A Volume To Value Ortho Service Line Model

A Volume to Value Service Line Model

November 16, 2016

William E. Munley

Vice President of Orthopedics, General Surgery & Professional Services

Goals of Presentation

• Model applicable to all service lines.

• Model that transitions from volume to value.

• Volume and Value are not necessarily mutually exclusive

• The sky is not falling.

• Bon Secours operates 19 acute-care hospitals, 1 psychiatric hospital, 5 nursing care facilities, 4 assisted living facilities, and 14 home care and hospice programs in 7 states.

…About Us

• St. Francis downtown– 10 IP operating suites / 8 OP operating suites– 202 Acute care beds– 19 Inpatient Rehab Beds– 27 ICU / CCU / CVICU– 248 Total Beds

• St. Francis eastside– 8 operating suites– 52 acute care beds– 35 LDRP– 6 ICU Beds– 93 Total Beds

…About Us

Service Line Management

Service Line Management

OthersAncillariesSurgeryNursing

OthersAncillariesSurgeryNursing

• Program development

• Enhanced teamwork

• Increased volumes

• Increased market share

• Increased quality

• Streamlined costs & efficiencies

• Value

• Positioning for healthcare reform

Benefits of Service Line Structure

Orthopedics is becoming a specialty within a specialty

• Foot & Ankle

• Fracture Care

• Hand & Upper Extremity

• Joint Replacement

• Medical Ortho

• Spine

• Sports Medicine

Orthopedic, Spine & Rehab Services

DYAD

Leader:

Dr. Baumgarten

Orthopedic Chair:

Dr. VanPelt

Joint Camp

Drs. Kavolus & Ridgeway

SFE OFC

Dr. O’Boyle

SFD

Sports Med. &

O/P Ortho

Dr. Baumgarten

SFD / SFE

O/P Rehab

Dr. Schwartz

SFD / SFE / Millennium

& 4 satellites

Other Orthopedics

Wound Healing Center

Dr. Melissa Richardson

SFE

InpatientRehab Center

Dr. Choe

SFD

Foot & Ankle

SFD / SFE

Spine Program

Dr. Bucci

SFD

Orthopedics is becoming a specialty within a specialty

• Foot & Ankle

• Fracture Care

• Hand & Upper Extremity

• Joint Replacement

• Medical Ortho

• Spine

• Sports Medicine

Future

Vision

Identify

Future Positioning/Regional

COE

Future Vision

Quality /Outcomes/Value

Future Vision Peripherals / Innovation

Future Vision COE’s

Centers of Excellence

Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e /

Mar

ket

Sh

are

/ G

row

th

Co

st

Munley Healthcare Consulting, LLC

Bon Secours St. Francis Health System Orthopedic Service Line

Vision StatementWe are committed to excellence as the high-quality patient-centered provider of choice for regional orthopedic and

spine services.

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e /

Mar

ket

Sh

are

/ G

row

th

Co

st




spine services.

• Majority of hospitals in the country (about 50% ) do not have formalized orthopedic programs.

• They deliver services and perform procedures only.

• We have a few services like this which we would like to take to the next level (i.e. Foot & Ankle).

Orthopedic Services

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e /

Mar

ket

Sh

are

/ G

row

th

Co

st




spine services.

Orthopedic Programs

• Another 25% of Hospitals delivering orthopedic service have organized programs.

• No formal programs before 2004 at St Francis.

• We have formalized a Shoulder Program, and initiated components of an Osteoporosis Program complete with Bone Health Navigator.

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e /

Mar

ket

Sh

are

/ G

row

th

Co

st




spine services.


• Fewer still (20% - 25%) have developed Centers of Excellence or are able to go to the next level

• We developed Center’s of Excellence in Joint Replacement (Joint Camp 2004), Hip Fracture (Osteoporotic Fracture Center 2007), Sports Medicine (2008), and Spine Care Center (2010)

• Center of Excellence Differentiation


We have differentiated our COEs through menus for success:

• Joint Camp

• Spine Care Center

• OFC

• Sports Medicine

Joint Camp Menu for Success

1. Medical Director / Physician Champion

2. Hip & Knee Pain Seminars3. Focus on Wellness4. “Prehab”5. Early Discharge Planning6. Multidisciplinary Team7. Regular Team Meetings8. Dedicated Program Manager9. Dedicated Unit10. Direct Admission into Room11. Group Therapy

