Value-Based Health Care Delivery
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1 Value-Based Health Care Delivery Professor Michael E. Porter Harvard Business School Institute for Strategy and Competitiveness Vanderbilt University Curriculum Information Session August 30, 2012 This presentation draws on Redefining Health Care: Creating Value-Based Competition on Results (with Elizabeth O. Teisberg), Harvard Business School Press, May 2006; A Strategy for Health Care Reform Toward a Value-Based System, New England Journal of Medicine, June 3, 2009; Value-Based Health Care Delivery, Annals of Surgery 248: 4, October 2008; Defining and Introducing Value in Healthcare, Institute of Medicine Annual Meeting, Additional information about these ideas, as well as case studies, can be found the Institute for Strategy & Competitiveness Redefining Health Care website at No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording, or otherwise without the permission of Michael E. Porter and Elizabeth O.Teisberg Comprehensive Deck 1 Copyright Michael Porter 2011
2 Value-Based Health Care Delivery Curriculum Distinctive curriculum developed at Harvard Based on VBHC delivery framework introduced in Redefining Health Care Case method teaching 2 Copyright Michael Porter 2013
3 Curriculum Goals Establish faculty as teachers and researchers in VBHCD concepts Introduce VBHCD material into the core curriculum of physicians in training Fourth year medical students Residents and fellows Create course offerings for clinical leaders and senior health care executives Extend VBHCD curriculum through local case development Engage universities and providers as leading forces in driving the value agenda in their regions and nations 3 Copyright Michael Porter 2013
4 Value-Based Health Care Courses Strategy for Health Care Delivery (January 6-8, 2014) HCS is targeted at the senior leadership (CEOs, COOs, and CMOs) of providers, payors, and government, and focuses on new strategies, organizational models, and measurement approaches to drive value improvement in health care delivery Total of 326 participants Value Measurement for Health Care Delivery (December 16-18, 2013) VMHC is targeted at senior leadership of clinical service lines, and quality and financial departments. Leadership from payors and government organizations with roles focused on quality and cost measurement are also invited. This workshop focuses in-depth on new approaches to outcome and cost measurement and their role in enabling bundled reimbursement Total of 249 participants Value Based Health Care Delivery Intensive Seminar (January 6-10, 2014) Intensive Seminar is a week-long course that covers strategy, measurement, and organizational models more in-depth, which is targeted to junior clinicians and clinicians-in-training Total of 508 participants Partners Healthcare Course (January 15-17, 2014 Tentative) VBHC curriculum taught to mainly residents, clinicians, and fellows in the Partners Healthcare network Total of 247 participants HBR One Day Faculty Course (January 14, 2014 Tentative) One day training the trainers type of workshop to be offered for those interested in teaching the VBHC agenda at their respective institutions. VBHC Course at Texas Medical Center (Spring 2014 Tentative) VBHC curriculum taught to affiliates of Texas Medical Center, MD Anderson, and other organizations. 4 Copyright Michael Porter 2013
