UH Clinical Update - June 2017
By Cliff A. Megerian, MD, FACS, President, University Hospitals Physician Services
Many physicians throughout the United States have concerns about the health care systems in this country. University Hospitals is well-positioned for challenges ahead. Our track record of performance is cause for confidence as change in health care accelerates.
Here are some of the reasons that UH is strong and you can be positive about the future:
- UH has the largest geographic provider network among health systems in Northeast Ohio, covering 15 counties.
- UH now has 120 health care delivery sites in the region, as well as our flagship academic medical center in Cleveland. This alignment of sites close to home in the communities we serve, complemented by the UH Cleveland Medical Center for tertiary and quaternary care, is an approach to care that our patients prefer. At every delivery site, patient experience is paramount.
- UH has achieved a steady and constant increase in the number of patients choosing to receive care at one of our many sites – we now see 1.2 million patients each year. Large businesses, as well as local and regional employers, have taken notice. We have the breadth and sophistication to create uniquely competitive narrow network contracts for employers, through which patients receive continuity of care for all of their health care needs.
- Beginning in 2012, UH moved proactively to extend population health care management to our Medicare patients through the formation of our Accountable Care Organization (ACO). Now our ACO is the fifth largest in the U.S., with more than 320,000 participants. Our ACO experience and success have helped prepare UH for the evolution of public health from fee-for-service to a value-based care model. UH has achieved ACO performance that is better than the targets set for nearly every measured category, including quality and cost. UH physicians share in the savings – UH delivered $11 million in physician pay-for-performance revenue in the last year alone. Yet ACOs are not the end game for population health. Population health will be evidence-based in the new MACRA rules, which will involve all Medicare patients; the commercial market also will evolve into value-based payments.
- MACRA, which is Congress’s new paradigm for reimbursing physicians, begins its rollout this year, with final implementation occurring in 2019. Nearly every category of MACRA measurement mirrors what we are already doing today with regard to our ACO quality initiatives and meaningful-use. In fact, it is likely that most UH physicians won’t have to do anything differently regarding MACRA. That’s a huge advantage for our organization, as others are not so well prepared.
- Formation of the Primary Care Institute, and its physician leadership structure, has enhanced communications and alignment. We are seeing strong support for point-of-service scheduling, which enhances patient satisfaction, improves outcomes and optimizes our capabilities. Recent focus groups have confirmed that, compared to other systems in the region, UH and its physicians are the best at providing patient-centered, humanistic and genuine care in a holistic environment, one that inspires confidence among our patients.
- The ongoing and successful VIP initiative has identified hundreds of millions of dollars savings our system will achieve through improved efficiencies and the elimination of redundancies. This savings is vital to sustaining the excellence of UH services as reimbursement levels decline.
- Another way we can enhance safety for patients while reducing costs is to reduce variability in treatment of such cases as sepsis and joint replacement, among others. The High-Reliability Medicine (HRM) initiative is flourishing and has taken hold in a dozen service lines. HRM is already delivering benefits. Improved safety and outcomes will result as we continue to advance this approach to quality care throughout the UH system.
These multiple initiatives, and many more, are advanced with one goal in mind, which is keeping UH strong and vital in a changing and uncertain health care environment in order that we sustain the UH mission: To Heal. To Teach. To Discover.