AGENDA

Program Objectives: The focus will be on transformative initiatives, both clinical and non clinical. As opposed to hypothetical solutions, the program will provide real world examples of successful programs in all domains: clinical programs, operations, quality, financial, strategic/governance/ organization.

June 12-14, 2013 Ritz-Carlton Buckhead • Atlanta, GA

Agenda Wednesday, June 12, 2013 7:00 am – 8:00 am Room: Salon 1

Breakfast (for pre-conference attendees)

Pre-Conference Session 8:00 am – 11:30 am The Nuts & Bolts of Integration & Service Line Development Suzette Jaskie, President & CEO, MedAxiom consulting

Joel Sauer, VP, MedAxiom Consulting

 The historical hospital services

management model, aligned around isolated business entities with little to no leadership, is being replaced by a model that delivers a unified business unit: the service line. This service line approach, designed around the way a patient experiences care, places physicians at the forefront of leadership and puts in place a single vision, governance and often a unified budget – including the physician practice component.

General Session 1:30 pm – 1:45 pm Room: Salon 1 & 2

Opening/Meeting Overview

1:45 pm – 2:30 pm Room: Salon 1 & 2

Strategic Change Management





Suzette Jaskie, President & CEO, MedAxiom consulting

Orlando Alvarez, Senior VP, Strategy and Business Development, Sisters of Charity

In response to the tremendous change in the healthcare environment, hospitals find themselves driving constant change. Managing multiple and often competing initiatives ranging from the deployment of information technology, the development of service lines to the formation of ACO’s and/or bundled payments, the effective management of change is difficult. Mr. Alvarez has developed a strategic management change approach to coordinate the multiple initiatives to optimize success, which he will overview in this presentation.

2:30 pm – 3:15 pm Cardiologist Workforce Room: Salon 1 & 2 Jerome Hines MD, PhD, FACC, FSCAI, Interventional Cardiologist, Illinois Heart and Vascular

 The physician role in the new value based economy is changing as well as incentives regarding prevention, wellness and cost. While cardiologist workforce studies have forecasted significant future cardiologist shortages, today’s healthcare economy may require us to reconsider what has been thought to be inevitable. In this session, Dr. Hines will lay out a compelling argument utilizing population, procedure acuity and volume data to reset our notion of physician recruiting and succession planning.

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3:15 pm – 3:45 pm Room: The Gallery

AGENDA

Afternoon break with Partners & Exhibitors

3:45 pm – 4:30 pm Managing Healthcare Reform and Integration from a Room: Salon 1 & 2 Financial Perspective Jim Landman, VP, Healthcare Financial Management Association

 Highlighting HFMA’s Value Project Research, Mr. Landman will describe how successful hospitals have created value in their physician integration strategies. He will address the common hospital board concern that the employment of physicians is a money losing proposition. 4:30 pm – 5:30 pm The Benefits of an Integrated and Comprehensive EP Program Room: Salon 1 & 2 Darryl Elmouchi, MD, FHRS, Medical Director Cardiac Electrophysiology, Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, MI Sharon Van Beek, BSN, Manager of Electrophysiology, Spectrum Health, Grand Rapids MI

 Dr. Elmouchi will present the Frederik Meijer Heart & Vascular Institute EP program as an example of complete program integration. In this program, the EP strategy, operations and performance are managed by a consistent physician and administrator paired team across all environments. Dr. Elmouchi will overview several program advances, such as the development of an emergency department deployed AFIB protocol as a collaborative initiative that improved the clinical, financial and market performance of the program. 5:30 pm – 6:00 pm Solutions Summary Panel Room: Salon 1 & 2 Speakers from the day 6:00 pm – 7:00 pm Room: The Gallery

Reception with Partners & Exhibitors

7:00 pm – 9:00 pm Group Dinner Room: Plaza Ballroom

Thursday, June 13, 2013 7:00 am – 8:00 am Room: The Gallery

Breakfast with Partners & Exhibitors

7:00 am – 7:30 am MedAxcess Demo Breakfast Room: Plaza Ballroom General Session 8:00 am – 9:00 am A Vision for the Future of Healthcare Room: Salon 1 & 2 Penny Wheeler, MD, Chief Clinical Officer, Allina Health  Organizing hospital structures horizontally, across the care continuum based on disease types appears to be an important structure emerging in the healthcare reform era. Survey data is indicating that systems who embrace the physician-led service line structure in a clinical area tend to expand that approach to additional clinical focuses. In this session, Dr. Wheeler will present Allina’s view of success in the future that embraces physician and clinical integration as a primary strategy.

