Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
2014 Annual Report Always. High Performance. High Reliability. Michael Tawney, DO Vice President of Medical Affairs McLaren Port Huron The McLaren Mission McLaren Health Care, through its subsidiaries, will be The best value in health care as defined by quality outcomes and cost. M c L a r e n H e alt h C a r e 1 Philip A. Incarnati President and CEO McLaren Health Care 2 2 0 1 4 A n n u al R e p o r t David S. McCredie Chairman, Board of Directors McLaren Health Care S haping the strategic road map for our system is one of the most important initiatives McLaren Health Care undertakes each year. Determining the priorities we set and the plan for achieving our initiatives is crucial, as it is for any major business enterprise. In developing our new three-year strategic plan, I realized that we had to build in more change than in any of our previous planning efforts. At one time, a corporation’s strategic plan could safely project a decade out. Then, the pace of change trimmed this to five years. Today, given the massive upheavals and challenges American health care has seen in just the last 12 months, planning even three years ahead demands enormous effort. Not only do we face rapidly moving targets in planning for the future, we must cope with some conflicting goals. For example, the stated goal of health care reform is to move toward paying care providers for “value” rather than for “volume.” “Value” means reimbursement that rewards overall quality and efficiency, care that supports the long-term health of the population. “Volume” is simpler — paying providers for total number of health care interactions. Value is the way of the future and is the mission we’ve adopted for McLaren Health Care. By ceaselessly driving to improve quality, add efficiency, and shape a continuum of care for people in our communities, we aim toward the coming era of health care. But in the here and now, most care reimbursement is still based on the “volume” model. That means individual episodes of treatment, rapid turnover, and inpatient care — all of which drive up costs and erode quality. Our long-term strategy must deal with other paradoxes as well. “Accountable Care Organizations (ACOs),” which bring together hospitals, physicians, and community health resources to coordinate care, are the coming model for health care delivery. Yet so far, threequarters of ACOs in the U.S. have failed to generate any cost savings. How does a major organization, with almost 22,000 employees, more than 300 facilities, and a service area that covers 75 percent of the state’s population craft a three-year plan in such a volatile economic and regulatory environment? By focusing on our fundamentals, and knowing that the rest of the health care world must soon catch up. This helps us reach beyond the short-term noise to pursue long-term goals. We have achieved a number of these goals in the past year, all important ones. Prime among these accomplishments was the acquisition of Port Huron Hospital. Adding this historic 186bed facility to the McLaren system increases our geographic footprint in the Thumb region, building our presence throughout the Lower Peninsula. Certainly completing our integration with the Karmanos Cancer Institute is another major achievement. Karmanos is a national leader in cancer research and treatment and is one of only 41 cancer centers in the United States designated by the National Cancer Institute as a “comprehensive cancer center.” Beyond achieving outstanding standards of care, this designation demands a regimen of continuous improvement. By integrating the Karmanos structure into our system, McLaren gains worldclass treatment capability and extends important clinical outreach throughout McLaren’s statewide footprint. These and the other milestones of the past year are part of our coordinated strategy. In guiding the direction of our organization, I often return to our mission statement, created in 1994: “McLaren Health Care, through its subsidiaries, will be the best value in health care as defined by quality outcomes and cost.” While some think mission statements are only corporate rhetoric, ours is what we do. To be effective, all of our planning for the future must yield precise, measurable actions needed to achieve that mission. At the end of the day, we must focus on the certainties. If we continue to drive toward high value and high reliability, if we focus on outcomes like lower costs and improved patient safety, we know there will always be a place for our health system, and that we will always be in demand. P h i l ip A . I n ca r n ati President and CEO McLaren Health Care D av id S . M c C r e di e Chairman, Board of Directors McLaren Health Care M c L a r e n H e alt h C a r e 3 High Performance. High Reliability. “The magic of three” has long been a basic concept of literature, of religion, of mathematics. An effective, harmonic system should have three elements that mutually support and check each other. They are interdependent legs of a common stool, each as necessary as the others to the functioning of the whole. McLaren Health Care is shaping a fresh strategy that acknowledges this philosophical truth. Even the world’s most modern, complex healthcare system ultimately must excel in three essential, mutually supporting disciplines to succeed. For us, these are: McLaren Experience, stressing safety, service and quality. Access and Affordability, the structures needed to grow and improve our system. McLaren Care, the strong integration of our care management systems. None are more important than the others, none are less; all are absolutes to be pursued with rigor and ceaseless self-improvement, and all support the overall concept of system reliability. 4 2 0 1 4 A n n u al R e p o r t Alfred Ajise, MD Nephrology McLaren Northern Michigan M c L a r e n H e alt h C a r e 5 McLaren Experience Stressing Safety, Service and Quality Aaron Leis, RN Intensive Care Unit McLaren Central Michigan 6 2 0 1 4 A n n u al R e p o r t S afety, service and quality address the overall McLaren experience, the fundamental “first things” of healthcare. A healthcare system that regularly fails the “First, do no harm” rule of care cannot be trusted with any of the others. “Ultimately, it’s all about safety,” says Dr. Mike McKenna, McLaren Health Care chief medical officer. “First and foremost, in delivering care to patients, it is our obligation to avoid all preventable patient harm.” To that end, McLaren maintains a quality and safety scorecard for every subsidiary that tracks more than 50 performance metrics and shows how well each hospital is performing against national and corporate benchmarks. Among the safety indicators that are measured and reviewed on a monthly basis are hospital‑acquired infections, falls, medication errors, and other safety concerns. This information is shared at all levels of the organization, from the corporate board of directors to the direct caregivers at each hospital. The overall goal is to have quality and safety outcomes that are consistently in the top decile. Across the corporation, McLaren is seeing outcomes that fall in the top 10 percent of hospitals nationwide. Quality leaders at each hospital in the McLaren system share best practices to insure that all subsidiaries can benefit from tactics and practices that yield these top outcomes. The past year has seen numerous McLaren facilities gain national notice for their patient safety and quality. For example, McLaren Bay Region earned the Patient Safety Excellence Award from Healthgrades, placing it among the top 5 percent nationally. McLaren Macomb earned recognition from U.S. News & World Report’s 2014-2015 “Best Hospitals” survey as one of the highest ranked hospitals in Michigan. Service is a distinct aspect of outstanding health care, vitally important, yet the most subjective. Is the patient experience a positive one, leaving patients to conclude that their care needs were well met? How does our community view McLaren, and are we perceived as a trusted partner for health care consumers? At the millions of contact points where McLaren staff and employees interact with the public, are we projecting competence, assurance and concern? McLaren takes these questions very seriously and has put numerous measures in place to insure that the right answers are achieved. Leading the effort is a Corporate Patient Experience Team, consisting of representatives from each subsidiary who gather monthly to set standards and review results from patient experience surveys systemwide. These team members are the leaders of the improvement efforts at their specific sites. The goal of the corporate team is to build a cohesive approach to patient experience at all of the McLaren sites by establishing and using best practices to enhance the patient experience. Recent initiatives include development of a comfort care kit for all patients; implementation of a plan to enhance communication among patients, nurses and doctors; development of a comprehensive admissions packet for patients, and promoting increased patient rounding at all facilities with set guidelines and outcome measurements. Each hospital subsidiary also participates in standardized patient experience surveys which are tracked monthly and utilized to drive improvement in key areas. Understanding the correlation between employee satisfaction and patient M c L a r e n H e alt h C a r e 7 satisfaction, McLaren