The fifth annual gathering of c-level executives from the most progressive hospitals

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1 Executive Summary Produced by Lincoln Healthcare Group About Hospital 100 Hospital 100 Leadership & Strategy Conference October 19 to 21, 2015 The Ritz-Carlton Key Biscayne, FL Hospital 100 is the annual gathering of C-level leaders from progressive, forwardthinking hospital organizations. Hospital 100 Leadership & Strategy Conference October 2014, Park Hyatt Aviara, Carlsbad, CA The fifth annual gathering of c-level executives from the most progressive hospitals and health systems across the nation was held October 19 to 21, in Carlsbad, CA. Provider executives learned from and contributed to a highly engaged dialogue around the pivotal topics affecting the future of hospitals and health systems, including Clinical Integration; Physician Relations; Partnerships and Affiliations; Collaborating with Managed Care; Data Analytics; Cost Management; Emerging ACO Models; and much more. The three-day gathering served as a forum for collaborative learning among executive leadership, and was punctuated by an intensive, half-day Executive MBA Program on the topic of Population Health Management. Attendees include: Leadership of Hospitals and Health Systems: President CEO COO CFO CMO CNO Board Members Executive MBA Program Population Health Management: Redefining Care for Our Communities As the marquee event at this year s Hospital 100 conference, the 2014 Executive MBA session on Population Health Management was an intensive half-day program in which executives from around the country gathered to share challenges and best practices about population health management and implementation. Plus, Select Executive Decision-Makers at Health Systems (such as EVP, SVP, VP, Director) with oversight for: Finance, Growth & Investment Strategy and Innovation Accountable Care Initiatives Population Health Management Clinical Integration MBA, Part I: Panel Discussion The Executive MBA began with a panel discussion about the strategic imperatives behind developing and enhancing a population health program and explored different approaches and lessons learned. Panelists included: Jeff Hoffman (Moderator), Senior Partner, Kurt Salmon Reese Jackson, President & CEO, Forbes Regional Hospital (Allegheny Health Network) Scott Pingree, Director of Strategic Planning, Chair of High-Cost Patient Review and Hotspotting, Intermountain Healthcare George Terrazas, President, Texas Care Alliance

2 Two core implementation challenges emerged from the discussion. First, given the unique and local nature of health care, overarching national population health solutions are not a fit for addressing individual market conditions, and hospitals are struggling to adapt others programs to meet their own community needs. Second, despite significant transformation, hospitals still have a long way to go in improving care delivery, and many hospitals and health systems are relying on dated infrastructures to support innovative population health strategies. Despite these difficulties, the benefits associated with a population health program substantially outweigh any short-term challenges. To capitalize on these benefits, panelists urged executives to do the following: Do get started. Don t wait for industry best practices to emerge. Do begin by looking at your hospital s clinical data. Not only will this promote transparency with physicians, but it will allow you to identify sources of waste whether it is behavioral, clinical or administrative. Don t model your population health program off those being used by competitors. Understand that the road to population health is an individualized process. There will be bumps in the road, but success comes only through trial and error. Don t wait for fully formed solutions. If you do, you will be overtaken by competitors who are experimenting, innovating and moving ahead. MBA, Part II: Presentations The second part of the Executive MBA guided attendees through potential trouble spots they might encounter later on in their population health journey. Challenge: Identify high-cost patients and transition them to an integrated delivery system. Scott Pingree of Intermountain Healthcare encouraged all hospitals and health systems to group their patients into five distinct categories: Top 1% of costliest patients Top 5% of costliest patients Rising-risk patients Low-risk patients Healthy patients Similarly, some hospitals find it beneficial to geocode their patient population by creating heat maps of medical condition density across their region. Stratifying the data allows hospitals to hotspot high-cost patients and identify cost-reduction solutions. After careful data analysis, Intermountain Healthcare launched two pilot programs aimed at reducing the number of high-cost patients a community care management pilot and a personalized care clinic pilot. The short-term longitudinal community care management program sent nurses and social workers to meet with high-cost patients in their homes. The personalized care clinic pilot included establishing outpatient clinics that provide intensive medical, behavioral and social management care. While Intermountain Healthcare is still evaluating the results of their pilots, patient-reported improvements thus far include better health, more confidence that their health care is moving in the right direction and increased patient engagement.

