Bridges To Excellence: The Partners Experience

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Bridges To Excellence: The Partners Experience. Harvard Quality Colloquium August 22, 2005 Jeff Levin-Scherz, MD MBA FACP Chief Medical Officer Partners Community HealthCare, Inc jlevinscherz@partners.org. Background: Partners Community HealthCare, Inc. (PCHI). Founded in 1994 - PowerPoint PPT Presentation

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  • Bridges To Excellence: The Partners Experience

    Harvard Quality ColloquiumAugust 22, 2005

    Jeff Levin-Scherz, MD MBA FACPChief Medical Officer Partners Community HealthCare, Incjlevinscherz@partners.org

  • Background: Partners Community HealthCare, Inc. (PCHI)Founded in 1994Division of Partners HealthCare System (PHS) formed with merger of MGH and BWH15 Regional Service Organizations (RSOs)2 AMCs with associated physician organizations2 community PHOs (facilities owned by PHS)3 community PHOs (facilities independent of PHS)9 physician groups (8 owned by PCHI)1200 primary care physicians and over 5000 specialists3 major commercial contracts with 5000,000 covered lives (these payers represent ~70% of commercial business in eastern Massachusetts)1 Medicare Advantage plan (16,000 enrollees)

  • Why Pay for Performance (P4P)?Capitation1995 1st generation P4P2000 2nd generation P4P2005Capitation

  • Performance Measures Embedded in PartnersP4P ContractsQuality MeasuresPhysicianHEDISDiabetes (adult)Asthma (pediatric)EMRPatient experience of careHospitalLeapfrogCPOELeap 4 SafetyLess interest in ICU intensivist and evidence-based hospital referralJCAHO Core MeasuresClaims based quality metrics

    Efficiency MeasuresPhysicianInpatientHigh Cost ImagingOutpatient PharmacyHospitalsInpatientHigh Cost ImagingBridges to Excellence fits into our strategic plan of building appropriate electronic infrastructure to allow us to succeed at P4P contracts in the future.

  • Ambulatory Electronic Infrastructure:PCPSpecialistCommunityAMCEMRPCPSpecialistCommunityAMCEMRWhere are we now?Where do we hope to be in 2008?

  • CPOEInpatient Electronic Infrastructure:Where are we now?Where do we hope to be in 2008?CPOE

  • The clinician perspective on BTEAdvantages New moneyProcess orientationInfrastructure developmentClear metricsMakes clinical senseOur Concerns No guarantee of continuation of programRules change from year to yearCovers only a small minority of our patientsPatient attribution concernsCost of complying with program

  • Bridges to Excellence Results First year results (year ended Feb, 05)31 PCHI groups (total of 150 individual physicians) participated in programAll participants were rewardedOfficeLink:Total of $545,180 in incremental payments Maximum payment:: $45,200Minimum payment: $1300Diabetes Care Link (21 physicians)Total of $11,100 in awardsSecond year plansPCHI will continue to assist groups in applying for BTE statusCardiac Care Link operational in Boston marketRequirements ramp up each year

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