Post-Acute / Ambulatory Planning. Creating the right access points along the care continuum

Transcription

1 Post-Acute / Ambulatory Planning Creating the right access points along the care continuum

2 Dennis Sherry - Mercy Health Dennis Sherry is Regional VP at Mercy Health in Toledo, Ohio, serving on Mercy's senior management team as the lead executive for strategic planning. In his primary role, he assists Mercy in setting its strategic direction as well as assuring execution of its strategies and driving business results. His current work is focused on Mercy s ambulatory strategy to increase Mercy s access points in the market. This includes development of freestanding EDs, outpatient imaging centers and other ambulatory campuses. As part of his current role, Dennis is a member of Mercy s Clinical Integration Team and has recently developed Mercy s post-acute strategy for building partnerships with post- acute providers in the market. 2

3 Jason Theadore - OhioHealth After many years of Ambulatory experience, Jason Theadore was named Vice President of Health Center Operations in September 2012 and this past February was named (Acting) President for OhioHealth Neighborhood Care. Jason is responsible for the planning, facility and clinical operations and culture for an Ambulatory division with nearly 50 sites of service and many community, employer and school partnerships. Jason has over 20 years of radiology experience and maintains his registry as a technologists, is a Certified Radiology Administrator and a Fellow with the AHRA: The Association for Medical Imaging Management. Jason serves on several healthcare and community boards. He is an experienced speaker and author of articles on ambulatory development, the importance of strong physician relationships and leadership and team development. 3

4 Chris Masone DHG Healthcare Chris background includes experience in hospital strategic planning for more than 30 hospitals and systems, service line optimization, capital equipment acquisitions and extensive physician alignment initiatives. Chris has worked with multiple hospital clients to assess access strategies, conduct geographic service line assessments and determine physician partnership opportunities through a variety of alignment models. In his past roles, Chris served as: Investments and Partnerships Specialist, Director of Physician Alignment and National Business Development Sales Manager. Chris currently serves as the President Elect for ACHE of Northern Ohio. 4

5 Learning Objectives Understand future payment models and the affect different sites of care will have on reimbursement Identify critical access points along the care continuum that are essential for providing seamless and high quality care Develop partnership strategies between your organization and those access points to prepare for future payment models 5

6 Post-Acute / Ambulatory Planning Creating the right access points along the care continuum Drivers

7 Format Drivers Mercy s Approach OhioHealth s Approach Questions

8 Driver #1 - Growing Medicare Volume Medicare to Become Majority of Volume by 2022 Projected Number of Medicare Beneficiaries Millions of Beneficiaries Average Inpatient Case Mix By Volume n = 785 Hospitals 6% 2% % 19% 25% 15% % 58% Self-Pay Medicaid Commercial Medicare Source: Advisory Board

9 Driver #2 - Transition to Value-Based Payments Accelerating Better, smarter, healthier: In historic announcement, HHS sets clear goals and timeline for shifting Medicare reimbursements from volume to value 30% of FFS Medicare payments to quality or value through ACO/BPCI by the end of % by the end of 2018

10 Driver #3 Understanding The Tipping Point at Altitude

11 Driver #4 - Risk Capability Is Becoming a Must Healthcare providers are preparing to accept greater risk for payment of services. Increasing an organization s risk capability requires a focus on three critical success factors.

12 Driver #5 - Strategy: Aligned Continuum of Care TELEHEALTH

13 Driver #6 - Reform Timeline is Here

14 Driver #7 - Hospital Consolidations ( ) 300 Number of Deals Number of Hospitals SOURCE: Irving Levin Associates, Inc. (2013) The Health care Acquisition Report, Nineteenth Edition 21

15 Post-Acute / Ambulatory Planning Dennis Sherry Mercy Health 52

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17 PHASE 3 Developer/Physician /Hospital owned PHASE 2 Physician Owned PHASE 1 Hospital owned 45