also conducts an annual employee engagement survey. Results of this confidential survey are shared with employees and used to identify strengths as well as opportunities for improvement in employee experience. Action plans around specific objectives are established both on the subsidiary and department levels, with the goal of exceeding national standards around employee engagement. Quality is an obvious element, but sometimes too obvious. Yes, McLaren facilities meet clinical standards and gain certifications for the quality of our care. But what about “stretch goals”? As we set our strategic goals around quality, it is imperative that we look ahead to the next generation of quality care standards and position ourselves to exceed them. We need to hone the talent, tools, systems and expertise we’ll need to continually reinvent our quality standards. And we need to continue to bake in a McLarenwide mindset that “good enough is never good enough.” Safety, service and quality are indivisible, and speak to the fundamental health care experience that our patients and communities encounter on a daily basis. assets, find synergies, and prove the saying that “the whole is more than the sum of its parts.” By completing our acquisition of the Barbara Ann Karmanos Cancer Institute last year, we achieved all of these goals for cancer services with a single, comprehensive transaction. Launched in 1989 by Compuware founder Peter Karmanos, Detroit-based Karmanos has evolved and grown over the years to become a national, even global, center for oncology research and treatment. It is one of only 41 National Cancer Institute (NCI)designated Comprehensive Cancer Centers in the United States. Karmanos has conducted more than 700 cancer-research programs and clinical trials, and its affiliation with Wayne State University’s School of Medicine empowers the two groups to work together in breaking new ground in cancer treatments. Karmanos brings together a staff of over 1,000 medical experts and is the only hospital in Michigan dedicated exclusively to fighting cancer. The Karmanos Effect on Quality and Service Karmanos has teamed up with the full resources of McLaren Health Care to extend these capabilities throughout our service area. “The key to Karmanos joining McLaren was that Karmanos would become the cancer brand for all of McLaren,” notes Dr. Gerold Bepler, Building a team with top contenders allows all parties to pool their strongest president and CEO of Karmanos. This means that the cancer treatments 8 2 0 1 4 A n n u al R e p o r t formerly centered around Karmanos’ facilities in Detroit will now be available in Petoskey, Bay City, Lansing, Flint, and everywhere else McLaren has a footprint. The greatest impact of the Karmanos acquisition will be seen throughout the McLaren system as we integrate their world-class clinical and research capabilities into our overall structure. Let’s examine the new strengths Karmanos adds to our institutional DNA. Karmanos’ status as an NCI-designated Comprehensive Cancer Center is recognition that is earned rather than simply granted. Such centers must continuously demonstrate expertise in research, laboratory, clinical and population-based cancer research. Further, they must also provide early-phase clinical trials and offer community outreach and education programs. Karmanos’ NCI status dates to its affiliation with Wayne State University, which has qualified for NCI status since 1978. In October, Karmanos and Wayne State renewed their affiliation agreement, with commitments for more research funding and closer strategic integration. With the acquisition, Karmanos, Wayne State and McLaren now form a powerful, three-part team. Smart management of big data is vital in cancer treatment and research. Late in 2013, McLaren contracted with Swedenbased medical technology leader Elekta to launch the MOSAIQ oncology information George Yoo, MD Chief Medical Officer Karmanos Cancer Hospital M c L a r e n H e alt h C a r e 9 Ruke Ehwarieme, MD Internal Medicine Resident McLaren Flint 10 2 0 1 4 A n n u al R e p o r t Jami Foreback, MD, PhD Director of Medical Education McLaren Flint system throughout McLaren’s cancer network. Clinical Integration IMPROVES PERFORMANCE MOSAIQ will centralize patient information across radiation oncology, particle therapy and medical oncology into a single, widely accessible user interface. Elekta will also supply 15 linear accelerators, a “Gamma Knife” system, brachytherapy technology, and Elekta’s Monaco treatment planning system. Clinical integration of healthcare services might seem like a dry, technical topic. Yet, for McLaren Health Care, it could just be the most exciting, rewarding strategic trend in our recent history, with solid payoffs for our hospitals, our staff, our physicians, but most of all, for our patients and communities. The $100 million project will “implement Elekta’s hardware and software throughout our system,” notes Dr. Justin Klamerus, chief quality officer and executive vice president of Karmanos Cancer Institute. “It’s the biggest agreement both McLaren and Elekta have ever signed.” While technology is impressive, its smart use and broad accessibility in fighting cancer will be the real payoff for the McLaren system broadly and Karmanos specifically. “From a radiation oncology perspective, we will be at the cutting edge for 10 years to come,” says Dr. Bepler. “If a patient needs radiation, we will always have the newest, latest technology right here in Michigan. Patients and their families won’t have to leave the area to receive the best cancer treatment options.” Dr. Klamerus concurs: “Clinical trials may be overseen from a central location in Detroit, but we can now offer them rapidly and efficiently at any McLaren site. This agreement builds on the strengths of both McLaren and Karmanos.” Clinical integration, in essence, is about transformation. About seeking not only high quality, high value health care, but shaping a total care structure that works toward this goal. It means relentless, continuous learning about how to deliver care of better quality, with greater efficiency. It means using every tool at your disposal to seize these goals, finding partners who can help to achieve them, and investing serious money. Karmanos Clinical Protocols Enrolled 3,560 Patients in Clinical Protocols Clinical 432 Current Protocols a large, diverse health care system. But there is more value to be cultivated through a system the size of McLaren. It requires breaking down barriers. It demands moving beyond the concept of a dozen or so hospitals with “McLaren” in their name, to forge a single, interactive McLaren that works, thinks, moves — and heals — with one mind. “Clinical integration is about ‘systemness,’ the transition from a group of collective, shared facilities to a single organism,” states Mark O’Halla, chief operating officer at McLaren Health Care. “It means finding best practices across the organization, reducing variability, and improving performance.” The potential benefits of full system integration are enormous. Patient data flows seamlessly between McLaren facilities. Quality steadily improves. New efficiencies are discovered, and costs trimmed. There is a smooth, supportive continuum of care from prevention, to wellness, to inpatient, to ambulatory, to follow-up. Patients share a uniformly positive “McLaren experience” anywhere in Michigan. True integration goes beyond the economies of scale achieved through the McLaren system’s impressive growth. Massive purchasing power, the scale needed to attract top physicians, strong insurance products through McLaren Health Plan … all are indeed benefits of Yes, there will be hurdles. McLaren CEO Phil Incarnati observes, “We have to learn to move as one. That may be uncomfortable for local governance, but at the end of the day, there is no other option. Everyone has to learn to do things the same way, every day.” M c L a r e n H e alt h C a r e 11 McLaren’s Chief Medical Officer, Dr. Mike McKenna, agrees, “There will be some cultural change to assure uniform procedures. When we pick a measure, someone will already be at the top, but some will be at the bottom.” How to make McLaren Health Care’s clinical integration effective, but also a pathfinder for complete system integration? Focus on doing everything the same only after learning how to do it better. O’Halla shares a recent example: “I was talking with the pharmacy directors across the company, and told them we needed to brainstorm a single pharmaceutical formulary across the entire system. There were a lot of questions on how this would work. I replied that ‘you are the experts, and you’re the ones who tell me how it should work.’ The result? A sound, effective procedure, based on data, was created.” Build a learning organization. A best practice has been instituted throughout the organization, whether it’s for delivering a medication, storing surgical gloves, or providing post-operative cardiac care. But what happens if a better practice comes along? “We need to be constantly learning,” notes O’Halla. “If we find that something no longer benefits us, then we adjust it. We’re not blindly lockstepping — we react constantly based on measurable data.” Smart use of committees throughout the McLaren structure means our front- 12 2 0 1 4 A n n u al R e p o r t line experts are constantly weighing and adjusting procedures based on internal experience and outside research. You can’t improve what you can’t measure. Health care delivery is one of the most monitored and graded industries in the U.S., and has grown more so since passage of the Affordable Care Act. Measures such as the Healthcare Effectiveness Data and Information Set (HEDIS) are used by regulators and consumers as a scorecard of a hospital’s effectiveness and safety. Tools such as the McLaren Patient Safety Dashboard, in place since 1994, measure and monitor over 50 unique clinical performance metrics, including infection rates, mortality, patient falls, 30-day readmissions and clinical utilization. The McLaren approach to the use of these report cards is simple: “Our target is to be the best,” says O’Halla. Build support (and skills) among your medical staff. McLaren Physician Partners, our Physician Hospital Organization (PHO), has grown steadily in recent years. Making it a keystone of integration efforts to standardize procedures has paid off. “Physicians don’t always like being told what to do, but the reality is that every physician also wants to do the right thing,” says Dr. McKenna. “We give them the tools to make the right choices.” Smarter and safer Blood management The three drivers for McLaren Health Care in the future will be quality, affordability and integration of care. Will that work in practice though? A new initiative that combines all three provides a good illustration. When we refer to a crucial element of something as its “lifeblood,” we’re usually being metaphorical. But in hospital surgical settings, the wise use, care and management of blood products gives the term a meaning that could not be more literal. Except for times of real shortage, health caregivers have historically been very openhanded in transfusing blood for patients. U.S. health care is wasteful when it comes to blood use compared to most of the world. Blood utilization in the U.S. is currently 15 percent higher per capita than in Europe and 44 percent higher than in Canada. While there are obviously events that require immediate, heavy blood transfusions, medical science has learned that better care often means more judicious use of blood. “Blood is really a product, and like any medical product, needs to be well managed,” observes Dr. Dennis Spender, medical director of the McLaren Medical Laboratory. Introducing any foreign product into the human bloodstream carries risks, and this includes blood. Any transfusion suppresses the immune Sandeep Mittal, MD Co-Leader, Neuro-Oncology Multidisciplinary Team Karmanos Cancer Hospital M c L a r e n H e alt h C a r e 13 Dennis Spender, MD Medical Director McLaren Medical Laboratory 14 2 0 1 4 A n n u al R e p o r t system to some degree, and there are risks of circulatory overload and other negative events. “Every transfusion reaction on average extends a hospital stay by four days,” notes Dr. Spender. Blood, like other products, also adds expense and difficulty, especially in storage and management. So if blood is a product, are there, as with other hospital products, smarter and safer ways to use it? There are now at McLaren, through its new blood management program. Over the past year, McLaren has teamed with Strategic Healthcare Group in Indianapolis to nurture an evidence-based, blood management program throughout our system. “They’re helping educate us on our substantial blood management 1 New 2 is the Less is more for blood transfusions. New treatment protocols recommend using one unit of Red Blood Cells instead of two. infrastructure,” says Dr. Spender. One initiative is the formation and training of “blood management teams” at each McLaren facility, made up of staff who work with blood banking, quality, and safety issues. Most of the blood management effort goes to education. Medical research has found that hemoglobin levels once thought optimal for patients may not be the ideal. “We have a saying as part of the program that, for hemoglobin levels, 7 is the new 10,” says Dr. Spender. In other examples, a patient diagnosed as anemic may be better served with iron supplements than a transfusion. A patient being treated with blood thinners such as Coumadin may have longer bleeding incidents, but simply adjusting the patient’s meds could be wiser than transfusing. Though smarter use of blood products lowers costs at McLaren, Dr. Spender stresses that the real benefits are improved safety and updated patient care standards. “This is based on peer reviewed scientific literature. It’s a high-quality initiative with the added benefit of shortening hospital stays and lowering expenses.” M c L a r e n H e alt h C a r e 15 A ccess and affordability are the big, systemic issues that grab the news headlines. With the national Affordable Care Act (ACA) now in place, much of the loud debate we’ve heard over the past several years has retreated, replaced by the buzzing activity of implementation. Yet there remain serious gaps between the ideal care, coverage and financial goals of the ACA and the realities that exist today. McLaren Health Care is striving to navigate these disparities. Innovations in care mean that patients in the smallest McLaren communities have access to the same capabilities as those at our largest facilities. By expanding and centralizing our research capabilities, we gain a reputation as a hotbed for research advancement, and our patients gain early access to new procedures and medications. Health care reform increasingly puts patients in charge of making their own health care decisions. McLaren innovations in data, access and information provide the tools patients need to be active, savvy partners in health care. 16 2 0 1 4 A n n u al R e p o r t Expanding Access in Eastern Michigan McLaren Health Care continued its pace of expansion in 2014 with acquisition of Port Huron Hospital in May. The 186bed hospital has been a fixture in the Sanilac and St. Clair county area since 1882, but the process by which it chose to join with McLaren offers valuable insight on the trends shaping 21st century health care. Port Huron president and CEO Tom DeFauw recounts that he and the hospital’s board began weighing future options several years ago. “Our board was looking for ways to advance our local health care capabilities beyond today’s needs, to build a strong system for the future.” A meticulous future strategy process included seeking input from the board, Port Huron physicians and community leaders, as well as hiring a consulting firm to aid in research. The hospital staff and advisors invested many hours in assessing industry trends, strategic options, capital requirements and local health care needs. The outcome of this fact finding confirmed that joining a larger health care system would prove best for the people of Port Huron. “Our goal was to join with a system that shared our vision on hospital/physician alignment, capital investment, management expertise and commitment to employees and the community,” DeFauw says. Access & Affordability The structures needed to grow and improve our system. Tom DeFauw President/CEO McLaren Port Huron M c L a r e n H e alt h C a r e 17 LaKeisha Blair-Watson, MD Family Medicine McLaren Oakland 18 2 0 1 4 A n n u al R e p o r t These sound like high, demanding standards to meet, yet Port Huron Hospital still received 10 separate proposals from interested suitors. After all were carefully reviewed by hospital leaders and board members, DeFauw notes that there seemed only one choice — “we unanimously felt that McLaren did an outstanding job. Given the strength of their proposal, we felt much better about moving away from independence.” The negotiation and due diligence process soon began and brought formal acquisition on May 1, 2014. Even a few months into the process, the McLaren Port Huron leadership has already seen solid benefits from the merger. “The new fiscal year began October 1, and we’ve already identified $4 million in new revenues and expense reductions,” says DeFauw. Capital funding for construction of a new Port Huron cancer center and a new inpatient tower is part of the agreement, with groundbreaking set for 2015. The new cancer center is part of a major expansion in Port Huron’s oncology capabilities, sparked by McLaren’s other major acquisition of the past year, the Karmanos Cancer Institute. Also, “McLaren brings incredible physician recruitment expertise, and their PHO model with McLaren Physician Partners was one of the factors that motivated us.” Indeed, DeFauw says McLaren’s noted expertise in smoothly integrating new hospitals in itself was a factor that helped sway Port Huron’s leaders. “McLaren has a very sophisticated integration process. They set up integration teams in June, and the whole process moved much quicker than we anticipated.” insuring Michiganders and their families, was launched in 1997 and includes Medicaid coverage, commercial plans and individual health care insurance plans offered through the health exchange. DeFauw believes that such linkages are the inevitable outcome of modern hospital trends. “More and more, we see that independent hospitals can best serve their communities by being part of a much larger system. Scale is important, and it’s harder to take risks if you remain small.” With the arrival of the ACA, McLaren Health Plan was ready with the right structure and the right products, at the very moment they were most needed. “The health care exchange was much more successful for McLaren Health Plan than anticipated,” recalls Kathy Kendall, president and CEO of MHP. The