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Marketplace Collaboratives
Better, Faster and More Affordable Robert S. Mecklenburg , MD Center for Healthcare Solutions at Virginia Mason © 2010 Virginia Mason Medical Center
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The Sensei and the Waiting Room
© 2010 Virginia Mason Medical Center
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Health care is unaffordable.
The Problem Health care is unaffordable. © 2010 Virginia Mason Medical Center
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Wasted Healthcare Dollars
Unnecessary waits and delays Reduce efficiency Non-value-added variation in content of care Reduces effectiveness © 2010 Virginia Mason Medical Center
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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
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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
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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
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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
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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
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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
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What Lean Looks Like To VM Providers
1. Home for dinner with better economics... © 2010 Virginia Mason Medical Center
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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
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Scalable and Transportable
Another market. Another Collaborative. © 2010 Virginia Mason Medical Center
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The obstacle is the path.
- Zen aphorism © 2010 Virginia Mason Medical Center
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