1. 2012 ADEA DEANS CONFERENCE November 11, 2012

2. TODAY’S TOPICS  The Osteopathic Medicine model  Educational Convergence  Organizational Separation  The Accountable Care Model  Dentistry in Accountable Care

3. EDUCATIONAL CONVERGENCE Entering Credentials and Outcomes MCATGPAUSMLE 1USMLE 2CKUSMLE 2CS M.D.31.13.6794%97% D.O.26.53.5089%93% 1 IN 5 MEDICAL STUDENTS ARE NOW DO STUDENTS DO GRADUATES TRAIN IN BOTH ACGME AND OSTEOPATHIC RESIDENCY PROGRAMS VIRTUALLY INDISTINGUISHABLE IN PRACTICE

4. ORGANIZATIONAL SEPARATION  MOST DO PROGRAMS NOT IN UNIVERSITY WITH AN AHC  CLERKSHIPS AND ROTATIONS INCLUDE AHC, COMMUNITY AND SMALLER SITES, “NON-TEACHING HOSPITALS”  ALL DO PROGRAMS PARTICIPATE IN OPTI  OSTEOPATHIC POSTDOCTORAL TRAINING INSTITUTE  HOSPITAL PARTNERSHIP WITH DO SCHOOLS  CLINICAL RESEARCH COMPONENT  32% PRIMARY CARE – BOTH ACGME AND AOA PROGRAMS  DO PROGRAMS BUILDING RESIDENCY CAPACITY & INTEGRATING  ACGME AND AOA – JOINT GME SYSTEM – JULY 2015

5. SYSTEMIC CHANGE WILL AFFECT EVERYONE  STRESSED SYSTEM PUSHED TOWARD THE PRECIPICE OF CHANGE  FRAGMENTED AND COSTLY HEALTH CARE SYSTEM  ACADEMIC HEALTH CENTERS – ALREADY A PRE-EXISTING CONDITION  THE FISCAL CLIFF OF SEQUESTRATION  “ALL SIGNS POINT TO SIGNIFICANT PRESSURE ON HEALTH SYSTEM REVENUES OVER THE NEXT FIVE YEARS.” (D.F. EVANS)

6. ACCOUNTABLE CARE MODEL DISRUPTIVE OR DESTRUCTIVE CHANGE?  THE ACCOUNTABLE CARE CONCEPT  WELLNESS, PREVENTION, EARLY INTERVENTION AND INTEGRATED CARE WILL LEAD TO REDUCED COSTS AND IMPROVED HEALTH  PROVIDER GROUPS ASSUME RESPONSIBILITY  BUNDLE THE MONEY - GO… DO…

7. IMPLEMENTING THE ACCOUNTABLE CARE MODEL  GIVING THE GORILLA THE CHECKBOOK  A NEW MODEL REQUIRES AN INVESTMENT PHASE  PREVENTION, EARLY INTERVENTION AND WELLNESS WILL TAKE TIME  INTEGRATED HEALTHCARE RECORDS, DATA DRIVEN CARE AND INTERPROFESSIONAL PRACTICE MODELS WILL TAKE RESOURCES AND TIME  THE EXPECTATION OF IMMEDIATE COST SAVINGS  IT HAS TO COME FROM SOMEWHERE

8. DENTISTRY IN THE ACCOUNTABLE CARE WORLD  DENTISTRY - STRONG PREVENTION / EARLY INTERVENTION TRACK RECORD  DENTISTRY HAS HISTORICALLY BEEN LAST IN AND FIRST OUT OF THE PUBLIC HEALTHCARE FUNDING STREAM  PRELIMINARLY PLANS IN CA AND OR  LOOK ESSENTIALLY LIKE OTHER PUBLICLY FUNDED DENTAL CARE  BASIC LEVELS OF CARE, LOW LEVELS OF FUNDING  SIGNIFICANT QUESTIONS REMAIN UNANSWERED  BOTH POSITIVE AND NEGATIVE SCENARIOS

9. A FUTURE WITH MORE QUESTIONS THAN ANSWERS  THANK YOU