1. Marketplace Collaboratives
Better, Faster and More Affordable
Robert S. Mecklenburg , MD
Center for Healthcare Solutions at Virginia Mason
© 2010 Virginia Mason Medical Center

2. The Sensei and the Waiting Room
© 2010 Virginia Mason Medical Center

3. Health care is unaffordable.
The Problem
Health care is unaffordable.
© 2010 Virginia Mason Medical Center

4. Wasted Healthcare Dollars
Unnecessary waits and delays
Reduce efficiency
Non-value-added variation in content of care
Reduces effectiveness
© 2010 Virginia Mason Medical Center

5. Affordable Healthcare Requires
Providers producing quality
Payers reimbursing for quality
Purchasers buying quality
All three are essential for healthcare reform.
© 2010 Virginia Mason Medical Center

6. Doing the Right Thing A focus on conditions of high cost for employers
Back pain
Shoulder, knee and hip pain
Headache
Heart burn
Respiratory disorders
© 2010 Virginia Mason Medical Center

7. Doing Things Right A focus on employers’ definition of quality
Evidence-based care
100% patient satisfaction
Same-day access
Rapid return to work
Affordable price for employer and provider
© 2010 Virginia Mason Medical Center

8. Previous Pathway for Back Pain
PT visits
1-15
PCP
PCP
MRI
PCP
Neurosurg
Physiatry
TIME
Waits and delays
Waiting has indirect cost to employer of over $18/hr
Non value-added
Evidence-based value
© 2010 Virginia Mason Medical Center

9. Current Pathway for Back Pain
Spine
Clinic
Wait for appt
PT: 2.8 visits
Waits and delays
Non value-added
Evidence-based value
TIME
Waiting has indirect cost to employer of over $18/hr
© 2010 Virginia Mason Medical Center

10. Better, Faster, More Affordable
Better for patients
All patients have value-added PT; none have unnecessary imaging
4.9/5.0 patient satisfaction
Faster for patients, employers and providers
Patients and employers: half the work loss
Providers: twice the MD work units per day
More affordable for employers, providers and health plans
Purchasers: fewer office visits, less imaging and less work loss
Providers: more patients with lower cost of production per patient
© 2010 Virginia Mason Medical Center

11. What Lean Looks Like To VM Providers
1. Home for dinner with better economics...
© 2010 Virginia Mason Medical Center

12. What Lean Looks Like To VM Providers
2. …by providing health care in a different way
Delivering care from the patient’s perspective
Gaining reliability through systems
Providers create the system prospectively
Quality is built in and delays built out
“Mistake-proofed” processes replace inspection steps
Zero defects are adopted as performance standards
Creating a worksite that is efficient, effective and “visual”
© 2010 Virginia Mason Medical Center

13. Scalable and Transportable
Another market. Another Collaborative.
© 2010 Virginia Mason Medical Center

14. The obstacle is the path.
- Zen aphorism
© 2010 Virginia Mason Medical Center