Green:Advertising/Promotion

Red: Differentiators


12. Coach Program13. Clinical Pathway & Standardized Orders14. Comprehensive Educational Information for

Patients & Families15. Rise & Shine Greeting Program16. Newsletters17. Graduation Ceremony18. Dashboard Development19. Annual Reunion

Green: Advertising/Promotion


Blue: Promotional materials

Purple: Outcomes

20. Physician “Buy In”

21. Dedicated, Consistent OR, Nursing & Therapy Staff

22. Flip Flop OR’s for high-volume surgeons

23. 1:5 Nurse-to-Patient Ratio


Green: Advertising / Promotion


Dr. Stephen

Ridgeway

Joint Camp

Medical Director

Dr. Christopher

Kavolus

Orthopedic Medical

Director

http://www.getmovinwithpoa.com/stephen-r-ridgeway-md.php

http://www.getmovinwithpoa.com/christopher-h-kavolus-md.php

Spine Care Center

Spine Care Center Menu for Success

1. Focus on Wellness

2. “Prehab”

3. Early Discharge Planning

4. Multidisciplinary Team

5. Regular Team Meetings

6. Coach Program


Spine Care Center Menu for Success

7. Clinical Pathway & Standardized Orders

8. Comprehensive Educational Information for Patients & Families

9. Dashboard Development


11. Dedicated, Consistent OR, Nursing & Therapy Staff

12. Designated Unit

13. Community Seminars




Purple: Outcomes

Spine Triage Center

• Initial consults with Physiatrists

• Primary Care Musculoskeletal Physician

• PCP/Network Referral

• RN Spine Navigator

• Specialty Network

St. Francis OFC(Osteoporotic Fracture Center)

St. Francis OFC Menu for Success

1. Medical Director / Physician Champion

2. OFC Coordinator

3. Streamlined Evaluation and admission process

4. Admission by Hospitalist

5. Clinical Pathway and Standardized Orders


7. Reserved O.R. time 5 days/week



St. Francis OFC Menu for Success

8. Multidisciplinary Team

9. Dedicated Beds

10. Dedicated / Specially trained OR, Nursing & Therapy staff

11. Aggressive Therapy

12. Early D/C Planning

13. Patient / Family Education

14. Regular Team Meetings

15. Dashboard Development

16. Administrative Support



Purple: Outcomes

Sports Medicine

Primary Target AudienceInjury-Prone Weekend Warrior/Baby Boomer

Secondary Target AudienceStudent Athletes

Strategies

–Pursue high injury risk weekend warriors/baby boomer sports leagues

–Increase awareness at public events focusing on multiple sporting venues utilizing our community-based ATC’s, sports medicine coordinators, and physician network.

–Provide Athletic Trainer Programs on-site to organizations

Sports Medicine Menu for Success


– Participate in non-traditional community events that promote health and wellness

– Sponsorships

– Promote HURT Line

– Provide Effective Materials for Events

– Develop a Comprehensive Marketing & Sales Package

– Incorporate with other St. Francis system-wide events

– Track Clubs– Mud Runs– Adult Basketball Leagues– Cycling Events– Tennis Clubs– Triathlons– Volleyball– Swimming Clubs– Adult Soccer

– Lacrosse Leagues– Corporate Leagues– Rugby– Sports Clubs– Hiking Clubs– Ballet– Senior Centers– YMCA / YWCA


• Pursue Injury Prone Weekend Warriors/ Baby-boomer Sports Leagues utilizing our community based ATC / Sports Medicine Coordinators and Physician Network

• Provide athletic trainer programs onsite to Organizations

– Bob Jones University

– Easley High School

– Powdersville High School

– Wren High School

– Shannon Forest High School

– CESA Youth Soccer

– Greenville Swamp Rabbits


• Participate in non-traditional community events that promote health and wellness

– Health Fairs

– Sports Performance Challenge in collaboration with D-1.

– Publish injury prevention articles/training kits

– Community educational programs

– Develop pre-season tune-up and/or post-event injury clinics


• Established Major Sponsorships– Clemson– Greenville Drive– Greenville Road Warriors– Downtown cycling classic– GO Magazine– Mud Run– Wheels for Meals– Track Clubs– Tennis Tournaments– Soccer Leagues– Cycling Events– Golf Tournaments– Universities


Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes

Vo

lum

e /

Mar

ket

Sh

are

/ G

row

th

Co

st




spine services.

Serv

ice

/Sat

isfa

ctio

n

Service Line Pillars(central to future vision for orthopedics)

Service & Satisfaction have been outstanding:

• 99th percentile for Orthopedist Satisfaction

• 4.84/5.00 Gallup Patient Satisfaction 3rd Floor Ortho SFE

• 4.73/5.00 Gallup Patient Satisfaction 7th Floor Ortho/Spine SFD

• 3.79/4.00 HCAHPS Grand Mean 3rd Floor Ortho SFE $

• 3.67/4.00 HCAHPS Grand Mean 7th Floor Ortho/Spine SFD $

• 4.76/5.00 Gallup Employee Engagement

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes

Co

st




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Volume/Market Share Growth:

• Most Joint Replacements and Shoulder Replacements performed in South Carolina

• Performed over 9,000 orthopedic surgical procedures in FY16.

Market Share:

• 40% Spine Care

• 49% Hip Fx. Care

• 51% Outpatient Ortho (knee, shoulder)

• 65% Joint Replacement


Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

Cost:

• Shorter Length of Stay

• Reduced O.R. Times

• Reduced Variation in Practice Patterns

• Lowest implant costs in BSHSI

• Lowest cost MS-DRGs in the Upstate as per American Hospital Directory

• Monitor MSPB (including SNF placements)


Comparative Data for Medicare Patients Total Joint Replacement and Joint Revisions

Hospital

Medicare

Inpatients ALOS

Average

Charges

Average

Payment

Average

Cost

St. Francis 718 3.4 $51,284 $11,492 $13,587

Spartanburg Regional 335 5.1 $48,966 $14,257 $15,673

Patewood Memorial Hospital 247 2.9 $40,525 $11,154 $16,927

Self Regional 242 3.8 $66,863 $14,082 $19,375

AnMed 224 5.1 $75,421 $13,608 $36,559

Greenville Memorial Hospital 73 6.4 $63,012 $16,984 $34,864

Hillcrest Hospital 57 3.8 $50,183 $13,172 $31,095

Village at Pelham 26 3.9 $42,880 $10,112 $42,125

MS-DRGs 469, 470: Major Joint Replacement or Reattachment of Lower Extremity w/MCC and

w/o MCC

MS-DRGs 466, 467, 468: Revision of Hip or Knee Replacement w/CC, w/MCC, and w/o CC/MCC

Hospital

Medicare

Inpatients ALOS

Average

Charges

Average

Payment

Average

Cost

Spartanburg Regional 49 5.6 $67,283 $18,761 $24,071

St. Francis 36 3.8 $86,362 $16,377 $22,270

Patewood Memorial Hospital 16 3.4 $55,442 $14,058 $22,290

Data is for Medicare inpatients only- year ending 9/30/09

Source: American Hospital Directory

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

Qu

alit

y /

Ou

tco

mes

Quality/Outcomes:• Premier top 10% Joint Replacement Quality and Cost

• Delta Care Chex/Comparion top 5% for Overall Orthopedic Surgery

• Becker’s Top 100 Orthopedic Hospitals Award

• Joint Commission DSC for Total Hip & Total Knee Replacement

• BCBS Preferred Distinction Center+ for Quality and Cost for Joint Replacement Surgery and Spine Surgery

• Aetna Institutes of Quality (IOQ) for Joint Replacement & Spine Surgery

• United Healthcare Specialty Center Designation for Joint Replacement & Spine Surgery

• Sg2 National Best Practice for Fracture Care

• Synthes Corporation Preferred Show Site for Fracture Care

• America’s Best Hospitals for Orthopedics-Women’s Choice Award 2013

• Consumer Reports Highest Rated Hospitals for Knee Surgery 2014

• Consumer Reports Highest Rated Hospitals for Hip Surgery 2014, 2016



HealthGrades

• America’s 100 Best Hospitals for Orthopedic Surgery, 6 years in a row (2012-2017)

• Top 5% in the Nation for Overall Orthopedic Surgery, 6 years in a row (2012-2017)

• Ranked #1 in SC for Overall Orthopedic Services (2012-2013, 2016-2017)

• 5-Star in Knee Replacement, 15 years in a row (2003-2017)

• 5-Star for Hip Fracture Treatment, 6 years in a row (2012-2017)

• 5-Star for Back Surgery, 2 years in a row (2013-2014)

