Fundamental market shifts present opportunities to leapfrog dominant suppliers. Five years ago, universal access and payment reform were enacted in Massachusetts, which has the highest medical costs in the U. S. This case study describes bold steps taken by a Harvard-affiliated practice plan to embrace payment reform for competitive market advantage.

Upon completion of this activity, participants should be able to apply analytic tools to assess opportunities in their local markets for using market-based payment reform to gain potential competitive advantage.

After years of successfully operating under a Medicare Advantage capitation arrangement, New West is now moving to achieve similar performance for its far larger commercially insured patient population by moving away from fee-for-service to more value-based reimbursement mechanisms and affiliation opportunities. This presentation will explore New West’s path in positioning primary care at the center of a value-based healthcare financing and delivery system that properly rewards the primary care medical profession.

Upon completion of this activity, participants should be able to describe a thorough process for maximizing financial performance while providing high-value medical care at lower total cost for patients and payers.

UNC Health Care System and Blue Cross Blue Shield of North Carolina have formed a joint venture LLC as a vehicle to create a patient-centered medical home with enhanced resources. Expenses are being shared by both organizations and funds flow will utilize a shared savings model. This presentation will explore the model, including funds flow and financing, provider and patient incentives, payer/provider communication, marketing, and data-sharing.

Upon completion of this activity, participants should be able to describe how a physician provider organization can partner with local health insurance plans to design and pilot innovative care delivery systems; identify reimbursement systems that align incentives for employers, insurers, and providers in delivery high-value health care; and explain how IT systems can be harnessed to support high-value health care.

As healthcare reimbursement transitions from volume- to value-based, provider organizations will need to eventually alter their physician compensation plans to mirror reimbursement. To this end, this case study presentation will provide attendees with key insights on developing a physician compensation system that incorporates elements such as patient satisfaction, quality, patient access, compliance, and citizenship.

Upon completion of this activity, participants should be able to describe major trends in non-productivity-based compensation, including the percentage of compensation that high-performing groups are allocating to these incentives (relative to productivity incentives or fixed components); discuss the relative strengths and weaknesses of the various non-productivity performance metrics that are utilized in physician compensation plans; identify the various methods for integrating non-productivity incentives into a market-based compensation plan; and describe best practices related to this topic from one of the nation’s high-performing medical groups.

This session will provide an overview of the transformation of physician compensation models from plans based primarily on production to systems that incorporate the goals of accountable care, patient-centered medical homes, and value-based purchasing. It will highlight the collective experiences of senior-level physician leaders and an attorney who have implemented these models in a variety of organizations and geographical locations and have assessed market dynamics to institute the compensation model that best aligns physicians and healthcare systems.

Upon completion of this activity, participants should be able evaluate a variety of physician compensation models and assessing the compensation plans that best fit with the strategic goals and mission of medical groups and foundations, community hospitals, academic medical centers and integrated delivery systems; develop a compensation model that ensures that the goals of accountable care, value-based purchasing, and bundled payments are achieved; create and implement a payment system that rewards physicians not only for production, but for care coordination in accordance with the new paradigm of health care delivery; develop a compensation plan that incorporates quality metrics and population health service measures to incentivize continual improvement in care, economic value, patient engagement and health outcomes; assess the legal and regulatory guidelines applicable to physician compensation in order to properly reward physicians for both clinical production and achievement of quality and cost outcomes; discuss the changing dynamics around federal and commercial payer reimbursement methodologies that require implementation of new payment structures for physicians; and compare physician compensation models that meet the goals of both primary care and specialist physicians while aligning with the strategic vision of the institutions or entities where the physicians practice.

HealthPartners has spent the past few years focusing on elements such as culture change and care redesign, which have led to results in the Triple Aim, improving experience, health, and affordability. In this presentation, presenters will share their success story and how that has led to positioning the organization as an ACO.

