Using Technology to Reduce Costs and Improve Quality

Transcription

1 Using Technology to Reduce Costs and Improve Quality Kari Cornicelli, FHFMA, CPA VP, CFO Sharp Grossmont Hospital SOHL, HIMSS, and HFMA Joint Chapter Meeting 9/20/12

2 HFMA s Value Project Objectives Understand what purchasers & payers seek from value providers Gain insights into stakeholder perspectives on how new payment methods can create value Learn how providers are preparing for value-based payment 2

3 The Value Equation VALUE = Quality {1} Payment {2} {1} Composite of patient outcomes, {2} Cost to all purchasers of safety, and experiences purchasing care 3

4 A Fundamental Shift in Focus View value through the purchaser s lens 4

5 Value Project Phase 1 Reports People & Culture Performance Improvement The Big Report Business Intelligence Contract & Risk Management

6 Value Project Provider Sponsors 6

7 Providers Expect Jump in Use of Value-Based Payment Percentage who anticipate 5% or more of payment from commercial carriers will be based on value-based mechanisms Today 3-5 Years Source: HFMA Value Metrics Survey, December

8 Build Four Key Organizational Capabilities Recommendation # 1 Collaboration, accountability, and communication People and Culture Performance Improvement Elimination of variation, unsafe practices, and waste Value Data and metrics Business Intelligence Contract and Risk Management Measurement, assessment, and mitigation of risk 8

9 How to Build Key Capabilities People and Culture Ensure that leadership is focused on value Promote interdisciplinary collaboration (among clinical leaders and with administration) Foster increased accountability Quality and cost targets Performance and reward systems Communicate value to stakeholders Source: HFMA Value Project, June

10 How to Build Key Capabilities Business Intelligence Address all aspects of business intelligence, including data analytics, financial/clinical data integration, & metrics Prioritize key areas Readmissions, value-based purchasing, healthcare-acquired conditions, etc. Rethink costing systems Seek near real-time data provision usable to decision makers Source: HFMA Value Project, June

11 How to Build Key Capabilities Performance Improvement Develop skills in continuous process improvement (6σ, Lean, etc.) Focus on safety improvement and near-term payment issues Eliminate variation (non-value added) Recognize that clinical leadership is critical Especially for the adoption of evidence-based practices Source: HFMA Value Project, June

12 How to Build Key Capabilities Contract Project &, Risk Management Source: HFMA Value June 2011 Assess market and role with other providers and payers Understand your organization's exposure to risk & tolerance for/ability to absorb downside financial risk Identify criteria for network participation Develop network using criteria and relationships Develop data and IT infrastructure to manage network Develop technology and analytics to assess and mitigate actuarial financial impact Source: HFMA Value Project, June

13 Larger Organizations Are Doing More to Prepare for Value 13

14 Clinical Systems & Coding Dominate Business Technology Investments 14

15 Most Expect Improvements in Inpatient Costing Capabilities... 15

16 ... and Costing Capabilities Across Care Settings 16

17 ... and Many Are Seeking a Reputation Based on High Quality 17

18 Healthcare Finance Professionals Must Take the Lead Somebody has to do something, and it s going to be and it has to be you. Former Senator and Senate Majority Leader Bill Frist, MD Speaking at HFMA s ANI: The Healthcare Finance Conference

19 Sharp s Journey to Providing Value Through Technology Identify, develop, and implement IT solutions to support effective care management from both an operational and patient-care focus. Continuum of Care fully integrated Electronic Health Record. Clinical documentation improvement strategy Comprehensive Health Information Exchange. Financial systems that support the analysis of quality and cost across the continuum. EPSi cost system

20 Health Reform: Full Continuum of Care IT Strategy Wellness Illness Prevention and Wellness Disease Management Outpatient Acute Post Acute Home Care Hospice/ Palliative Care Evidence-Based Care Operational Excellence Master Patient Index (MPI) Financial & Practice Mgt Sharp s Information Technology Hospital EMR Medical Group EHR Data Warehouse MEDai Health Information Exchange mysharp External Care Coordination Quality Reporting Providers Patients Government Quality Programs Pay for Performance Meaningful Use

21 Virtual EHR Strategy Important data elements to share throughout the continuum of care Major Elements Cerner Allscripts mysharp Portal HIE Med Groups IPA Transcription Immunizations Lab Meds Radiology Problems Allergies Acute Care Specialty Hospitals

22 Health Information Exchange

23 Clinical Documentation Improvement Strategy New technologies to support improved clinical documentation: Front end speech (Nuance) Computer assisted coding (3M) Further development of Cerner dynamic documentation

24 Leveraging Technology to Reduce Costs and Improve Quality Sharp has positioned itself with technologies that support: Sharing clinical data across the continuum Complete and thorough capture of clinical data Ability to measure quality and cost data across the continuum

25 Sharp s Value Journey: Delivering on Quality and the Patient Experience People and Culture Performance Improvement EMR, EHR Value Data Warehouse, Financial Systems, & EPSi Business Intelligence Contract and Risk Management ACO, Health Plan, Managed Care Partners & HEI