• Service Excellence Award for Joint Replacement (2011-2014, 2016-2017)

QUALITY

• Mortality • Infections • Readmission Rate • PE • DVT • Dural Tears • Patient Falls • CMS/VBP Indicators

• Clinical Pathway Usage • Time between ER Arrival to Surgery in < 12 hrs. & < 24 hrs. • Time b/w ER Arrival

to Floor < 4.5 hrs. Complications: Delirium, Ileus, Pneumonia, Renal Failure, Respiratory Failure, UTI

SERVICE

• On-time starts for 1st case • Turnover time • Surgery Block Utilization • Patient Satisfaction

• Cancellations w/in 24 hours

OUTCOMES

• Pain level • Functional level • Return to Work • Return to Former Activities • Maintain Independent Living

FINANCIAL

• Implant Cost • Total Cost • Volume • LOS • Wasted Implants • MSPB

MISC.

• Seminars / Screenings • Percent of Patients D/C to Home

Dashboard

QUALITY

• Mortality • Infections • Readmission Rate • PE • DVT • Dural Tears • Patient Falls • CMS/VBP Indicators • Clinical Pathway Usage • Time between ER Arrival to Surgery in < 12 hrs. & < 24 hrs. • Time b/w ER Arrival to Floor < 4.5 hrs. Complications: Delirium, Ileus, Pneumonia, Renal Failure, Respiratory Failure, UTI

SERVICE

• On-time starts for 1st case • Turnover time • Surgery Block Utilization

• Patient Satisfaction


OUTCOMES


FINANCIAL

• Implant Cost • Volume • LOS • Wasted Implants • MSPB

• Total Cost $

MISC.

•Seminars / Screenings • Percent of Patients D/C to Home

Dashboard

QUALITY

• Mortality • Readmission Rate • PE • DVT • Dural Tears • CMS/VBP Indicators

• Clinical Pathway Usage • Time between ER Arrival to Surgery in < 12 hrs. & < 24 hrs. • Time b/w ER Arrival to Floor < 4.5 hrs.

• Infections $ • Patient Falls $

• Complications: Delirium, Ileus, Pneumonia, Renal Failure, Respiratory Failure, UTI

SERVICE



OUTCOMES


FINANCIAL


MISC.


Dashboard

QUALITY

• Mortality • Infections • Readmission Rate • PE • DVT • Dural Tears • Patient Falls

• CMS/VBP Indicators $

• Clinical Pathway Usage • Maintain Independent Living • Time between ER Arrival to Surgery in < 12 hrs. & < 24 hrs. • Time b/w ER Arrival to Floor < 4.5 hrs. Complications: Delirium, Ilius, Pneumonia, Renal Failure, Respiratory Failure, UTI

SERVICE



OUTCOMES

• Pain level • Functional level • Return to Work • Return to Former Activities

FINANCIAL

• Implant Cost • Total Cost • Volume • LOS • Wasted Implants • MSPB $

MISC.


Dashboard

QUALITY

• Mortality • Infections • Readmission Rate • PE • DVT • Dural Tears • Patient Falls • CMS/VBP Indicators • Clinical Pathway Usage • Maintain Independent Living • Time between ER Arrival to Surgery in < 12 hrs. & < 24 hrs. • Time b/w ER Arrival to Floor < 4.5 hrs. Complications: Delirium, Ileus, Pneumonia, Renal Failure, Respiratory Failure, UTI

SERVICE



OUTCOMES

• Pain level • Functional level • Return to Work • Return to Former Activities

FINANCIAL


MISC.

•Seminars / Screenings • Percent of Patients D/C to Home

Dashboard

QUALITY

• Mortality • Infections • Readmission Rate • PE • DVT • Dural Tears • Patient Falls • CMS/VBP Indicators • Clinical Pathway Usage • Time between ER Arrival to Surgery in < 12 hrs. & < 24 hrs. • Time b/w ER Arrival to Floor < 4.5 hrs.

• Complications: Delirium, Ileus, Pneumonia, Renal Failure, Respiratory Failure, UTI $

SERVICE



OUTCOMES


FINANCIAL


MISC.


Dashboard

QUALITY

• Mortality $ • Readmission Rate $

• Infections • PE • DVT • Dural Tears • Patient Falls • CMS/VBP Indicators • Clinical Pathway Usage

• Time between ER Arrival to Surgery in < 12 hrs. & < 24 hrs. • Time b/w ER Arrival to Floor < 4.5 hrs.

