IHI Expedition Expedition: Preparing Care Teams for Bundled Payments - PDF document

4/7/2015 April 7, 2015 Begins at 1:00 PM ET IHI Expedition Expedition: Preparing Care Teams for Bundled Payments Session 2: Building a Care Bundle Nick Bassett, MBA Trisha Frick, MS, RN Lucy Savitz, PhD, MBA Molly Bogan, MA Today’s Host 2 Akiera Gilbert Project Office Assistant Institute for Healthcare Improvement 1

4/7/2015 3 Phone Connection (Preferred) To join by phone : 1) Click on the “Participants” and “Chat” icons in the top right hand side of your screen. 2) Click the button on the right hand side of the screen. 3) A pop-up box will appear with the option “I will call in.” Click that option. 4) Please dial the phone number , the event number and your attendee ID to connect correctly . 4 WebEx Quick Reference • Please use chat to “ All Participants ” for questions Raise your hand • For technology issues only, please chat to “ Host ” Select Chat recipient Enter Text 2

4/7/2015 Chat 5 Name and the Organization you represent Example: Sam Jones, Midwest Health Please send your message to All Participants 5 6 Expedition Director Molly Bogan, MA Director Institute for Healthcare Improvement 3

4/7/2015 7 Expedition Objectives At the end of this Expedition, participants will be able to: Describe the benefit of transitioning to a value-based purchasing model Understand and apply activity-based cost accounting methodology to at least one care process Demonstrate examples of how to engage stakeholders in building a bundle Describe how to customize care team redesign to deliver optimum care under value-based purchasing Today’s Agenda 8  Introductions  Session 1 Action Period Assignment Debrief  Building a Care Bundle  Action Period Assignment  Closing 4

4/7/2015 9 Expedition Sessions Session 1: Volume to Value; Describe the benefit of transitioning Value- Based Purchasing Lead Faculty: Lucy Savitz & Trisha Frick Session 2: Getting Started with Building a Care Bundle Lead Faculty: Trisha Frick & Nick Bassett Session 3: Collecting Data Using Activity-based Costing Lead Faculty: Nick Bassett & Lucy Savitz Session 4: Engaging Stakeholders in Bundle Design Lead Faculty: Trisha Frick Session 5: Care Team Redesign Lead Faculty: Trisha Frick Session 6: Case Study: CMS Bundled Payments for Care Improvement Experience Lead Faculty: Trisha Frick & Kathy Luther 10 Action Period Assignment Debrief • What patient population, procedure, or episode of care did you identify to test a bundled payment design? • What criteria did you use to select it? • Share with others using the chat to All Participants 5

4/7/2015 Chat 11 Please chat in the population or procedure you chose to test a bundled design & what criteria you used to select it. Please send your message to All Participants 11 12 Faculty Nick Bassett, MBA Trisha Frick, MS, RN Lucy Savitz, PhD, MBA Healthcare Assistant Director of Director of Research and Transformation Managed Care Education Manager Johns Hopkins Intermountain Healthcare Intermountain HealthCare LLC Salt Lake City, Utah Healthcare Glen Burnie, Maryland Salt Lake City, Utah 6

4/7/2015 IHI Expedition: Preparing Teams for Bundled Payments April 7, 2015 Webinar Trisha Frick, MS, RN Nick Bassett, MBA • Identify episodes to bundle Initiate • Identify available clinical champions • Identify payer partners Session 2 • Flowchart the episode across the continuum Create • Capture cost & revenue streams • Identify potential areas to eliminate waste • Run retrospective analysis to determine potential bottom-line impact Complete • Structure the feedback system for cost, quality and service metrics 7

4/7/2015 Common Guiding Principles for Identifying the Bundled Procedure • Balance: volume, cost and risk • Large variability • Acute vs. chronic episodes • Clearly understood patient population • Elective vs. emergent • Accessible data • Engaged providers Identifying an Available Clinical Champion • Practicing physician • Respected by their peers • Benchmark practice • Analytically minded • Early adopter • Strong relationships with key stakeholders • Passionate about their program David Jevsevar, MD, MBA 8

4/7/2015 Payer Partners • Government programs (BPCI) • Commercial Insurance • Direct-to-employer contracts • Claims data (data sharing agreements) • Other contracted groups 9

4/7/2015 Initiators for Bundled Rates • Physicians • Managed Care • Commercial Insurance • Direct-to-employer contracts • Government programs (BPCI) Assemble the Team • Clinical champion • Administrator • CMO • Front-line nurse(s) • Quality consultant • CFO/Analyst • Project Manager 10

4/7/2015 Components of Healthcare Costs Cost Processes Episodes Cost per Person Process Episode Person Costs for a # lab tests with # TKRs single lab test a TKR Flowchart the Processes in the Episode Determine the scope of the bundle BPCI Example 11

4/7/2015 Flowchart the Processes in the Episode Begin with front-line staff Flowchart the Processes in the Episode Establishing Baselines • Create or refine the existing CPM (care delivery baseline) • Identify and approve quality metrics • Determine the costs associated with the outlined processes 12

4/7/2015 Various types of Data • Claims data • Clinical (EMR) data • Manually collected data • Costing (chargemaster) data (will be discussed next time) 26 Questions/Discussion Raise your hand Use the chat 13

4/7/2015 Action Period Assignment • Focus on population or episode of care identified in Session One • Assemble the team using the members identified in slide 20 • Flowchart out at least one sub-process in the episode selected. 28 Expedition Communications • All sessions are recorded • Materials are sent one day in advance • Listserv address for session communications: bundledpaymentexp@ls.ihi.org • To add colleagues, email us at info@ihi.org 14

4/7/2015 29 Session 3 Collecting Data Using Activity-Based Costing Nick Bassett, MBA Lucy Savitz, PhD, MBA Healthcare Transformation Director of Research and Manager Education Intermountain Healthcare Intermountain Healthcare Salt Lake City, Utah Salt Lake City, Utah Tuesday, April 21 st , 1:00 – 2:00 PM ET Thank You! 30 Please let us know if you have any questions or feedback following today’s Expedition webinar. Director: Molly Bogan Akiera Gilbert mbogan@ihi.org agilbert@ihi.org 15