18 SNF Collaborative 18

19 Strategy: Aligned Continuum of Care TELEHEALTH

20 Mercy s Future System of Care Community-Based Care Home 4 MyChart MMP Itriage E-visits Employed Through to 182 PCPs/Ob -129 to 158Specialists to 340 Total - Blue Font = Current - LifeFlight - Red Font = Future - Mobile Transport Reconfigured hospitals - Defiance Clinic Optical & Pharmacy - Sunforest Court Weight Mngmt - Wound Care - Sleep Center Retail Locations 2 + partner Aligned through 2014 = MOBs - Oregon & 2 others Wellness, Fitness Center 340 Employed Physicians - Arrowhead ASC - Defiance Clinic ASC -Mercy Tiffin JV ASC - Perrysburg Oncology - Sylvania Oncology - Ortho COE with Sports Medicine 3 ASC 1 - GI 2 - Oncology 1- Ortho Procedure Center Diagnostic/ Imaging Center 6 + acquisition opportunities Freestanding ER/Urgent Care 2 ED 2- UC 2 + partner Inpt Rehab Hospital Skilled Nursing Facility partner Outpt Rehab Home Care Disease Management 7 - Consolidated services - Consolidated nursing units - Fewer inpatient beds Acuity - St Charles - MHT VOA SNF - MHW LTC/SNF - PAC Collaborative - St Charles Center for Health Promotion - Sunforest Court - Perrysburg YMCA - Defiance Clinic - Mercy Willard - Mercy St Charles Center for Health Promotion - Sunforest Court Fitness - Arrowhead - Defiance Clinic - Perrysburg - Oregon - Sylvania - Perrysburg FSED - Sylvania FSED Urgent Care - Defiance Clinic - Metro Urgent Care - SI Home Care Partnership - Tiffin/Willard Home Care - SVs Dialysis - MT Dialysis/Fresenius - Chronic Disease Management - NWO Hospice Partnership

21 Post-Acute / Ambulatory Planning Jason Theadore - OhioHealth 52

22 OhioHealth Neighborhood Care

23 Approach Strategic placement of accessible facilities to drive geographic expansion Effective alignment of physician and service-line strategies Providing the right mix of innovative services Achieving quality outcomes Ensuring growth of physician referrals and market-share Providing an unmatched service experience

24 Options Hilliard Medical Center Lane Avenue Easton Mobile Mammography

25 Size & Scope of Services Satellite What Center Facility Options Health are Center Available? Medical Campuses Building sq.ft. Small Medium Large Visits 14,000-15,000 25,000-26,000 50,000-53,000 Loyal Physicians (1) Less Than 10 Less Than Products/ Services Physical Rehabilitation Therapy Basic Diagnostics X-Ray Mammography Ultrasound Lab Draw MOB Comprehensive Diagnostics- X-Ray Mammography Ultrasound MRI and/or CT Physical Rehabilitation Therapy Lab Draw Urgent Care MOB Pre-Registration Site for Admission Comprehensive Diagnostics X-Ray Mammography MRI Ultrasound CT Nuclear Medicine Laboratory Services Physical Rehabilitation Therapy Ambulatory Surgery Center Occupational Medicine Urgent Care Center Hospital Affiliated Specialty Centers Preventive Screening & Educational Center MOB Pre-Registration Site for Admission 25

26 Delivering on Patient Perceptions: Patients Utilize Very Different Criteria Hospital Experience Ambulatory Experience Involuntary Voluntary Patient: weak, vulnerable, passive Cost seems unimportant ( Do whatever is necessary ) Little or no shopping around Control Discharge is in the hand of others (physicians and case workers) Comparison generally limited to other hospital experiences Evaluated on cleanliness, attention and responsiveness Patient: strong, questioning, determined Cost a major consideration ( What s my least expensive option? ) Shop around for best price Control I can terminate at any time Comparison to other exceptional retail experiences Evaluated on price, convenience, responsiveness, tangible results

27 Know your Customers 2 Key Questions: What criteria do customers (Patients & Payors) use to evaluate health care services? How do we need to alter/expand our offerings to compete for their business? Care Continuum Services Imaging Rehabilitation Sleep ASC Sports Medicine Urgent Care Occupational Medicine Employer Services Pricing Access Multi Access Options Customer Experience Brand Understanding Customer Needs Service Relevance

28 QUESTIONS? 6/15/

29 Post-Acute / Ambulatory Planning Creating the right access points along the care continuum Masone, Chris DHG Healthcare Hudson, OH P: C: