#HASummit14 Session #21: Multicare: Organizing for Accountable Care and Population Health Christopher Kodama, MD Christi McCarren, RN, MBA Pre-Session Poll Question On a scale of 1-5, how would you rate your healthcare organization’s preparedness for accountable care and population health? 1)Not at all ready 2)Somewhat ready 3)Moderately ready 4)Very ready 5)Extremely ready 6)Unsure or not applicable

#HASummit14 About the Organization 2 Not-for-profit healthcare organization Addressing accountable care and population health 10,000+ employees 500,000+ patients 1188 providers 1.4B revenue

#HASummit14 Once Upon a Time… 3 Delivery System Delivery System Value-based Reimbursement Operational Efficiency Consumer Expectations

#HASummit14 MultiCare Clinical Integration Network 4 Regence Contract MultiCare Connected Care Network Premera Boeing Contract United Contract Humana Plan Sponsor Contract Value Creation

#HASummit14 Our Approach and Results 5

#HASummit14 Focus and Prioritization 6 Internal Opportunity Existing VBP Obligations Potential Purchaser Priorities Collaboratives

#HASummit14 Clinical Collaboratives 7 Design and Deploy Empower Measure Improve Physician-led Evidence- based Multi- disciplinary Dedicated resources

#HASummit14 The Collaborative Journey 8

#HASummit14 MultiCare Collaboratives 9 Systemwide Anesthesia Committee (SWAC) Medical Value Program (MVP) Critical Care Collaborative Women’s Collaborative Surgery Collaborative Medicine Collaborative Cardiac Collaborative Pediatric Collaborative SepsisRespProningEarly Mobility OBGyn Ortho JointsColon Spine (Surgical) Glycemic Control PneumoniaCOPDSpirometry Spine (Acute BP) Heart FailureAMICAB TBD Supported by Program Manager Supported by Coordinator

#HASummit14 Sepsis – In Process Measures 10

#HASummit14 CHF– In Process Measures 11

#HASummit14 CHF– In Process Measures 12 By Provider Type By Facility

#HASummit14 Poll Question #2 13 On a scale of 1-5, how effectively is your organization using healthcare analytics to support accountable care and population health? 1)Not at all effective 2)Somewhat effective 3)Moderately effective 4)Very effective 5)Extremely effective 6)Unsure or not applicable

#HASummit14 Results 14 65% Decrease in mortality rate from 15-17% to 7-8% Sepsis 22%37% Heart Failure Pneumonia Decrease in 30-Day all-cause CHF readmission rate from 25.4% to 20-21% Reduction in pneumonia readmissions

#HASummit14 Results 15 50% Labor and Delivery 71% Total Joint Surgery Colon Surgery 21.8% Reduction in median LOS for elective colon surgery Reduction below target in readmission rates for elective colon surgery patients 18.8% Reduction below target in readmission rates for total joint surgery patients Elimination of vaginal deliveries with LOS > 4 days and reduction in C-section deliveries with LOS > 6 days

#HASummit14 Future Plans 16 Renew focus on service and cost, in addition to clinical improvement Develop a greater partnership with emergency services and the post-acute realm, in order to spread the effects of improvement efforts to impact more of the patient care continuum Increase MultiCare’s flexibility to respond to a rapidly changing market

#HASummit14 Lessons Learned 17 1.Involve physicians early in the analytic design and implementation effort 2.Do not let a desire for perfection be the enemy of good; it will stand in the way of progress 3.Understand the importance of effective change management 4.Effective leadership from the top is critical

#HASummit14 Analytic Insights A Questions & Answers 18

#HASummit14 Choose one thing… 19 What one thing (or more) can you do differently after hearing this presentation?

#HASummit14 Thank You 20

#HASummit14 21 Session Feedback Survey 1.On a scale of 1-5, how satisfied were you overall with this session? 1)Not at all satisfied 2)Somewhat satisfied 3)Moderately satisfied 4)Very satisfied 5)Extremely satisfied 2.What feedback or suggestions do you have?

#HASummit14 Upcoming Sessions Breakout Sessions – Wave 4 (1:15 PM – 2:00 PM) 26)Panel – How Community Hospitals Thrive with Analytics John Wadsworth, Vice President, Technical Operations, Health Catalyst 27)Quality Improvement in Healthcare: An ACO Palliative Care Case Dr. Robert Sawicki, MD, Senior Vice President, Supportive Care, OSF Healthcare Roopa Foulger, Executive Director, Data Delivery, OSF Healthcare Linda Fehr, RN, Division Director, Supportive Care, OSF Healthcare 28)Clinical Standards Work To Improve Evidence-Based Care Delivery: A How-To Workshop Charles Macias, MD, MPH, Chief Clinical Systems Integration Officer, Texas Children’s Hospital Terri Brown, MSN, RN, CPN, Assistant Director, Clinical Outcomes & Data Support; Research Specialist, Center for Research and EBP, Texas Children’s Hospital 29)Five Months to Improvement: How Stanford Built an Improvement Program the Gets Results Spencer H. Kubo, MD, Associate Professor of Radiology (Pediatric Radiology), Stanford University Medical Center 30)Breaking Down Silos: Resolving Academic, Medical, and Research Interests Once and for All Samuel L. Volchenboum, MS, MD, PhD, Assistant Professor of Pediatrics, Director, Informatics Program, The University of Chicago Medicine) 22 Location Imperial Ballroom B Imperial Ballroom A Grand Salon Murano Venezia