Webinar: Thriving in the New Healthcare Environment: 3 Key Strategies
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Webinar: Thriving in the New Healthcare Environment: 3 Key Strategies

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www.modernhealthcare.com/article/20140512/SPONSORED/305129926/webinar-thriving-in-the-new-healthcare-environment-3-key-strategies
Many CEOs are looking to make cost and revenue improvements between 20 and 40 percent. Attend this webinar to hear success strategies from two leading CEOs.

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Webinar: Thriving in the New Healthcare Environment: 3 Key Strategies Presentation Transcript

  • 1. Thriving in the New Healthcare Environment: Three Key Strategies David Bernd, CEO,Sentara Healthcare David Feinberg, MD, MBA,President, UCLAHealth System Jeff Jones, Managing Director, Huron Healthcare Broughtto you by ModernHealthcare June 17, 2014
  • 2. David Bernd CEO Sentara Healthcare Today’s Presenters 2 Jeff Jones Managing Director Huron Healthcare Modern Healthcare Webinar | David Feinberg, MD, MBA President UCLA Health System © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.
  • 3. NEW HEALTHCARE IMPERATIVES: STRATEGIES FOR CHANGE © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential. JEFFJONES,MANAGINGDIRECTOR,HURONHEALTHCARE 3Modern Healthcare Webinar |
  • 4. Unprecedented Market Pressures  Reimbursementcompression – Organizations face the imperative of operating on/thriving on rates that are at or near Medicare/Medicaid levels  Volumecompression – Reliance on volume growth no longer feasible. Many organizations forecast flat volume levels  Increasedportionof revenue at risk  Major IT and capital costs for managingacross the continuum 4Modern Healthcare Webinar |
  • 5. Market Demands 20% to 40% Performance Improvement 5Modern Healthcare Webinar | © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.
  • 6. Audience Question: Clinical Quality Wheredo you see the greatest opportunity for improvingclinicalquality? 1. Reducingunnecessarycare variation 2. Patient-centeredmedicalhomes 3. System-widequality standards 4. Partnerships withcommunityorganizations 6Modern Healthcare Webinar | © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.
  • 7. DRIVING CLINICAL QUALITY © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential. DR. DAVIDFEINBERG,PRESIDENT,UCLAHEALTH SYSTEM 7Modern Healthcare Webinar |
  • 8. 8
  • 9. 9 The Patient Experience • Our overarching focus is on the patient experience • Safety, quality, and cost are all components of the patient experience • It’s the type of care I would want for my mom if she were sick • Access, safety, quality, comfort, cost effective, timely, and seamless • Achieving this comes from listening to patients and taking really good care of them
  • 10. UCLA’s ValU Initiative • The ValU Initiative focuses on the quality and cost components of the patient experience • UCLA sees 45,000 inpatients a year and treats over 2 million throughout the UCLA Health System • ValU is a way of improving the patient experience by redesigning clinical service practices 10
  • 11. Primary Care Redesign • We began with primary care innovation • Primary care redesign includes multiple service lines • We then moved to specific service lines • We prioritize service redesign by looking at four criteria 11
  • 12. Prioritizing Service Lines – Four Criteria • Are patients engaged in their care? • Is there strong physician leadership and engagement? • Is the service line important to UCLA’s long-term growth strategy? • Is the service line meeting financial benchmarks? 12
  • 13. Service Line Redesign • Requires a partnership including: • Patients, Performance Excellence team, physician leaders, nurse leaders, administrators • Reduce medically unnecessary clinical practice variation • Daily interdisciplinary meetings for care coordination 13
  • 14. Potential Barriers • Physician resistance to change • Departmental or silo model • Lack of robust cost accounting or financial data 14
  • 15. Beginning of Our Journey • We are early in this journey • Learning from models outside the organization • A year from now we will have data and trends showing where we have succeeded and what we need to refocus on 15
  • 16. 16
  • 17. Audience Question: Operational Excellence Whatis the most significant obstacle to achievingoperational excellencein your organization? 1. Competingpriorities 2. Tools and technology 3. Physician/providerbuy-in 4. Siloed departments 5. Lack of a clear strategy 17Modern Healthcare Webinar | © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.
