1. National Stage for IHS Innovation Aligning IHS Strategic Initiatives with Federal Payment Reform Opportunities

2. Payment Reform Mechanisms Federal Overview Sabra Rosener, Vice President, Government Relations Iowa Health System

3. HEALTH REFORM - PASSAGE Patient Protection and Accountable Care Act Passed in 2010 with a Democratic majority Contains many topics, including payment reform and insurance mandates Many provisions had delayed effective dates Not all provisions were funded

4. HEALTH REFORM - NOTABLE PROVISIONS

5. HEALTH REFORM

7. CMMI

9. IHS LONG-TERM STRATEGIC PLAN

10. IHS ROADMAP TO INTEGRATION Physician Alignment Clinical integration Employed physician integration Physician Leadership Academy Create Value Advanced Medical Team HealthNet connect Standardization Demonstrate Value IHS Employee Health Plan Measure outcomes Development of Attribution Model Value-Based Contracting ACO Readiness Bend the cost curve Tiered contracting

11. IHS INITIATIVES MIRROR NATIONAL IDEAL

12. IHS STRATEGIC INITIATIVES

13. Partial Capitation FORT DODGE PAYMENT REFORM PROJECT Sue Thompson, President / CEO Trinity Health Systems

14. FORT DODGE - PARTIAL CAPITATION

15. FORT DODGE – ACO SERVICE AREA

16. FORT DODGE - PARTNERS

17. FORT DODGE – STRATEGIC PARTNERS

18. FORT DODGE – PAYER ENGAGEMENT

19. FORT DODGE – CLINICAL INNOVATION

20. FORT DODGE – QUALITY INITIATIVES

23. DES MOINES - BUNDLED PAYMENTS

24. DES MOINES – RATIONALE FOR FOCUS

25. DES MOINES – PROJECT SERVICE AREA

26. DES MOINES - PARTNERS

27. DES MOINES – PAYER ENGAGEMENT

28. DES MOINES – PROJECT INNOVATION

29. DES MOINES – QUALITY INITIATIVES