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READY BY 2014:CLINICIAN CAPACITY SURVEY HIGHLIGHTS

Presentation for CSRHA Annual ConferenceNovember 16, 2011

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Co-facilitators:

Casie Parrish, M.P.A., Administrative Coordinator, WCN

Lyman Dennis, MBA, PhD, CPHIMS, HIMSSPrincipal, Eldorado Consulting

Charla Parker, M.P.A.Presenter, CEO, WCN

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Survey Objectives

Survey Highlights

“Think Tank” Solutions – Attendees1. Physician Recruitment & Retention2. Preparing for P4P3. Improving PCP/Specialty Care Communications

Summary and Next Steps

Participation Map

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Study Goal:To identify the capacity of safety-net providers to take on newly insured patients according to standards set under the Affordable Care Act and to utilize that information to develop technical, educational and funding assistance programs.

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Kaiser Permanente Southern California Community Benefit

Kaiser Permanente National Community Benefit

Study Sponsor

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Survey Partners in CA

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Arizona Association of Community Health Centers

Great Basin Primary Care Association

Survey Partners in AZ and NV

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What did we learn?

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Clinicians Are Eager to Express Their Opinions

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Clinicians Hate to Complete Surveys

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Nevada◦ 17 started and all completed survey

Arizona◦ 11 started and 7 completed survey

California◦ 29 started survey and 13 completed

◦ Nearly all were from rural communities

Survey Responses: 57 total

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Ability to take new patients into panel?

Yes responses:a. 50-60%b. 60-70%c. 70-80%d. 90-100%

What do you think they said?

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Provider Ability to Increase Patient Load• AZ 85.7%• NV 93.8%• CA 93.3%Physical Office Capacity to Increase• AZ 100%• NV 87.5%• CA 100%

Clinicians’ Perspective on “Ready by 2014”?

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Clinician Perception of Ability to Add 25% More Patients

26.83% Not Ready 23.08% Not Ready

39.02%

31.71%

17.07%

4.88%7.32%

Increase your registered patient population by

25% - % Roll Up

12345

53.85%

15.38%

15.38%

7.69%

7.69%

Increase your registered patient population by

25% - % CA

12345

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Perception of PCMH Readiness

Not Ready 9.76% Not Ready 0%

34.15%

41.46%

14.63%

2.44%7.32%

Be fully certified as a PCMH

% Roll Up

12345

38.46%

38.46%

23.08%

Be fully certified as a PCMH - % CA

12345

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Perception of Ability to Enter into ACO Contracting Relationship

Not Ready 26.83% Not Ready 23.08%

19.51%

26.83%

26.83%

14.63%

12.20%

Enter into an ACO contracting relation-

ship % Roll Up

12345

15.38%

23.08%

38.46%

23.08%

Enter into an ACO contracting relation-

ship % CA

12345

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Recruitment and Retention of Clinicians

Improving Communications Between PCP’s, Specialists, Hospitals, etc.

Participating in Pay-for-Performance Programs

Top Critical Issues

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Provider Recruitment & Retention

#1Critical Issue

Degree of Challenge:

Extreme33.33%

Considerable 41.67%Moderate 16.67%Low 2.78%None 5.56%

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More Pts. – Not Enough PCP’s

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How to see more patients with reduced$’s?

#2:Participating in Pay-for-Performance Programs

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*Better Care

*Better Health

*Lower Costs

The 3-PART AIM:

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Workflows before implementing EHR are different from those after

EHR adoptionPractice Manager

Practice Manager

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Workflow Redesign for Increased Efficiency◦ Reduces Cost

Panel Management for Patient Centered Access◦ Provides Better Care

Population Care Management for Improved Health Outcomes◦ Provides Better Health for the Community

Practice Management Coaching

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Improving Communications Between PCP, Specialists, Hospitals & Ancillary Providers

No. 3 Optimizing EHR Critical Issue

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The Past Information System

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Potential for Real Time Health Information Exchange

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Real time data creates opportunity for shared decision making between provider and patient

According to an IOM report, uninformed patients spend 40cents per dollar more on unnecessary care and less-involved patients often demand unwarranted tests and treatment because they don’t know about varying risks and benefit

Shared Decision Making

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How do we move from past to present to the future integrating all of the new Ready by 2014 “guidelines”?

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Convene in small groups – 5minutes1. Assign a discussion leader2. Assign a recorder3. Assign a reporter Identify challenges faced with your topic – 5 minutes

Identify innovations that are overcoming those challenges – 30 minutes

Chose one innovative practice to share with larger group – 10 minutes

Report back out at the end of 50 minutes

Assignment for “Power Dating” Break-outs

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Attendee’s ShowcaseInnovations

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Conclusion Summary of Break-out Reports Next Steps

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Opportunities for the Future of Improved Financial & Clinical Performance

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UCSF Practice Management Facilitation◦ 2 scholarships available: No. and So. CA

Practice Based Research Opportunities◦ Application of Predictive Analytics in PCP Office◦ Colorectal FLU-FIT Best Practices Project◦ Other topics being developed

Ongoing Peer Support and Networking New CMO Boot Camp

◦ April 22, 2012 Las Vegas

WCN Current Program Offerings:

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Survey Summary & Best Practices Resources Will be posted on WCN website

www.westerncliniciansnetwork.net or contact Charla Parker, MPA at (530) 383-5030

charla_parker@msn.com Casie Parrish, MPA at (916) 993-7770 x3670 westernclinciansnetwork@gmail.com Lyman Dennis, MBA, PhD, CPHIMS, FHIMSS Ldennis@eldoradohc.com

Resources and References

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With Special Thanks toThomas Bodenheimer, M.D. Associate Professor, UCSF Center for Excellence in Primary Care