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9:00 am – 10:00 am Partnering with Emergency Department Room: Salon 1 & 2 Phil Levy, M.D., Associate Professor of Emergency Medicine; Assistant Director of Clinical Research, Cardiovascular Research Inst; Associate Director of Clinical Research, Dept of Emergency Medicine, Wayne State University School of Medicine

AGENDA

 Dr. Levy has extensive experience both leading and participating in collaborative clinical initiatives involving the emergency department and the cardiology service line in his program. Dr. Levy will detail the community emergency department model in Detroit and the many collaborative efforts with cardiology in co-managing patients. 10:00 am – 10:30 am Morning Break with Partners & Exhibitors Room: The Gallery Breakout Sessions 10:30 am – 11:30 am • Session 1 / Clinical Room: Salon 6, 7 & 8 HF Symposium, Part I: Key Features of Programs Aimed at Reducing Heart Failure Hospitalization Nancy Albert PhD, CCNS, CHFN, CCRN, NE-BC, FAHA, FCCM, Associate Chief Nursing Officer, Research and Innovation, Cleveland Clinic Health System; Clinical Nurse Specialist in the Heart and Vascular Institute’s Kaufman Center for Heart Failure at the Cleveland Clinic, Cleveland, Ohio; Adjunct Associate Professor at Case Western Reserve University, Bolton School of Nursing, Cleveland Ohio and the University of Akron College of Nursing,Akron Ohio; Full Professor at Aalborg University in Aalborg, Denmark.

 Patients with heart failure (HF) have a high rate of hospitalization and one of the highest rates of early (30 day) re-hospitalization after discharge. Factors associated with re-hospitalization may involve (1) patients and caregivers, (2) hospital and (3) healthcare providers. In this session, the problem of heart failure re-hospitalization will be described and key components of bundled interventions known to reduce unplanned hospitalization will be discussed. • Session 2 / Financial Room: Plaza Ballroom Defining, Measuring and Adapting: Dashboard Applications in the CVSL

Mark McDonald, Assistant Vice President of The Heart Institute

Dr. Catherine Krawczeski, Cardiac Intensive Care, Director, Quality Improvement & Clinical Effectiveness, Co-Director, Center for Acute Care Nephrology

Cincinnati Children’s Hospital Medical Center

 Monitoring and assessing progress towards the execution of a strategic plan is facilitated by employing a dashboard technique. This presentation will demonstrate the development and articulation of a comprehensive dashboard incorporating clinical, business, and academic metrics with a five year strategic plan associated with the creation of the Heart Institute at Cincinnati Children’s Hospital Medical Center. A detailed outline of the strategic plan will be employed to illustrate the feedback and prospective applications of the dashboard tool.

• Session 3 / OpERATIONS AND MANAGEMENT Room: Salon 1 & 2 Slam-Dunk Strategies for Creating Financial Value in the Service Line Suzette Jaskie, President & CEO, MedAxiom consulting

 The premise for creating integrated approaches to patient care lies in the notion that with alignment, care systems will perform better from a clinical, operations and financial perspective. In this session, Ms. Jaskie will overview several strategies that have reliably resulted in improved financial performance in the cardiovascular service line.

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11:30 am – 12:30 pm • Session 1 / Clinical Room: Salon 6, 7 & 8 HF Symposium, Part II: Keeping Up With Current Heart Failure Evidence – What Resources Matter Nancy Albert PhD, CCNS, CHFN, CCRN, NE-BC, FAHA, FCCM, Associate Chief Nursing Officer, Research and Innovation, Cleveland Clinic Health System; Clinical Nurse Specialist in the Heart and Vascular Institute’s Kaufman Center for Heart Failure at the Cleveland Clinic, Cleveland, Ohio; Adjunct Associate Professor at Case Western Reserve University, Bolton School of Nursing, Cleveland Ohio and the University of Akron College of Nursing,Akron Ohio; Full Professor at Aalborg University in Aalborg, Denmark.

AGENDA

 At the end of this session, participants will be able to discuss results of meta-analyses and systematic reviews that discuss expected outcomes and program features of effective disease management and post-discharge care programs; describe evidence for use of controversial heart failure therapies such as ultrafiltration (aquapheresis), IV diuresis clinics and telemonitoring. • Session 2 / Financial Room: Plaza Ballroom QRUR Report Deep Dive Cathie Biga, CEO, Cardiovascular Management of Illinois

 The physician feedback program, which is a component of the healthcare reform legislation, has been rolled out in 8 states. The goal of the program is to encourage higher quality and increased efficiency in the physician practice as well as to provide transparency toward meaningful performance indicators. The program’s basic data is provided in the Quality and Resource Use Report. In this session, Ms. Biga will provide detailed information as to the reports components and sources of data. Ms. Biga will also overview the expected utilization of the information. • Session 3 / OpERATIONS AND MANAGEMENT Room: Salon 1 & 2 Optimizing the Cath Lab Operations Denise Brown, VP–Business Intelligence Solutions & Senior Consultant, MedAxiom Consulting