3 Challenge: Transition to reimbursement models that incentivize population health. David Terry, founder and CEO at Archway Health Advisors, recommended that hospitals and health systems look at variation in care and cost patterns across physicians, post-acute care providers and clinical areas. Many hospitals would be surprised to learn there is significant deviation.

4 With such variation, he explained that managing the post-discharge period is one way to improve care and risk management success. But regardless of the solution used, the optimal model, as recommended by David Terry, has the ACO s primary care physician managing population health and directing patients to specialty providers on an as-needed basis. MBA, Part III: Collaboration To close the Executive MBA, Lindsey Mosby, executive strategy director, healthcare, and Drew Miller, creative director, both of Austin, TX-based Frog Design, led attendees through an interactive workshop designed to help executives think differently about population health strategies, business opportunities and game-changing innovations. Executives worked in small groups to discuss ideas, best practices and lessons learned. The following are highlights of the workshop outcomes: Repairing Relationships with Existing Customers Observations included: Shift to providing Concierge services which treat patients like customers and strive to coordinate their activities Incorporate and track patient service needs in their EMR - (what pharmacy? what physician?) And connect them into our portal Decrease wait times (make our service better) Treat patients like customers and demonstrate how valuable they are to us by showing them that we know them

5 Renewing your Value Proposition to New and Existing Customers Observations included: Develop new categories of customer service that focus on prevention and health - not just illness Integrate more information geared towards health and care into illness treatment to broaden the value we provide to our customers Focus on higher acuity customers and cases to make sure physicians are practicing at the top of their licenses and providing the most value possible Retaining Existing Customers Observations across this aspect of the discussions included: Decrease customer wait times and increase the value of the physician interaction Improve customer communication - via digital channels , text, mobile - post care Build better patient feedback systems and learn why they are going to CVS, etc. Develop new partnerships to increase efficiencies and improve customer experience - are we providing alternatives? The right ones? Become relationists - and better understand the broader customer context Make it more difficult for new competitors to attract/employ doctors by providing them higher pay and better hours Attracting New Customers Observations across this aspect of the discussions included: Need for developing service that focuses on greater customer convenience and improving speed and efficiency of services Embracing opportunity to help develop the capabilities of new partners rather than compete with them Create richer and more personal connection with customers Develop new services and new value propositions Better utilize or rethink the relationship with the PCP and bethink more creatively about how the shared information about the customer that can be leveraged

6 Other Education Highlights at Hospital 100 In addition to the Executive MBA session described above, attendees had the opportunity to participate in a number of other panels and interactive sessions. Topics included partnerships and affiliations, physician alignment, clinical integration, value-based care, hospital leadership, big data/it, and the Affordable Care Act, among others. Over the course of the conference, more than 40 hospital executives took the stage to discuss the above and drilled down on a range of topics, including: Criteria to consider when deciding between independence and affiliation and examples of non-acquisition alliances and partnerships between independent hospitals and systems The physician point of view in an era of integration, value-based reimbursement and population health Keys to aligning hospital structure and culture in order to achieve clinical integration Dr. Eric J. Topol, director, Scripps Translational Science Institute; professor of genomics, The Scripps Research Institute; and chief academic officer, Scripps Health, gave the keynote address, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Healthcare. The keynote focused on how social networking, smartphones and genome sequencing will boost consumer control over medical information and revolutionize medicine. The conference closed with a session discussing The Hospital of Given the massive transformation in the health care industry, and with further changes still to come, Charles Griffin of The Academy of Architecture for Health, Michel Nadeau of Tactio Health Group, Vance Moore of Mercy Health System and Gil Hoffman of Mercy Technology Services worked with attendees to envision the next chapter of community-based care, with a focus on emerging technology, the outpatient revolution and alternate revenue streams A complete list of sessions and speakers from the 2014 Hospital 100 conference is available on the website: 2014 Education Program About This Executive Summary This report was produced in collaboration with Kurt Salmon, a global management consulting firm dedicated to building the market leaders of tomorrow. For more information about Kurt Salmon, visit: