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Scott Smith, MD

Associate Medical Director of Operations

Kaiser Permanente Colorado

S.Scott.Smith@kp.org

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D E DA TSAL

Largest nonprofit health plan in the U.S. Integrated health care

delivery system 9.1 million members 16,000+ physicians

48,000+ nurses

174,000+ employees Serving 8 states and the

District of Columbia

37 hospitals

Almost 600 medical offices/ outpatient facilities

$50.6billion operating revenue*

Scope includes ambulatory, inpatient, ACS, behavioral health, SNF, home health, hospice, pharmacy, imaging, laboratory, optical, dental, and insurance

*Source: 2012 Kaiser Permanente Annual Report

Mid-Atlantic Region

Georgia Region

Colorado Region

NorthernCalifornia Region

Hawaii Region

Northwest Region

SouthernCalifornia Region

About Kaiser Permanente

Our Mission

To provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.

5

NCQA Health Insurance Plan Rankings 2013-2014 Summary Report (Medicare)

Kaiser Permanente Colorado

• 540,000 Patients, 27 Medical Offices

• 1000 Physicians

• 1 Electronic Medical Record (EMR)

• Revenue in Excess of $3 Billion USD

• Physicians Are Paid on Salaryo Up to 10% bonus based on service & quality

• Pharmacy, X-Ray, Lab in each medical office

Role of EACH Physician

LEADER

HEALER

PARTNER

Jack Cochran, MD, Executive Director, Permanente Federation

KP Colorado Primary Care Model

• 300 Primary Care Physicians• 130 General Practice• 110 Internal Medicine• 60 Pediatricians

• Roughly 1 physician per 1800 members• We register each patient with one

physician• All booking and care is directed to this physician• Patients see their personal physician 82% of the time

Primary Care – Our Triple Aim

Patient-Centered Medical Home

Link Each Patient to One Primary

New Access

TeamEnhancement

Care Doctor

Models

Quality Outreach

Population Health

Per Capita CostCare Experience

Primary Care

Team

Patient

Patients Needs Come First

Team Delivers Care

Respectful & Compassionate Care

Typical Day

Routine Access to Care is less than 4 days

15 Patients in office 3 Scheduled phone 8 Patient emails 5 Unscheduled phone45% of all patient contacts are virtual

Typical Day

QualityAll prevention needs and gaps are known

All chronic condition monitoring results and gaps are known

Centralized team outreaches to complete

Yesterday’s Care Tomorrow’s Care

Our patients are those who make appointments to see us

Our patients are those who are in our panel

Patients’ chief complaints or reasons for visit determines care

We systematically assess all our patients’ health needs to plan care

Care is determined by today’s problem and time available today

Care is determined by a proactive plan to meet patient needs without visits

Care varies by scheduled time and memory or skill of the doctor

Care is standardized according to evidence-based guidelines

Patients are responsible for coordinating their own care

A prepared team of professionals coordinates all patients’ care

I know I deliver high quality care because I’m well trained

We measure our quality and make rapid changes to improve it

It’s up to the patient to tell us what happened to them

We track tests & consultations, and follow-up after ED & hospital

Clinic operations center on meeting the doctor’s needs

A multidisciplinary team works at the top of our licenses to serve patients

Acute care is delivered in the next available appointment and walk-ins

Acute care is delivered by open access and non-visit contacts

Slide from Daniel Duffy, MD School of Community Medicine Tulsa, Oklahoma

Innovation distinguishes between a leader and a follower ---Steve Jobs

13

Let me put it simply: I

In this room, with the successes already in hand among you here, you collectively have enough knowledge to rescue (American) health care – hands

down. Better care, better health, and lower cost through improvement right here.In this room.

The only question left is: Will you do it?

When we entered the world of health care improvement as our life’s work, we didn’t ask for the burden we now bear.

We did not ask to be responsible for rescuing health care.But, here we are, and, as intimidating as the fact may be,

that burden is ours.

Donald Berwick, MD

We’re Here to Make Lives Better