 For the past several years, cardiac catheterization procedures have been seeing a downward trend due to multiple factors. The cath lab can, however, remain one of your organizations’ most valuable revenue centers if you are serious about process optimization. During this session, learn from a Lean Six Sigma expert how you can revamp your processes, update your capacity model and balance your staff and costly technical infrastructure in order to make your cath lab more profitable. 12:30 pm – 1:45 pm

SPOTLIGHT EDUCATIONAL LUNCH PROGRAM

Room: Salon 1 & 2 • Aligning Risk in the New Normal – A Manufacturer’s Contribution in Improving Outcomes and Reducing Total Health Expenditure Ryan M. Graver, MPH, Sr. Director, Healthcare Economics, St. Jude Medical, United States Division

Room: Plaza Ballroom • Provider Compensation & Production Review

SUZETTE JASKIE, PRESIDENT & CEO, MEDAXIOM CONSULTING JOEL SAUER, VP – CONSULTING, MEDAXIOM CONSULTING

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Breakout Sessions 1:45 pm – 2:30 pm • Session 1 / Clinical Room: Salon 6, 7 & 8 CV Surgery/Anesthesiology, Partnering for Value

AGENDA

Michael Ronning, CAO, Nebraska Heart Institute Dr. Eric Crimmins, Anesthesiologist, Nebraska Heart Hospital

 At Nebraska Heart Hospital, surgeons, cardiologists and anesthesiologists are integrated into a single practice. These teams of physicians collaborate to deliver cutting-edge programs. Nebraska Heart will share its success in integrating anesthesiology into the practice to optimize the competency, efficiency and economics of the cardiology, cardiovascular and thoracic surgery programs. • Session 2 / Financial Room: Salon 1 & 2 Physician Engagement Impact on Revenue Cycle Margie AMato, MBA, RHIA, ACS-CA, Vice President, Revenue Cycle Solutions & Senior Consultant, MedAxiom Cathie Biga, CEO, Cardiovascular Management of Illinois

 This session will review elements that are critical to reimbursement within the CVSL environment - msDRG’s, AUC, patient status, and discharge diagnosis. Tips and techniques will be shared that emphasize how central the physician is to all these elements and how their documentation directly impacts reimbursement. Those clinical details that only a physician provides, not only determines and charts a patient’s course, it is reflected in cost efficiency and quality report cards. • Session 3 / OpERATIONS AND MANAGEMENT Room: Plaza Ballroom  Healthcare Leadership of the Future: Is it a new story or a roundup of the usual cast of Villains and Hero’s? Why “story” matters for the future of leadership in healthcare ERIC DE NIJS, Principal, The De Nijs Company  The

Healthcare environment continues to change rapidly. Nothing new here. But what is different is the extent to which you as physician leaders and physicians can really make a difference on the patients’ perception of their service, and hence your profitability. The changes that have come and will come are hard to decipher and implement, especially with measures we really don’t fully understand. Creating and presenting a new “story” about the reality and inevitability of a new healthcare system will help all involved understand their role and the impact they can have on patient care and satisfaction. Only when you can engage your staff in a bigger “story” can you begin to transform patient experiences from a transactional feel into a commitment based experience. This short presentation will give you an introduction to the power of story and what you can do to help begin a shift in the relationships that matter most for your success.

2:30 pm – 3:00 pm Room: The Gallery

Afternoon Break with Partners & Exhibitors

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General Session

AGENDA

3:00 pm – 4:00 pm Cultural Integration Case Study – Austin Heart Hospital, HCA Room: Salon 1 & 2 Norman Risinger, MD; South Regional Medical Director, Austin Heart John Rebok, Vice President Physician Services, Central/West Texas Division HCA Healthcare/St. David’s Partnership

 Cultural integration in pragmatic terms is the implementation of the negotiated governance structure of the cardiovascular service line and learning how to co-manage the cardiovascular service line incorporating both hospital and practice culture. Austin Heart Hospital will overview its integration with HCA, the integration of management styles and the eventual cultural integration of the entities. The speakers will overview both style and substance issues ranging from reconciling vision and strategy approach to implementing and working within a new set of management controls. 4:00 pm – 5:00 pm Realigning the Quality Organization with Integration Room: Salon 1 & 2 Jennie Dulac, BSN, MS, VP Clinical Quality, Sisters of Charity of Leavenworth Health System, Denver, CO