Upon completion of this activity, participants should be able to identify Triple Aim transformation elements. (Improved health, enhanced experience, affordable cost); describe transformation elements of goal setting, redesigning care, proactively identifying and engaging high risk populations, supporting healthy lifestyle choices, providing actionable Triple Aim data, transparently reporting results, and aligning compensation, payment, and plan benefit design with Triple Aim goals; describe the importance of culture in relationship to the transformational elements; and describe how achieving Triple Aim results can prepare an organization in becoming an ACO.

This interactive presentation highlights how the use of technology, as an appropriate tool, can make dramatic differences in design, flow, and outcomes. Pacific Medical Centers has found that real-time locating systems (RTLS) can help improve patient flow, waste less time and space, track assets, and increase patient satisfaction. RTLS helped them raise patient satisfaction to over 90% excellent, and decreased average door-to-door time for primary care visits to less than 45 minutes.

Upon completion of this activity, participants should be able to describe the important roles of real-time locating systems (RTLS) in patient flow and satisfaction, asset tracking, and improved clinical efficiency; describe what a few hidden minutes per patient can do to help create a patient-centered medical home model in a fee-for-service and capitated system; improve projected net revenues of remodeled or newly built space through the use of RTLS; and identify how to overcome common barriers to RTLS implementation and use.

Starting in 2009, The Everett Clinic and Providence Regional Medical Center Everett embarked upon a three-year collaboration to improve the care experience for patients needing acute hospital services. Working alongside patient-and-family advisors, the two organizations sought nothing less than to re-build the hospitalization journey. This presentation will describe the various ways they have been able to reduce time from office to hospital bed, ED visits, and readmission rates; develop team-based care processes, improve designation of patient status based on severity and overall and most importantly improve patient experience.

Upon completion of this activity, participants should be able to identify strategies to build and sustain a common culture between a for-profit multispecialty clinic and a not-for-profit regional hospital; delineate various considerations during planning and development phase to achieve maximum buy-in among health care professionals to build teams across multiple organizations; describe value-added core metrics used by The Everett Clinic and Providence Regional Medical Center Everett in measuring success; and recount lessons learned in developing an integrated care model for patients needing acute hospital services in a community that is not financially integrated.

Chronic-disease patients require efficient, patient-centered care coordination because of the complex nature of their illnesses. The medical groups represented on this panel will share their experience implementing telehealth interventions that are effective in slowing cost growth, reducing hospitalizations, and improving health outcomes and quality.

Upon completion of this activity, participants should be able to describe the mechanics, benefits, and challenges of implementing a patient-centered, telehealth-based care management program in both acute and chronic care settings.

This presentation will examine MIMA’s experience with patient portals, which began in 2001. Administrators interested in the initial launch of a portal or those who want to further develop an existing portal’s functionality will learn how to organize the team that drives the process, how to obtain and employ feedback from all stakeholders, and how to promote portal use to attain operational efficiencies.

Upon completion of this activity, participants should be able to describe how to plan the start-up phase of portal development and how to advance portal development.

Fundamental market shifts present opportunities to leapfrog dominant suppliers. Five years ago, universal access and payment reform were enacted in Massachusetts, which has the highest medical costs in the U. S. This case study describes bold steps taken by a Harvard-affiliated practice plan to embrace payment reform for competitive market advantage.

Upon completion of this activity, participants should be able to apply analytic tools to assess opportunities in their local markets for using market-based payment reform to gain potential competitive advantage.

Appointing physicians into leadership roles on the basis of clinical or academic accomplishment can have disastrous financial and cultural results for an organization. This session will provide practical tools and insights you can use to find and develop leaders with the experience, attributes, and skills essential for group success.

Upon completion of this activity, participants should be able to evaluate the essential characteristics of behavior and self management as the most important determinants of leadership success; assess how previous work history and effective interview techniques reveal the potential for future leadership success; articulate the value of formal training curriculum-based instruction, coaching, mentoring, and individual growth in a successful leadership development program; and identify personality traits that define a potential leader’s distinguishing qualities and their readiness to think and act under various situations.

Tomorrow’s physician leaders need finely tuned skills in order to successfully lead other physicians through change, the amount and pace of which is, and will be, unprecedented. Ochsner’s Talent Review process allows the organization to determine where their physician leaders are and what they need to be successful. This presentation will describe the process components, share examples of the results achieved at Ochsner, and provide an opportunity for the participants to work through examples as individuals or organizational teams, if present.

