program/ Service Line Performance improvements underwayOperations and Management • Service line performance managementPlanning systems and processes not fully • Capital Planning Systems implementedAccounting and • Patient Billing Systems • Implementation of centralized billing in processFinance • Budgeting Systems • Inadequate analysis of true costs • Difficult to identify profitability trends for services across the network Lower Higher 39
    • Service Distribution System 40
    • Characteristics of a Well-Organized Service Distribution System • Ready access (in person, by phone, online) to care coordinators (PCPs, NP/ PAs) • Distributed ambulatory capacity (primary care, specialty care, outpatient diagnostic and testing services) • Concentration of highly specialized technologies and clinical resources (e.g., super specialists) to support quality and cost considerations • Effective linkages and transfer protocols with “downstream” providers (Home Health, SNF, Rehab, etc.) • Strong communication connectivity across the entire delivery spectrum 41
    • Holy Family Memorial Service Distribution Studying clinic expansion to Kewaunee (20 mi NE)  PT and Wellness  Family Practice  Pharmacy  Walk-In Care  Pediatrics Clinic  Orthopaedics  GI Clinic  ENT Clinic  Internal Medicine Clinic  Pediatrics Clinic  Pharmacy  Urology Clinic  HME  Lab  Diabetes Studying clinic expansion to Chilton (20 mi SW)  Behavioral Health Clinic  Neurology Clinic  Dialysis Orthopaedics Clinic Family Practice Clinic PT and Wellness  Inpatient Services Walk-in Care  Chiropractic Clinic  Diagnostic Center of Excellence Lab  Podiatry Clinic  Cancer Care Center Nutrition Counseling Orthopaedics Clinic  Endocrinology Clinic  Heart and Vascular Center Well Spa in Sheboygan  Women’s Health Clinic  Pain Center (20 mi south)  Pediatric Therapy  General Surgery  Lab  Wound Clinic  Sleep Lab 42  Main Laboratory
    • How Well Positioned Is HFM Delivery System? Program Key Elements of Well Prepared Small/ Current Attribute Rural Providers Capabilities • Relatively large number of employed primary • Physicians care physiciansAccessible • Mid-level providers • Very accessible care locations and schedulesPrimary Care • Market slow to respond to innovative care • Urgent Care, Retail, etc. delivery mechanisms (i.e., retail clinics)Logical Grouping • Imaging and Lab • Minimal redundancy of diagnostics or other highof Highly • Cardiology, CVS, Pulmonary capital services across local service areaInterrelated • Medical/ Radiation/ Surgical Oncology andServices others • Significant facility consolidation efforts under way • Concentration of higher cost acute care • Outreach based on clinics; though there is someSingle Site Acute services; geographic footprint based on lower redundancy of clinic space within local regionCare Center acuity services and diagnostics • Coordination of referrals through network • Well established and coordinated referral generally smoothStrong Referral • Very little telemedicine or outreach from tertiary relationships with tertiary providers, SNF, rehabRelationships centers in Green Bay to supplement current and home health specialistsContemporary • “Clean”, modern, contemporary physical plants • Aged main inpatient plantFacilities and • Competitive diagnostic technology and service • Clinical technology and diagnostics veryEquipment portfolio competitive for the market • Facility master plan being updated to show replacement options Lower Higher 43
    • Financial Position and Capital Capacity Assessment 44
    • How Well Positioned Is HFM Financially? Program 2009 Position • Moderate growth in net patient service revenue (3.6% compounded annual growth) from 2005 Attribute Relative to Medians to 2009; however consistent year to year margin improvements despite national trend • Operating performance has varied greatly over the last five years, from a $1.7 million loss in 2006 due to employee health claims to a projected high point of $6.1 million in 2009Profitability • The variability in operating performance has lead to variability in underlying operating EBIDA margins, from a low point of 7.9% in 2006 to a projected high point of 13.5% in 2009 • HFM’s liquidity decreased significantly in 2008, most likely due to the high level of capital spending and negative performance from the investment marketsLiquidity • As such, cash to debt levels remain below targets • Projected days cash on hand of 135 days for 2009 are in-line with appropriate credit median levelsLeverage and • Relative to equity and cash, HFM is leveraged slightly higher than “BBB+” mediansCapital Capacity • Debt service coverage has remained relatively consistent and is currently in line with “BBB+” medians • HFM is anticipating approximately $40.6 million in building, MIS, contingency, and equipment capital expenditures from FY2010-2014 Lower Higher • HFM has no major projects planned requiring access to the debt markets. However like most smaller healthcare organizations, HFM will have difficulty in accessing debt in the current lending environment at favorable rates 45
    • Scale 46
    • Scale: A Requisite for Success in the Future Healthcare Market? Organizations that attain a greater scale can better leverage their fixed cost base, deliver higher quality care, achieve variable cost efficiencies, build market leverage, diversify risk across markets or a broader base of programs/ services, preserve long-term access to capital, and ensure ongoing viability though the attraction and recruitment of top talent. 47
