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s I Scottsdale Institute Collaboration Education Networking The 21 st Annual Spring Conference April 23-25, 2014 Moving from Volume to Value Scottsdale Institute s third decade began auspiciously with our 21 st Spring Conference at the Camelback Inn. More than 120 energized executives from SI member organizations and sponsors gathered to address the issue of the day: how do we move from a volume-based, fee-for-service world to one focused on value, patient-centered accountable care and population-health management? SI Chairman Don Wegmiller kicked off the three-day event and introduced keynote speaker Paul H. Keckley, PhD, Editor of the Keckley Report and Advisor to the American Hospital Association and the Bipartisan Policy Center. Mr. Keckley addressed Health Reform 2.0: What s Ahead? Among other trends, he noted, bundled payments will take center stage, many states are rewriting the Medicaid program while they expand it and insurers are more than willing to play in the health insurance exchanges. TOP Strategies Super-executive panelists Marc L. Boom, MD, president & CEO of Houston Methodist, Tom Sadvary, CEO of Scottsdale Lincoln Health Network, David Campbell, executive VP at Oakwood Healthcare, and Laura Kaiser, executive VP & COO at Intermountain Healthcare, discussed their strategies as healthcare moves into a highly uncertain new landscape. We don t really know what the right model is, said Dr. Boom, for care and financing in the future. It will probably be a mix. Population-health management is more like a rheostat than a fixed strategy, said Mr. Sadvary, adding that the tipping point for a full value-based model is when a health system s risk contracts achieve 25 percent to 30 percent of the total. Mr. Campbell described how the new alliance among Oakwood Healthcare, Beaumont Health System and Botsford Healthcare improves access to capital, physician alignment, market share and population health and will serve 4 million people in southeast Michigan. Ms. Kaiser noted how, as part of an initiative to redesign care, Intermountain a 22-hospital system with its own health plan just opened a complex care clinic limited to 1,200 by-invitation-only patients with chronic disease, co-morbidities and social issues. Marc Boom, MD, David Campbell, Tom Sadvary, Laura Kaiser David Blumenthal, MD HIGH PERFORMANCE In his address, Creating a High Performance Health System, David Blumenthal, MD, president of The Commonwealth Fund and former National Coordinator for Health Information Technology, discussed how the United States is essentially two countries when it comes to healthcare and it s not only because of low income. Systems are failing even well-resourced people in our country, as a result of geographical variance in quality, he said. We have failed to create macro-systems drivers such as health policy and payment structures that encourage and support the best use of microsystems the actual local care delivery structures. The good news is that readmissions are declining as a result of provider initiatives.

Healthcare Imperatives Susan Devore, president & CEO, Premier Inc., addressed the topic, Healthcare s Imperatives: Scale, Infrastructure and Transformation, which offered many nuggets including key features of a successful ACO: Susan Devore Owning your health plan Managing risk Access to EHR data Patient-centered medical home Significant market share Employment of physicians Glimpse of the future The panel, Successful Partnerships for New Models of Care, moderated by Mike Kramer, MD, senior VP & CQO, Spectrum Health, highlighted innovations with exciting results occurring across the healthcare environment led by retailers, payers and other non-provider organizations. The Jeffrey Kang, MD, and Mike Kramer, MD panel included Jeffrey Kang, MD, senior VP, health & wellness, Walgreens; Miles Snowden, MD, CMO, Optum; Sam Nussbaum, MD, executive VP, clinical health policy, Wellpoint; and David Muntz, senior VP & Miles Snowden, MD, and Sam Nussbaum, MD CIO, GetWellNetwork. High reliability Mark R. Chassin, MD, president and CEO of the Joint Commission, described how the Commission has made it a mission to help transform healthcare systems into high reliability organizations like those in aviation and the nuclear industries. He provided specific examples of the three keys to success he has seen across many health systems around the globe: 1. Leadership commitment to the ultimate goal of zero harm 2. Establishment of a safety culture 3. Robust process improvement (RPI) He also emphasized the many resources available to health systems at their website www.jointcommission.org. PANEL DISCUSSIONS David Muntz, Mark Chassin, MD, and David Classen, MD Tom Giella, managing director, Korn-Ferry, moderated the Town Hall discussion, a review of the topics raised during the conference. The panel, which took questions from the audience, included Mark Chassin, MD; David Classen, MD, associate professor of medicine, University of Utah and Board Member, Scottsdale Institute; David Muntz; and Sam Nussbaum, MD. Predictably, this annual capstone session evoked lively and passionate discussions about the many challenges as well as our progress in the emerging healthcare environment. The panel Convergence, Consolidation and Cost Reduction in Healthcare discussed how the activity level of health-system mergers & acquisitions varies tremendously from region to region. Among physicians there s a lot of activity in seeking employment with those health systems as they see their income decline. Healthcare-delivery organizations are collaborating more with payers than ever before. (l-r) Michael Taylor, MD, CMO, Truven Health Analytics; Jay Anderson, Senior VP & CIO, Northwestern Memorial; Dennis Dahlen, senior VP & CFO, Banner Health; Mitch Morris, MD, national leader, Deloitte; Frederick Hessler, retired, managing director, Citigroup, moderator.

