Spectrum Article Kevorkian Jan 2105

SpectrumSociety for Healthcare Strategy & Market Development® January/February 2015

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The Elusive Value-based Purchasing Score

Find out why the value-based purchasing score is getting harder to predict and why HCAHPS is important to track.

By Ginny Kevorkian

In 2012, Beacon Health System’s ex-ecutive team asked me to give an overview of the Centers for Medicare & Medicaid Services’ (CMS) Value-based Purchasing program (VBP) to our management group. Questions kept popping up, such as: How does the scoring for the VBP work? What exactly are they measuring? And, more frequently: How can we tell how we are doing? What should we be focusing on? Two years later, these questions are still relevant, but the answers to some of these questions have changed.

I had developed a model for fiscal year (FY) 2013 designed to track the VBP

score and the financial impact of that score. I came pretty close to the mark, but in truth, predicting the financial impact was like skeet shooting off the back of a moving boat…with a rifle. Marketing professionals may recall the old marketing campaign decision-making analogy: When trying to reach the

broader market, use the shot gun approach. When targeting a small

niche, use the narrower, rifle approach. Predicting the VBP financial impact was

difficult then, but the difficulty has only increased over the last couple of years with changes in the number of measures and categories (domains) and the emphasis placed on these categories.

Q U A L I T Y A N A L Y T I C S

2 Spectrum | January/February 2015

Purchasing Score(continued from page 1)

Society for HealthcareStrategy & Market Development®

PresidentChristine GallerySenior Vice President, Planning & Chief Strategy OfficerEmerson HospitalConcord, MA

President-electLarry MargolisManaging PartnerSPM Marketing & CommunicationsLaGrange, IL

Immediate Past PresidentMark ParringtonVice President, Strategic Transactions and Development Catholic Health InitiativesEnglewood, CO

Executive DirectorDiane Weber, RNSociety for Healthcare Strategy &Market DevelopmentChicago, IL

EditorMary P. CampbellSociety for Healthcare Strategy &Market DevelopmentChicago, IL

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How Does It Work?In 2010, the VBP program was developed to incentivize hospitals to provide high qual-ity clinical and interpersonal care. It sounds simple enough; if a hospital performs well for the items measured, Medicare reimburse-ment will be greater. If a hospital performs poorly, it will be reimbursed less. Currently, nearly 4,000 hospitals participate in this program. The first fiscal year that the VBP program affected was 2013.

A small, but increasing proportion of the annual Medicare reimbursement is with-held from participating hospitals (1.0 per-cent in FY 2013, 1.25 percent in FY 2014, 1.5 percent in FY 2015, 1.75 percent in FY 2016, 2.0 percent in FY 2017 and sub-sequent years). All of the funds withheld will be paid out such that hospitals that do not perform well will not get back all of the proportion withheld from them, and those hospitals that perform well will get their own withheld percentage of their estimated DRG reimbursement and, in addition, they will receive what is withheld from others.

All items earn scores for a baseline time frame and a performance period-time frame. The time frames vary indicator to indicator, but for many indicators, a year’s worth of data is included for both the baseline and performance periods. The fiscal year of fi-nancial impact is roughly a year after the performance period ends. For example, Hos-pital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores for patients discharged in calendar year 2014 will represent the performance period for fiscal year 2016. Items get two scores: one for the performance period and one for how much improvement occurred between the baseline and the performance period. The higher of the two scores is used in computing the total score for each domain.

What Is CMS Measuring?In the first year (FY 2013), there were two domains: Patient Experience of Care (HCAHPS survey) and Clinical Process of Care. The HCAHPS Patient Experience of Care is measured using a survey adminis-tered to patients after discharge. The survey is not limited to Medicare patients, but there are several exclusions (patients under the

age of 18 at admission, patients discharged to hospice, psychiatric DRGs, rehabilita-tion DRGs, and a few others). Initially, the Clinical Process of Care measures included 12 measures, such as discharge instructions for heart failure patients, appropriate antibi-otics for pneumonia patients, prophylactic antibiotic selection and administration prior to surgery, and appropriate venous thrombo-embolism prophylaxis for surgical patients. Since the first year, three indicators have been added and eleven have been removed. Measures are removed when they “top out.” Frequently, this means the national average score reaches over 99 percent and the top performers are at 100 percent.

