TLE Session 1 - HCR: Opportunities for Therapy Practices. Take Action
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This SlideShare is a summary of the 1st Session of The Leadership Edge. It encourages the TLE participant to take action with team members to deliver Triple Aim Value
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TLE Session 1 - HCR: Opportunities for Therapy Practices. Take Action
- 1. The Leadership Edge: Session 1 Health Care Reform: Opportunities for Physical Therapists Time to Take Action
- 2. 2 “If the rate of change on the outside . . . Exceeds the rate of change on the inside . . . the end is in sight.”
- 3. 3 Health care world IS CHANGING dramatically . . . How can you SUCCEED . . . MAKE CHANGES in practice ALIGNED with THE DEMANDS of CHANGING market. Mergers . . . Acquisitions . . . Powerful Decision Makers BCBS-Cigna . . . Aetna-Human . . . United Health Group-Optum Integrated Health Systems . . . ACOs . . . PCMHs More Regulations . . . Compliance . . . Higher Taxes Value Based Models . . . Financial Risk Sharing . . . Triple AIm Outcomes . . . Patient Engagement . . . Collaboration
- 4. 4 Work within Bundled Payments Manage Care to Get BEST Outcomes Deliver Triple Aim Value Manage Case Rate Payments Optimize Care and Finances Based on Payment Model Develop Innovative Collaborative Care Models with other Providers Remote Visits with Technology Use Telehealth Collaborate with others Develop Relationships with Powerful Decision Makers
- 5. 5 1 CONNECT the Dots.. 5 Change Leadership Resist Fail OK Good Great 2 Grow or Die 5 Realities to Consider 3 Volume to Value.. Value 4 Commodity Syndrome.. Volume 180° Incentives
- 6. 2 BIG Changes are driving most of the internal changes in therapy practices like TPI 6 1 CONSOLIDATION BIG is Strong 2 VALUE Quality ÷ Cost
- 7. 1 POWERFUL Concept 7 The Triple Aim Measurable Quality An Exceptional Patient Experience Lower TOTAL Cost of Care
- 9. 9 Health Care Reform and Value Therapy Can Be a VALUE Added SOLUTION Many Not Covered Provider Shortage ACA Forces Change Health Plans Force Change Must Lower TCOC Demand Real VALUE Demand Risk Sharing 50% Wasted $$High $$$$ TCOC MSK is 17% TCOC MRI Surgery Drive $$ PT Primary Care Early Therapy Lowers TCOC Therapists Get Great Results
- 10. 10 Health Care Reform and Value Therapy Can Be a VALUE Added SOLUTION Connecting These REALITIES Brings Therapy Practices Great Opportunities . . . But only if we Deliver VALUE
- 11. BIG is Strong 2 Grow or Die Key Points 1. Market Realities show PT is a Value solution
- 14. Consolidation 4 Health Plans BCBS, HP, Medica, PreferredOne 4 ACOs Twin Cities Allina, Fairview, HP-Park Nic, Health East/Entira 4 ACOs Outstate Essentia, CentraCare, Sanford, Mayo 3 Large Ortho Practices Twin Cities TCO, Summit, Tria
- 15. Health Care Reform and Value 15 3 Volume to.. Value Volume Value 180° Incentives Key Points 1. Market Realities show PT is a Value solution 2. If you don’t grow, you die; payors and providers are consolidating to gain strength of size
- 16. The Health Care Delivery System is moving away from Fee for Service to Value Based Models 16 Volume Based Fee for Service The More You Do The More You Get Paid Value Based Models The Better the Outcome The Better the Payments 180° Financial Incentives Health Care Reform and Value
- 17. Quality Care 17 The VALUE Equation Health Care Reform and Value Convenient Access + Caring Service + = Consumer ValueTotal Cost of Care Volume Value 180° Incentives
- 18. Health Care Reform and Value 18 Decision Makers Government Health Plans ACOs & Medical Homes Business & Individuals Innovation Integration Care Model Change Technology Efficiencies Risk Sharing Models Triple Aim Measurable Quality An Exceptional Patient Experience Lower TCOC Value Outcomes Patient Centeredness & Collaboration Care Management Reality of Power Strategy Your Mission Your Culture
- 19. 19 Health Care Reform and Value 4 Commodity Syndrome Key Points 1. Market Realities Show PT is a Value solution 2. If you don’t grow, you die; payors and providers are consolidating to gain strength of size 3. Changing to Value Based Models built around The Triple Aim
- 20. 20 Commodity Syndrome Seek Win-Win Adopt TCOC Approach Prove Reduce MSK Costs Fight with Payors . . . Payors Win Silo Mentality of Cost Control High Profile Provides get Focus Therapists Viewed as Ancillary to MDs Few Therapists Can Negotiate with Plans Therapists Lack Innovative Solutions Primary Care for MSK Deliver Size and Value Innovate to Meet HC Needs
- 21. 21 Health Care Reform and Value Understand their problem Respect their INTERESTS Understand their NEEDS Determine Solution They Don’t Even See Exceed Their Expectations In Working with the Powerful Decision Makers
- 22. 22 Health Care Reform and Value ChanGe Is Hard Resist Fail OK Good Great Key Points 1. Market Realities Show PT is a Value solution 2. If you don’t grow, you die; payors and providers are consolidating to gain strength of size 3. Changing to Value Based Models built around The Triple Aim 4. Overcome Commodity Syndrome by creating size, delivering value, and sharing risk
- 23. 23 Health Care Reform and Value Change? Lots of it . . . Care Model Collaboration Manage YOUR Care Decisions Outcomes Discharge Planning Delegation Communication Population Health vs Rehab Resist Fail OK Good Great
- 24. 24 Most People Struggle with Change and Need Leaders to Guide Them and Managers to Help Them 5-10% Hate It! Resist It! Try to Make It Fail! 15-20% Hate It! Resist It! 30-40% Go with the Flow But Won’t Try to Convert Resistors 15-20% Embrace Change Convert Resistors 5-10% Love it! I’m Your Change Champion 20-30% Hold You Back 50-70% Take Your Time 20-30% Will Help You Health Care Reform and Value How People Respond to Change
- 25. 25 Health Care Reform and Value Resist Fail OK Good Great Leaders & High Performance Teams
- 26. What Can You Do . . . Triple Aim Value Achieve excellent FOTO outcomes Deliver an exceptional experience for patients Help patients achieve their goals, reduce costly services If You are Not Growing, You’re Dying Help your practice grow new and loyal patients Connect with Powerful Decision Makers Build relationships with those who choose your clinic Embrace & Lead Change Lead . . . Help your team make innovative changes 26 Tie it Together
- 27. 1. Have discussions with your team at a monthly staff meetings . . . How can we – as a team – deliver each aspect of the Triple Aim? How do you manage patient expectations and care after asking each patient ‘what are the two most important goals you want to achieve with me in therapy’? How can we help patients make good decisions about the interventions they seek from other providers? 27 PLAN . . . Take Action