View from the mountain top In a breaking-out-of-the-box presentation, Kilimanjaro and Health Reform, two Texas Health Resources executives, Ed Marx, senior VP and CIO, and Elizabeth Ransom, MD, executive VP, conveyed novel leadership lessons for healthcare leaders learned from their experience climbing mountains around the globe. Innovation in Indiana Elizabeth Ransom, MD, and Ed Marx Bill McConnell, senior VP of IU Health, an Indiana-based 18-hospital health system, and Tim Tarnowski, VP and CIO at IU Health s Academic Health Center, described the health system s evolution from a holding company with multiple fragmented systems to ultimate systemness with a single, high-performing IS function focused on fee for value and population health. Software-application rationalization & simplification Moving from a holding company to an operating company CIO Summit During free time, CIOs gathered for a breakout session to discuss the top issues they face, and planned for a 2014 SI CIO Summit to discuss these issues in more depth. Their top issues include: Analytics: direction, needs, budget, talent Supporting initiatives around the patient experience CIO role versus Chief Digital Officer and other emerging roles Clinical connectivity with private MD practices Project, program & portfolio management & governance--including demand management IT operating excellence business & service management; IT operations improvement IT talent management new skill sets for pop health Development of common accounting methods for top cost categories like depreciation & capitalization in collaboration w/ big accounting firm or HFMA Coming soon Brent Snyder, CIO, Adventist Health System, invited everyone to SI s 2014 Fall Forum in Celebration, Fla., October 23-24, hosted by Adventist Health System at Florida Hospital. In closing the 21 st Annual Spring Conference, SI Chairman Don Wegmiller noted that of the 23 speakers at the conference, nine of them were active physician leaders, reflecting that physician executives are increasingly part of solution in the redesign of the healthcare industry. He also reminded everyone to mark their calendars for April 29 to May 1 for the 2015 SI Spring Conference. For complete presentations, audio recordings and photos visit the SI website at www.scottsdaleinstitute.org. A conference faculty list is on the back page.

COL LAB ORAT I ON E D U C A T I O N I N G N E T W O R K

2014 Spring Conference Faculty List Jay Anderson, SVP Performance Improvement/CIO, Northwestern Memorial HealthCare David Blumenthal, MD, President, The Commonwealth Fund Marc L. Boom, MD, President/CEO, Houston Methodist David Campbell, EVP Operations, System Strategy & Growth, Oakwood Healthcare Mark R. Chassin, MD, President/CEO, The Joint Commission David C. Classen, MD, CMIO, Pascal Metrics/Associate Professor of Medicine, University of Utah Dennis Dahlen, SVP/CFO, Banner Health Susan D. DeVore, President/CEO, Premier Inc. Tom Giella, Senior Client Partner/Managing Director, Healthcare Services, Korn-Ferry International Frederick Hessler, Retired Managing Director, Citigroup Laura S. Kaiser, EVP/COO, Intermountain Healthcare Jeffrey Kang, MD, SVP, Health and Wellness Division, Walgreens Paul Keckley, PhD, Editor, The Keckley Report Michael Kramer, MD, SVP/Chief Quality Officer, Spectrum Health Ed Marx, SVP/CIO, Texas Health Resources Bill McConnell, SVP/CIO, IU Health Mitch Morris, MD, National Sector Leader, Healthcare Provider, Deloitte David S. Muntz, SVP/CIO, GetWellNetwork Sam Nussbaum, MD, EVP Clinical Health Policy/CMO, WellPoint, Inc. Elizabeth Ransom, MD, EVP/ Clinical Zone Leader, Texas Health Resources Tom Sadvary, CEO, Scottsdale Lincoln Health Network Miles Snowden, MD, CMO, Optum Brent Snyder, CIO, Adventist Health System Tim Tarnowski, VP/CIO Academic Health Center, IU Health Michael Taylor, MD, CMO, Truven Health Analytics Don Wegmiller, Chairman, Scottsdale Institute and Co-Founder, C-Suite Resources s I Scottsdale Institute Collaboration Education Networking Stanley R. Nelson, Founder & Chairman Emeritus (1926 2012) Donald C. Wegmiller, Chairman Shelli Williamson, Executive Director 1660 Highway 100 South, Suite 306 Minneapolis, MN 55416 Phone: 952.545.5880 Fax: 952.545.6116 scottsdale@scottsdaleinstitute.org www.scottsdaleinstitute.org