Right Plan at the Right Time For the health exchange, our ACAapproved plans offer both groups and individuals “Silver,” “Gold,” and “Platinum” coverage based on the level of deductibles sought. A year ago, the phrase “Affordable Care Act” (ACA) was identified with broken government websites, wholesale changes in insurance coverage and cost, and widespread confusion. Today, a bit of the fear factor is gone, and some of the credit, at least in Michigan, should go to the McLaren Health Plan (MHP). October 1 of 2013 saw open enrollment begin for the “health insurance marketplace” required under the Affordable Care Act. Glitches in the system were immediately apparent, the most famous being the ACA’s infamous healthcare.gov website. For MHP, being ready the moment the ACA rolled out was an example of McLaren’s overall approach of preparing to meet the demands of where health care is headed, rather than where it is at the moment. MHP, our system’s approach to “McLaren is the only plan in Michigan offering products on the exchange that feature a unique preferred network option,” observes Kendall. The “McLaren Rewards” option waives patient deductibles and co-pays for services from a network of preferred providers. Many competitor networks are so small that patients must leave their personal health care providers to seek out-of-network services that are very costly and inconvenient. “A lot of plans implement narrow networks, but ours is just the opposite of a narrow network,” says Kendall. There are some 2,500 such zero-deductible “reward” providers in the plan, including the 2,000-member McLaren Physician Partners PHO. M c L a r e n H e alt h C a r e 19 The McLaren Rewards network of providers eligible for discounts is much bigger and includes the plan’s affiliation with Oakwood Health System in Detroit and Mercy Memorial in Monroe. “If you enroll with us, you gain a total network of 37,527 providers,” notes Kendall. “That’s a huge number.” The full ACA rollout drove some of the expansion in the MHP for 2014, but growth was also fueled by Medicaid expansion in Michigan. Launched on April 1, the state’s Healthy Michigan Plan expanded Medicaid coverage to almost half a million more residents. The result was another blast of new demand for healthcare coverage taking many by surprise. The state projected new Medicaid enrollees to total perhaps 300,000 by the end of the year, when in fact 400,000 signed up just by the end of October. MHP increased by 49,000 new members through its own Healthy Michigan Medicaid coverage offerings. Added to this was overall system growth for MHP over the year. MHP’s push into the Medicare Advantage market includes two products, a premium “Diamond” plan and a value-priced “Sapphire” plan. Both of these feature-rich products are being sold in an expanded 34-county market in Michigan. Number of McLaren Rewards Network Providers 37,527 20 2 0 1 4 A n n u al R e p o r t Commercial insurance expanded to four more counties in the state, bringing the total to 35, and Medicaid expansion pushed MHP’s Healthy Michigan product out to all 53 counties in the state where McLaren has a presence. Plus, the MHP network of providers gained 7,000 new members. MHP had the programs and offerings in place to meet this boom, but Kendall admits that the sheer enrollment numbers pushed their infrastructure. “The growth has been explosive. In one month we expected 5,000 new members, and instead received almost 20,000. We put an emergency plan in place, and pulled staff from all departments to man customer service.” Explosive growth may have been the McLaren Health Plan story for 2014, but Kendall views it as both a sign of success and a key to MHP’s ongoing strategy. “These huge initiatives are where we really fit in. We’re trying to maximize the abilities our plan brings as we move further into the market. Population health management, improving our quality scores, paying for value, and setting new metrics — this is what health plans should do.” Shaping New Care MOdels With Physician Partners Technology, smart financial and administrative infrastructure, the latest medical techniques … all are useless without skilled, aligned physicians to put them to work in saving lives. McLaren Health Care takes great pride in the skills and passion that all of our physicians display on a daily basis. The high quality rankings of our facilities and care outcomes attest to this talent. Physician/hospital organizations (PHOs), a partnership bringing together hospitals and physicians, have become a popular business model in American health care. Our system has offered a successful PHO, McLaren Physician Partners (MPP), for a number of years. As in most hospital health care settings, however, the majority of our physicians are still independent. “Even though we employ about 430 physicians, there are still thousands of independent physicians in the system,” notes McLaren CEO Phil Incarnati. Yet MPP is developing an important cadre for over 2,000 physician members that points to the future. It allows us to shape new models of care, improve standards, and grow tomorrow’s integrated health care system. “MPP shows the spirit of partnering with physicians,” says Gary Wentzloff, MPP president and CEO. The past year has seen initiatives to offer new resources to member physicians in practice improvement, clinical integration, contracting and quality. For example, MPP provides “practice coaches” who will come to the physician’s office to help identify gaps in care and offer process improvements. “Suppose a patient comes in with a diagnosis of diabetes, there is also further lab work that’s needed periodically,” Wentzloff observes. “That could be a gap in care if not followed up carefully.” Ramy Kurdi, DO Orthopedic Surgeon McLaren Bay Region M c L a r e n H e alt h C a r e 21 Alex Steinbock, DO Neurologist McLaren Medical Group 22 2 0 1 4 A n n u al R e p o r t MPP is also at the cutting edge of McLaren’s clinical and practice integration mission. Clinical integration scorecards are in the works to establish and share care quality metrics. “We assemble empirical data across programs, so every physician can examine his or her office by objective measures.” Physicians from across the McLaren system are taking part in regional medical director networks to shape these quality care metrics, which also aids in system integration. Wentzloff credits these networks with “allowing physicians to meet their peers and develop engagement.” Physicians are vital to the “medical home” model, which is at the heart of the population health management concept endorsed by the ACA. The medical home model seeks to develop an ongoing arc of care for the patient throughout treatment, and puts the physician in charge as the manager of that care. “Coordination of care is crucial,” says Wentzloff, and MPP is working to assure its physicians have the knowledge and tools to handle this new role. As noted, MPP is a cadre, nurturing the changes that are on their way for how all physicians will be practicing in the future. Wentzloff sees McLaren Physician Partners in the vanguard of improving the practice of medicine. “Getting physicians to say ‘yes, I’m willing to reach out’ is the first step bringing greater quality to care.” New Programs Assure Quality and Access Of all the ingredients that go into great health care, one may be paramount — access. Excellent physicians, good facilities, and technology won’t help if patients lack fast, convenient access to that care. McLaren Medical Group (MMG) specializes in delivering on this crucial element for health care excellence. MMG is the ambulatory network of McLaren Health Care. With more than 80 primary and specialty care centers located throughout our statewide service area, our physicians assure continuity and access to care throughout all stages of treatment. For 2014, the Medical Group focused on two initiatives to improve access for McLaren patients, making it not only easier to see a physician, but to assure the highest quality of care at that visit. In September, MMG rolled out a free online appointment scheduling program. This service allows patients to find local physicians who will accept their insurance coverage, check scheduling, and instantly book appointments online and also provides information on physician qualifications and specialties, aiding in making informed care decisions. MMG launched this online appointment initiative with nearly 100 McLaren primary care, Ob/Gyn, and pediatric physicians in the Flint, Lansing and Macomb areas. Participation in the program was notable over the last quarter of 2014, with more than 300 new patient visits booked. Success is driving expansion of this initiative into other McLaren regions, with Oakland planned for early 2015. The past year also saw advances in certifying McLaren facilities as Patient Centered Medical Homes (PCMHs). The medical home concept is a central element of health care reform. This primary care model empowers patients in management of their care, coordinating care through a high-access, high-quality team approach. This includes not only primary care, but also specialty care, hospital services, home health and community services. PCMHs demand certification on a large number of strict and objective technical criteria. Reimbursement for care is increasingly keyed to gaining this PCMH certification for care sites. Blue Cross/Blue Shield of Michigan PCMH certification, for example, is based on meeting over 140 “capabilities,” such as patient registries, tight performance reporting, broad access, and follow-up regimens. While many of these capabilities seem technical and esoteric, “in my mind, the most important relate to quality,” says Kim Hamm, director of quality and compliance for MMG. “We have to deliver high performance, quality care standards, and assure all the needs of the patient are met.” BCBSM certifies PCMH sites annually, and 2014 was a strong year for McLaren. “We now have 86 of our care sites designated as medical homes, and the number of our providers working through these sites jumped 25 percent just this year.” Such progress is vital, says Hamm, because ultimately “some payers may move toward reimbursement only for care at certified [PCMH] sites.” M c L a r e n H e alt h C a r e 23 McLaren Care The strong integration of our care management systems Josh Straus, RN Heart and Vascular Center McLaren Central Michigan 24 2 0 1 4 A n n u al R e p o r t M cLaren Care, the third element in our bold new strategic approach, puts the unique, broad structure we’ve crafted for McLaren Health Care to work in fulfilling the needs of the first two elements. The scale and scope of our system, covering a geography representing 75 percent of the state’s population with hundreds of facilities and thousands of physicians and employees, create a powerful tool for meeting the demands of modern health care. We’re able to discover best practices for medical procedures throughout a large, diverse system, refine these, and then roll them out as standards throughout the McLaren family. A growing network of world-class physicians raises quality of care and attracts the notice of more world-class physicians … a virtuous circle. An enormous purchasing system and smart use of “big data” allow us to negotiate the best prices on products and services and to harness technology as a tool for improving efficiency and quality. PatientS as Active Partners There is a long tradition in health care of seeing the major elements of good care delivery as physicians, hospitals, the hospital staff, and the various funding mechanisms (most of these competing against each other). McLaren Health Care has crafted a structure for bringing these elements into a quality-driven whole. But even if you stop viewing these players as separate silos, what’s missing from this formula? The patient. McLaren Health Care is taking its place at the front of health care reform to change this. Patients are increasingly expected to be active partners in shaping the course of their health care, and McLaren is giving them the tools and knowledge to be effective. “Patients need to engage with their health care more now than ever before,” observes Dr. Mike McKenna, McLaren Health Care chief medical officer. “We’re working to educate our patients to ask the right questions and make better choices. Is this treatment worth the cost … do I really need that MRI?” While this is indeed empowering for the people in McLaren’s communities, it’s also more demanding. Who is ultimately in charge of your health care records now? You are. Who decides how to best spend your limited budget of health care dollars? You will. “More choices are shifting to consumers,” notes McLaren CEO Phil Incarnati. “And they’ll have to be better consumers.” McLaren Health Care is working to assure that its patients are up to the demands of being their own care managers. The mymclarenchart.org patient portal is one tool. With the power to access health and treatment records anywhere and anytime, the online portal alters the health care conversation, making it more of a partnership. Customer education through the various McLaren Health Plan offerings is another tool for nurturing smarter health care consumers. With a strong emphasis on M c L a r e n H e alt h C a r e 25 member outreach, education and support, the plan is literally reshaping the health care aptitude of its 260,000 covered members. “Most health plans talk about population health management,” says Kathy Kendall, CEO of McLaren Health Plan. “But this is what we actually do — work to manage the health care for our covered population.” Best PRactices for the BEst Care “Not invented here.” It’s one of the most common — and most negative — concepts in technology and business. It means shunning a technology, technique or talent solely because it wasn’t developed in house. A “not invented here” approach places the parochial above the innovative, mediocrity above excellence, and the present above demands of the future. The McLaren Health Care approach might just be the exact opposite of this insular philosophy. That’s because our talent for smart, strategic growth and acquisition is not based on a simple “bigger is better.” Rather, we take a “who knows what we don’t?” tack. Who has expertise we can use to improve our system … where do we need to be in the future … what capability can we add to strengthen the McLaren community? Take McLaren’s acquisition of Karmanos Cancer Institute. “Through this transaction, we are delivering the vision of worldclass cancer treatment here in Michigan,” 26 2 0 1 4 A n n u al R e p o r t observes McLaren CEO Phil Incarnati. While Karmanos is famed for its cancer treatments and research, these are just the end result of a robust, best-practice clinical care structure. “Karmanos serves as an example,” notes McLaren Chief Medical Officer Dr. Mike McKenna. “They’ve standardized their best practices. Now we want to take those best practices throughout our Michigan-wide network. Variation kills quality.” The process of integrating this clinical-care quality into McLaren’s DNA has already begun and offers a good example of how a “learning organization” transforms itself. Step one is clinical integration itself, begun by bringing the Karmanos template into McLaren’s various oncology programs. A clinical integration committee was created, with representatives from McLaren’s oncology sites and Karmanos staff. Dr. Gerold Bepler, Karmanos CEO, recalls that this included “developing guidelines for integration, policies and procedures, site visits to all oncology and infusion centers, and compiling a list of best practices.” With best-practice clinical guidelines in hand, all McLaren cancer facilities then implemented them throughout the system. “Each site has been approved and accredited,” says Dr. Bepler. Meeting such tough, uniform clinical standards is crucial if Karmanos, as a part of McLaren, is to keep its NCI Comprehensive Cancer Center designation. Step two is research integration. Before McLaren facilities could take part in Karmanos’ extensive cancer research projects, the integration committee conducted reviews and site visits across the McLaren system. Medical research is tightly regulated, with demanding standards for “processes, patient consent, data collection and storage, and site approval,” notes Dr. Bepler. A central Protocol Review and Monitoring Committee now vets all oncology drug and device trials for scientific rigor and procedures, making it far simpler to gain research approval. Forging McLaren’s widespread oncology sites into a centralized clinical trial program has paid off, with five new trials recently launched. Step three of oncology clinical integration is a vital one in this digital age, ensuring a common oncology data system is in place throughout the McLaren structure. McLaren created one of the largest partnerships of its kind with medical tech firm Elekta to unify and standardize our cancer data collection, storage and access system, assuring that all McLaren and Karmanos facilities have seamless data accessibility. This technology has been implemented in McLaren Macomb, McLaren Clarkston and McLaren Lapeer and should be online throughout the full McLaren network in 2015. Standardized treatments, drug mix and delivery, ancillary medications and other oncology needs can be easily Calandra Anderson, RN, MBA Director of Patient Care Services McLaren Oakland M c L a r e n H e alt h C a r e 27 Beth King, RN, BSN Certified Branch Manager-Davison McLaren Home Care 28 2 0 1 4 A n n u al R e p o r t prescribed across all McLaren sites. Finally, McLaren is using smart integration to help build linkages with outside resources. Karmanos has long had a productive affiliation with Wayne State University (WSU), sharing faculty, medical staff, residency programs and research. Following our Karmanos acquisition, McLaren helped in negotiating a new contract with WSU that deepens collaboration, increases funding, and improves shared governance. The task of blending McLaren and Karmanos into a superior system continues into 2015. One key project underway is melding the work of McLaren’s current oncology staff with Karmanos, of particular benefit because Karmanos’ staff brings a number of cancer subspecialties not currently available in the McLaren system. Also in progress is full integration of electronic health records (EHRs) for oncology to ensure more effective collaboration, and finalizing consistent treatment guidelines and scope of practice issues. McLaren’s Service Area Covers 75% of the State’s Population The integration of Karmanos as a trailblazer for clinical integration and renewal has proven both enriching and demanding. “It’s been a very intense year … a lot of people have put a lot of work into this,” observes Dr. Bepler. Now that the huge effort of crafting this prototype for successful clinical integration is in progress, what next? Replicate it, again, and