• Complications: Delirium, Ileus, Pneumonia, Renal Failure, Respiratory Failure, UTI

SERVICE

• On-time starts for 1st case • Turnover time • Surgery Block Utilization

• Patient Satisfaction • Cancellations w/in 24 hours

OUTCOMES

• Pain level • Functional level • Return to Work • Return to Former Activities • Maintain Independent

Living

FINANCIAL


MISC.


Dashboard

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

• Foot & Ankle

• Osteoporosis

• Shoulder Replacement

Future Vision Centers of Excellence

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

Da Vinci Robot

St. Francis Millennium St. Francis

Outpatient Center

http://maps.google.com/maps/ms?hl=en&gl=us&ie=UTF8&oe=UTF8&msa=0&msid=202936004911850734473.00044ec41b19cf20cdf00&ll=34.803338,-82.318239&spn=0.012492,0.027874&z=16&iwloc=00047d12381f022c8e0f1

https://maps.google.com/maps?q=3+St+Francis+Dr,+Greenville,+SC&hl=en&sll=34.84903,-82.372494&sspn=0.054308,0.13175&oq=3+&hnear=3+St+Francis+Dr,+Greenville,+South+Carolina+29601&t=m&z=17

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

Qu

alit

y /

Ou

tco

mes

• Dr. Marc Tanner - Hand (2012)

• Dr. Shay Koch - Sports Medicine (2013)

• Dr. Dylan Watson - Joint Replacement Surgeon (2015)

• Pain Management Physician (2017)

• Foot & Ankle (2017)

• Hand Surgeon (2017)

Specialist Recruitment

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

• Investigate and maintain new government regulations/coding

• Prepare operationally for new reimbursement strategies

• Maintain & improve efficiencies (on-time starts, turnover time, etc.)

• Improve consistency, ability, experience and training with OR staff and possibly Anesthesia/Hospitalists

• Site visits to other premier programs

Operating Excellence

• Concentrate on patient-centered coordination of care

• Continued task force meetings

• Program element upgrades, protocol updates, continued differentiation

• Maintain and further develop dashboards and benchmarks (re-admission rates, quality, return to community, return to work, pain levels, return the functional activities, etc.)

Operating Excellence

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

• Identified as having one of the most comprehensive and diversified orthopedic marketing plans by Innovator’s Studio (Chicago 2010)

• Current & future strategies

Service Line Focused Marketing

Joint Camp

Patient / Family Items

Tee Shirt Coach’s Guide Coffee Cup Bag

Hip & Knee Pain Seminars

• Bi–Monthly at St. Francis Eastside

• Participation in Community Events

Patient Testimonials

http://www.youtube.com/watch?v=gBFDBE7Rm0c&feature=player_embedded

Success Story Letter

Billboard

Joint Camp Annual Reunion

HealthGrades

5-Star in Hip Replacement

5-Star in Knee Replacement

5-Star in Total Joint Replacement

Spine Marketing Efforts

• Brochure

• Community Seminars

• Website

• Peripheral Materials

OFC Marketing Efforts

• EMS

• Community Outreach

– Seminars

– Churches

– Senior Centers

– Assisted Living

• SNF

– Inservices

– OFC Coordinator

•Development of Osteoporosis Program

•Peripheral Materials

•HealthGrades

•Media Coverage

“Take me to St. Francis” Brochure

• HURT Line (864-675-HURT)• Outpatient surgical patient T-shirts with “Life is a Sport” theme• Program ads – High Schools, Furman, North Greenville• Faith characters and associated ads, magnets, giveaways• Comprehensive website• Program literature and other peripheral materials• GO Magazine• Message on hold• Webinars• Banners• E-newsletter• Collaborative events with corporate partners• DVD through Clemson Sponsorship• Community Service Announcements• Success stories postcards• Sales Package • Sponsorships• “Not all athletes wear jerseys” campaign

St. Francis Marketing Department Responds to

Sports Medicine!

