“ROADMAP TO RESULTS”

HOLY FAMILY MEMORIAL

Mark Herzog, FACHEPresident & CEO

Laura FieldingAdministrative Director – Organizational Development

Manitowoc, WI

City of Manitowoc33,545 residents (level since 1990)

Manitowoc County80,976 residents (level since 1990)

80 miles north of Milwaukee

35 miles southeast of Green Bay

Holy Family Memorial

Overview of Holy Family Memorial

▪ Medical Center

▪ Faith based, full range of services

▪ Employed Physician Network

▪ Multi-specialty practice

▪ Regional Orthopaedic Program

▪ Wellness & Prevention

▪ Wellness Center, ACO

▪ Work Health Options/Bus. Connections

▪ Our people

▪ 1,220 Employees including 90 Providers

▪ 300+ Volunteers

single-market, tightly integrated healthcare delivery system including:

Mind ~ Body ~ Spirit

First-Curve to Second-Curve MarketsHow will hospitals successfully navigate the shift from first-curve to second-curve economics?

Between the Curves

Payment Model

Collaboration

Culture

Infrastructure

First Curve FFS

Second CurvePopulation Health

Core Beliefs Driving HFM’s Care System Design

I. Provide the RIGHT CARE – the most effective evidence based approach possible

II. In the RIGHT SETTING – the most cost effective, safest, highest quality and greatest value

III. To achieve the RIGHT OUTCOME – achieve the greatest long term benefit to the patient and society while minimizing physical and financial risk

IV. Cultural and Organizational transformation between the Curves must Maximize Human Capital & Leadership

The results……..

5K

3K

4K

2011

2009

2007200520032001

InpatientEOC

OutpatientEOC

Total Charges (less price increases)

18% Decrease Since 2001 8% Increase

Since 2001

43% Decrease Since 2001

$35M

$45M

$55M

$65M

HFM Inpatients, Outpatients, and Charges: 2001 to TODAY

*EOC-Episodes of Care10/11/12

25% Decrease Since 2001

Nationally recognized for Safety, Innovation & Thought Leadership

Focus on Wellness

& Prevention

90 Employed Providers

2001

90 bed hospital

35 Employed Physicians

Focus on the Sick

Population

HOSPITAL PHYSICIANS & NP/PA

MISSION FOCUS

RECOGNITION

10 Senior Leaders

SENIOR LEADERS

Locally Recognized

35 bed hospital

5 Senior Leaders

2012 HFM Care System Design

150

50

100

0

Major Disease Mortality Rates in Manitowoc County

2010

2008

2006

2004

2002

15.6% Decline in Mortality Rates of

Major Diseases

200

STROKE

LUNG

CANCER

HEART DISEASE

Population Health

▪ Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute have documented a 42% improvement from 2009 to 2011 in Manitowoc County’s overall Clinical Care Rank in Wisconsin moving from 31st to 18th out of the 72 counties.

▪ Led by HFM’s focus on the right care/setting/outcome our community is moving the needle on population health. Other factors include Health Behaviors, Social & Economic and Physical Environment. The challenge in these areas is much greater……..

This very moment on 21st & Franklin……..

Reform Roadmap

Improvement(Incremental/Process)

LEANSix Sigma

Innovation(Service/Operations)

SPURStrategic

Program

Unit Review

Strategic Transformation(Fundamental Model Change)

OPEN INNOVATIO

N

Staff &

Physicians

Leadership

Board/

Community

Reform Roadmap’s Compass

N Hardwire “the HFM way” (I & I) into HFM culture

S Sharpen leadership processes to focus more on strategy and achievement, broader engagement and integrate physician leadership

E Raise the bar for success as a leader, provider and employee –

“We are what we tolerate…we become what we reward.”

