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UC Irvine Health

Institute for Clinical and Translational ScienceAddressing unmet clinical needs

Terry A. Belmont

CEO, UC Irvine Medical CenterJune 19, 2012

UC Irvine Health | ICTSUC Irvine Health | ICTS

Will hospitals become extinct in 2050?What would be the implications?Will hospitals become extinct in 2050?What would be the implications?

Addressing unmet clinical needs


An evolution is taking place in healthcare

Mainframe

Minicomputers

Desktops

Laptops

Smartphones

Tablets/iPads

Our changing needs will require innovation


An ever-present reminder of why our organization exists. In addition to describing what we do, it centers us and serves as a foundation for our work, plans and vision.

An ever-present reminder of why our organization exists. In addition to describing what we do, it centers us and serves as a foundation for our work, plans and vision.

Mission – our purpose

Discover Teach Heal


Identifies the overall direction and long-term view of our organization. It is visceral and inspiring and serves to differentiate and promote our aspirations to all constituents.

Identifies the overall direction and long-term view of our organization. It is visceral and inspiring and serves to differentiate and promote our aspirations to all constituents.

Vision – our aspiration

To be among the best (top 20) academic health centers in the nation in research,

medical education, and excellence in patient care


ARI2SE:Accountability – We are each responsible for the achievements and successes of UC Irvine

Health.

Respect – We foster an environment of mutual respect and trust amongst ourselves and with all whom we serve.

Integrity – We tell the truth and strive to earn the trust of those around us.

Innovation – We seek ideas and approaches that can change the way the world discovers,

teaches and heals.

Service through teamwork – As departments, units and individuals, we collaborate to effectively and compassionately serve our patients, each other and our community.

Excellence – We are committed to achieving the highest level of excellence in patient care, discovery and education.

Core values


Combined, these elements represent the foundation of UC Irvine Health’s strategic plan. They ensure that all strategies and actions within the strategic plan support UC Irvine Health’s purpose and long-term direction.

Combined, these elements represent the foundation of UC Irvine Health’s strategic plan. They ensure that all strategies and actions within the strategic plan support UC Irvine Health’s purpose and long-term direction.

Mission

Core ValuesVision

Our foundation


UC Irvine Health

Advance clinical excellence

Broaden the impact of our

clinical expertise

Advance premier research

Educate for the future

Foster an outstanding team

Financial sustainability

Strengthen image & community partnerships

Strategic themes

The seven strategic themes represent key areas of focus.

Each of these themes has one or more goals and associated strategies defining the actions required to move UC Irvine Health closer to its vision.

The seven strategic themes represent key areas of focus.

Each of these themes has one or more goals and associated strategies defining the actions required to move UC Irvine Health closer to its vision.


There are many external pressures / forces impacting UC Irvine Health today and in the future.

Legislative / Policy

Demographic & Epidemiology

Economic

Purchasers / Consumers

Payer (Gov’t or Private)

Provider (Hospital & Physician)

Teaching and Research

UC IrvineHealth

Where we are today


• Activity based reimbursement / reward volume growth

• Emphasis on aggressive top line / revenue negotiations

• Consolidate for market / negotiating power

• Indirect / minimal financial incentives for quality, safety, satisfaction etc.

• Minimal risk assumed by hospitals

Current / ExistingBusiness Model

• Provider payment tied to quality, outcomes, and cost effectiveness

• Emphasis on cost control, productivity, and efficiencies

• Consolidate to secure “populations”, scale, and build coordinated / aligned continuum

• Assuming / sharing risk (next generation capitation)

• Pricing power tied to ability to demonstrate “value”

FutureBusiness Model

The long-standing, existing provider business model based on volume, will be supplanted by a model based on the best possible quality at the lowest possible price or “VALUE”

Prepared by UC Irvine Medical Center Strategic Services Department


Provider (Hospital & Physician)

The emphasis on “value” will require providers to re-evaluate their clinical processes and infrastructure

Healthcare is rapidly moving from an activity-based model to a value-based care delivery model

o Best possible quality at lowest possible price

o Away from fee-for-service model

o Community or population health models


Patient Experience + Quality of Care

Cost of Care

Quality / Safety

Size / Growth

Service / Patient Experience

Finance / Cost

Quality of Care

PatientExperience

Cost of Care

I.T.