Sports Medicine

Team Sponsorships

Greenville High Rugby

CESA

Greenville Griffins Adult Rugby League

Newsletters

E-newsletter

Brochure

Go Magazine Ads

96

http://www.stfrancishealth.org/video_test2.php

CESA Tournament Program Ad

• Secondary Audience – Student Athletes

http://www.stfrancishealth.org/combine_challenge.php

St. Francis Combine Challenge Awards Ceremony 12/07

St. Francis Sports Performance Challenge Awards Ceremony 5/08

Greenville High Red Raiders

The Word is Out2009 – 2016• Becker’s Hospital Conference: Chicago, IL

• HealthLeaders Media Magazine

• IHI Conference: Nashville, TN

• ACI Conference: Dallas, TX

• HCPro Webinar on Joint Replacements

• Marshall Steele Summits: Chicago / Orlanda

• HCPro Webinar on Service Line Marketing

• Marshall Steele Book

• Sg2 Webinar on Hip Fracture

• Bon Secours Health System: Richmond, VA

• Chief Marketing Officers’ Innovator’s Studio: Chicago, IL

• Sg2 Conference, San Francisco, CA

• Stryker Performance Solutions, San Antonio, TX

• SharePoint HealthGrades Symposium: Miami, FL

• Sg2 Executive Summit: Washington, DC

• HealthGrades Webinar on Volume to Value

• OrthoServiceLine.com

• Wall Street Journal Article-Hip Fractures

• The key is a combined effort marketing the overall identity/co-branding while not losing the current marketing strategies of the individual centers of excellence

• Communicate the quality accolades, differentiators, outcomes, and value to:

1. The public

2. Business community

3. Third-party insurers

4. BSMG & other physicians

• Emphasize Regional Presence

Future Marketing

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

• SC MedTransTech Program (Clemson Biomedical Engineering Research)

• Latest Technology

– New cervical cages

– Patient specific knees

– Patient specific hips

– Ankle replacements

Future Vision for Peripherals/Innovation

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

• Quality / Outcomes / Value will be the “Tip of the Spear” for differentiation

• Quality / Outcomes / Value will be the future of marketing and steerage

• Mid-Level Practitioner in Preassessment for Joint Replacement and Spine

• Potential Outcomes Tracking:

– SF 12, Lower Extremity Functional Scale, DASH, Oswestry, Stryker Performance Management & Outcomes

– OBERD or similar tool for outpatient orthopedic surgery

– Create outcomes measures, track, and publish

Future Vision Quality/Outcomes/Value

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

• Bundling

• Episodic Care

• Aetna & BCBS

• Industry

• Workers Comp

• Preferred Insurance Steerage

• Surgical Tourism (i.e. BridgeHealth)

• ACOs

Future Vision / Positioning for Regional Center of Excellence

Future

Vision

Identify


COE

Future Vision





Orthopedic Programs

Orthopedic Services

Qu

alit

y /

Ou

tco

mes




spine services.

Serv

ice

/Sat

isfa

ctio

n

Vo

lum

e/M

arke

t Sh

are

Gro

wth

Co

st

The Experts Say…

Sg2 -- Marshall Steele & Associates -- HealthGrades -- Premier

“The vision of most orthopedic hospital programs is to become where St. Francis is now.”

“Most hospitals that have orthopedic services dream to be where St. Francis is currently, and your future plan is visionary.”

“St. Francis is at the top and is one of the best programs in the country, and your model takes you even further.”

“The Future Vision for the Orthopedics & Spine Service Line at St. Francis is one of the most clear, concise visions we have ever seen.”

Vision in a Nutshell

• Maintain and seek continuous operational improvement in our current COE programs: Joint Camp; OFC; Spine Care Center; Sports Medicine

• Manage current and future programs and services around the four service line pillars:

Quality/Outcomes; Service/Satisfaction; Volume/Market Share

Growth; and Cost

• Develop future COE programs in Foot & Ankle, Osteoporosis, and Shoulder Replacement

• Implement outcome measures in both inpatient/outpatient surgery

• Focus efforts around Patient Centered Coordination of Care and Transition of Care

• Package our product to become preferred provider (Bundling, Episodic Care, ACOs, Industry, Centers of Distinction, Preferred Insurance Sites, and Surgical Tourism)

• Create Overall Umbrella Identity and Co-branding

• Market new identity and co-branding utilizing a unified strategy while maintaining marketing for individuals subspecialties. Quality, Outcomes, Differentiation & Value are the “tip of the spear.”

Vision in a Nutshell

Thank you for your attention.

William E. Munley

Vice President of Orthopedics, General Surgery & Professional Services

Bon Secours St. Francis Health System

[email protected](864) 449-3386

115

Streamlining Orthopedic Patient Pathways

www.wellbe.me/CJR