    • How Well Positioned Is HFM in Terms of Scale? • HFM has been able to retain talent • HFM has a highly tenured work force Integration Current and a typical hospital culture. An Key Elements of Most Prepared intentional culture shaping process is Attributes Capabilities in place to spur innovation and • Broad and deep clinical and management talent from a variety of backgrounds change capacity Talent • Empowerment throughout a large part of the organization to take risks; ability • Opportunity exists to encourage risk taking within the organization to absorb impact from those risks • Ability to leverage scale (in terms of facilities and volume) to reduce variable • Membership in GPOs are the extent costs and efficiently deploy routine capital to which HFM can leverage scale in Purchasin – Shared purchasing purchasing g Power • Evaluating leverage options with – Lab potential regional strategic partners – Back office • Sustained negotiating ability with payors • Major competitors are large players in the broader regional market • Ability to drive change in the market Market • Ability to draw patients to Manitowoc Influence – Advancement of technology (e.g., drive adoption of 64-slice CT) limited by HFM’s size relative to – Advancement of service models and expectations within market (e.g., others in the market emergency room wait guarantees/ transparency) • HFM market influence has pockets of strength, especially with • Clinical employers and regional orthopedics Innovation • Operational • Technological • Organization size challenges R&D • Cost advantage resource investment to optimally Access to support innovation • Favorable terms and conditions Capital • Flexibility • Limited capital excess given current Lower Higher system position 48
    • Conclusions and Summary 49
    • Reform Readiness Assessment Typical Community Hospital Most Prepared Organizations Independent/ Employed physicians with unaligned staff “reform compatible” compensation models Physician Integration Limited or no Extensive use of protocols/ EBM protocols/ EBM Care Coordination Infrastructure Limited historical care Strong historical care management orientation management orientation Care Coordination Culture No EMR, limited EMR, IT distributed throughout system, sophisticated connectivity care management and monitoring software Information System Sophistication Poor primary care access, extensive Highly accessible primary care, unnecessary service duplication rationalized upper-level care Balanced Service Distribution System Insufficient Sufficient Capital Capacity Smallest in Market Largest in Market Scale Weak Strong 50 Composite Position
    • Summary of Key PointsCare HFM has the pieces in place for sophisticated care management (especially for its size). A broad array of protocols andCoordination information systems, as well as clinical leadership in decision making allows the Network to adequately track and audit itsInfrastructure care processes and errors.Care The culture of independence in physician practice at HFM will be among the largest hurdles for the organization.Coordination Historically, physician practice patterns have complicated the management of downstream and post-discharge care.Culture Additionally, the physician culture’s risk averse nature can limit empowering physician extenders to fullest potential. Past physician employment initiatives have paid off for HFM. Despite a lack of depth in some specialties, HFM’s physicianPhysician workforce is more aligned than most comparable hospitals. Opportunities to improve alignment lie in continuedIntegration development of physician leaders and greater alignment of compensation systems and incentives. A full complement of clinical IT systems position HFM for success in this respect. HFM has an opportunity to be a regionalInformation leader. Quick and efficient IT planning, implementation, and adoption show that the Network can adapt to change withSystems strong leadership.Service Balanced service distribution system in the local market. Despite this, HFM is weighed down by legacy assets and is underDistribution increasing competitive pressures. Opportunities exist to better leverage clinical outreach sites. Additionally, a lack of clinicalSystem scale (i.e., volume) limits HFM’s ability to fully leverage efficiencies and demonstrate quality. HFM faces significant challenges from its limited size and scale. In addition to challenges identified in other areas of theScale report, lack of scale limits its ability to control the market and maintain the breadth and depth of top management and clinical talent to serve in the challenging reform environmentCapital Limited capital capacity. Like most similar organizations, HFM must focus on improving operating performance to continueCapacity its growth and maintain its leadership position related to physician integration and information systems. 51
    • Key Takeaways • The old business model is “dead” regardless of the reform outcome • Early movers will be rewarded • An incremental approach to change and adaptation is not sufficient in the new era • Effective physician integration and care management capabilities will define future success for hospitals and health systems • More than one success model will emerge – not all organizations can evolve into a Mayo, Geisinger, or Kaiser type of provider • Evaluate and “grade” your readiness right now • Start taking the required steps toward success 52
