Physician Discovery Services Provide a Full Range of Physician Practice Solutions

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1 Physician Discovery Services OUR SOLUTION Truven Health Physician Discovery Services experts provide insights into a hospital or health system s physician enterprise. With experience in physician assessment, operations improvement, integrating physicians into health systems, and improving practice performance, Truven Health will help your team implement solutions that drive results. FACT: Each year, 45 percent of all hospitals in the United States buy a data product, solution, or consulting service from Truven Health Analytics. Physician Discovery Services Provide a Full Range of Physician Practice Solutions Having a sound physician integration strategy is even more important with the passage of the Patient Protection and Affordable Care Act. To succeed in the new payment environment and reap the rewards associated with improving quality and reducing cost, hospitals and physicians must further integrate to manage patient populations through enhanced analytics and communication. Truven Health Physician Discovery Services provide valuable insights into a hospital or health system s progress and/or performance gaps associated with their physician enterprise. Experts from Truven Health Analytics SM offer experienced leadership with proven skills that will ultimately guide and support the development of a fully functioning, clinically integrated network. Our offerings are consolidated into four key areas. Within each area there are various services offered that can be customized based on your specific needs. The four key areas are: Comprehensive Physician Practice Assessment Service Line Co-Management Central Business Office Operational Efficiency Assessment Clinical Integration Gap Analysis Comprehensive Physician Practice Assessment Truven Health experts will evaluate your current physician practice and provide you with an operational and financial assessment of your independent or employed group practice. We assess workflow, billing and collection efficiencies, staffing ratios, benchmarking of physician performance, policies and procedures, and staff training opportunities. You receive our findings and recommendations in a written practice assessment analysis that can be used as a plan for implementation. Our team is also available to help project manage the implementation as a second phase of the assessment process. Solution Spotlight

2 AMA surveys found that in 2008 just over 60 percent of physicians were self-employed, with the remainder employed either by group practices or hospitals. A similar survey conducted by Accenture and released last June estimates that by 2013, less than onethird of physicians will be independent. Physician Productivity and Compensation Plan Review We conduct an assessment of your employed physician group compensation plan. In cases where multiple compensation models exist, we evaluate the models and determine the best model or hybrid that could be used across the entire physician enterprise. The assessment evaluates how effective the models are at encouraging productivity, quality, and/or other desired behavior for the physician group. Our final report offers recommendations for changes to the compensation plans and/or methods for consolidating multiple plans. CMMI Bundled Payment Gainsharing between the hospital and physicians is an integral part of the Center for Medicare & Medicaid Innovation (CMMI) shared savings initiative. We facilitate the collaboration between hospitals and their physician partners to develop gainsharing methods that can be included in the CMMI application process. Practice Management System Utilization Our experts review and analyze the information technology utilized by your employed group practice. Our work includes: Assessment and strategy for migration to a single platform Assistance in request for proposal for the purchase of new billing and collection systems Evaluation and assessment of proper use of system tools to maximize operational efficiencies and accounts receivable management Physician Financial Loss Reduction Hospitals are experiencing large financial losses per employed physician. Factors contributing to the losses are numerous and require extensive analysis. We provide an assessment and recommendations, along with implementation or facilitation of both the financial and operational tactics required to reduce losses. This process helps mitigate your loss per physician and improve the overall financial performance of the group or physician enterprise. Moving Your Hospital to the Next Level Service Line Co- Management Commercial Bundled Payment Strategy Patient Centered Medical Home Clinical Integration Readiness & Gap Analysis Revenue Operations Analysis Physician Enterprise Development and Management Physician Financial Loss Reduction Comprehensive Operational Assessment 2

3 Our assessment provides an estimated Financial Reduction Impact Analysis. Assistance with the implementation of our final recommendations would be available through a phase II engagement process. Service Line Co-Management Truven Health experts help hospitals develop co-management programs for specific service lines. Service line comanagement can improve quality for the service line and provide incentives for physicians and hospitals to work collaboratively toward value-based purchasing targets. Our services lead the hospital and targeted physicians through the development of quality indicators for the service that physicians will be measured against. We also develop the structure of the comanagement company in concert with a legal team and a valuation expert that would determine the fair market value of the physician compensation under this model. Practice Acquisition Strategies We help you develop an alignment structure in addition to your fullemployment model for attracting physician groups. It includes: Leasing models Joint equity model Physician service agreements Stock purchase Management services Service line co-management Management services organization development Development of Physician Enterprise Structure and Management We assist hospitals in sizing and scaling the management entity for their employed physician practices. This includes: Evaluation of management staffing levels Recommendation of when to discontinue shared services with the hospital Revenue cycle operations Managed care contracting Human resource management Benchmarking 3

4 Truven Health also facilitates operational and cultural due diligence on targeted physician acquisition and transition planning post-acquisition, as well as physician on-boarding. Our due diligence includes a physician clinical profile to assist you in selecting best performers for the clinically integrated network. Physician Compensation Development, Modeling, and Implementation We develop comprehensive compensation plans that align the interests of the hospital and physicians. It is particularly important to have a unified compensation plan as you move toward an environment where you pay for value and outcomes. All compensation plans should include reward for quality performance and patient-centered outcomes. Our compensation planning includes an assessment of the current compensation model and benchmarking of that model against Medical Group Management Association (MGMA) norms for productivity and pay. Through a committee process, we create a new compensation model that meets the goals and objectives of the hospital and physicians group. Physician Governance and Leadership Our experts provide an assessment of your current physician leadership structure within the group practice. We work with management to develop a strategy for evolving to a physicianled organization by structuring a governance model that integrates physician involvement with business and clinical decisions of the group practice. We re also available to facilitate an educational series for the physician and provider staff on integrations, alignment, and working collaboratively between hospitals and physicians. 4