again, and again throughout the McLaren system. Says McLaren Health Care COO Mark O’Halla, “In the new year, we’ll be doing the same thing for cardiovascular care, neurosciences, and orthopedics.” At McLaren, the learning never ends. Meaningful use of Data While information technology has been transforming health care over the past decade, McLaren has aimed ahead of the curve to shape technology and smart data usage into a strategic strength. The U.S. Centers for Medicare and Medicaid Services (CMS) has set a goal of driving health care providers to implement broad electronic health record usage. To assure compliance with this mandate, CMS implemented a multistage “meaningful use” test of technical measures. There are many items to be met for meaningful use, from computerized provider order entry, to bar code use for administration of meds, to public health reporting, all with steadily rising thresholds. Hefty Medicare and Medicaid funding incentives are at risk for providers who don’t comply. In October, McLaren Health Care could attest that eight of its hospitals had achieved meaningful use under current guidelines. “This is important to the future,” notes Mark Gray, corporate director of information technology. “Over the next four years, roughly $60 million in Medicare and Medicaid incentives are at stake.” One important meaningful use measure is implementation of “patient portals.” These are secure online websites that give patients 24-hour access to personal health information, such as clinical summaries, care instructions about recent visits, and lab or test results. McLaren Health Care’s patient portal is mymclarenchart.® “This is an excellent tool for empowering patients in allowing them to keep all their health information accessible, anywhere, anytime,” Gray notes. This highly secure system taps patients into the expanded, centralized data network McLaren has created for its own facilities. McLaren patients are readily responding to and adopting this new technology. “As of November, 22 percent of our eligible patients have already signed up,” well above projections. M c L a r e n H e alt h C a r e 29 Always. Throughout this report, we have underscored the three strategic pillars that are helping McLaren Health Care prepare for the future: The overall McLaren experience, focused on safety, service and quality … the structures we need to strengthen access and affordability … and finally, the dawning “McLaren Care” model, shaped by careful integration of our care management systems. We have invested substantial amounts of human and capital resources into the process of interpreting these three legs of our overarching plan for the system. The transformation being driven by our clinical integration effort is revolutionizing the McLaren experience, but it also boosts access and affordability, and is a prototype for the coming integrated McLaren Care model. Our acquisitions add value by improving care standards, broadening access, and expanding our systemwide skill base. This, perhaps, has been the real key to McLaren’s strategy for success in 2014, and aiming into the future. Add talent, facilities, expertise, technology and services wisely, and only if they deliver on all three of the elements above. A future of integrated health care demands nothing less than such an integrated strategy. 30 2 0 1 4 A n n u al R e p o r t 15 14 McLaren Service Area 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 cLaren Bay Region M McLaren Bay Special Care McLaren Central Michigan McLaren Greater Lansing McLaren Orthopedic Hospital McLaren Lapeer Region McLaren Clarkston McLaren Health Plan McLaren Flint McLaren Macomb McLaren Oakland McLaren Homecare Group McLaren Insurance Company, Ltd. McLaren Northern Michigan McLaren Northern Michigan at Cheboygan McLaren Port Huron Karmanos Cancer Institute Karmanos Cancer Hospital McLaren Medical Group 3 1 2 9 8 4 5 13 12 16 6 7 11 10 McLaren Proton Therapy Center McLaren by the Numbers Discharges ���������������������������������������������������������������������������������� 100,958 ER Visits �������������������������������������������������������������������������������������� 395,902 Surgeries�����������������������������������������������������������������������������������100,000+ Births������������������������������������������������������������������������������������������������� 6,297 Ambulatory Visits��������������������������������������������������������������������3.7 Million Home Care Visits ������������������������������������������������������������������������137,734 Hospice Days����������������������������������������������������������������������������������76,941 Licensed Beds����������������������������������������������������������������������������������2,857 Community Benefit �����������������������������������������������������������$205 Million Employees ������������������������������������������������������������������������������������ 22,000 Days of Inpatient Care ������������������������������������������������������������ 470,563 Contracted Providers �����������������������������������������������������������������37,527 Annual Payroll������������������������������������������������������������������������ $1.2 Billion Net Revenue �����������������������������������������������������������������������������$3 Billion M c L a r e n H e alt h C a r e 31 Governance McLaren Health Care Board of Directors David McCredie, Chairman E. James Barrett Daniel Boge David Buzzelli H. James Fitzgerald James George Tony Hain Philip Incarnati Kathryn Lawter Dominic Monastiere James Prowse Thomas Robinet David Thompson Karmanos Cancer Hospital Board of Directors Timothy Monahan, Chairman Leslie Bowman Armando Cavazos Ethan Davidson Myron Frasier Thomas Goss Scott Hunter, DMin Tom Kalas W. James Prowse III Anthony Rusciano Alan Schwartz Maureen Stapleton Buzz Thomas Jane Thomas, PhD Manuel Valdivieso, MD Ex-Officio Charles Becker Gerold Bepler, MD, PhD Margaret Dimond, PhD Elisabeth Heath, MD Philip Incarnati Valerie Parisi, MD George Yoo, MD Karmanos Cancer Institute Board of Directors Charles Becker, Chairman W. James Prowse III, Vice Chair Alan Schwartz, Vice Chair Randolph Agley Eugene Applebaum Mary Barra Jim Bennethum Armando Cavazos Daniel Cornwell KC Crain Karen Cullen Debbie Dingell David Drews David Duprey Kenneth Eisenberg Jay Farner Michael Ferrantino, Jr. Richard Gabrys Bruce Gershenson John Giampetroni Adnan Hammad, PhD Mohammad Muhsin Chisti, MD Hematology/Oncology McLaren Oakland 32 2 0 1 4 A n n u al R e p o r t Patricia Hartman Ellen Hill-Zeringue David Jacob Peter Karmanos, Jr. C. Michael Kojaian Edward Levy Donald Manvel Mary Matuja Timothy Monahan Amy Morgan Paul Nine Paul Purtan Eunice Ring Gary Sakwa Nazli Sater Marc Schechter John (Joe) Schwarz, MD Nedda Shayota Robert Skandalaris Robert Stone David Trott Vainutis Vaitkevicius, MD Jeffrey Williams Nancy Yaw Ex-Officio Gerold Bepler, MD, PhD Philip Incarnati Valerie Parisi, MD M. Roy Wilson, MD McLaren Bay Region Board of Directors William Bowen, Chairman Gary Bosco Terrence Cherwin, DO Eileen Curtis Kathy Czerwinski Mitzi Dimitroff Alice Gerard Mark Jaffe Mark Komorowski, MD Debra Lutz David Mikolajczak Dominic Monastiere Mark O’Halla Amy Rodriguez Douglas Saylor, MD McLaren Bay Medical Foundation Board of Trustees Dan Engelhardt, Chairman Ashley Anderson Paul Begick Sally Bowen Mark Brissette Eileen Curtis Robert Dimitroff Wendy Dore Timothy Dust Daniel Engelhardt Nancy Greve Edward Keating Stephen Kent JoAnna Kolbiaz Mark Komorowski, MD Richard Lyon Donald Massnick Pamela Monastiere Guy Moulthrop Lee Newton, OD Cynthia Phares Roger Pickering Richard Spence Richard Steele Mike Stodolak Barbara Sundstrom Mary Beth Taglauer Ex-Officio Alice Gerard Konnie Gill Stephen Scannell McLaren Bay Special Care Board of Directors Andreas Teich, Chairman Ashley Anderson Lori Appold Scott Carmona Matt Jeffrey Aaron Madziar Kimberly Prime, EdD Ex-Officio Cheryl Burzynski McLaren Bay Region Auxiliary Executive Board Debra Kohn, President Barbara Sundstrom, Past President Judy Johnson, 2nd Vice President McLaren Central Michigan Board of Directors Kenneth Bovee, Chairman Daniel Boge Sandy Caul Frank Cloutier David Keilitz Maxine Klumpp Kent Bill Lawrence Charles Lilly, MD Janet Maar-Strickler Steven Martineau Pamela Myler Steven Pung Michael Swirtz, MD Ashok Vashishta, MD James Wojcik McLaren Central Michigan Volunteers Bonnie Vetter, Director McLaren Flint Board of Trustees Jim Cummins, Chairman Edward Abbott Jagdish Bhagat, MD Philip Incarnati Donald Kooy David Mazurkiewicz Duane Miller Lawrence Moon Elizabeth Murphy Patricia Perrine Ghassan Saab Sherri Stephens Frazer Wadenstorer, MD Trustees Emeritus Sandra Applegate William Churchill Lynn Evans Harriet Kenworthy Olivia Maynard Edward Neithercut William Piper McLaren Foundation Board of Trustees Tom Donaldson, Chairman Steve Cook Hesham Gayar, MD Donald Kooy Raymond Rudoni, MD Mona Sahouri Lakshmi Tummala Marie Wadecki Rick Wyles Trustees Emeritus Daniel Anbe, MD Sandra Applegate William Churchill Frederick VanDuyne, MD McLaren Flint Hospitality House Board of Trustees Steve Cook, Chairman Roxanne Caine Gary Gagnon Donald Kooy Rick Wyles McLaren Greater Lansing Board of Trustees E. James Barrett, Chairman David Boes, DO Paula Cunningham Tico Duckett Sal Durso Ramiro Gonzales Theresa Hubbell Philip Incarnati Patricia Lowrie Thomas Mee Ralph Shaheen Charles Steinberg Scott Stewart Sadiq Syed, MD Ex-Officio