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Journey to Integra-on
Changing Market Place
• Affordable Care Act – Medicare Fee-‐for Service Cuts – $415 Billion by 2022 – Accountable Care OrganizaDon – Healthcare Exchanges, Public and Private
• Narrow Networks • Medicare Advantage Growth • Medicaid Expansion • High DeducDble Health Plans
– Retail RevoluDon • Healthcare Industry from B2B to B2C (Business to Business -‐ Business to Consumer)
Changing Market Place –Cont. • Meaningful Use -‐ IT Costs • Value Based Payment -‐ HHS Targets
– AlternaDve Payment Model • 30% by 2016 • 50% by 2018
– Fee-‐For-‐Service Payment Tied to Value • 85% by 2016 • 90% by 2018
• MACRA -‐ Medicare Access and CHIP ReauthorizaDon Act
• Industry ConsolidaDon “Our Mission is YOUR Health.”
Improving the Health of Popula-ons
-‐-‐Dr. Don Berwick
CVRMC’s Strategies • Internal/External Environmental Assessment • Strategic Planning: Plan your work – Work your plan.
• Service Excellence Strategy • Quality Improvement Strategy • Community Partnerships • Growth • OperaDng Performance • CollaboraDon • Regional Partnerships
“Quality, Efficiency, Compassion.”
Environmental Assessment • Hospital Market Data
– Service Area DefiniDon – Demographics – Market Share – Internal Trends – Snapshot of Area Hospitals & Medical Centers
• Future ProjecDons • Physician Demand
6 “It’s All About You.”
2014 IP Pa-ent Origin, Market Share & Popula-on
7
Roosevelt Peridot
Globe
San Carlos Superior
Kearny
Miami
Winkelman
37.3% 37.8%
21.1% 29.3%
1.1% 24.0%
8.6% 25.9%
1.4% 7.9%
23.1% 39.6%
0.5% 3.4%
1.4% 6.2%
Patient Origin = Top Number Market Share = Bottom Number
Source: HealthTech, July 2015; iVantage Health AnalyDcs; Note: Normal Newborns Excluded
Cobre Valley Reg Medical Center
2012 Total Pop
by ZIP Code
13,125 (1) (0)5,200 - 6,600 (2) (0)
2,200 - 3,300 (4) (0)85 (1) (0)
Bound ary Styles
ZIP Code
L an dmarks
US Hospitals
Scale
13.45 mi/inch
2014 Total Pop by ZIP Code
12,676 (1) 5,300-‐6,900 (2) 2,800-‐3,800 (3) 80-‐660
Service Line Opportuni-es – 2014 PSA and SSA
Cardiology
Orthopedics Pulmonary Gen Surgery Gen Medicine Gastroenterology
Neurology OB/Delivery
Nephrology
Neonatology
50
100
150
200
250
300
350
400
450
500
0% 10% 20% 30% 40% 50% 60% 70%
Opp
ortunity:
Non
CVR
MC Discha
rges 201
4
CVRMC 2014 Market Share
Development OpportuniDes
As Resources Allow
Build on Strength
Defend and Grow
CVRMC PSA&SSA Market Share
Source: HealthTech, July 2015; Stratasan; iVantage Health AnalyDcs
Strategic Planning • Comprehensive Planning Completed Every 3 Years • Annual Updates • OperaDonal Plan – Pushed to Employees • Quarterly Review with Board of Directors • Bi-‐Annual Environmental Assessment
Partnership Types • Merger or AcquisiDon -‐
• Formal Purchase or Another OrganizaDon • Clinically-‐Integrated Network
• CollecDon of hospitals contracDng jointly to improve coordinaDon and outcomes
• Accountable Care OrganizaDons • Independent enDty, owned by one or several independent organizaDons to
accept and share risk and savings • CollaboraDon
• Flexible umbrella structure ojen encompassing many independent organizaDons of geography that may serve as foundaDon for further integraDon
• Clinical AffiliaDon • An agreement to cooperate around a parDcular iniDaDve or service line
Integra-on Considera-ons • Governance – Independence / Local Control • Mutual Benefit – Win, Win! • Care Models -‐ Improve quality • Reduce Costs -‐ Shared infrastructure, process efficiencies • Cultural Alignment • Community Benefit • Branding/IdenDty • Set Clear Goals and ExpectaDons • Payer ContracDng • Clinical IT • OperaDons • Access to Resources
– Capital – Training – Clinical tools – ExperDse
Ques-ons?