During the second year (FY 2014), an additional domain was added to the mix: Outcomes (all-cause Mortality for pneumonia, heart failure, and heart at-tack patients). Since then, Efficiency and Safety have been added, so there are now five domains to consider. Some of these new measures are virtually impossible to track. Mortality is “all-cause” 30 days post-discharge; which means if a patient dies anywhere from something unrelated to their hospital stay, it can count as a mortality. The Efficiency domain measures Medicare spending three days before ad-mission and thirty days after discharge. It is not likely that hospitals have access to this information. Safety scores measure conditions such as hospital acquired infec-tions and pressure ulcers. These indicators seem like they might be easier to monitor, but subtleties in coding and adjusting for expected-versus-actual occurrence make them difficult to track as well.

As CMS adds domains, the weight as-signed to each domain to calculate a hospi-tal’s overall VBP scores changes too. Much to the frustration of quality departments who worked hard to improve their Surgical Care Improvement Project (SCIP) scores, once the national average was high and threshold was over 99 percent and the top decile was at 100 percent, the measure was considered “topped out” and removed from the mix.

Exhibit 1 shows how the weight percent-ages have changed over the past few years. Note that the Safety domain was part of the Outcomes domain, but CMS gave it its own domain for FY 2017. We do not know yet exactly what will be included or what the weight will be for FY 2018. With

January/February 2015 | Spectrum 3

the change in weight, it is possible for a hospital to have greatly improved clinical process of care measures and still have a declining VBP score.

On What Should Hospitals Focus?All of the domains and the indicators within them are important, of course. The Out-comes and Safety measures are gaining in emphasis, making them obvious points of focus; however, these measures are problem-atic and complex. What does that leave? Pa-tient experience—HCAHPS scores.

One can argue that patients’ ratings are subjective perceptions and not accurate gauges of clinical quality; that patients mix up the scales; or that one negative interaction can affect a patient’s answers to the entire survey. These issues, however, are common to all hospitals across the nation. Here are three solid reasons why hospitals should focus on their HCAHPS scores:

HCAHPS scores are easily trackable. While performance for Mortality and

Exhibit 1. Value-based Purchasing Domain Weighting over Time

some Safety measures are virtually impos-sible to track, most vendors who adminis-ter the HCAHPS survey can provide data within a couple of weeks after a patient’s discharge. The data are available to act on faster than most other data that feed into the VBP equation.

HCAHPS scores are constant. While the clinical process of care indicators are added and removed each year, and other domains are added, the variables within the HCAHPS survey have remained constant. The survey questions used in the VBP scoring have not changed. There is the likelihood that the newer “Transitions of Care” items will be added to the equation, but they have been a required part of the survey for more than a year. HCAHPS surveys, in some respects, are open-book tests. The survey is available to anyone with online access; thus, all staff in the hospital should know on what they are being measured.

Within the VBP equation, HCAHPS scores are important. The weight CMS puts on HCAHPS scores is relatively high and

remains relatively constant. In FY 2017 (for some indicators, the performance period for FY 2017 has begun), it accounts for as much weight as any other indicator and more than the Clinical Process of Care and Safety mea-sures. By increasing your HCAHPS score, with all other variables held constant, you are likely to increase your overall VBP score.

While precisely estimating your VBP score is virtually impossible, and even tracking how well your organization is do-ing for measures like Mortality is a shot in the dark, it is relatively easier to monitor and affect HCAHPS scores. Although you won’t be able to use the broad shot gun approach with VBP scores and hit all the indicators with one shot, directing your attention to HCAHPS scores will allow a pretty good rifle shot.

Ginny Kevorkian, MBA, PRCManager of Market Research and Strategy

Beacon Health System

South Bend, IN

[email protected]

FY17FY16FY15FY14FY13

100

90

80

70

60

50

40

30

20

10

0

Safety

Efficiency

Outcomes /Safety

Patient Experience of Care

Clinical Process of Care

70

45

20

30

30

10

25

40

5

25

25

25

30

30

25 20 25 20


By informing and engaging the public and building partnerships within its rural community, Brookings Health System has leveraged resources to improve its obstetrics services and outcomes for mothers and children in the community.

By Julia Yoder

Brookings Health System (Brookings Health) is an independent, city-owned system that serves Brookings County and the surrounding rural area. It includes a 49-bed hospital, a 79-bed nursing home, and three rural health clinics. Lo-cated in Brookings, South Dakota, one of its community neighbors is South Dakota State University (SDSU), the state’s largest higher-education institution.

Engaging the CommunityBrookings Health had lost obstetrics (OB) patients to larger facilities in Sioux Falls—South Dakota’s largest city, which is an hour’s

The Power of Community Engagement and Partnerships

drive from Brookings. The larger facilities had greater financial resources and were able to add amenities to the OB experience that Brookings Health could not afford.