Performance categories for UC Irvine Medical Center’s organizational goals are based on the value equation


Needs in patient care delivery. Burning platform priorities and initiatives for FY2013

Quality & Safety Outcomes

o Utilization Management / Case Management

o Lean Sigma (SPI)

Patient Experience (SPI)

Cost Reduction

o Throughput Improvement

o Lean Sigma (SPI)

o Resource Opportunity Improvement (ROI)

Robust EMR/EHR

o QUEST implementation

Delivery System / Network Infrastructure

o Primary Care Strategy (SPI)

o Ambulatory Care Strategy (SPI)

Market Essentiality

o Brand Strategy Development & Implementation (SPI)

o Portfolio Analysis (SPI)

o Cancer Center Clinical Strategic Business Plan

Funds Flow / SOM Deficit (SPI)

*(SPI) = Strategic Plan initiative


10 value imperative issues1. Quality Outcomes: Ability to demonstrate quality outcomes (outcomes of care, process of care, safety, etc.) that are

exceptional.

2. ALOS / Throughput: Reduction in ALOS and improvements in throughput (patient flow and reduced wait times once in our system) that free up capacity, improve service, and reduce costs.

3. Cost Reduction (Make Margin at Medicare Rates): Reduce the cost of delivering care (both inpatient and outpatient) at UC Irvine Medical Center to improve our value, enable competitive pricing and provide sustainable cash flow and capital to the organization.

4. Payment Models (Taking Risk): Pilot, build infrastructure for and begin taking risk (capitation) for populations. May include large populations (ACO), professional capitation (HMO), or target specific populations (bundled payments).

5. Primary Care: Develop a robust primary care network in key geographies to secure secondary referrals and prepare for primary management of (select) patient populations.

6. Community Network of Care: Expand UC Irvine Health’s ambulatory footprint in the community including specialty care and ambulatory care both on / off campus as well as implementation of other cost-effective care settings (urgent care, retail, etc.).

7. Patient Experience: Ability to demonstrate and distinguish UC Irvine Medical Center through an exceptional patient experience as measured by HCAHPS and other service measurements.

8. Senior / Medicare Opportunities: Implement strategies and programs to capture senior market share and capitalize on the growing senior market. Includes dual-eligible strategy.

9. Health Insurance Exchanges: Implement strategies and programs to capture market share resulting from the advent of the California Health Benefit Exchange.

10.Medi-Cal Eligibility Expansion: Implement strategies and programs to capture market share resulting from the eligibility expansion of Medi-Cal.


So, will hospitals become extinct in 2050?


Rethinking the delivery of care

Outcomes vs. Volume

Health vs. Healthcare

Home vs. Hospital


Rethinking the delivery of care

Prepared by Geisinger Health System, Nov. 2011


The implications

Will require us to continue leveraging technology.

The iPad iMedEd Initiative •UC Irvine continues to lead in the development of a completely tablet-based medical school curriculum. It was the first in the nation to do so in August 2010.

Diagnostic ultrasonography •UC Irvine School of Medicine was the first medical school on the West Coast and the second in the nation to introduce this into all four years of medical school curriculum. The technology has the potential to improve the quality of patient care.

Telemedicine•Will provide greater access to quality healthcare. Used in medical education and to consult with patients remotely. Home care is going to become increasingly important in all aspects of medicine in the next decade.

…and more from you


Yes. In their present form.

Again, will hospitals become extinct?


Thank you.

Questions?

Download - - 1 - UC Irvine Health Institute for Clinical and Translational Science Addressing unmet clinical needs UC Irvine Health Institute for Clinical and Translational

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