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EPIP Fall Conference Banner Pioneer ACO and Patient-Centered Medical Home/ Alternatives to Admissions & Readmission PowerPoint Presentation
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EPIP Fall Conference Banner Pioneer ACO and Patient-Centered Medical Home/ Alternatives to Admissions & Readmissions. Chuck Lehn CEO Banner Health Network 11/4 and 11/5/2013. Objectives.

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EPIP Fall Conference Banner Pioneer ACO and Patient-Centered Medical Home/ Alternatives to Admissions & Readmission


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Presentation Transcript
slide1

EPIP Fall Conference

Banner Pioneer ACO and

Patient-Centered Medical Home/ Alternatives to Admissions & Readmissions

Chuck Lehn

CEO Banner Health Network

11/4 and 11/5/2013

objectives
Objectives
  • Understand the transition of the U.S. healthcare system from a transactional, episodic system to an integrated and continuum-based system
  • Review the needs of individual, employer, and governmental purchasers of healthcare
  • Discuss the value-based opportunities for the providers of emergency care within the care continuum
  • Identify potential barriers to achieving enhanced value in emergency medicine and methods to overcome those barriers
banner health snapshot
Banner Health Snapshot
  • 23 Acute Care Hospitals
  • Banner Health Network
  • Banner Medical Group with more than 900 doctors
  • Banner Health Centers and Clinics
  • Behavioral Hospital
  • Outpatient Surgery
  • Medical Education
  • $4.9 billion in revenue, 2012
  • AA- bond rating
  • $395 million in community benefit including $149 million in charity care, 2012
health care spending per capita life expectancy
Health Care Spending per Capita & Life Expectancy

Source: OECD Health Data, 2007 (data extracted 6.182.10)

5

bhn at a glance

Banner Health Network (BHN)

BHN at a Glance

12 Acute Care AZ Facilities

Share = 50%

Approx. 800 Physicians

Share = 13.3%

Approx. 900 Physicians

Share = 13.3%

Approx. 1,000 Physicians

Share = 13.3%

plan coordinate manage care
Plan, Coordinate, & Manage Care

Tools

Outcomes

Goals

ACO 33 Quality/Clinical Outcomes

  • Disease specific (Diabetes, Cardio, Resp)
  • Preventive care
  • Care coordination (all cause readmission, admission for ambulatory sensitive conditions)
  • Member experience

Disease Registry

Quality Measure

Case Managers

Disease Managers

Robust reporting tools and dashboards

Financial Outcomes

  • Total medical PMPM
case management practice settings
Case Management Practice Settings
  • There is a single, standardized model for Case Management; the setting varies.
  • A standardized process requires standardized assessment tools, action plans, and workflows.
  • Supporting programs are developed that support and mimic the standardized approach to case management (IAC and Bundled Payment).
banner health network
Banner Health Network

Current State

Strengths

Challenges

  • Geographic coverage
  • Integrated payment models
  • Blend of employed and contracted physicians
  • Years of experience managing risk
  • Acute care facility clinical performance
  • Breadth of medical service capabilities
  • Culture is built upon acute care
  • Cultural integration across continuum of care
  • IT infrastructure across continuum
  • Funding resources
  • Balance between volume based and value based models
  • Beneficiary engagement
bhn overall lessons learned
BHN - Overall Lessons Learned
  • New business models ranging from shared savings to joint ventures have developed faster than we anticipated.
  • Physicians will adapt to accountable care principles if you have specific clinical and financial models to invite them into, such as patient-centered medical home, bundled payments, shared savings, or other mechanisms to align quality, service, and cost goals.
  • Finance, data infrastructure, and administrative work dominate time and attention during the start-up phase.
bhn overall lessons learned cont
BHN - Overall Lessons Learned(cont.)
  • Clinical performance, innovation, and member service are the keys to long term success. We plan to stay focused in these areas.
  • Identifying specific areas of financial quality or service improvement is a great way to align interests of all parties toward a common goal.
  • Don’t underestimate the extent to which communication is needed for these relationships to be successful. In-person meetings of any type (formal or informal, large or small) seem to be the most useful method of transmitting information.