5 Courses with Other Organizations and Constituencies Harvard School of Public Health Global Health Delivery (80 participants) 2011, 2013 Dartmouth Masters in Health Care Delivery Science (100 participants) May 2013 AAOS Shifting from Volume to Value: Preparing your Practice for Health Reform (50 participants) 2010, 2012 UCLA Workshop on Value-Based Health Care Delivery (80 participants) 2010, 2012 Medicaid Leadership Institute (80 participants) June 2011 Strategy for Health Care Delivery: United Kingdom (80 participants) 5 Copyright Michael Porter 2013
6 Curriculum Materials Teaching Materials: Classroom use: Case studies Videos of guest protagonists Videos of topic lectures Video footage of profiled organizations Faculty Use: Teaching notes Videos of class discussions Articles and Books: Redefining Health Care Articles on specific aspects of value-based health care delivery Books evaluating national health care systems: Germany Finland 6 Copyright Michael Porter 2013
7 Selected Case Studies: Advanced Economies Acute Ledina Lushko: Navigating Health Care Delivery The Cleveland Clinic: Growth Strategy 2011 ThedaCare: System Strategy The University of Texas MD Anderson Cancer Center: Interdisciplinary Cancer Care The UCLA Health System: Kidney Transplantation Chronic The Dartmouth-Hitchcock Medical Center: Spine Care The Joslin Diabetes Center The West German Headache Center: Integrated Migraine Care Primary Care Commonwealth Care Alliance: Elderly and Disabled Care Health Plan/Employer Pitney Bowes: Employer Health Strategy International Highland District County Hospital: Gastroenterology Care in Sweden Koo Foundation Sun-Yat Sen Cancer Center: Breast Cancer Care in Taiwan Reconfiguring Stroke Care in North Central London Great Western Hospital: High Risk Pregnancy Care Schön Klinik: Eating Disorders Care Global Health Partner: Obesity Care 7 Copyright Michael Porter 2013
8 Cases Information and Topic Areas Case Study Completed Case Studies Patient Experience 1 Ledina Lushko: Navigating Health Care Delivery Integrated Care 2 The University of Texas MD Anderson Cancer Center: Interdisciplinary Cancer Care 3 The West German Headache Center: Integrated Migraine Care 4 Dartmouth-Hitchcock Medical Center: Spine Care 5 Sun Yat-Sen Cancer Center: Breast Cancer Care in Taiwan 6 Global Health Partner: Obesity Care Case Discussion Videos Protagonist Teaching Note Medical Condition/ Treatment x x Adrenal Cortical Carcinoma Cancer Care Chronic Conditions Coordinating Primary/ Acute Cost Measur ement Defining Cycles of Care Employers Health Plans Integrated Practice Units International Health Care Systems National Health Policy Provider System Integration Reimbursement Models Resource- Poor Settings Chicago, IL x x x x x x x Results Measurement x x x Head and Neck, Endocrine Cancer Houston, TX x x x x x x x Migraine Germany x x x x x x x x Spine Care Lebanon, NH x x x x x x Breast Cancer Taiwan x x x x x x x Obesity/ Bariatric Surgery Location Topic Area Sweden x x x x x x Service Expansion/ Growth 7 Gastroenterology Care at Sweden's Inflammatory Sweden x x x x Highland Hospital Bowel Disease 8 The Joslin Diabetes Center x x x Diabetes Boston, MA x x x x 9 In-Vitro Fertilization: Outcomes Measurement 10 Partners In Health: HIV Care in Rwanda 11 Brigham and Women's Hospital Shapiro Cardiovascular Center 12 The UCLA Health System Kidney Transplantation 13 Great Western Hospital: High-Risk Pregnancy Care Provider Systems 14 The Cleveland Clinic: Growth Strategy Children's Hospital of Philadelphia: Network Stratgey x Infertility/IVF x x HIV/AIDS Rwanda x Cardiovascular Care x x x ESRD, Kidney Transplantation x x x High-Risk Pregnancy Boston, MA Los Angeles, CA x x x Various Ohio, FL, International x x x x x UK x x x x x x x x x x x x x Various PA x x x 16 ThedaCare: System Strategy x x x Various WI x x 17 Schon Klinik Eating Disorder Care x x x Eating Disorders Germany x x x x x x x x 18 Reconfiguring Stroke Care in North x x x Stroke UK x x x x x x 19 Central Boston Children's London Hospital TDABC x x Various Boston, MA x x x x 20 Schon Klinik: Measuring Cost and Value x x Total Knee Replacement Germany x x x x x Health Plan / Employer 21 Commonwealth Care Alliance: Elderly and Disabled Care 22 Pitney Bowes: Employer Health Strategy In Process x x x Various Boston, MA x x x x x x x x x Various USA x x x Integrated Care 23 Martini Klinik: Prostate Cancer Care Prostate Cancer Hamburg, Germany 24 OrthoChoice: Bundled Payments in Total Hip and Stockholm, the County of Stockholm Knee Sweden Replacement 25 Texas Children's Hospital: Congenital Heart Disease Congenial Heart Disease x x x x x x x x x x x x Houston, TX x x x x x 8 Copyright Michael Porter 2013
9 Advanced Economies Health Care Books and Articles Books: Porter, Michael E. and Clemens Guth. Redefining German Health Care. (2012) Porter, Michael E., Juha Teperi, Lauri Vuorenkoski and Jennifer F. Baron. The Finnish Health Care System: A Value-Based Perspective. (2009) Porter, Michael E. and Elizabeth Olmsted Teisberg. Redefining Health Care: Creating Value- Based Competition on Results. (2006) ARTICLES: Porter, Michael E. and Thomas H. Lee. The Strategy that Will Fix Health Care, Harvard Business Review, Oct, Porter, Michael E. with Thomas H. Lee and Erika A. Pabo. Redesigning Primary Care: A Strategic Vision to Improve Value by Organizing Around Patients Needs, Health Affairs, Mar, Porter, Michael E. and Robert Kaplan. How to Solve the Cost Crisis in Health Care, Harvard Business Review, Sep, Porter, Michael E. What is Value in Health Care and supplementary papers, New England Journal of Medicine, Dec, Teisberg, Elizabeth O. and Scott Wallace. Creating a High-Value Delivery System for Health Care. Semin Thorac Cardiovasc Surg, Spring, Porter, Michael E. A Strategy for Health Care Reform Toward a Value-Based System, New England Journal of Medicine, Jun, Porter, Michael E. Value-Based Health Care Delivery, Annals of Surgery 248, no. 4 (Oct, 2008): Porter, Michael E and Elizabeth Olmsted Teisberg. How Physicians Can Change the Future of Health Care, JAMA, Mar, Porter, Michael E. with Elizabeth O. Teisberg and Gregory B. Brown. Making Competition in Health Care Work, Harvard Business Review, Jul-Aug, Porter, Michael E. and Elizabeth O. Teisberg, Redefining Competition in Health Care, Harvard Business Review, Jun, Copyright Michael Porter 2013
10 Strategy for Health Care Delivery Leadership Workshop January 7-9, 2013 Professor Michael E. Porter 8:30 8:45 Monday, January 7 Tuesday, January 8 Wednesday, January 9 9:00 Session 2: (9:00AM - 10:30AM) Session 5: (9:00AM-10:30AM) 9:15 Case: Commonwealth Care Alliance: Elderly and Disabled Case: The Cleveland Clinic: Growth Strategy :30 Care Michael Porter 9:45 Elizabeth Teisberg 10:00 10:15 10:30 Break (10:30AM - 10:45AM) Break (10:30AM - 10:45AM) 10:45 Case Protagonists (10:45AM - 11:30AM) Case Protagonist (10:45AM-11:30AM) 11:00 Bob Master, CEO and Lois Simon, COO Toby Cosgrove, CEO 11:15 11:30 Topic Lecture: (11:30AM - 