1. www.prohealthmd.com How to Achieve Cost Savings and Patient Satisfaction Through Clinical Best Practices James Cox-Chapman, MD February 18, 2015 1

2. Today’s Presenter James Cox-Chapman Senior Vice President and CMO ProHealth Physicians

3. Introduction to ProHealth Physicians The Path to Proactive Risk Management Strategy for Change Designing the Program The Experience Results Impact Today’s Discussion 3

4. Founded in 1997 Largest physician-owned healthcare delivery system in Connecticut 95 practices Over 350 providers Cares for over 10% of state population Introduction to ProHealth Physicians 4

5. Alarming increases in claim frequency and severity Significant increases in PL premiums – In danger of being dropped by carrier – Threat to expansion plans / ability to attract new groups Patient satisfaction not part of culture Clear need for decisive action The Path to Proactive Risk Management 5

6. Create a risk management committee Identify issues – Perform baseline assessments – Analyze claims Create an action plan – Develop a risk education program Ensure success – Gain physician buy-in Share claims experience and educate on necessity – Develop an incentive program to ensure compliance Premium rebates – Failure was not an option Strategy for Change 6

7. Annual themes – Enable team to focus on risk priorities Multi-modality approach – Combination of live and online learning to reinforce annual themes – Analysis of actual malpractice cases – Interactive sessions, not just lectures and recordings Audits and measurement – Track compliance – Track reactions to program – Track behavior change Designing the Program 7

8. Reluctance to change Skeptical of need / value of program Initial sessions were confrontational The Experience: A Painful Start 8

9. By 2011, 99% of participants requested that the program be held every year Physicians requested that program be extended to the entire staff Achieved culture change (2 to 3 years) Strong impact on financial health Strong impact on patient satisfaction Ability to respond quickly to threats The Experience: Ten Years Later 9

10. Results 10 Risk management intervention 82% reduction

11. Results 11 Risk management intervention 82% reduction

12. Results 12 69% reduction

13. Compliance of best practices in colorectal screening during well visits was identified as a problem area Our 2008 risk education program specifically targeted failure to diagnose colorectal and breast cancer Example: Ability to Respond to Threats 13 2007 2008

14. Example: Ability to Respond to Threats 14 Best Practices Compliance Colorectal screening during health maintenance visits Risk management intervention Poor performance of best practices increased to 99% compliance 2010

15. Example: Ability to Respond to Threats 15 Best Practices Compliance Colorectal screening during health maintenance visits EHR Implementation With EHR implementation, compliance plummeted 2011

16. With risk management audits and infrastructure in place, and with a strong, patient-centric culture: – The problem was immediately exposed – We were able to immediately react – The problem was proactively solved before adverse events occurred Example: Ability to Respond to Threats 16

17. Example: Ability to Respond to Threats 17 Best Practices Compliance Colorectal screening during health maintenance visits EHR ImplementationRisk management intervention

18. Improved patient communication Improved patient follow-up Improved perception of care received Greater focus on quality measures Reduced number and severity of incidents Improved patient safety leads to improved patient satisfaction Impact 18

19. Questions? 19

20. Thank You! 20