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Becker’s Hospital Review Annual Meeting David Ertel, Chief Financial Officer May 15, 2014 1 Today’s Discussion 1. Introduction 2. Case Studies • Bundled Payments • IPPIP • Noble Health Alliance 2 Introduction • Chief Financial Officer at Einstein Healthcare Network • Former Roles: • Managing Director and Head of Healthcare at Morgan Stanley • Vice Chairman and Chair of the Finance Committee for Princeton Health System • Education Background: MBA and MPH at Columbia 3 Einstein has served the Philadelphia region for years, providing a range of healthcare services • 148-year history • Independent academic medical center: 416 residents and fellows; over 3,000 clinical students • The network is licensed for over 1,000 acute care, rehabilitation and psychiatric care beds in 5 hospitals – Tertiary care flagship teaching facility – Einstein Medical Center Philadelphia – Inpatient rehabilitation hospital – MossRehab – General acute facilities – Einstein Medical Center Elkins Park and Einstein Medical Center Montgomery (new; opened in 2012) – Private psychiatric hospital - Belmont Behavioral Health • $1.2 billion in annual revenue • Over 8,600 employees • 1,300 physicians (including 520+ employed physicians) in over 35 medical and surgical subspecialties 4 Case Study: IBC’s Integrated Provider Performance Incentive Plan The largest local private payor in the region, Independence Blue Cross, has launched a hospital/physician pay-for-performance program as they begin to shift towards accountable care. Overview of the IPPIP Program 50% Medical Cost Participants of IBC IPPIP Program 50% Quality Metrics Einstein Health Network A Abington Health E Aria Health 50% Quality Metrics Per Member Per Month savings over a medical cost target B Crozer-Keystone Health System C D Managing only a small portion of the total lives under a shared savings payment arrangement can provide a valuable small scale learning experience, but may not lead to a significant financial return Source: IBC Press Release and Web Research, 2013 Jefferson Health System Holy Redeemer Doylestown Penn Medicine 5 Case Study: Noble Health Alliance Goals of the Alliance: • • Manage the self-insured, health-care benefit plans for their employees and families Post-acute facilities Independent providers Promote a comprehensive network to manage patient care across care settings • Share the costs for capital intensive investments (IT, care management) • Sharing of existing clinical protocol best practices • Provider recruitment and partnership development • Evolution towards direct contracting Independent providers Noble Health -Governance -Clinical Programs -Contracting -Infrastructure Independent providers • Track outcomes, costs and manage patient referrals within the network 6