  • 18. 6/16/2014 186/16/2014 18www.sentara.com 18 Operational Excellence David L. Bernd Chief Executive Officer June 17, 2014 SentaraStrategicPlan
  • 19. 6/16/2014 196/16/2014 19www.sentara.com 19 Sentara Healthcare • Mission: We improve health everyday • 126-year not-for-profit mission • 12 hospitals; 2,727 beds; 3,799 physicians on staff • 11 long term care/assisted living centers • Extended stay hospital • 4 Medical Groups (900+ Providers) • 440,000 - member health plan • Sentara College of Health Sciences • $4.3B total operating revenues • $5.9B total assets • 27,000+ members of the team • AA/Aa2 bond ratings Virginia North Carolina
  • 20. 6/16/2014 206/16/2014 20www.sentara.com 20 Sentara Strategic Plan Always Improving
  • 21. 6/16/2014 216/16/2014 21www.sentara.com 21 Operational Excellence 1. Strategy of Integration; Execution of Strategy 2. Uniform Goals Across System 3. Transparency of Performance – External Benchmarks 4. Balanced Scorecard: Quality, Safety, Customer Satisfaction, Members of Team Engagement; Financial (both revenue & cost) 5. Keep operations and finances well disciplined – gives you time to strategize, plan and execute
  • 22. Quality Developed and implemented 3 System Cardiac Score Cards: Strategic Operational Reputation Achieved 90% yellow or green on Operational Score Card Systemized CCEC Policies and procedures (Compliance 360) Outcomes report analysis Nurse Stress Testing Telemetry Pilot LOS(AMI, Arrhythmia,Intervention) Identified opportunities for improvement and developed process to improve LOS Strategic Imperative I 22 I. Be the Leader in Value as measured by quality,satisfaction, and cost for Heart Services Cardiac Operational Scorecard (90% yellow orgreen) Length of StayOpportunities Example of System-Wide Cardiac Strategy Execution 22
  • 23. Strategic Imperative I 23 I. Be the Leader in Value as measured by quality, satisfaction, and cost for Heart Services Patient Satisfaction Initiatives Discharge Planning •Begins on admission •Whiteboard utilization •Multidisciplinary rounds daily Quiet at Night •Posters •Complimentary ear plugs and sleeping masks •Preferences on whiteboard Education about Medication •Detailed, consistent education to all patients and family •Tiger Videos Create “Best Practice” Forum •Cardiac nursing leadership participation •Share tactics, initiatives, etc. Example of System-Wide Cardiac Strategy Execution
  • 24. In the Weeds Homeostasis Patches • Switched from Svek Patch to QuickClot • Annualized savings for 2014 will be over $175,000 Strategic Imperative I 24 Cardiac PerformanceImprovement Plan(PIP) Cardiac Service Line identified $6.2m in cost savings opportunityin 2014 Key measuresuccessis improvedoperationsand collaborationwithSMG and Hospitals •Efficiency (scheduling/staffing) $2.65m •Access (Rehab, EP, AIC, Clinics) $555k •Quality (improve LOS) $510k •Supply Savings (Physician scorecards,CVAC, CCAP) $2.5m •Productivity (102% is the new 100%) SavingsYTD Cardiac OR supplysavings $125kytd, estimate$760k RevenueGrowth Ablations exceeding budget by41 cases= $200k net rev Cardiac OP CTA exceedingbudget I. Be the Leader in Value as measured by quality, satisfaction, andcost for Heart Services Example of System-Wide Cardiac Strategy Execution
  • 25. Strategic Imperative I 25 Physician Resource Utilization Report Card John Doe, M.D. AVG COST - ALL SUPPLIES Baseline Actual (SHH) DIAGCATH $1,520 $801.98 INTERVENTION $3,000 $2,562.10 CATH W/INTERVENTION $2,800 $2,856.84 # OF CASES 700 658 FLUORO - MEDIAN MINS DIAGCATH 7.20 5.60 INTERVENTION 9.5 10.51 CATH W/INTERVENTION 17.7 14.60 # OF CASES 540 651 MD On Time Start - First Case % On Time 42% 64% # On Time 50 72 # Late 70 40 TOTAL FIRST CASES 120 112 MD GlovedTime - MEDIAN MINS DIAGCATH 42.1 33.86 INTERVENTION 45 47.17 CATH W/INTERVENTION 60.2 58.12 # OF CASES 540 659 Example of System-Wide Cardiac Strategy Execution
  • 26. 6/16/2014 266/16/2014 26www.sentara.com 26 Sentara Strategic Plan Caring for Defined Populations
  • 27. 6/16/2014 276/16/2014 27www.sentara.com 27 CarnegieMellon University, Paul Fischbeck 2009 Caring for Defined Populations = Solve This Problem
  • 28. 6/16/2014 286/16/2014 28www.sentara.com 28 Sentara Strategic Plan Create Growth Organic Growth Product Re-design Strategic Affiliations New Care Models Innovation Unique Technologies InnovationSentara Hospitals & Services Physicians Optima Health