12:15PM) Topic Lecture: (11:30AM - 12:00PM) 11:45 IPUs, Integrated Chronic Care, and Employer Roles System Integration & Growth Elizabeth Teisberg 12:00 Elizabeth Teisberg Wrap Up (12:00-12:15PM) 12:15 Group Photo (12:15-12:30PM) 12:30 Lunch (12:30-1:30PM) 12:45 1:00 1:15 1:30 Session 3: (1:30-2:45PM) 1:45 Case: Sch ön Klinik: Measuring Cost and Value 2:00 Bob Kaplan 2:15 2:30 2:45 Case Protagonist (2:45-3:30PM) 3:00 Mani Rafii and Jens Deerberg 3:15 3:30 Break (3:30PM-3:45PM) 3:45 Topic Lecture: Measuring and Paying for Value 4:00 (3:45-5:15PM) 4:15 Michael Porter (Outcomes) (35 min) 4:30 Bob Kaplan (Cost and Reimbursement) (35 min) 4:45 Q&A (20 min) 5:00 Welcome (5:00PM - 5:15PM) 5:15 Session 1: (5:15PM - 6:30PM) Session 4: (5:15PM - 6:45PM) 5:30 Case: The University of Texas MD Anderson Cancer Alumni in Action 5:45 Center: Interdisciplinary Cancer Care Larry Higgins, JP Warner, Kathy Carberry, Charles 6:00 Michael Porter Fraser, Michael Sherman 6:15 6:30 Case Protagonist (6:30PM - 7:15PM) 6:45 Tom Burke, EVP, Phsycician in Chief; Break (6:45PM-7:00PM) 7:00 Tom Feeley, Head, Institute for Cancer Care Innovation Reception and Dinner (7:00PM) 7:15 Topic Lecture: (7:15PM - 8:00PM) McArthur Lounge and Kresge Hall South Terrace 7:30 Introduction to Value-Based Health Care Delivery (Porter) 7:45 Introduction to TDABC in Helath Care (Kaplan) 8:00 Buffet Dinner (8:15PM) 8:15 Kresge Hall, South Terrace 8:30 8:45 Strategy for Health Care Delivery Leadership Workshop 10 Copyright Michael Porter 2013
11 Value Measurement in Health Care Course May 6-8, 2013 Professor Michael E. Porter Value Measurement for Health Care Leadership Workshop May 6-8, 2013 Time Monday, May 6 Tuesday, May 7 Wednesday, May 8 Hawes 102 Hawes 102 Hawes 102 7:30 AM Small Group Discussion: (7:30am - 8:30am) Small Group Discussion: (7:30am - 8:45am) 7:45 AM McArthur Living Groups McArthur Living Groups 8:00 AM 8:15 AM 8:30 AM Break (8:30-9:00am) 8:45 AM Break (8:45-9:00am) 9:00 AM Session 2: (9:00-10:30am) Session 4: (9:00am - 10:30am) 9:15 AM Case: Boston Children's Hospital Case: The Schön Klinik: Measuring Cost and Value 9:30 AM Bob Kaplan Bob Kaplan 9:45 AM 10:00 AM 10:15 AM 10:30 AM Break (10:30-10:45am) Case Protagonist (10:30-11:00am) 10:45 AM Case Protagonist (10:45am - 11:15am) Axel Fischer video 11:00 AM John Meara and Peter Waters Break (11:00-11:15am) 11:15 AM Topic Lecture (11:15am- 12:00) Cost Session 11:30 AM TDABC 11:15-11:40 TDABC Implementation (Derek Haas) 11:45 AM Bob Kaplan 11:40-12:05 Implementation (Tom Feeley, Heidi Albright) 12:00 PM 12:15 PM 12:30 PM Lunch 12:30-1:30 "Stump the Professor" Q&A (12:30-1:15 pm) 12:45 PM Michael Porter, Bob Kaplan 1:00 PM 1:15 PM Take Aways and Wrap Up (1:15-1:30pm) 1:30 PM Session 3: (1:30pm - 3:00pm) 1:45 PM Case: UCLA 2:00 PM Michael Porter 2:15 PM 2:30 PM 2:45 PM 3:00 PM Case Protagonist (3:00pm - 3:30pm) 3:15 PM Tom Rosenthal video 3:30 PM Topic Lecture: (3:30-4:45) 3:45 PM Outcome Measurement 4:00 PM Michael Porter and Jens Deerberg 4:15 PM 4:30 PM Opening Reception (4:30-5:00pm) 4:45 PM Break (4:45-5:00) 5:00 PM Welcome (5:00-5:10pm) Topic Lecture: (5:00-6:30pm) 5:15 PM Session 1: (5:10pm - 6:30pm) Reimbursement 5:30 PM Case: Schön Klinik: Eating Disorders Care Bob Kaplan 5:45 PM Michael Porter 6:00 PM 6:15 PM 6:30 PM Case Protagonist (6:30-7:00pm) Dinner 6:30PM 6:45 PM Mani Rafii Kresge Hall 7:00 PM Topic Lecture: (7:00-8:00pm) 7:15 PM Intro. to Value-Based Health Care Delivery 7:30 PM Michael Porter 7:45 PM ` 8:00 PM Group Photo (8:00-8:15pm) 8:15 PM Dinner (8:15pm) 8:30 PM Kresge Hall, North terrace Leading Change and Overcoming Organizational Resistance 12:00-12:30 (Bob Kaplan and Heidi Albright) Bundled Payments Panel: Michael Sherman, Larry Higgins, JP Warner 11 12:05-12:30 Discussion Copyright Michael Porter 2013
