Post on 24-Feb-2016
description
1
Johns Hopkins Community Physicians
Presentation to MCMSOctober 25, 2012
Presented by: Matt Poffenroth, MD, MBADirector of Clinical Integration, JHCP
2
JHM Organizational Structure………focusing on strategic interfaces
The Johns HopkinsHealth System
Corporation (JHHSC)
The Johns HopkinsUniversity (JHU)
The Johns
HopkinsHospital
JohnsHopkinsBayviewMedicalCenter,
Inc.
HowardCountyGeneral Hospital
JohnsHopkins
CommunityPhysicians
SchoolOf
Medicine
JohnsHopkins
HealthCareLLC
JHVentures,
LLC
Johns HopkinsMedicine
(JHM)
JohnsHopkinsMedicine
International,LLC
JohnsHopkinsHomeCare
Group
SuburbanHospital,
Inc.
SuburbanHospital
HealthcareSystem,
Inc.
= Unincorporated board or division
= Legal entity
SibleyMemorialHospital
3
JHCP SectionsFY 12
• Each section with clinical chiefs and administrators
JHCP FY 2012
• 36 outpatient sites• 11 counties,
Baltimore City• 400+ providers• 1000 staff• 800 K encounters• 230 K patients
4** Bayview Internal Medicine, practice managed by JHCP
JHM Clinical Enterprise
TRENDED VOLUME
FY 2005 FY 2006 FY 2007 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 (est)
FY 2013 (budget)
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
1,000,000
Encounters
Encounters
7
Provider Growth Summary
FY 2006 FY 2007 FY 2008 FY 2009 FY 2010 FY 20110
50
100
150
200
250
FTE - Providers
8
JHCP Challenges
In many ways, similar to private practice:• Insure access to growing volume of patients • Coordinate care for patients in a fragmented delivery
system• Meet demands of payers to measure and report data• How to position ourselves for payment reform• Physician work:life balance
9
How is JHCP meeting these challenges?
• Strategically adding capacity, based on access needs• Partnering with other private practice physicians in
the community• New models of care – PCMH, extended hours, etc. • Participating with various P4P programs• Implementing EPIC in April, 2013• Evaluating physician compensation model
Pay for Performance Programs at JHCP• Value Based Purchasing (JHHC)• Meaningful Use of EHR’s• Patient Centered Medical Home (PCMH)
– Maryland Multi-Payer Pilot (MMPP)- 5 sites– CareFirst– USFHP
• ACO-prepared• PQRS• ePrescribing• Maryland State-Regulated Payer EHR Adoption
Incentive Program
10
Future of healthcare in Maryland• Payment reform is happening – providers
increasingly will be asked to take risk• Quality and transparency is be demanded by payers
and patients• Shift towards population health management• Uncertainty about HSCRC waiver and how this could
affect providers
11
How will the system respond?
• Continued and accelerated consolidation– Physicians increasingly seeking “safe haven” of
employment– Hospitals increasingly reliant on physicians to
meet access and quality needs– Bundled payments, shared savings programs, etc.
• Alignment of incentives between providers, patients, payers and purchasers (is this a dream?)
12
JHM Strategic Response
• Developing an integrated delivery system is one of JHM’s Mission Imperatives
• Alignment with private physicians is a JHM priority to achieve clinical integration
• Strategies include:1. Employment2. Shared EHR3. Accountable Care Organizations4. Other
13
Employment
• Typically not “purchasing” practices• Not always an appealing option for either side
– Financial risk– Culture
• Requires a shared Mission and Vision
14
Shared EHR
• JHM begins transitioning to EPIC in April 2013, beginning with our ambulatory practices
• JH Community Division to offer EPIC Community Connect to private practices
• Full EHR and practice management system, without billing module
• Marketing to begin late fall 2012, implementation fall 2013
15
ACOs
• CMMI grant approval for J-CHiP in June 2012 – “academic ACO”
• Exploring community ACO model with intent to file letter of intent by June 2013 with implementation January 2014
• Success (i.e. improved quality at lower cost) will require:– Infrastructure– Resources– Expertise in population health management
• Not all “ACOs” will succeed
16
Other methods to enhance alignment• Improved access to JH clinics• Part-time faculty appointments• CME• Shared purchasing agreements • Networking with JH health plans• MSO services• “True” clinical integration model with shared contracting
17