  • 29. 6/16/2014 296/16/2014 29www.sentara.com 29 Sentara Five-Year Outlook 1. Sentara will be a larger integrated health system 2. Transformation of care and shared learning across the system will allow Sentara to compete by demonstrating value through outcomes, informatics and innovations;this is made possible by enhanced system scale and integration – Health Plan, Hospitals, Physicians,Ambulatory Care and Post-Acute Care 3. Positioned well for major system consolidationas the market continues to aggregate 4. Provider and health plan diversification from a geographic position will continue to offset inherent risk issues e.g. Tricare; Anthem 5. Leverage of infrastructure over large base of services will yield efficiencies across the system
  • 30. 6/16/2014 306/16/2014 30www.sentara.com 30 Lessons Learned 1. Be Strategically Driven to Execute Your Strategy 2. Designated Strategic Capital– Innovate – Safe to Fail/Great to Succeed 3. Focus on Quality, Patient Safety, Satisfaction and Members of the Team – Finances Will Follow 4. Flexible Organization Structure –Change is Part of Culture 5. What Gets Measured and Reported Gets Done 6. REPEAT - Keep operations and finances well disciplined – gives you time to strategize, plan and execute 7. Merger/Affiliations – Culture Fit – we do 1 in 4 opportunities 8. Enjoy the ride – our best days are in front of us
  • 31. 6/16/2014 316/16/2014 31www.sentara.com 31 Get Social With Us…
  • 32. TRANSITIONING REVENUE STREAMS 32Modern Healthcare Webinar | © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential. JEFF JONES,MANAGINGDIRECTOR,HURONHEALTHCARE
  • 33. Market Demands 20% to 40% Performance Improvement 33Modern Healthcare Webinar | © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.
  • 34. Revenue Transition  Happening at different speeds in different markets  Regardless,CEOs are committedto preparing for the shift  Organizations must build capabilitiesneeded to operate and thrive under the value model – while remaining financially soundunder the current model  Organizations must developa granular understandingof where current and futuretop-line revenue is coming from  The type of revenue changes and the rate of change will help each health systemset priorities for healthcaretransformation 34Modern Healthcare Webinar | © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.
  • 35. Current and Forecasted Revenue Sources  What portionof your top-line revenue is from traditional fee-for-service, and what portion is from emergingvalue-basedmodels (bundled payment, sharedsavings, sharedrisk, capitation,etc.)?  What increases or decreases in utilizationare occurringacross the health system?  What shifts in utilizationare occurringacross the health system?  What portionof revenue is from non-patient care sources?  What changes are you forecastingfor top-line revenue mix, utilization, and non-patient care revenue? 35Modern Healthcare Webinar | © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.
  • 36. Organizations are Following Multiple Tracks  Transformativechange – Going beyond traditional revenue and cost improvement initiatives  New patient care revenue – Expanding market share and reach, expanding programs and services  Non-patient revenue – Exploring cautiously 36Modern Healthcare Webinar | © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.
  • 37. Key Takeaways  Over-relianceon revenuefrom inpatient care carries one set of risks, while reliance on new, alternativerevenuestreams carries another  Movingfrom volumemodels is essential, but moving too quickly weakens revenues and puts significantpressureon the organization  Improvingquality, improvingthepatient experience, and improvingthe cost structureremains the winningcombination 37Modern Healthcare Webinar | © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.
  • 38. David Bernd CEO Sentara Healthcare Q&A With Today’s Presenters 38 Jeff Jones Managing Director Huron Healthcare jdjones@huronconsultinggroup.com 503.347.0554 Modern Healthcare Webinar | David Feinberg, MD, MBA President UCLA Health System © 2014 Huron Consulting Group. Allrightsreserved. Proprietaryand confidential.