Tulare Regional Medical Center

Agenda Key data Why change is necessary Ideal solutions Conclusion

Key Data 112 bed, acute-care hospital 3 Rural Health Clinics, 2 more clinics opening Medical tower expansion Significant growth potential

Service Area Demographics Population estimate: 171, 438 Average age: % Hispanic High poverty rates

Why Change is Necessary Lack of physician alignment Quality perception Disproportionate market share Current payer mix

Physician Alignment To remain competitive, physicians must be fully integrated into TRMC

Perceived Lack of Quality HCAHPS lower than state and national averages HCAHPS lower than Kaweah Delta Medical Center in almost every category Metric TRMCKaweah Delta Patients who would definitely recommend hospital 50%69% Patients who reported area around their room was always quiet at night 37%50%

TRMCs Current Market Share 80% of patients participate in government insurance programs 45% Medi-Cal Poor quality perception is hurting patient retention Potential patients directed elsewhere

Key Operating Indicators TRMC2010 OSHPD Net Rev/APD1,9463,124 Supply/APD Labor/APD7301,590 Total/APD1,9153,082

Ideal Solutions Physician alignment

Renegotiate Physician Contracts Business development and physician communication What do they want? What do competitors offer? Sizeable share of the newly insured PPACA will increase commercial payers Focus on community needs

Optimize TRMCs Clinic Network Maintain 3 Rural Health Clinics and (d) clinics RHCs Higher Medi-Cal reimbursement rates PPACA increasing Medi-Cal rates Patient access to care Specialized care for the population

Optimize TRMCs Clinic Network 1206(d) Clinics Hospitals Higher Medicare reimbursement rates % Increased patient base Reinforce physician-TRMC alignment efforts Inpatient referrals

Optimize TRMCs Clinic Network Physicians No overhead, focus on patients New technology Community Increase quality perception Bring access to health care Programs for elderly

Establish Medical Foundation Key component of physician alignment Will help facilitate recruiting and retention PPACA influential in the move toward collaborative care

Conclusion Physician alignment with TRMC Care for population health needs Funnel patients to TRMC main campus Increase revenue generation 1206(d) and rural clinics are a first effort toward long-term Foundation goals

Mission Statement A patient-centered organization that sets the standard for patient experience and quality of care by pushing the boundaries of technology in service to our community.

References Abbott, D. (2009, March 12). Healdsburg hospital to partner with primary care. Sonoma West Times and News. Retrieved from Kaweah Delta Health Care District. (2012). Kaweah Delta welcomes second neonatologist to NICU. Retrieved from news/view_details.asp?newsid=221 Mineful Demographics. (2010). Tulare household income. Retrieved from Tulare_County_CA_income_ignore.html Schiff, A. (2010). Hospital outpatient clinics--legal considerations impacting physicians. Retrieved from Studer Group. (2012). About Studer Group. Retrieved from Taylor, M. (2006). Californias health care districts. Retrieved from

References Tulare County Association of Governments. (2008). Tulare county. Retrieved from Tulare Regional Medical Center. (2012). Tulare Regional Medical Center. Retrieved from U.S. Department of Health and Human Services. (2006). Comparison of the rural health clinic and federally qualified health center programs. Retrieved from rhccomparison.pdf U.S. Department of Labor. (n.d.). General facts on women and job based health. Retrieved from fshlth5.html U.S. House of Representatives. (2010). Compilation of patient protection and affordable care act. Retrieved from energycommerce/ppacacon.pdf Weekly Probe. (2011). Hospitals use focus group to drive changes to surgical procedures. Retrieved from hospital-uses-focus-group-to-drive-changes-to-surgical-procedures/