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Population Management Executive Development

Program: April 2016Informational Call

February 2, 2016

These presenters have

nothing to disclose

Molly Bogan, MASaranya Loehrer, MD, MPH

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Agenda

Welcome and introductions

Why population management and why now?

Accelerators of progress

Faculty highlights: factors of success in

population management

Program overview

Questions

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Welcome & Introductions4

Saranya Loehrer, MD, MPHExecutive Director

Institute for Healthcare Improvement

Molly Bogan, MAProject Director

Institute for Healthcare Improvement

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Welcome & Introductions5

Richard Gitomer, MDPresident & CQO

Emory Healthcare Network

George Kerwin, FACHEPresident & CEO

Bellin Health

Meryl Moss, MPA, EHMLChief Operating Officer

Coastal Medical

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Context Setting:

Why population management

and why now?

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Healthcare in the US is changing…

Bring Down Health Care Premiums (1/1/11)

President Obama signs the Affordable Care Act. (3/23/2010)

Prohibit Denying Coverage of Children Based on Pre-Existing Conditions (9/23/2010)

Provide Free Preventative Care (9/23/2010)

Increase Access to Services at Home and in the Community (10/1/1/11)

Encouraging Integrated Health Systems &Launch of ACO Pioneer Program (1/1/12)

2010 2011 2012 2013 2014

Understanding and Fighting Health Disparities (3/1/12)

Improving Preventative Health Coverage & Launch of SSP ACO model (1/1/13)

Open Enrollment in the Health Insurance Marketplace Begins (10/1/13)

Prohibiting Discrimination Due to Pre-Existing Conditions or Gender (1/1/14)

Establishing the Health Insurance Marketplace (2014)

HHS to tie 90% of all traditional Medicare payments to quality or value by 2018

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2015

Fee for ServicePay for

PerformanceShared Savings

Shared RiskGlobal

Payment

Changing Healthcare Context

Focus on IndividualsIndividuals and

PopulationsIndividuals, Populations

and Communities

Care Care and Cost The Triple Aim

Do to Do for Do WITH

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Triple Aim

We define the Triple Aim as system

designs that simultaneously improve

three dimensions:

o Improving the health of the

populations;

o Improving the patient experience

of care (including quality and

satisfaction); and

o Reducing the per capita cost of

health care.

Berwick DM, Nolan TW, Whittington J. The Triple Aim: Care, health, and cost. Health Affairs. 2008 May/June;27(3):759-769

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Population Health10

http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=81ca4a47-4ccd-4e9e-89d9-14d88ec59e8d&ID=50

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Population Management

We define population management as the design, delivery,

coordination, and payment of services for a defined group

of people to achieve specified cost, quality and health

outcomes for that group of people.

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http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=81ca4a47-4ccd-4e9e-89d9-14d88ec59e8d&ID=50

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Framework:

Accelerators to Successful

Population Management

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Our Framework: Five Accelerators13

• Demonstrating effective leadership

• Creating data systems for performance improvement

• Building robust improvement infrastructure

• Engaging stakeholders and communities

• Leveraging payment models

Population Management

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Poll:

Which accelerator represents the

greatest challenge in your organization?

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Chat Question:

What would success in population

management look like in your

organization?

Faculty Highlights

What did success look like for our faculty at their

organizations?

What challenges did they overcome?

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Faculty Highlights17

Meryl Moss, MPA, EHMLChief Operating Officer

Coastal Medical

Faculty Highlights: Meryl Moss18

• Physicians and staff alike have a shared vision and

commitment to managing Coastal Medical’s primary

care patients for optimal population health.

• Physicians feel that we are providing a differentiated

level of care to our sickest high-risk patients in a way

we were unable to in the past.

• Coastal has achieved outstanding results in quality

metrics, including being in the top 1% for quality of all

MSSP ACOs in the country.

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Faculty Highlights19

George Kerwin, FACHEPresident & CEO

Bellin Health

Faculty Highlights: George Kerwin20

• Developed the ability to manage the overall health

of populations when Bellin faced a crisis with the health

of a critical population segment–our employees.

• 640,000 people make up the population Bellin serves.

Segmenting this population is important to improving

the health of so many people

• Data systems and payment models support the shift

from insuring health to managing the health of

populations

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Faculty Highlights21

Richard Gitomer, MDPresident & CQO

Emory Healthcare Network

Faculty Highlights: Richard Gitomer22

• Developed a productive collaboration between the non

Emory-employed physicians and the Emory Healthcare

Network.

• Transitioned from a successful academic medical center

in the fee-for-service world with little clinical integration

to a clinically integrated network with a value-based

contract in 17 months.

• Improved quality and earned shared savings in the

first year of a value-based contract.

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Faculty: Navigating Challenges23

• Negotiating tensions and trying to keep the lights on

while maintaining fee-for-service models and

implementing the new activities of value-based models.

• Achieving productive electronic data integration

across a widely variable network in the context of the

currently available technologies.

• Having to rely on payers analytics infrastructure for

data and support.

Orlando, FL

ihi.org/PopulationManagement

Population Management Executive

Development Program

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Program Highlights

2.5 day program for executives and other leaders

accountable for population management

Learn from a team of expert faculty with deep experience

in a variety of settings

Network with other executives navigating similar

challenges

Dedicated retreat time and action planning: leave with a

plan for how to immediately apply the concepts and

promising practices learned about in the program in your

own organization

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Questions?

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Orlando, FL

ihi.org/PopulationManagement

Population Management Executive

Development Program

Please contact us with any questions

or you would like to speak to a member of the team

about joining the April 2016 program!

Thank You!28

Molly Bogan

mbogan@IHI.org

Kristen Kennedy

kekennedy@IHI.org