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Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
Scp for physician organizations
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Scp for physician organizations

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Spine Care Partners presentation to physician organizations

Spine Care Partners presentation to physician organizations

Published in: Health & Medicine
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  • Good morning, I’m John Ventura, one of the founders of Spine Care Partners. We are a limited liability corporation incorporated in December 2010 and has thus far been self funded; our guiding principles are accountability, sustainability and excellence. Our initial focus is upon the establishment of spine centers as a component of large physician organizations.
  • As a health care consulting company assisting physician organizations in establishing a Spine Center, Our goal is to get the right patient to the right treatment at the right time while increasing the spine care market share for our partners and managing the costs associated with spine pain; Our care pathway is based in NCQA quality standards and Lean Six Sigma process management; Part of our training is linked to our marketing: providing a patient centered, evidence based pathway for primary care physicians (those who see majority of spine patients initially) to utilize in determining need for referral to spine center; This increases referrals to spine center and creates strong alliance with physicians in the community;
  • Our spine center model has been tested in a hospital based setting in the challenging state of MA (where national health care is beginning) and we have published an overview of our pathway and the beneficial clinical and financial outcomes associated with this model;
  • And here are some of the positive clinical and financial outcomes realized from the implementation of our model; Jordan hospital spine center, located in Plymouth MA, operates under the NCQA LSS management strategies of SCP; subsequent data reveal 1400 new patients for spine center for first full year of operation; created strong alliance with physicians in the community; by effectively managing the 80% effectively, increased traffic through spine center, which indirectly then increases advanced care (MRI, PM, surgery); surgical fast track days greatly increase the surgical yield for the spine surgeon, maximizing their time efficiency (in their office they may need to see 20 spine patients to generate 1 surgery, in our fast track clinic, they may only need to see 5 patients to generate a spine surgery, all the while appropriately triaging patients so that no unnecessary imaging, pain management or surgery is performed;
  • Why is our model important: it answers some disturbing trends hospitals are forced to deal with; There is a trend to reimburse based upon condition, much like DRGs of the past, which necessitates utilizing a clinically and cost effective model of care; a prominent hospital administrator suggested to me that 20% of hospitals will close their doors or merge over the next 5 years; RACs = recovery audit contractors who look to recoup what they deem to be inappropriate payments to hospitals
  • We are over managing spine care; higher costs with higher disabilty we’ve seen 423% increase in opiate use; 220% increase in spinal fusion 307% increase in MRIs 629% increase in ESIs And none of these increased costs have been proven to improve quality of care (this is exactly why NCQA has chosen back pain as one of its initial quality improvement programs)
  • SCP hospital based spine center provides excellence in a sustainable, accountable model; We have developed a process driven It is high value care: quality based algorithm, lean six sigma process management, excellent clinical and patient satisfaction outcomes, rapidly increased volume of patients, free of provider bias, appropriate care at the appropriate time The Jordan Hospital Spine Center has operated in the black since its inception; Our model is sustainable, no matter the direction health care is taking
  • Thank you very much for your attention, I look forward to your comments and questions.
  • Transcript

    • 1. [email_address] www.spinecarepartners.com 200 Worcester Rd Suite B Falmouth, MA 02540 508-457-1245 Accountable Sustainable Excellence
    • 2. jventura6@rochester.rr.com 585-943-7680 Spine Care Partners, LLC healthcare consultants
    • 3. Spine Care Partners Team Ian Paskowski Tom Neuner Brian Justice John Ventura <ul><li>Collectively over 90 years clinical experience </li></ul><ul><li>evaluating and treating spine pain </li></ul><ul><li>Ian Paskowski – medical director spine center of Jordan Hospital </li></ul><ul><li>Tom Neuner – clinician Michigan Head and Spine Institute and practicing attorney </li></ul><ul><li>Brian Justice, John Ventura – among first in nation to achieve recognition status with NCQA Back Pain Recognition Program, clinicians with Unity Hospital spine center </li></ul>jventura6@rochester.rr.com 585-943-7680
    • 4. Value: Jordan Hospital Experience jventura6@rochester.rr.com 585-943-7680 JMPT 2011 Vol 34 No 2
    • 5. VALUE: Jordan Hospital Experience jventura6@rochester.rr.com 585-943-7680 Paskowski I, Ventura J, et al. JMPT 2011
    • 6. ROI for physician groups: Jordan Spine Center experience <ul><li>Excellent clinical outcomes </li></ul><ul><li>High patient satisfaction </li></ul><ul><li>Extremely cost efficient per case </li></ul><ul><li>80% of spine pain managed conservatively </li></ul><ul><li><15% require MRI </li></ul><ul><li><15% require pain management </li></ul><ul><li><5% require surgical intervention </li></ul>jventura6@rochester.rr.com 585-943-7680
    • 7. Trends jventura6@rochester.rr.com 585-943-7680 American Hospital Association survey April 2010 Becker’s Hospital Review Jan/Feb 2011
    • 8. Spine Care Market jventura6@rochester.rr.com 585-943-7680 Martin BI. JAMA 2008; 299(6)
    • 9. The Solution: Spine Care Partners, LLC jventura6@rochester.rr.com 585-943-7680 <ul><li>Add Efficiencies to the market: </li></ul><ul><li>High patient satisfaction </li></ul><ul><li>Improved patient outcomes </li></ul><ul><li>Appropriate costs </li></ul>
    • 10. jventura6@rochester.rr.com 585-943-7680 ‘ Right Patient/Right Provider/Right Time’
    • 11. Discovery and Implementation Spine Center <ul><li>Throughout our plan we will constantly perform the following DASIT elements: </li></ul><ul><li>D iscovery weighted mostly Day 1-3 and Proposal </li></ul><ul><li>A nalyze although performed throughout </li></ul><ul><li>S trategize </li></ul><ul><li>I mplement weighted mostly Month 3-12 </li></ul><ul><li>  T rack although performed throughout   </li></ul>jventura6@rochester.rr.com 585-943-7680
    • 12. Discovery phase <ul><li>1) Payer Mix </li></ul><ul><li>2) Player Mix/ Cultural Survey (Power Brokers, Champion, Personalities Inventory) </li></ul><ul><li>3) Satisfaction Surveys (Patient, Surgeons, Clinicians, Staff) </li></ul><ul><li>4) Service lines </li></ul><ul><li>5) Care Pathways </li></ul><ul><li>6) Costs/Revenue logistics (per case, per provider or dept.) </li></ul><ul><li>7) Efficiency Factors (floor plan, patient flow, staff flow, EHR, impediments) </li></ul><ul><li>8) Productivity (room use, scheduling, documentation, EHR, unused) </li></ul><ul><li>9) Physical Plant (600 sq. ft additional space or re-tool, </li></ul><ul><li>adequate proximity to support, patient access, flow-able, Disney-able) </li></ul><ul><li>10) Growth possibilities (or hindrance factors) of SC based on above </li></ul><ul><li>combined with: Inter and Intra-Service Line cross pollination, Trends, </li></ul><ul><li>unseen Variables. </li></ul>jventura6@rochester.rr.com 585-943-7680
    • 13. Thank You jventura6@rochester.rr.com 585-943-7680 Accountable Sustainable Excellence John M Ventura [email_address] (585)943-7680

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