J. Wesley Mesko, MD Mia Michelena, DO Guest Member Tim Johnson Trustees Emeritus James Fitzgerald Donald Hines Thomas Hoffmeyer Michael Murphy, PhD Barbara Sawyer-Koch Everett Zack McLaren Greater Lansing Foundation Board of Trustees Scott Stewart, Chairman Peg Brown Thomas Conroy Sara Dolan Jennifer Dubey Calvin Jones Michael Kowalczyk, DO Darrell Lindman Rachel Michaud Michael Nordman John O’Toole Charles Owens Charles Taunt, DO Christine Tenaglia, DDS Richard Wendorf, PhD Keith Williams Angela Witwer Lyn Zynda Trustees Emeritus Becky Beauchine Kulka Seong Chi, MD Nancy Elwood Gordon Guyer, PhD Thomas Hoffmeyer Charles Laskey Dennis Louney Jeffrey Williams McLaren Greater Lansing Volunteer Board of Directors Peggy Brown, President Ray Elton Nancy Meddaugh Siray Taylor McLaren Health Advantage Board of Directors Kevin Tompkins, Chairman Kathy Kendall Gregory Lane McLaren Health Plan Board of Directors Kevin Tompkins, Chairman Lakisha Atkins Patrick Hayes Kathy Kendall Donald Kooy Dennis LaForest David Mazurkiewicz Ronald Shaheen, DO McLaren Lapeer Region Foundation Board Tim Turkelson, Chairman Elfatih Abter, MD Rick Burrough Barton Buxton Mary Beth Callahan James Greenwald Andy Harrington Rod Mersino Marguerite Pope Bob Riehl Diane Scott Steve Starking Kenneth Tarr, DO McLaren Health Plan Community Board of Directors Kevin Tompkins, Chairman Kathy Kendall David Mazurkiewicz McLaren Homecare Group Board of Directors Joseph Sasiela, Chairman Barton Buxton David Dixner Tom Donaldson Mark O’Halla Dennis Perry, MD Clarence Sevillian Carl Simcox Frank Wronski McLaren Lapeer Region Board of Trustees Kathryn Lawter, Chairperson Mike Robinet, Vice Chair Brad Blaker, DO Barton Buxton Curt Carter Joan Maten, FNP Karen Mersino Mark O’Halla Justus Scott Roger Skindell, DO Kenneth Tarr, DO Kari Jarabek, RN Manager, Medical Management McLaren Health Plan M c L a r e n H e alt h C a r e 33 McLaren Lapeer Region Auxillary Board James Greenwald, President McLaren Macomb Board of Trustees Ted Wahby, Chairman Peter Ajluni, DO Tom Brisse Robert Cannon Carolyn Dorian Bernadette Gendernalik, DO James George John Paul Hunt Philip Incarnati Matthew Moroun Mark O’Halla Dean Petitpren Albert Przybylski, DO Thomas Schwanitz Andrew Staricco, MD The Hon. George Steeh McLaren Macomb Foundation Board of Trustees Randy Pagel, Chairman Linda S. Adams, Vice Chair Madip Atwal, DO Rita Cavataio Tiffane Colombo Frank Henke Timothy Logan, DO Frank Maniaci Robbyn Martin James McQuinston, DO John Nori Mark O’Halla Carl Pesta, DO Steven Rybicki Grace Shore McLaren Macomb Volunteer Guild Officers Paul Palazzolo, Director Pam Berloski McLaren Medical Group Board of Trustees Philip Incarnati, Chairman Ed Abbott James Fitzgerald William Hardimon Donald Kooy David Mazurkiewicz Michael McKenna, MD Mark O’Halla David Frescoln William Hampton, MD William Henry, MD Philip Incarnati Tom Irwin Tom Moran Jim Shirilla, MD Ann Stallkamp David M. Zechman McLaren Northern Michigan Cheboygan Campus Guild Kathie Nihls, President Kathy Cell Bonnie Lorenz Jill Lutz Aurelia Tenerovicz McLaren Northern Michigan Foundation Board of Trustees Robert Schirmer, Chairman Patricia Anton Lawrence Buhl, Jr. (deceased) Sally Cannon, PhD David Corteville, MD Murray Cotter, MD, PhD Gay Cummings Stephen Eibling Matthew Frentz Elise Hayes Patrick Leavy Deborah Nachtrab Miriam Schulingkamp John Shevillo Tracy Souder Miles Trumble, MD Pamela Wyett David M. Zechman McLaren Oakland Board of Trustees The Hon. Leo Bowman, Chairman John Bueno Ralph Gilles Tony Hain Wendy Hemingway Jeff Love Mark O’Halla Allen Prince, DO Clarence Sevillian James Stepanski, DO McLaren Northern Michigan Board of Trustees Bob Foster, Chairman Dave Buzzelli H. Gunner Deery, MD Cindy Dickson 34 2 0 1 4 A n n u al R e p o r t McLaren Riley Foundation Board of Trustees Tressa Gardner, DO, Chairperson Jackie Buchanan Laura Clark-Brown Charles Hall Christopher Johnston Diana Jones Rick Laney Forrest Milzow William Price Barbara Whittaker McLaren Port Huron Board of Directors Mona Armstrong, Chairperson John Ogden, Vice Chair Glenn Betrus, MD John Brooks, MD F. William Coop, MD Thomas DeFauw Philip Incarnati David Keyes James Larsen Richard Levielle Janet Lomasney, OD David Mazurkiewicz Bassem Nasr, MD Janice Rose David Thompson Karl Tomion David Tracy, MD Suresh Tumma, MD David Whipple McLaren Port Huron Foundation Board of Directors James Larson, Chairman Linda Finnegan, Vice Chair Cynthia Ainsworth Greg Busdicker Brandi DeBell Brian Duda Ross Green Cynthia Nunn Brian Oberly Wendy Thompson Gary Trump Ernest Werth Jeffrey Wine Meredith Wirtz McLaren Port Huron Auxiliary Board of Directors Mary Lou Kraft, President Sue Barbe, Vice President McLaren Port Huron Marwood Nursing & Rehab Board of Directors Michael Turnbull, Chairman Bethany Belanger Edmond Fitzgerald, MD John Jarad, MD Geoffrey Kusch, MD Susan Meeker, RN The Hon. John Monaghan Franklin Mortimer Michael Vinckier Regional EMS Board of Directors Greg Lane, Chairman Greg Beauchemin Gerson Cooper David Mazurkiewicz Thomas Mee Thomas Mee President/CEO McLaren Greater Lansing Administration McLaren Health Care Philip Incarnati President and Chief Executive Officer Gregory Lane Senior Vice President and Chief Administrative Officer David Mazurkiewicz Senior Vice President and Chief Financial Officer Michael McKenna, MD Executive Vice President and Chief Medical Officer Mark O’Halla Executive Vice President and Chief Operating Officer William Peterson Vice President of Human Resources Ronald Strachan Chief Information Officer Kevin Tompkins Vice President of Marketing Karmanos Cancer Hospital Margaret Dimond, PhD President and Chief Executive Officer Kathleen Carolin, RN Senior Vice President of Ambulatory and Support Services Karen Goldman, RN, MSN, AOCN Chief Nursing Officer and Senior Vice President of Cancer Patient Services Allison Martin Vice President of Compliance and Regulatory Affairs Philip Philip, MD, PhD Vice President of Medical Affairs George Yoo, MD Chief Medical Officer Karmanos Cancer Institute Gerold Bepler, MD, PhD President and Chief Executive Officer Carol Christner Director of Government Relations Connie Claybaker Associate Center Director of Research Administration David Jansen Vice President of Human Resources Nick Karmanos Senior Vice President of Institutional Relations Justin Klamerus, MD, MMM Chief Quality Officer and Executive Vice President of Community Based Cancer Programs Scott McCarter Chief Information Officer Pamela Mollan Interim Chief Financial Officer Linda Remington Executive Director of Marketing and Communications Ann Schwartz, PhD, MPH Deputy Director and Executive Vice President of Research and Academic Affairs George Yoo, MD Physician-in-Chief McLaren Bay Region Alice Gerard President and Chief Executive Officer Stephen Scannell Chief Financial Officer Carolyn Potter Vice President of Human Resources Magen Samyn Vice President of Marketing/Public Relations Jay Summer, MD Vice President of Medical Affairs Ellen Talbott Vice President of Patient Care Services McLaren Bay Special Care Cheryl Burzynski President McLaren Central Michigan William Lawrence President and Chief Executive Officer Gerad Theriac Chief Financial Officer Sheri Underwood Vice President Patient Care Services Carolyn Potter Vice President of Human Resources Joyce Schafer Director of Risk and Corporate Compliance Mike Terwilliger Vice President Facilities and Support Services Jennifer White Vice President of Marketing and Physician Services Sheila Kress MMG Operations Manager McLaren Flint Donald Kooy President and Chief Executive Officer Roxanne Caine Vice President of The McLaren Foundation Cheryl Ellegood Vice President of Business Development and Clinical Services Rachelle Hulett Vice President of Human Resources Diane Kallas Vice President of Nursing Services Brent Wheeler Vice President of Ancillary and Support Services Jason White, MD Vice President of Medical Affairs Rick Wyles Vice President of Finance and Chief Financial Officer McLaren Greater Lansing Thomas Mee President and Chief Executive Officer Floyd Chasse Vice President of Human Resources Linda Peterson, MD Chief Medical Officer Dale Thompson Chief Financial Officer McLaren Health Plan Kathy Kendall President and Chief Executive Officer Beth Caughlin Vice President of Health Services Kathleen Kudray, DO Chief Medical Officer Teri Mikan Vice President and General Counsel Carol Solomon Vice President, Chief Financial and Operating Officer McLaren Homecare Group Steven Serra President and Chief Executive Officer Paul Belonga Vice President Laboratory Dan Gillett Vice President of Homecare, Hospice and Integration Carla Henry Vice President of Human Resources Mark McPherson Vice President and Chief Financial Officer Jennifer Anderson Director of Customer Service Homecare Support Wendy Dupuy Director of Home Care Operations Susan Penl Director of Hospice Operations McLaren Lapeer Region Barton Buxton President and Chief Executive Officer Mary Beth Callahan Chief Financial Officer Amy Dorr Vice President of Human Resources Jeffery Euclide Chief Nursing Officer and Vice President of Patient Care Gary Salem, DO Vice President of Medical Affairs Susan Perry-Nolte Marketing Director McLaren Macomb Tom Brisse President and Chief Executive Officer Chris Candela Chief Operating Officer Andrea Phillips, RN, MS Chief Nursing Officer Laura Gibbard Vice President of Human Resources David Pinelli, DO Vice President of Medical Affairs, Chief Medical Officer Sharyl