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

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IHI Expedition

Expedition: Preparing Care Teams for Bundled Payments Session 2: Building a Care Bundle April 7, 2015 Nick Bassett, MBA Trisha Frick, MS, RN Lucy Savitz, PhD, MBA Molly Bogan, MA

Begins at 1:00 PM ET

Today’s Host

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Akiera Gilbert

Project Office Assistant Institute for Healthcare Improvement

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Phone Connection (Preferred)

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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

• n the right hand side of

the screen. 3) A pop-up box will appear with the option “I will call in.” Click that

• ption.

4) Please dial the phone number, the event number and your attendee ID to connect correctly .

WebEx Quick Reference

• Please use chat to

“All Participants” for questions

• For technology

issues only, please chat to “Host”

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Enter Text Select Chat recipient Raise your hand

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Chat

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Name and the Organization you represent Example: Sam Jones, Midwest Health

Please send your message to All Participants

Expedition Director

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Molly Bogan, MA

Director Institute for Healthcare Improvement

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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

• ne 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

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Today’s Agenda

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• Introductions
• Session 1 Action Period Assignment Debrief
• Building a Care Bundle
• Action Period Assignment
• Closing

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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

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Action Period Assignment Debrief

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• 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

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Chat

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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

Faculty

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Lucy Savitz, PhD, MBA Director of Research and Education Intermountain Healthcare Salt Lake City, Utah Trisha Frick, MS, RN Assistant Director of Managed Care Johns Hopkins HealthCare LLC Glen Burnie, Maryland Nick Bassett, MBA Healthcare Transformation Manager Intermountain Healthcare Salt Lake City, Utah

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IHI Expedition: Preparing Teams for Bundled Payments

April 7, 2015 Webinar

Trisha Frick, MS, RN Nick Bassett, MBA

• Identify episodes to bundle
• Identify available clinical champions
• Identify payer partners

Initiate

• Flowchart the episode across the continuum
• Capture cost & revenue streams
• Identify potential areas to eliminate waste

Create

• Run retrospective analysis to determine

potential bottom-line impact

• Structure the feedback system for cost, quality

and service metrics

Complete

Session 2

4/7/2015 8 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

4/7/2015 9 Payer Partners

• Government programs (BPCI)
• Commercial Insurance
• Direct-to-employer contracts
• Claims data (data sharing agreements)
• Other contracted groups

4/7/2015 10 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

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Components of Healthcare Costs

Cost per Person Cost Process Episode Processes Person Episodes Costs for a single lab test # lab tests with a TKR # TKRs Flowchart the Processes in the Episode Determine the scope of the bundle BPCI Example

4/7/2015 12 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

4/7/2015 13 Various types of Data

• Claims data
• Clinical (EMR) data
• Manually collected data
• Costing (chargemaster) data (will be discussed next

time)

Questions/Discussion

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Raise your hand Use the chat

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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.

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

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Session 3

Lucy Savitz, PhD, MBA Director of Research and Education Intermountain Healthcare Salt Lake City, Utah

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Tuesday, April 21st, 1:00 – 2:00 PM ET

Collecting Data Using Activity-Based Costing

Nick Bassett, MBA Healthcare Transformation Manager Intermountain Healthcare Salt Lake City, Utah

Thank You!

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Director: Molly Bogan mbogan@ihi.org Akiera Gilbert agilbert@ihi.org

Please let us know if you have any questions or feedback following today’s Expedition webinar.