1. Regional Outreach Challenges
Shaun Hernandez
University of Wisconsin
AASA National Conference
October 6, 2015

2. Overview
The Big Picture: The Wisconsin healthcare market and how UW Health fits in
Goals, Strategy, and Results: Leveraging Outreach to drive regional success
The Learning Curve: Challenges Faced

3. The Big Picture
The Wisconsin healthcare market and how UW Health fits in

4. The Wisconsin Healthcare Market
The Big Picture
Total Region Population =
6.8 Million

5. UW Health Has Concluded…
The Big Picture
UW Health Has Concluded…
Consolidation in the region is accelerating and UW Health must seek innovative partnerships to achieve the appropriate scale to create a vibrant clinical enterprise and support our academic mission
An effective population base of 2-3 million lives is necessary to effectively manage population health, support tertiary / quaternary service lines, and achieve academic goals
A multi-pronged approach is required to protect current markets while proactively seeking partners with access to new markets
Significant growth is required and focusing solely on local and ring markets will be insufficient
Our Focus is to Move From “Why” We Need to Grow to “How” and “With Whom”

6. The Wisconsin Healthcare Market
The Big Picture
Large, Established Systems Are Entrenched Across the Entire Region
Aspirus
140K
Marshfield/Ministry
500K
2-3 Million Lives = success
Bellin
106K
Problem: No one has this yet
Mayo
220K
ThedaCare
117K
Aurora
1.2M
Gundersen 135K
SSM
312K
Unity Point
1.2M
Froedtert
310K
UW Health
550K

7. Our Focus is to Move From Why We Need to Grow to How and With Whom
Goals and Strategy
Our Focus is to Move From Why We Need to Grow to How and With Whom

8. Goals, Strategy, and Results
Leveraging Outreach to drive regional success

9. This strategy is the foundation of the UW Surgery Outreach Program
Leveraging “Outreach” to drive regional success
Goals, Strategy, and Results
Goal: Increase Population Base of Patients Served
Strategy: Develop collaborative, sustainable, and service-oriented partnerships with individual providers, physician groups, and hospitals/health systems throughout the region
This strategy is the foundation of the UW Surgery Outreach Program

10. Leveraging Outreach to drive regional success
Goals, Strategy, and Results

11. Physician Relations/Communication Regional Outpatient Services
Leveraging Outreach to drive regional success
Goals, Strategy, and Results
Tactics
Physician Relations/Communication
Regional Outpatient Services
Call and elective services at regional facilities
Full-time regional practices

12. Leveraging Outreach to drive regional success
Goals, Strategy, and Results

13. New Regional Coverage Locations Since 2013

14. Financial Models “Traditional” Outreach Services
Leveraging Outreach to drive regional success
Financial Models
Goals, Strategy, and Results
“Traditional” Outreach Services
Department/UW medical group responsible for professional billing
Billing providers keep revenue less full assessment
UW Health provides per diem support to supplement/incentivize outreach services
Purchased Services/Assigned Billing
Contracted hospital responsible for professional billing
Contracted hospital retains all professional revenue received
Contracted hospital pays department a fixed rate per unit time (hour, day, month, etc.)
Faculty keep revenue less a reduced assessment

15. Financial Models Calculation of Purchased Services Rate
Leveraging Outreach to drive regional success
Goals, Strategy, and Results
Financial Models
Calculation of Purchased Services Rate
UW Medical Foundation developed standard “Blended Benchmark” calculation for all relevant specialties
+ University and Foundation fringe
+ Reduced assessment (corporate and department overhead)
/number of days per year
= daily rate

16. Totally New Revenue Stream to Department
Leveraging Outreach to drive regional success
Goals, Strategy, and Results
Totally New Revenue Stream to Department
(2014)
(2015)

17. The Learning Curve
Challenges Faced

18. Does all this really work? One more responsibility on top of many
The Learning Curve
Challenges Faced
Faculty Buy-In
Does all this really work?
One more responsibility on top of many
Opportunity cost (local practice, family, research)
Academic surgery is not community surgery
Who goes and who doesn’t? Non-accredited fellows?
Show me the money!
Who gets assessment? Department only? Division?
Are we charging too little? Too much?
What to do with faculty on guarantee?
Cost vs. Benefit
Finance, Licensing/Credentialing, Admin Support, IT, Business Planning-time is money
Is there a downstream benefit? How to calculate this?
Supply and Demand
How much work is “enough”?
Catch-22: Need + FTE to expand but need to expand to justify + FTE

19. Thank You