Surviving the Healthcare Tsunami - Renato Suntay, Meadville Medical Center

HOW TO SURVIVE THE

HEALTHCARE TSUNAMI

May 2016

Industry Dynamics:

• Payment and Delivery becoming more

interdependent

• Health care becoming more retail

• New clinical care models transforming

care delivery

Industry Dynamics:

• Technology changes creating business

models to change

• Government is playing a larger role

• Local competitive dynamics shifting

Why is Change so Difficult:

• Fee for service engrained in existing

architecture/reimbursement

leadership is required to change

• Uncertainty of what future state looks like

• Value based models and measures are still developing in some specialties and settings

Why is Change so Difficult:

• Transformation requires funds for support

and infrastructure

• Health IT infrastructure needed to share

health information to new models to be

successful

• Difficult to communicate with patients,

doctors, employers, payers and others

How Do Companies Reduce Health

Care Cost:

• Through benefit design

• Pass through costs

• Incentive fees

• Company subsidy of copayments

How Do Providers Reduce Cost:

• Cost reduction does not work!

• Need to keep up with new costly technology

• Expert Labor costs are unsustainable

• New generation drugs always in demand

• Providers need to change the way care is delivered!

Things that you do not want to see!

• You do not want to see how Democracy works

• You do not want to see how sausage is made

• You do not want to see how healthcare is developed

What is the Problem in Healthcare

• Money’s worth vs. Cost

• Care vs. Value

• Reimbursement vs. Outcome

• Compassionate care vs. Technology

• As you can see, it is very difficult to define the overall objective of Healthcare

Current Trends

• OutPatient Services

• Pharmacy

• Inpatient Services

Current Trends

• Ambulatory & retail site

• Post Acute care

• Alternative care

• Government set the stage for providers to deliver care!

Opportunities

• Maximize HACHPS value based scores

COURTESY OF PERSON CLEANING ROOM RESULTS

0

25

50

75

100

1st Qtr 2nd Qtr

3rd Qtr Goal 4th Qtr

34

84 81

90 92

COURTESY OF PERSON SERVING FOOD RESULTS

NURSING RESULTS

0

22.5

45

67.5

90

2N 3N 4N ED

22

48

27

9

48 54

40

20

81

54 54

28

Nurses Treat w/ Courtesy and Respect HCAHPS - Overall MMC

HACHPS April 2015

HCAHPS May 2015

HCAHPS June 2015

HCAHPS July 2015

HCAHPS August 2015

Opportunities

• Maximize HACHPS value based scores

• Maximize quality incentives and Gain Share programs

• Develop Community Care Networks

• Expand services in growth areas

• Look for opportunities to allocate overhead in other service lines

• Develop Rural Health Centers in appropriate areas