    • Moving from Assessment to Readiness • Size alone is insufficient • Start building the systems and programs for success • The emerging success model requires: – Scale – A strong position in the geographies served – Multiple operations in a connected geography – A solid, integrated physician platform – A care, cost, and quality management culture – Sophisticated IT and care management infrastructures – Acute attention to operations and business portfolio management 53
    • Question & Answer Session To submit a question via your phone, please dial *1 on your keypad. You will be placed in queue, your phone line will be opened by operator when it’s your turn. (To be taken out of queue, press *1 again.) 54
    • Upcoming: AHA Solutions Signature Learning Series Webinars: HIE: Assimilating Patient Data to Leverage Your Technology and Applications to Meet “Meaningful Use” Requirements Featuring a case study by West Tennessee Healthcare Thursday, December 10 1 - 2pm Eastern Time Creating Quality Initiatives through Policies & Procedures: Best Practices for Adherence and Management Featuring Eastern Idaho Regional Medical Center Tuesday, December 15 3 - 4pm Eastern Time To learn more or to register, call 1.800.242.4677 or visit aha-solutions.org 55
    • About This Webinar • This educational webinar has been developed by AHA Solutions in partnership with Kaufman, Hall & Associates, Inc. • Kaufman Hall has the exclusive endorsement of The American Hospital Association for its Integrated Planning and Capital Markets Solutions. 2009. Kaufman Hall has been ranked #1 for the sixth consecutive year by Thomson Reuters as the country’s top financial advisor to healthcare providers. 56
    • Contact Information Mark P. Herzog Mark E. Grube President and Chief Executive Officer Partner Holy Family Memorial, Inc. Kaufman, Hall & Associates, Inc. 920.320.3470 847.441.8780 mherzog@hfmhealth.org mgrube@kaufmanhall.com For more information on AHA Solutions or Kaufman Hall please visit www.aha-solutions.org 57
    • Featured Speaker Mark P. Herzog Mark P. Herzog has served as President and CEO of Holy Family Memorial, Inc. (HFM) since 2001. Prior to this, Mr. Herzog served as EVP/COO for 10 years at two hospitals in northwest Indiana. His 25 years of experience also include leadership roles in health systems in Ohio and Pennsylvania. He was awarded an MHSA degree from the University of Michigan, and is an ACHE Fellow. HFM is a small-market, tightly integrated health delivery system located in Manitowoc, WI, serving a population of nearly 100,000. It includes a hospital, an employed 80-practitioner multispecialty group practice, a comprehensive outpatient campus (“healthcare village”) and a wide range of prevention-focused retail services. HFM was an early adopter of clinical information systems and care management tools. During the past five years, HFM has been named Solucient Top Performance Improvement Leader, has received a Premier/ CareScience Select Practice National Quality Award, and has been recognized twice nationally for Patient Safety Excellence, with designation in 2009 as a Top 25 Most Wired Small Hospitals, and a Stage 6 EMR Adopter by HIMSS. 58
    • Featured SpeakerMark E. GrubeMark Grube, Partner, leads Kaufman Hall’s integrated strategic advisory practice. This practice provides strategic and financialplanning and implementation assistance related to enterprise-level strategies, clinical programs and service lines, physicians,health facilities planning, competitive markets, joint ventures, mergers and acquisitions, and overall organizational growth.Mr. Grube has more than 25 years of experience in the healthcare industry, as a consultant and as a planning executive withone of the nation’s largest healthcare systems. He has worked extensively with a broad range of healthcare providers,including community hospitals, specialty hospitals, regional and national health systems, and academic medical centers.Mr. Grube is a frequent speaker and author on healthcare topics, including strategy development, sustainable revenue growth,replacement facility development, and mergers and acquisitions. Over the past five years, Mr. Grube has published more thantwo dozen articles and white papers. He received the Helen Yerger/L.Vann Seawell Best Article Award from the HealthcareFinancial Management Association (HFMA) in 2007 for his cover story in the May 2007 issue of hfm magazine titled “Growingthe Top Line: 5 Strategies to Expand Your Business,” and in 2009 for the article he co-authored in the May 2009 issue of hfmtitled “Ensuring Affordability of Your Hospital’s Strategies.”Mr. Grube has presented at national meetings of the American College of Healthcare Executives (ACHE), The GovernanceInstitute, HFMA, and the Society for Healthcare Strategy and Market Development (SHSMD). Reflecting his seriouscommitment to healthcare management and governance education, Mr. Grube presents frequently at hospital/health systemretreats and university graduate programs in health administration. He is a member of ACHE, HFMA, SHSMD, and theLeaders Board for Healthcare Strategy and Public Policy.Mr. Grube received an M.B. A. from the University of Chicago Graduate School of Business and a B.S., magna cum laude, inEconomics from Bradley University. 59
    • Kaufman Hall: Who We Are • Kaufman Hall is an independent consulting firm that offers integrated strategic, capital, and financial advisory services and software to healthcare organizations of all types and sizes • National practice established in 1985 • Clients throughout the United States • Offices in Chicago, Atlanta, Boston, Los Angeles, New York, and San Francisco • Impeccable industry credentials and national “gold standard” hospital and health system client base • To learn more visit http://www.kaufmanhall.com. 60
    • Thank You 61