Upon completion of this activity, participants should be able to utilize metrics to assess the leadership skills and abilities of their physicians; evaluate the leadership in their organization from a global perspective; develop a succession plan for each leadership position in the organization; and design and/or recommend leadership development opportunities for physicians that address their own career aspirations as well as the needs of the organization.

Learn how a 630-member physician practice created and evolved an in-house Leadership Academy to develop a broad network of physician/non-physician leadership teams to support change initiatives and innovation. Engage in assessing your organization’s needs and identifying attributes of Leadership Academy to strengthen your leadership development and change initiatives.

Upon completion of this activity, participants will be able to describe how to create and continuously evolve and improve an in-house Leadership Academy to develop distributed, engaged physician/non-physician leadership teams for effective change initiatives; discuss the key attributes of a Leadership Development program that supports creating and sustaining major system-wide change initiatives such as Lean process improvement and innovation efforts to meet aggressive cost and quality goals; assess their current leadership development and change management needs and how to use attributes of Harvard Vanguard’s Leadership Academy program to introduce their own customized programs and strengthen their current offerings.

As many organizations are rapidly expanding their employed physician practices and Ambulatory Divisions, they are facing the challenge of finding people who are able to lead others. In the past five years, Renown Health tripled its Ambulatory Division in size in five years and implemented a new EMR and was faced with the challenge of finding people who are able to lead others. This presentation will focus on how Renown is identifying, developing, and growing talent― including individuals without healthcare backgrounds―to meet its leadership needs with minimal expense.

Upon completion of this activity, participants should be able to evaluate leader talent differently, identify potential leaders, and assess their capabilities as leaders.

In June 2011, the Institute for Clinical Quality and Value (ICQV) was officially dissolved and its leaders endorsed AMGA as the best venue for healthcare leaders to share ideas, experiences, and best practices in the creation of structures, programs, and initiatives that improve clinical quality and efficiency. AMGA created the Collaborative for Clinical Integration and Value (CCIV) to continue the work of ICQV and designed this day-long immersion session for attendees who wish to gain a better understanding of some of the factors influencing, and critical elements of, clinical integration in medical groups and other organized systems of care.

This session will explore Fairview’s clinical integration journey and how the organization is responding to the challenges of the changing environment using innovative strategies and concepts. The presenter will describe the transition form a volume-based system to a value-based one, with early results from Fairview Physician Associates. Attendees will be able to apply these lessons learned on their own clinical integration journey. Upon completion of the activity, participants should be able to describe how Fairview’s care delivery model has changed; delineate the challenge for leaders to move to a value-based payment system; describe the value proposition for physicians; and anticipate and manage through the challenges of a changing paradigm.

Panelists: Markus Meier, Assistant Director of the Health Care Division of the FTC Bureau of Competition and Medical Group Representatives (to be announced) This panel discussion features a high-level FTC representative who will discuss emerging hot topics and advisories from the commission and two medical group executives who will provide their reaction to the directives as well as guidance on how their groups have responded to other emerging issues related to clinical integration and ACOs.

Integrated care delivery is a prerequisite for population health management, the ultimate goal for an accountable care organization. In this session, the speakers will describe their organization’s work with key clinical quality metrics and operational access goals that when aligned contribute to a critical mass for system integration.

The presentation will use the Portland IPA’s journey toward clinical integration as a framework for discussing key elements in implementing wide spread system change among a diverse group of medical practices. The presenters will provide an interactive forum for sharing ideas and processes to promote clinical integration.

The noted researcher and thought leader on integrated delivery systems and ACOs will provide an overview of evolving ACOs and the challenges they face. He challenge you to position your organization to succeed in your efforts to achieve clinical integration and value for the patients you serve. Upon completion of the activity, participants should be able to describe the value proposition for payers, providers, and patients from an ACO; explain the things that can go wrong and keep an ACO from succeeding; and describe the current environment as Medicare and commercial ACOs evolve.