Healthcare at a Crossroads

Transcription

1 Healthcare at a Crossroads A Discussion Among Leading IDN Executives Kettering Health Network Steve Huckabaa, Network Vice President Beth Israel Deaconess Medical Center Joe Sheil, Director of Contracting

2 Agenda Context: IDN Particulars Perspective: Imperatives/Goals Actions: Strategies & Tactics

3 Healthcare at a Crossroads Kettering Health Network Steve Huckabaa, Network Vice President

4 Snapshot of Kettering Health Network Particulars 7 Hospital Network; 8 in 2012 (new hospital) 2 Nursing Homes 2 Retirement/Assisted Living Communities College of Medical Arts 1,600+ Beds 1,400+ Physicians 9,500+ Employees 1,370+ Volunteers Service Area Primary and Secondary service area covers nine counties with a population of 1.6m

5 Snapshot of Kettering Health Network Financials Projected Net Operating Revenue = $1.1b+ Projected Net Operating Expense = $1.0b+ Projected Non-Labor Spend = $300m+ Projected Supplies Expense = $200m+ Quality/Excellence 2010 Platinum Level Governor s Award from Ohio Partnership for Excellence, state Baldrige Thomas Reuters Top 10 health systems 2009, 2010 Dayton Best Places to Work 2007, 2008, 2009

6 Steve Huckabaa Network Vice President Ronda Fedor Executive Assistant Dan Harnen Network Director David Starkey Network Director Suzanne Coleman Network Director Jeff Post Network Director Supply Chain Management Distribution & Materials Operations Innovation Center Retail Pharmacy Centralized Purchasing Biomedical & Clinical Engineer Office of Research LTC Pharmacy Capital Program Courier Service Imaging Research Owner Investments Supply Chain Analytics Linen Service Grants Administration & Operations Benefits & Wellness Programs Physician Direct Program DME/Infusion

7 Present & Future Impact Growing National & State Debt Decreased national and state revenues Aggressive approach to balancing budget Healthcare Reform Act Adding 32 million to healthcare Percentage of reimbursement tied to quality outcomes Increasing Never Events ACO concept gaining traction Non-government issuers will follow

8 Present & Future Impact Many Physician Concerns Reduced physician reimbursement Physician employment Impact on Research and New Technology Higher reimbursement is questionable Re-importation of drugs and implants Manufacturer profit margins publicly scrutinized Investor retirement plans affected

9 Present & Future Impact Unionization of Healthcare Providers Focus on nurses Little focus, if any, on employed hospital physicians and support staff Little focus, if any, on non-hospital clinicians and support staff Healthcare Reform Financial Impact on KHN in 2013/4 $80m in revenue

10 High Level Tactics Present and Future Self Distribution (local, regional) Growing private label program for medical products In-sourcing services; outsourcing services in local market Private label program for implant devices Develop broad continuum-of-care services Engage physician-scientist in research (pharmaceutical, medical device, imaging, etc.)

11 High Level Tactics Present and Future Acquire practices; physician employment Use of Service Line & Supply Chain Analytics Conformance to FDA Act of 2007 (H.R. 3580, Section 226, Unique Device Identification System) E-expense (electronic requisition to electronic payment) Electronic Medical Record Individual Health record

12 Important Crossroad for Supply Are you the. Chain of the Future Supply chain executive/chief purchasing officer?» or Chief non-labor officer?» or Chief non-labor officer with revenue responsibilities?

13 KHN Strategies Deploy continuum-of-care service offerings Implement Service Line & Supply Chain Analytics

14 Service Line Concept Deployed in mid 90 s Service Lines Behavioral Services Cardiovascular Medicine Neuroscience Oncology Orthopedic Surgery Women & Children Strategic Business Units Emergency Department College of Medical Arts Outpatient Services Senior Services

15 Service Line Concept Deployed in mid 90 s Structure Council meets quarterly Executive sponsor SL Leader Physician Leader Marketing Representative Decision Support Liaison SCE as attendee New Structure Along with current structure: Deploy SL analytics tool Assign SCM staff to each SL Dedicated SC director or manager to meet with SL throughout month Identify opportunities for targeted savings

16 Continuum-of-Care Prior to Retail Pharmacies Sold DME in 2003; never aligned with hospital services Shutdown closed-door pharmacy in 90 s Since Retail Pharmacy locations Concierge service to bedside Reopened closed-door pharmacy Reopened DME Infusion ownership Physician Program

17 Continuum-of-Care Prior to & Beyond 3 Retail Pharmacy locations Retail Pharmacy on local university campus Mobile Imaging Laboratory Services Rehab Services Consultant Services Other Support Services

18 Conclusion You ve learned a little about KHN You ve learned a little about some of our strategies and tactics

19 Healthcare at a Crossroads Beth Israel Deaconess Medical Center Joe Sheil, Director of Contracting

20 BIDMC at a Glance Locations Financials Multi-campus academic medical center Level 1 Trauma Harvard Teaching Affiliate 621 Licensed beds Official Hospital of the Boston Red Sox Operating Revenue - $1.4 Billion Margin Target 4% Volume Discharges 40.1K Surgeries 24K Supply Expense ED Visits K Clinic Encounters K Births -- 7K $350 M; CAPEX $82 M

21 BIDMC Goals Growth in market share and clinical affiliations, Expansion of a world-class research program Enhancement of both undergraduate medical education and residency programs.

22 BIDMC Characteristics Intense focus on quality and safety improvement Unprecedented level of transparency Highly collaborative Rabid enthusiasm for the proposition that hospitals should not harm patients: we adopted an audacious goal of eliminating preventable harm over a four year period, and we are on track to reach that goal.

23 BIDMC Tactics Engage front-line staff in all job categories in a sustained and respectful program of process improvement Full-fledged implementation of the Lean process improvement philosophy

24 Harvard with A Heart We "discovered" that patients and their families need to be part of the planning and management of the hospital If our purpose is to deliver the kind of care we would want for members of our own family, incorporating the unique perspective of patients and their families is the only way we can achieve that purpose

25 BIDMC Supply Chain FY11 New GPO membership Reorganize to better align resources Redevelop Value Analysis teams Expand automation $6 million savings target Tighten expense control

26 Healthcare at a Crossroads A Discussion Among Leading IDN Executives Kettering Health Network Steve Huckabaa, Network Vice President Beth Israel Deaconess Medical Center Joe Sheil, Director of Contracting

27 Summary Context: Regional Network Academic Medical Center Perspective: Imperatives/Goals Debt and Reform impact on physicians, R&D, staff Growth thru affiliation/acquisition/differentiation Actions: Strategies & Tactics Disintermediation, Continuum-of-Care and Analytics Reinvention, Transparency and Collaboration