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Brigham and Women’s Physicians Organization Overview Center for Expertise in Healthcare Management Allen Smith, MD, MS January 20, 2010. Agenda. Introductions BWPO Introduction Overall corporate structure Mission Senior Management Role Physician statistics BWPO Areas of Focus

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Brigham and Women’s Physicians Organization OverviewCenter for Expertise in Healthcare ManagementAllen Smith, MD, MSJanuary 20, 2010

  • Introductions
  • BWPO Introduction
    • Overall corporate structure
    • Mission
    • Senior Management
    • Role
    • Physician statistics
  • BWPO Areas of Focus
    • Patient Experience
    • Pay for Performance
    • Physician Experience: Volunteerism
    • Network Development
  • Challenges and Opportunities
partners healthcare system inc phs
Partners HealthCare System, Inc. (PHS)

Partners HealthCare System, Inc.

Partners CommunityHealthCare, Inc.

Newton- Wellesley Health Care System, Inc.

Brigham and Women’s/ Faulkner Hospitals

The Massachusetts General Hospital

North Shore Medical Center, Inc.

Newton- Wellesley Hospital, Inc.

The Brigham and Women’s Hospital, Inc.

Brigham and Women’s Physicians Organization

The Salem Hospital

AtlantiCare Medical Center, Inc.

Faulkner Hospital, Inc.

The General Hospital Corporation

BWPO is a faculty practice plan which supports its physicians and departments in their aspirations to:

Provide the highest quality patient care

Develop the next generation of physician leaders

Be world leaders in translational research

management team
Management Team


Allen Smith, MD, MS

Chief Medical Officer

Jessica Dudley, MD

Chief Financial Officer

William Johnston

Vice President of Ambulatory and Women’s Health

Sharon Vitti

Director of Administration

Sharon Cohen

role of bwpo
Streamline operations where possible

Organize and manage billing, administration and financial components of its 17 business units

Foster departmental autonomy while supporting the overall mission and goals of the organization

Support physicians in contracting and providing “medical management” support for high quality, efficient care

Includes efforts in ambulatory experience

Focus on physician work life

Leadership, Volunteerism, IT systems

Role of BWPO





BWPO Areas of Focus







patient experience
Patient Experience

Patient First

Launched by the Ambulatory Council

Helped focus attention on improving patient satisfaction

Staff Training

Lean Practitioner Training

Ambulatory operations improvement

Ambulatory patient satisfaction scores surpass 75th percentile mark

BW/F Ambulatory Services in top tier of UHC facilities that use Press Ganey

ambulatory patient satisfaction scores overall trend of percentile rank
Ambulatory Patient Satisfaction Scores: Overall Trend of Percentile Rank

Target: 75th Percentile

pay for performance contracts
Pay-for-Performance Contracts
  • Ability to negotiate collaboratively as a physician network
  • Pay-for-performance contracts with the 3 major commercial insurers for shared financial responsibility (risk) and interdependent clinical programs
  • Withhold of an annual amount of revenue
  • Withhold returned when network achieves certain efficiency and quality measures
pay for performance training education and management team
Pay for Performance: Training, Education, and Management (TEAM)
  • BWPO TEAM program focuses on improving patient care outcomes and preventing unnecessary hospital admissions
  • A team of nurses, doctors, pharmacist, social work, and administrative staff identify high risk patients and provide the following:
    • High risk patient mgmt – face to face counseling and coaching
    • Immediate access to necessary MD visits
    • Programs for getting patients to LDL, BP, A1c targets + getting right meds prescribed

Volunteerism: Indian Health Service

Goal:Provide opportunities for teaching and clinical care in an impoverished setting

Indian Health Service (IHS):Compelling health care needs of Navajo population

Relatively easy for physicians to volunteer there

IHS Sites:

Gallup, NM

Shiprock, NM

Progress:Assessment of needs (both IHS and BWH) and initial visits completed

Next Steps:Regular site visits

and additional fundraising for program

Christian Arbelaez, MD, MPH and staff

at Gallup Indian Medical Center


Map Key:

MACC** Sites

Physician Relationships

Map of BW/F Relationships in Southeastern Mass

  • Quincy Medical Ctr
  • Providing Cardiology dept chair
  • Tertiary trauma services

Near West

1. OB/Gyn, CIRS practice @ NWH

  • Metrowest Area
  • BWPO Rheumatology
  • BWPO Cardiology
  • South Shore Hospital
  • DFBWCC with SSH
  • Expanded Surgery, Cardiology, Neurology and OB/Gyn affiliations
  • Milford
  • DFBWCC at Milford
  • New PCHI group (Tri-County)
  • OB-Gyn (MIGS) services
  • Compass Medical
  • BWH MRI service
  • BWPO surgery
  • BWH Vein center, Center for Repr. Medicine
  • BWPO Cardiology
  • Foxboro MACC
  • Primary Care
  • Dx. Imaging
  • Surg Specialties
  • Med Specialties
  • Amb Surgery
  • Pathology, etc
  • Plymouth
  • Relationship Mgmt with new PCHI groups
  • Cape Cod Hospital
  • BWH cardiac surgery and anesthesia services
  • BWPO radiology services
  • BWPO cardiology services
  • South Coast
  • PrimaCare, Hawthorne (PCHI) relationship mgmt.
  • BWPO Rad Onc services at St.Anne’s Hospital
  • Rhode Island
  • Memorial Hospital (Pawtucket) affiliation
  • Emergency Medicine management & Cardiology consulting services

*Map represents primarily “major” external relationships where we have on-the-ground presence or provide key on-site leadership

**MACC is a Multi-specialty Ambulatory Care Center

challenges and opportunities
Challenges and Opportunities
  • Health Care Reform
  • Patient Experience
    • Meeting ambulatory goals consistently at practice level
    • Structured approach to ambulatory quality and safety
  • Referring Physician Experience
    • Access, communication, transitions, cost
  • Faculty Experience
    • Worklife satisfaction and balance
    • Future of Primary Care
  • Financial Health
    • Controlling expenses
    • Ambulatory revenue growth
    • Alternative revenue streams to offset declining reimbursements
health care reform models
Health Care Reform: Models

Payment Model


Bundled Payments

Global Capitation

Augmented Primary Care

Fee for Service

BW/F is engaged in all three models

Big 3 Contracts

Bundled Payment Pilot

CMS Demo

Foxborough Medical Home

Level of financial risk borne by payor

Level of financial risk borne by provider

Adapted from Dr. James Mongan presentation 5/26/2009