Upload
lyminh
View
220
Download
3
Embed Size (px)
Citation preview
The CHI Physician Services (CHIPS) Journey: Transforming the Physician Practice Model
Across a Large Hospital Based System
AMGA Conference – March 2015
Jamie Dye Chief Development Officer
MedSynergies
CHIPS Board Member
Beth Cafaro, JD Vice President
Practice Operations
President of CHIPS
Introductions
Catholic Health Initiatives (CHI) Today
MISSION: To nurture the healing ministry of the Church, supported by research and education. Fidelity to the Gospel urges us to emphasize human dignity and social justice as we create healthy communities
24 Markets
Providers 7.6K
Number of Patients
2.2M Visits
10.6M 1.3B Total
Collections
MedSynergies – By the Numbers
Next Era Evolution Focused Next Era Strategic Priorities
Clinically Integrated Network (CIN) Development
Organic Growth Strategies
Care Management Models and Capabilities
Integrated National and Regional Service Lines
Retail, Ambulatory and Post-Acute Strategies
Demonstrated Quality and Service
Physician Network Growth and Engagement
Cost Effectiveness
Financial Performance
Organizational Model
IT Investment
Risk and Insurance Capability (Prominence Health)
Employee Health Management
Payer and Insurance Product Strategies
Consumer Engagement Strategies
Clinical and Operational Excellence
Integrated Care Delivery Payment for Value
The Next Era of Healthy Communities
Physician Enterprise Growth
Region # of Providers
Nebraska 898
Pacific Northwest 746
KentuckyOne 556
Iowa 517
East-Southeast 616
Minnesota/North Dakota 366
Texas 74
Total Providers 3,773
1,320 Advance Practice Clinicians
33%
55%
12%
Primary Care Specialists Other
Catholic Health Initiatives Physician Services is a management services organization created
to support our provider practices with resources and proven practice management solutions that optimize
performance and free up physicians, clinicians and their staffs to deliver better patient care.
What is CHIPS?
Governance Laying the Foundation
3. Transition and on-board resources with diligent and thoughtful care.
2. Lead with a defined communications campaign.
4. Implement solutions on-time and on-budget.
1. Establish and maintain a clear organizational governance structure.
5. Identify data sources of truth.
6. Establish baseline standards and success criteria metrics.
Strategic Imperatives
MSO Services Alignment Establishing the Framework
CHIPS
Coding Quality Metrics/Management
JV Management Services Revenue Cycle
Practice Management Centralized Scheduling (option)
Practice Marketing Strategy (option) Charge Entry
Human Resources
CHI Will Retain the Provision of Some Physician Services
Practice Accounting Services Legal
Communications Compliance
Care Management
5-Phase Implementation Starting the Build
Phase 1
Complete
Fargo
CHI Health Nebraska
Phase 2
Complete
KentuckyOne
Roseburg
St. Luke’s
Phase 3
Complete
Pendleton
Tacoma
Phase 4
Current
Reading
Mercy
Des Moines
Chattanooga
Little Rock
Phase 5
Future
Lufkin
Steubenville /Bryan
Bismarck
The People Transition Installation of Core Features
CHIPS employees have their own compensation, benefits and retirement programs aligned with ambulatory practice — not hospitals
All other practice employees transition to CHIPS
Common Job Descriptions
Billable providers (MD’s, DO’s, NP’s PA’s) and Directors remain employees of the MBO
Standardized compensation
Best Practices The Finish Out
Patient Outreach Solutions
Online Appointment Scheduling
Referral Management Solutions
CHIPS Suite of Tools
Enhancing Operational & Financial Performance Inspection
Pre Point-of-Service
First point of contact with the patient during which the appointment is
scheduled and continues through pre-registration and benefits verification
Point-of-Service
Activities begin with the check-in process prior to the patient seeing the physician and after they have received
care with patient check-out
Post Point-of-Service
Administrative and financial activities associated with collecting payment for
services rendered
Revenue Cycle Management
Process & Discipline The Walkthrough
Monthly Meetings with practice managers, client services managers and health system leadership
Metrics that are tracked and reviewed:
HR analytics
Five key metrics
Optimal Practice Model
Optimal Practice Model The Walkthrough
Business Reviews
Real-time Customer Service
Service Requests Client
Management
CHI Physicians/ Physician
Organization
Practice Managers
Operations Business Partner
Practice Partners
CHI/CHIPS MedSynergies
Tick
etin
g, M
etri
cs, R
ep
ort
ing
Syst
em
s an
d L
ean
An
alys
is/I
mp
rove
men
t
Mic
ha
el S
tro
op
e
Business Reviews
Tact
ical
Stra
tegi
c
Overall Financial Metrics The Punch List
Metric Sample Market Benchmark Variance
Total collections (in dollars) $ 4,982,071 $ 6,642,762 25%
Total Collection Rate (includes adjustments)3 96% 91% 5%
Payment per RVU3 $ 48.27 $ 52.71 -9%
Days in A/R (total A/R / (total charges/365))4 31.87 33.59 -5%
A/R% > 90 days4 17.2% 20.41% -3%
Charges % of Medicare (2013 Fee Schedule)2 250% 250-400% -
Successes Benefits of Building
Front End Process Improvements
Coding
Patient Outreach – remove burden to staff, excellent early results
Revenue Cycle Enhancements – starting to allow positive gains
CHIPS Today Fiscal Year 2014 Statistics
3,800 CHIPS Employees
Including approximately 3,500 employed physicians and advance practice clinicians
EMPLOYEE COMMUNITY Approximately 90,500 Employees
Lessons Learned
Sense of loss of control by market leadership
Unanticipated level of resistance to change
Lack of analytic tools in the markets
Training and education of staff
Difficulty in extracting data (willingness to share data)
Expectations for immediate results following transition
Prioritize markets using an overall needs assessment
Although providers are not in scope, they are a key audience
Need to over communicate to leadership in markets and national office
The Future of CHIPS
Closer alignment with our JV partners
Practice and Revenue Cycle Assessments across our Service Line Structure
Develop MSO Offerings for our Private Aligned Physicians delivered through our CIN’s