12 Value-Based Health Care Delivery Intensive Seminar January 7-11, 2013 Value-Based Health Care Delivery Intensive Seminar, January 7-11, 2013 Professor Michael E. Porter 8:00 8:15 Monday, January 7 Tuesday, January 8 Wednesday, January 9 Thursday, January 10 Friday, January 11 8:30 Session 5: (8:30-9:45) 8:45 Case: Boston Children's Hospital 9:00 Welcome: (9:00-9:15) Session 3: (9:00-10:30) Mary Witkowski Session 8: (9:00-10:30) Session 10: (9:00-10:30) 9:15 Session 1: (9:15-10:45) Case: Schön Klinik: Eating Disorders Care Case: Children's Hospital of Philadelphia Case: Cleveland Clinic: Growth Strategy :30 Case: MD Anderson Cancer Center Caleb Stowell Jens Deerberg Michael Porter 9:45 Michael Porter Case Protagonist (9:45-10:15) 10:00 John Meara 10:15 Break (10:15-10:30) 10:30 Break (10:30-10:45) Session 6: (10:30-11:45) Break (10:30-10:45) Break (10:30-10:45) 10:45 Break (10:45-11:00) Case Protagonists (10:45-11:30) Case: UCLA Protagonist: (10:45-11:30) Protagonist Session (10:45-11:30) 11:00 Case Protagonist (11:00-11:45) Jens Deerberg, Mani Rafii Kevin Bozic Steve Altschuler Martin Harris 11:15 Heidi Albright, Tom Feeley 11:30 Topic Lecture: Outcomes Measurement in Topic Lecture: System Integration and Growth Discussion and Wrap up (11:30-12:30) 11:45 Topic Lecture: Intro. to Value-Based Health Practice (11:30-12:15) Case Protagonist Video (11:45-12:15) (11:30-12:00) Elizabeth Teisberg 12:00 Care Delivery (11:45-12:30) Jens Deerberg Group Photo (12:00-12:15) 12:15 Michael Porter Lunch and Discussion Groups (12:15-1:45) Lunch and Preparation (12:15-1:00) Lunch and Preparation (12:15-1:00) 12:30 Lunch and Preparation (12:30-1:15) 12:45 1:00 Topic Lecture: Reimbursement (1:00-1:30) Session 9: (1:00-3:00) 1:15 Session 2: (1:15-2:45) Michael Porter Case: Michelin 1:30 Case: CCA Topic Lecture: Bundled Payments in Practice Elizabeth Teisberg 1:45 Elizabeth Teisberg Session 4: (1:45-2:45) (1:30-2:00) Kevin Bozic 2:00 Case: Reconfiguring Stroke Care in North Central Break (2:00-2:15) 2:15 London Session 7: (2:15-3:30) 2:30 Tom Lee Case: Sch ö n Klinik: Measuring Cost and Value 2:45 Break (2:45-3:00) Break (2:45-3:00) Bob Kaplan 3:00 Case Protagonists (3:00-3:45) Protagonist Video (3:00-3:30) Break (3:00-3:15) 3:15 Bob Master, Lois Simon 3:30 Topic Lecture: Putting the Value Framework Case Protagonist Video (3:30-4:00) Topic Lecture: Employer/Payer Roles (3:15-4:00) 3:45 Topic Lecture: IPUs, Chronic care (3:45-4:30) to Work (3:30-4:15) (Tom Lee) Elizabeth Teisberg 4:00 Elizabeth Teisberg Break (4:00-4:15) Faculty Session (optional) (4:15-5:00) 4:15 Topic Lecture: Cost Measurement 4:30 Systems (4:15-4:45) Bob Kaplan 4:45 Cost Measurement in Practice 5:00 (4:45-5:15) Mary Witkowski 5:15 For participants interested in teaching our health care curriculum at their institutions 12 Copyright Michael Porter 2013
13 Supplementary Information Comprehensive information on teaching Value-Based Health Care Delivery can be found in the Prospectus for Universities and Faculty For additional information please visit the following websites: Copyright Michael Porter 2013
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