Smith Vice President of Marketing, Planning and Public Relations Damon Sorensen Vice President and Chief Financial Officer McLaren Medical Group William Hardimon President and Chief Executive Officer Robert Guha Vice President and Chief Financial Officer Carla Henry Vice President of Human Resources M c L a r e n H e alt h C a r e 35 McLaren Northern Michigan David M. Zechman, FACHE President and Chief Executive Officer David Bellamy Chief Financial Officer Mary-Anne Ponti Chief Operating Officer Jennifer Woods Vice President and Chief Nursing Officer Kirk Lufkin, MD Vice President of Medical Affairs Gene Kaminski Vice President of Human Resources Moon Seagren Foundation Chief Development Officer McLaren Oakland Clarence Sevillian President and Chief Executive Officer Steven Calkin, DO Vice President of Medical Affairs Michele Carey, RN Vice President of Nursing Fred Korte Chief Financial Officer McLaren Port Huron Thomas DeFauw President and Chief Executive Officer David McEwen Vice President Operations John Liston Vice President Finance and CFO Jennifer Montgomery Vice President Nursing and Clinical Services Doris Seidl Vice President Human Resources Michael Tawney, DO Vice President of Medical Affairs McLaren Port Huron Marwood Nursing & Rehab Brian Oberly Administrator Regional EMS Keith Hart Operations Manager Harold McNew Operations Supervisor 36 Medical Executives Karmanos Cancer Institute President Elisabeth Heath, MD President-Elect Sandeep Mittal, MD Secretary-Treasurer Amy Weise, DO Members At Large Abhinav Deol, MD Natasha Robinette, MD Department Chairmen Anesthesiology Samir Fuleihan, MD Cancer Rehabilitation Lawrence Horn, MD Cardiology Brian Ference, MD Dermatology Darius Mehregan, MD Diagnostic Radiology Sharon Helmer, MD Hematology-BMT Joseph Uberti, MD Infectious Diseases Pranatharthi Chandrasekar, MD Medical Laboratory Dennis Spender, MD Medical Oncology Antoinette Wozniak, MD Medicine Jack Sobel, MD Neurosurgery Murali Guthikonda, MD Obstetrics-Gynecology Elizabeth Puscheck, MD Ophthalmology Mark Juzych, MD Orthopedics Lawrence Morowa, MD Otolaryngology Ho-Sheng Lin, MD Pathology Wael Sakr, MD Psychiatry Richard Balon, MD Pulmonary and Critical Care Ayman Soubani, MD Radiation Oncology Harry Kim, MD Surgical Oncology Steve Kim, MD 2 0 1 4 A n n u al R e p o r t Thoracic Surgery Frank Baciewicz, MD Urology Michael Cher, MD McLaren Bay Region Chief of Staff Mark Komorowski, MD Immediate Past Chief Japhet Joseph, MD Vice Chief of Staff Jonathan Abramson, MD Secretary-Treasurer Scott Vandenbelt, MD Utilization and Record Management Committee Chairman Valluru Reddy, MD Practitioner Excellence Committee Chairman Christopher Bruck, MD Quality Council Chairman Scott Vandenbelt, MD Secretary-Treasurer Jerry Elliot, MD Members At Large Brian Doughty, MD Constanza Fox, MD Michael Gross, MD Robin O’Dell, DO Department Chairmen Anesthesiology Michael Gross, MD Ambulatory Medicine Daniel Wilkerson, MD Department Chairmen Anesthesia Prem Kundi, MD Cardiac Services Subbarao Chavali, MD Diagnostic Imaging Bassam Daghman, MD Emergency Services Kenneth Parsons, MD Family Practice Sheryl Hasegawa, DO Internal Medicine Saad Ahmad, MD Neurosciences Srinivasachari Chakravarthi, MD Obstetrics-Gynecology Douglas Saylor, MD Ophthalmology-Otolaryngology Scott Baker, MD Orthopedic Surgery Branislav Behan, MD Pediatrics Dariusz Balinski, MD Psychiatry Mukesh Lathia, MD Surgery Richard Rahall, DO McLaren Central Michigan Chief of Staff Charles Lilly, MD Albert Przybylski, DO Family Medicine McLaren Macomb Diagnostic Imaging Surender Kurapati, MD Family Practice Nisha Vashishta, MD Internal Medicine Ashok Vashishta, MD Obstetrics-Gynecology Michael Swirtz, MD Pediatrics Bhekumusa Msibi, DO Surgery Kent Kirby, MD McLaren Flint Chief of Staff Devinder Bhrany, MD Immediate Past Chief Jagdish Bhagat, MD Vice Chief of Staff Michael Mueller, MD Secretary-Treasurer Sukamal Saha, MD Members At Large Jami Foreback, MD Linda Lawrence, MD David Wiese, MD Department Chairmen Anesthesiology Jeffrey Smith, DO Venkata Kilaru, MD Emergency Medicine Raymond Rudoni, MD Jodi Ralston, MD Family Practice Paul Lazar, MD Ronald Hunt, MD Internal Medicine T. Trevor Singh, MD James Vyskocil, MD Obstetrics-Gynecology Alexey Levashkevich, MD Nita Kulkarni, MD Orthopedic Surgery Norman Walter, MD Sidney Martin, MD Pathology David Wiese, MD Aamir Ahsan, MD Pediatrics Kenneth Vobach, MD Physical Medicine Ed Atty, MD James Stathakios, Jr., MD Psychiatry K. V. Mathew, MD James Aills, MD Radiology Christopher Conlin, MD Edmund Louvar, MD Radiation Oncology Hesham Gayar, MD Jack Nettleton, MD Surgery Frederick Armenti, MD Michael Mueller, MD Division Chiefs Internal Medicine Department Allergy Fikria Hassan, MD Cardiology James Chambers, DO Dermatology Vacancy Endocrinology Jamal Hammoud, MD Gastroenterology Sunil Kaushal, MD General Internal Medicine Shady Megala, MD Hematology-Oncology Madan Arora, MD Infectious Diseases Gregory Forstall, MD Nephrology Nabil Zaki, MD Neurology Jaime Ballesteros, MD Pulmonary Diseases Piyush Patel, MD Rheumatic Diseases Ali Karrar, MD Division Chiefs Surgery Department General Surgery Sukamal Saha, MD Neurological Surgery Hugo Lopez-Negrete, MD Ophthalmology Frederick Bruening, MD Oral Surgery Vacancy Otolaryngology Vacancy Plastic Surgery William Thompson, Jr., MD Thoracic Surgery Anup Sud, MD Urology Stephen Wang, MD Vascular Surgery Robert Molnar, MD McLaren Greater Lansing Co-Chiefs of Staff David Boes, DO Sadiq Syed, MD Immediate Past Chief Joseph Kozlowski, DO Co-Chiefs of Staff Elect J. Wesley Mesko, MD Mia Michelena, DO Secretary John Flood, DO Treasurer John Throckmorton, DPM Members At Large David Detrisac, MD Michael Kowalczyk, DO Scott Plaehn, DO Michael Winkelpleck, DO MSU-COM Representative Dean William Strampel, DO Medicine Muhammad Kashlan, MD Medicine QM Chair Vishnu Sharma, MD Neurosurgery Moses Jones, MD Surgery Sabry Mansour, MD McLaren Macomb Chief of Staff Andrew Starrico, MD Immediate Past Chief Bernadette Gendernalik, DO Vice Chief of Staff James Larkin, DO Anesthesiology James Jordan, DO EENT&PS David DeMello, DO Department Chairmen Anesthesiology Dana Duren, DO Cardiology Chad Link, DO Emergency Medicine Robert Orr, DO Family Practice Kashmira Chinoy, MD Internal Medicine Aaron Bohrer, DO Obstetrics-Gynecology Robert Seiler, DO Orthopedics Charles Taunt, DO Michael Shingles, DO Pathology Neil Caliman, MD Pediatrics and Adolescent Medicine Abdalla Abdalla-Ali, MD Psychiatry Linda Peterson, MD Radiology Amy Federico, DO Surgery Jeffrey Deppen, DO McLaren Lapeer Region Chief of Staff Kevin Carter, DO Department Chairmen Anesthesia Baher Boctor, MD PQPRC Kenneth Tarr, DO ED Section Chair and Credentials Chair Brad Blaker, DO Family Practice Christopher Steinacker, DO Sheri Underwood, RN, BSN, MSN Vice President, Patient Care Services McLaren Central Michigan M c L a r e n H e alt h C a r e 37 Emergency Medicine James Larkin, DO Family Practice Walter Klimkowski, MD Internal Medicine Richard Reece, DO Obstetrics-Gynecology Thomas Alderson, DO Orthopedic Surgery James Kehoe, DO Pathology Monroe Adams, DO Pediatrics Hassan Hasaba, MD Radiology Karl Doelle, DO Surgery Michael D’Almedia, DO McLaren Medical Group Michael McKenna, MD Geoffrey Linz, MD Ronald Shaheen, DO Preston Thomas, MD Ashok Vashishta, MD Michael Ziccardi, DO Physician Liaisons Wafa Abbud, MD James Brouillette, MD Stanley Conhon, MD Craig Duncan, DO John Everett, DO Mark Ginther, MD Brian Glenn, DO Joseph Metz, MD Jennifer Rise, DO Sandra Russell, DO Pooja Tangri, MD Timothy Wellemeyer, MD Chong Yi, MD McLaren Northern Michigan Chief of Staff William Henry, MD Chief of Staff Elect William Hampton, MD Members At Large John Everett, DO William Heise, MD Zachary Horton, MD David Knitter, MD Mark McMurray, MD JD Talbott, DO Medical Staff Quality Committee Brian Gelb, MD Credentials Committee Marc Feeley, MD Medicine Eric Basmaji, MD Surgery Daniel O’Donnell, DO McLaren Oakland President of Professional Staff Mark Schury, DO Secretary-Treasurer Paul Urbanowski, DO Department Chairmen Anesthesiology Paul Urbanowski, DO Bio-Ethics Kenneth Richter, DO Cardiology Mark Stuart, DO Credentials Craig Magnatta, DO Critical Care Scott Simecek, DO Family Practice Robert Basak, DO Internal Medicine Stephen Clyne, MD Medical Education Jo Ann Mitchell, DO Mortality Review Lisa Kaiser, DO OMT Committee Mary Goldman, DO Orthopedic Michael Fugle, DO Otolaryngology Gary Kwartowitz, DO Pathology David Wiese, DO Radiology Mahmood Khalid, MD Surgery John Ketner, DO Trauma David Foster, DO Utilization Review Harrison Tong, DO McLaren Port Huron Chief of Staff David Tracy, MD Vice Chief of Staff Suresh Tumma, MD Secretary-Treasurer Glenn Betrus, MO Department Chairmen Carol Fischer, DO Obstetrics-Gynecology McLaren Macomb 38 2 0 1 4 A n n u al R e p o r t Anesthesiology Harpreet Singh, MD Cardiovascular Surgery Vernon Dencklau, DO Emergency Medicine Christopher Hunt, MD Family Practice Beau Dowden, MD Internal Medicine Ali Haidar, MD Obstetrics-Gynecology Kathleen Fabian, DO Pathology Lisa Geffros, MD Pediatrics Sarah Pasia, DO Psychiatry Robert Bauer, DO Radiology David Tracy, MD Surgery Christopher Beck, DDS McLaren Port Huron Marwood Nursing & Rehab Medical Director John Jarad, MD Kenneth Parsons, MD, MPH Medical Director, Emergency Medicine McLaren Bay Region Moses Jones, MD, FACS Medical Director, Neurosurgical Services McLaren Lapeer Region 3235 Beecher Road Flint, Michigan 48532-3985 810.342.1100 | McLaren.org