 Using her experiences in multiple hospital systems as VP of Clinical Quality, Ms. Dulac will describe the formation of an integrated quality organization in the cardiovascular service line. Ms. Dulac will address such issues as determining the measures, data sources, appropriate benchmarking selection and the participation in registries. She will also discuss important issues of data governance and the incorporation of the quality function within the comanagement structure. 5:00 pm – 5:15 pm Solutions Summary Panel Room: Salon 1 & 2 5:15 pm – 6:15 pm Reception with Partners & Exhibitors Room: The Gallery 6:15 pm Dinner on Own

Friday, June 14, 2013 7:00 am – 8:00 am Room: The Gallery

Breakfast

General Session 8:00 am – 9:00 am Dispersed Physician Leadership Room: Salon 1 & 2 Dr. Charles Brown, Chief of Cardiovascular Services, FACC, FSCAI Dr. William A. Blincoe, Chief Medical Officer, FACC, FSCAI

Piedmont Heart Institute

 Dr Brown will present the Piedmont Heart Institute’s physician leadership model and discuss how the construction of distributed leadership has impacted PHI’s growth and progress. Dr. Blincoe will discuss the impact this structure has had on truly aligning and integrating the physicians with the mission of the cardiovascular service line and healthcare system. The model is based on dispersed leadership among many physicians, who manage outpatient services in addition to the full CVSL through a five hospital system, “hubs and spoke” hospital system.

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Breakout Sessions

AGENDA

9:00 am –10:00 am • Session 1 / Clinical Room: Salon 6, 7 & 8 Clinical Quality Program Terry Carter, Director, Cardiovascular Service Line, Regions Hospital, Health Partners Medical Group, Minneapolis MN Dr. William B. Nelson, Department Head Cardiovascular Services HPMG, Section Head and Medical Director of Regions Heart Hospital, Assistant Professor of Medicine, University of Minnesota

 Health Partners Medical Group is part of an integrated system that owns a health plan in addition to hospital and physician organizations. HPMG’s integration effort has been based largely on continuously improving clinical quality and has developed a quality management dashboard that has been recognized by NCQA. In this presentation, HPMG will present their quality model and discuss its specific application to the cardiovascular service line. • Session 2 / Financial Room: Salon 1 & 2 Incentive Program, OFC based Cathie Biga, CEO, Cardiovascular Management of Illinois

 With the advent of the physician value based program, it is more important than ever for providers to understand the role these programs play in their compensation plans. This session will cover the highlights of the physician VBP, Meaningful Use, eRx, PQRS, and CG TCAPS programs and how to best situate your practice for successful implementation. • Session 3 / Operations and management Room: Plaza Ballroom Clinical Redesign Josh Roberts, Senior Director Transformation and Integration,

Piedmont Heart Institute

Dr. Tom Deering, Chief, Centers of Excellence; Chief, Arrhythmia Center of Excellence; Mark E. Silverman Educational Chair, Piedmont Heart Institute

 Changes in healthcare are forcing us to look critically at our traditional care models and question their efficiency. In this session we will discuss the initiative around Pathway Development at Piedmont Heart Institute. We will highlight the development of Patient First, a novel redesign of clinical care at Piedmont Atlanta, and show how Pathway implementation through the Patient First model is affecting patient care. We will discuss its impact on efficiency of delivery and the eventual measurement of metrics related to improved care delivery. 10:00 am –11:00 am • Session 1 / Clinical Room: Plaza Ballroom Length of Stay Josh Roberts, Senior Director Transformation and Integration Kathryn Lund, Senior Director Clinical Integration

Piedmont Heart Institute

 With increasing pressure on hospital efficiency, length of stay (LOS) continues to be a target of improved performance. In this session, we will describe the effects of the Integration and Transformation department at PHI in attempting to blend clinical and business initiatives. This will include a description of Clinical Pathway development at PHI, and its direct impact on a specific initiative around CABG LOS reduction. We will show the impact of process improvement and how it improves clinical care.

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• Session 2 / Financial Room: Salon 1 & 2 Incentive Program, Hospital Based Cathie Biga, CEO, Cardiovascular Management of Illinois

AGENDA

 From core measure to readmission reduction, the trend is rapidly transitioning from Fee for Service to Value Based Purchasing. This session will cover the evolving hospital based programs and how the CVSL can dramatically impact the outcome. • Session 3 / Financial Room: Salon 6, 7 & 8  Co-Management Model Primer – Case study Joel Sauer, VP MedAxiom Consulting

 Mr. Sauer will define and illustrate several models of co-management including an employed physician model, a model including both employed and independent physicians, and a hospital to hospital co-management model. An actual co-management case study will also be presented.

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