Download April Board Meeting - Becker`s Hospital Review

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
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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
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