To determine how Brookings Health could attract local OB patients to its facility, the health system held birth experience focus groups in 2011. Brookings Health invited community members to voice their opinions about what services they would like avail-able in the hospital’s OB unit. One of those services was the option of doulas, a service the Sioux Falls’ facilities offered.

A doula is a woman who provides con-tinuous labor support during childbirth. She helps with parents emotional and physical needs, making the experience as comfortable and memorable as possible.

As a smaller facility with limited re-sources, Brookings Health instituted a vol-unteer doula program in which volunteers who completed Doulas of North America (DONA) training committed to either one 24-hour or two 12-hour shifts per month. In exchange for the volunteers’ commitment to the health system and the program, DONA

course fees were waived. The volunteers’ ser-vices were offered free of charge to delivering parents, and the health system was the first in the state to offer a free volunteer doula program. In 2012, Brookings Health ex-panded the program and became the first in the nation to offer free volunteer post-partum doulas to parents.

Forming PartnershipsBrookings Health advertised the free doula service and caught the attention of a health communications professor at SDSU. Be-cause the health system broke new ground with the doula program, SDSU approached the health system to join forces and apply for research grants to assess the program’s effectiveness. Professors from SDSU’s com-munication studies, counseling and human development, and geography departments wanted to comprehensively examine the volunteer doula program from a variety of perspectives. Brookings Health saw an opportunity to cost effectively measure its program and learn how it could improve.

In 2012, the two organizations applied

M A R K E T I N GM A R K E T I N G


Exhibit 1. Brookings Supports Breastfeeding Logo

for and received grants from the Rural Health Research Center and the Women & Giving Foundation. The team initiated research by holding focus groups for women who recently gave birth at the health system, including both women who had and had not used a volunteer doula. In addition, the team conducted one-on-one interviews with mothers, volunteer doulas, and the hospital’s medical staff to comprehensively assess the program’s strengths and areas of opportunity.

The study discovered that parents, doulas, and hospital staff all had positive experi-ences with the program. The doulas added a sense of calm for parents and created a constant supportive presence, reducing the use of call lights for nurses. Suggestions for improvement included educating patients on a doula’s ability to provide support for fathers and birth partners and emphasizing the doula’s role as part of the OB team.

Building on SuccessAlso during 2012, Brookings Health formed a partnership with local, independent lacta-tion consultants, including one who taught nursing at SDSU. The group wanted to improve the exclusive breastfeeding rate of mothers in Brookings County and sur-rounding communities.

The group began its efforts with local healthcare professionals who were most likely to influence mothers’ feeding decisions for their infants. The Brookings Health-lactation consultant team received a grant from the US Department of Health and Human Services, Office of Women’s Health,

to offer the course, “Ten Steps to Successful Breastfeeding.” The free course was offered to all community medical professionals in the spring and summer of 2012. Course topics included how human milk is produced, how to help with breastfeeding, and how, during pregnancy care, to promote breastfeeding.

Class flyers were posted in key work areas for health professionals across the commu-nity. In addition, the class was listed in the local newspaper and on Brookings Health’s website and Facebook page. Healthcare pro-fessionals from as far as 50 miles away at-tended the classes, including hospital, public health, and clinic nurses, and doulas.

Expanding CollaborationWhen Brookings Health System started on the path to become recognized as a baby-friendly hospital in 2013, it leveraged the partnerships it had formed with lactation consultants and the university to work to-gether on a new project: improving breast-feeding outcomes within the community. Specifically, the Brookings Health wanted to support and encourage mothers to ex-clusively breastfeed their babies for at least six months. Breastfeeding initiation rates at the hospital were high, but many moth-ers stopped breastfeeding before a baby was six months old.

In line with provisions of the Affordable Care Act, Brookings Health and its part-ners sought to help area businesses support breastfeeding mothers as either employees or customers. To engage the business commu-nity, the partners enlisted the Brookings Area Chamber of Commerce. The team applied for and received a 2013 Bush Foundation Community Innovation Grant, which al-lowed the team to generate and test ideas and implement solutions specific to the Brookings community.

In spring 2014, the joint team—called Brookings Supports Breastfeeding (BSB)—held focus groups with mothers who had breastfed their children within the past five years. BSB also held focus groups with area business leaders to learn how the busi-nesses were currently supporting breast-feeding mothers and what challenges the businesses faced. In addition, the group gathered more data from the community via an online survey.