W Accelerate transformation by leveraging the Change Support Team

Strategies

▪ Redesigning Care –Be a recognized role model for redesigning the healthcare delivery model to achieve excellent quality, cost and population health outcomes

▪ Exceptional Experience – We will create patient and customer experiences so exceptional that we drive market share to Holy Family Memorial

▪ Ideal Culture – We will have the most innovative, engaged and high achieving culture

Redesigning Care around an

Exceptional Experience by way of

Ideal Culture

2009HFM Culture

Conventional

Dependent

Approval-Oriented

Source: Human Synergistics, Michigan

Shaping HFM’s Culture

IdealHFM Culture

Humanistic/Encouraging

Self Actualizing

Achievement

Leadership Development

▪ Leadership Institute

▪ Leadership Assessment / Ranking

▪ Continuity & Development of Self, Staff & Providers

▪ Administrative Fellowship/Internship

▪ Learning Partnerships

Performance Accountability Review

Source: NCHL

“Rearview Mirror”

Leadership Team Assessment

30% Weighting ABLE TO: competent to

lead WILLING TO: desire to lead

20% Weighting PROMOTABILITY:

Advancement potential

50% Weighting COURAGE TO: internal fortitude to lead CULTURE SHAPING CONGRUITY: ability to fit in

current culture & transform to ideal culture

Every leader ranked 1-5annually

“Headlights ”

9276

68

9080

93

Ldrship Assessment Score"Headlights"

PAR Score-"Rearview Mirror"

Assessment vs. PARSample of Individual Leadership Scores

High Middle Low

Since 2009…

66 of 91 SPURS conducted

SPUR OUTCOMES

Grow/Improve Maintain Reposition

# of Projects 26 26 14

$$$ Impact $447,014 ($259,831)

$2,137,852

Reposition, 21%

Grow/Im-prove, 40%

Maintain, 39%

SPUR - Making a Difference

The Green Dollar Difference

$4.3M

Improvement Savings

2009 – 2011

$2.6M

InnovationImpact

2009 – 2011

$6.9M

Total Improvement2009 – 2011

The Culture Difference

▪ 70% survey participation rate

▪ All categories show significant growth!

HFM’s leadership team welcomes my ideas and suggestions for process improvement

I feel a part of HFM and am excited about its future

I would recommend HFM’s care and service to friends & family

I am proud to work for HFM

EMPLOYEE PRIDE SURVEY%

strongly agree 2008

% stronglyagree 2011

71.1% 87.2%

76.3% 86.7%

48.4% 73.1%

42.0% 64.6%

% Chang

e

23%

14%

51%

54%

The Culture Difference

▪ 47% survey participation rate

I feel a part of and am excited for HFM’s future n/a

I would recommend HFM to family & friends n/a

I am proud to be part of HFM n/a

I have confidence, trust in HFM’s leadership

PHYSICIAN PRIDE SURVEY%

strongly agree 2008

% stronglyagree 2011

40% 87%

90%

81%

88%

% Chang

e

118%

Recent Recognition

Top 25 Most Wired—Small and Rural Hospitals

Healthcare Information & Management Systems Society Stage 6

2010 New North Excellence in the Workplace

4x Recipient of HealthGrades Excellence in Patient Safety

Solucient 100 Top Performance Improvement Leaders

2009 Manitowoc Chamber Business of the Year

REGIONAL RECOGNITION

TOP 2% NATIONALLY

Ideal transitions between Curves is impossible given the uncertain change timetable

Organizational planning & execution risk is increasingly high at the same time detached critical thought is most needed

A highly competent first curve work force will not be the “A” team in the second curve leadership paradigm

Maintaining full engagement of the organization’s Human Capital to connect with the “why” behind our service will be challenging

Success Factors

Reform Roadmap – Aligns transformation process & engages all stakeholders; Governance & Sponsor “on board”

Leadership Development – Maximizing the human capital of aspiring and established administrative, clinical and physician leaders

Culture shaping – creating an increasingly adaptable & achievement oriented organization

Engaged, empowered leaders at all levels – most (not all) can develop second curve competences

BarriersSUCCESS FACTORS & BARRIERS

Thank you!QUESTIONS?