Scott Smith, MD, Associate Medical Director of Operations for the Colorado Kaiser Permanente Group


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The Kaiser Permanente Model

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Scott Smith, MD, Associate Medical Director of Operations for the Colorado Kaiser Permanente Group

  1. 1. maroonbells9-1024x640.jpeg See if you can get this one to work. Mountain picture Scott Smith, MD Associate Medical Director of Operations Kaiser Permanente Colorado
  2. 2. D E A D L A S T
  3. 3. About Kaiser Permanente  Largest nonprofit health plan in the U.S. Northwest Region  Integrated health care delivery system  9.1 million members Northern California Region  16,000+ physicians Colorado Region Mid-Atlantic Region  174,000+ employees Southern California Region Georgia Region Hawaii Region  48,000+ nurses  Serving 8 states and the District of Columbia  37 hospitals  Almost 600 medical offices/ outpatient facilities  $50.6billion operating revenue*  Scope includes ambulatory, inpatient, ACS, behavioral health, SNF, home health, hospice, pharmacy, imaging, laboratory, optical, dental, and insurance *Source: 2012 Kaiser Permanente Annual Report
  4. 4. Our Mission To provide highquality, affordable health care services and to improve the health of our members and the communities we serve.
  5. 5. NCQA Health Insurance Plan Rankings 2013-2014 Summary Report (Medicare) 5
  6. 6. Kaiser Permanente Colorado • 540,000 Patients, 27 Medical Offices • 1000 Physicians • 1 Electronic Medical Record (EMR) • Revenue in Excess of $3 Billion USD • Physicians Are Paid on Salary o Up to 10% bonus based on service & quality • Pharmacy, X-Ray, Lab in each medical office
  7. 7. Role of EACH Physician LEADER HEALER PARTNER Jack Cochran, MD, Executive Director, Permanente Federation
  8. 8. KP Colorado Primary Care Model • 300 Primary Care Physicians • • • 130 General Practice 110 Internal Medicine 60 Pediatricians • Roughly 1 physician per 1800 members • We register each patient with one physician • • All booking and care is directed to this physician Patients see their personal physician 82% of the time
  9. 9. Primary Care – Our Triple Aim Population Health  Patients Needs Come First  Team Delivers Care  Respectful & Compassionate Care Primary Care PatientCentered Medical Home Team Enhancement Patient Quality Team Care Experience Per Capita Cost Link Each New Outreach Access Models Patient to One Primary Care Doctor
  10. 10. Typical Day Routine Access to Care is less than 4 days 15 Patients in office 3 Scheduled phone 8 Patient emails 5 Unscheduled phone 45% of all patient contacts are virtual
  11. 11. Typical Day Quality All prevention needs and gaps are known All chronic condition monitoring results and gaps are known Centralized team outreaches to complete
  12. 12. Yesterday’s Care Tomorrow’s Care Our patients are those who make appointments to see us Our patients are those who are in our panel Patients’ chief complaints or reasons for visit determines care We systematically assess all our patients’ health needs to plan care Care is determined by today’s problem and time available today Care is determined by a proactive plan to meet patient needs without visits Care varies by scheduled time and memory or skill of the doctor Care is standardized according to evidence-based guidelines Patients are responsible for coordinating their own care A prepared team of professionals coordinates all patients’ care I know I deliver high quality care because I’m well trained We measure our quality and make rapid changes to improve it Acute care is delivered in the next available appointment and walk-ins Acute care is delivered by open access and non-visit contacts It’s up to the patient to tell us what happened to them We track tests & consultations, and follow-up after ED & hospital Clinic operations center on meeting the doctor’s needs A multidisciplinary team works at the top of our licenses to serve patients Slide from Daniel Duffy, MD School of Community Medicine Tulsa, Oklahoma
  13. 13. Innovation distinguishes between a leader and a follower ---Steve Jobs 13
  14. 14. Let me put it simply: I In this room, with the successes already in hand among you here, you collectively have enough knowledge to rescue (American) health care – hands down. Better care, better health, and lower cost through improvement right here. In this room. The only question left is: Will you do it? When we entered the world of health care improvement as our life’s work, we didn’t ask for the burden we now bear. We did not ask to be responsible for rescuing health care. But, here we are, and, as intimidating as the fact may be, that burden is ours. Donald Berwick, MD
  15. 15. We’re Here to Make Lives Better