5 Central Business Office Operational Efficiency Assessment Our Central Business Office (CBO) Operational Process Efficiency Assessment will review each of the functional areas of a CBO and evaluate them for effectiveness, ideal structure, and workflow. The assessment includes: Analysis of daily workflow Transactions per employee per day Front-end registration coordination and effectiveness Clinical office coordination on billing information Evaluation of system use and report generation Overall effectiveness on the training and knowledge of CBO staff Performance will be benchmarked against best-practice metrics and any financial improvement opportunities will be identified with recommendations on how to improve collections through changes to your revenue cycle operations. Our experts are available to assist with the implementation of our recommendations. Electronic Health Record (EHR) Utilization Truven Health experts review and analyze the information technology utilized by your employed group practice. Our evaluation includes: Assessment and strategy for migration to a single platform Assistance in request for proposal for the purchase of new EHR systems Assessment of proper utilization of existing EHR by physicians Meaningful Use gap analysis and project implementation We also provide assessment of the practice workflow and EHR set-up to determine impact to proper physician utilization and/or need for redesign of work space and/or workflow processes. Group Payer-Contract Analysis We review your payer contracting mechanism to determine if the contracts are specific to physician services and meet the financial commitments of the physician compensation agreement and overhead structure of the group. Using the Truven Health Reimbursement Benchmark Tool, we can assess the current payer contract rates against regional reimbursement averages to determine opportunities for increased rates in contract negotiations. This analysis provides you with confidence to present payers with a specific plan and lead them through a successful, professional fee contract renegotiation or new contract negotiation. Clinical Integration Gap Analysis Truven Health provides a high-level, multi-disciplinary team to assess effectiveness of the hospital or health system in their ability to develop a clinically integrated network (CIN). The analysis examines all components of a health systems CIN to determine if there are gaps in the development of a more integrated system. The following components are included in the assessment: Physician enterprise and network Physician variability Benchmarking and bellwether comparison to other best practice CIN organizations Value-based purchasing scores Financial impact on system to move from fee-for-service to pay-forperformance 5

6 Hospital Risk Readiness Assessment We conduct a high-level assessment of the current state of a hospital s physician-hospital integration program. The assessment evaluates your hospital s relationship with its medical staff and employed physician group to determine if you are ready to enter into bundled, global, or other risk type reimbursement. The assessment focuses on key infrastructure components needed to move from a fee-for-service environment to a model similar to an accountable care organization or other risk bearing arrangement. Patient-Centered Medical Home (PCMH) Development and NCQA Recognition We work with the hospital-owned primary care physician/group to develop patient-centered medical home programs that support disease management initiatives and further prepare the organization for healthcare reform. Work in this area begins with an assessment of the current infrastructure and a gap analysis of what needs to be developed internally to develop a PCMH. In addition, we provide assistance in achieving Level I, II, or III National Committee for Quality Assurance (NCQA) Recognition. Patient-Centered Medical Home NCQA Recognition Gap Analysis As mature PCMHs look to become NCQA-Recognized, our assessment of practice operations highlights gaps in the current operations as compared to the NCQA Level I, II, or III Recognition level. This gap analysis helps you make changes in the current system, develop policy or procedures to support the level of recognition you desire to achieve, and where deficiencies exist, our experts help you develop processes and acceptable supporting documentation for the application process. Transitions of Care Programs Care of the patient after discharge becomes more important in risk type payment models. Our assessment of your current patient-transition process will identify gaps in your process or systems that may prevent patients from being readmitted. Our focus in this program is to manage the discharge of the patient and create pathways of care that reduce readmissions and provide a healthier outcome for the patient encounter. Value-Based Purchasing Truven Health experts give recommendations on how to improve Hospital Consumer Assessment of Healthcare Provider and Systems (HCAHPS) star ratings (Medicare Scores) so your providers can improve scores associated with patient satisfaction. Why Truven Health? Our Physician Discovery Services experts have more than 45 years of combined healthcare experience in physician assessment, operations improvement, integrating physicians into health systems, and improve practice performance. They can help you quantify operational issues and work with your team to implement solutions and drive results. 6

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8 For more information Contact Carol Alexander at or Michael Coppola at ABOUT TRUVEN HEALTH ANALYTICS Truven Health Analytics delivers unbiased information, analytic tools, benchmarks, and services to the healthcare industry. Hospitals, government agencies, employers, health plans, clinicians, pharmaceutical, and medical device companies have relied on us for more than 30 years. We combine our deep clinical, financial, and healthcare management expertise with innovative technology platforms and information assets to make healthcare better by collaborating with our customers to uncover and realize opportunities for improving quality, efficiency, and outcomes. With more than 2,000 employees globally, we have major offices in Ann Arbor, Mich.; Chicago; and Denver. Advantage Suite, Micromedex, ActionOI, MarketScan, and 100 Top Hospitals are registered trademarks or trademarks of Truven Health Analytics. truvenhealth.com Truven Health Analytics Inc. All rights reserved. All other product names used herein are trademarks of their respective owners. HOSP