The data revealed a lack of proper environ-ments to express milk at work or breastfeed

at public locations. In addition, employ-ers lacked formal awareness, education, and policies regarding breastfeeding. The community’s culture was non-supportive of breastfeeding mothers; many individuals felt uncomfortable talking about the subject. In addition, mothers experienced difficulty juggling work demands and expressing milk.

BSB will conduct a charrette on breast-feeding. At the charrette, community mem-bers will be asked to brainstorm possible solutions to the challenges gathered from the focus groups and surveys. BSB will then use the community-driven solutions to apply for implementation funding.

Informing the CommunityPublic relations has proved to be an im-portant aspect of each project and has con-tributed to the overall success of Brookings Health System and its partners. The projects have used both traditional and social media to broadcast partnerships, research topics, and research findings. Radio, newspaper, and television coverage as well as flyers and Facebook posts helped recruit community member participation in focus groups and surveys. Public presentations, newspaper coverage, and Facebook furthered the dis-semination of research results.

By informing the community about the projects, Brookings Health and its partners established goodwill for securing future project funding and also increased public awareness of Brookings Health’s OB services.

In addition, project communications have catalyzed community discussion about health issues. For example, although the BSB team has not yet implemented solutions to help Brookings become a community sup-portive of breastfeeding, several businesses have requested information from BSB and Brookings Health on how to implement lactation rooms for their employees.

The health system’s persistence in inform-ing the community has also supported the goal to attract patients for its OB services. In 2013, the OB unit increased deliveries by 14 percent and, in August 2014, the unit expe-rienced its busiest delivery month on record.

Julia YoderMarketing & PR Director

Brookings Health System

Brookings, SD

[email protected]

broo

kings supports

breastfeeding


Social Media—The New Marketing FrontierFirst address the risks associated with social media, and then reap the potential benefits of increased brand recognition and loyalty.

By Rick W. Smith, Sr.

It seems like every couple of months, a new social media platform finds its way to the web. From Academia.edu to Zooppa.com, social media has changed our world, and it has introduced us to a whole new frontier in the world of marketing.

With new social networking platforms sprouting up like wildflowers, it can be hard to know exactly where to commit your or-ganization’s time and resources. And as we forge ahead in 2015, it’s important to project where social networking is going, and how

and if we should get onboard.At least 42 percent of adults who are on-

line use multiple social networking sites, but one of the granddaddies of them all, Face-book, which celebrated its tenth birthday in 2014, remains the platform of choice, according to the Pew Research Center.1 Facebook boasts more than one billion us-ers and is showing no signs of slowing down. If Facebook were a country, it would be the third largest country in the world, larger than the United States.

According to Pew research conducted in 2014, Facebook is used by 57 percent of all American adults and 73 percent of young people ages 12–17.2 Adult Facebook use is intensifying: 64 percent of Facebook users visit the site on a daily basis, up from 51 per-cent of users who were daily users in 2010.

Some hospital executives reluctantly jumped on, or were pushed on, the social media bandwagon. If you ask some health-care risk managers their opinion of social media use in the company marketing mix, they may tell you they would rather spend limited resources advertising on a hot air balloon. Perhaps that would be safer from a legal standpoint.

While there are a lot of positives when you introduce social media into your mar-keting mix, there are also risks. It’s up to you, however, to decide if the reward outweighs the risk.

RisksActiance, a social media governance expert, identifies five legal issues related to social media.3

M A R K E T I N GM A R K E T I N G


●● Privacy. In healthcare, we have to educate our employees about how a seemingly meaningless tweet or post can threaten a patient’s privacy. If your hospital does not have a clearly defined policy about sharing a patient’s image or distinguish-ing information, you are risking major legal troubles.

●● Content ownership. As with many social media sites that are content-rich, there exists the issue of who owns the content—the site owner or the one who posts the content. Organizations need to under-stand each site’s “terms of use,” which detail ownership rights in various situa-tions, such as the closing of an account.

●● Intellectual property infringement. The rapid-fire exchange of information on

“If you want something new, you have to stop doing something old.”

—Peter F. Drucker

social sites may lead to nonchalance about improperly using material owned by oth-ers. Organizations must be mindful of obtaining the proper permissions to re-print or re-post copyright- or trademark-protected material.

●● Unauthorized activities. Unauthorized issues include harassment, discrimination, unfair competition, and criminal activity, just to name a few. When developing a social media policy for your healthcare facility, make sure that these areas are considered.

●● Regulatory compliance. The main con-cern here is compliance with HIPAA regulations. The Health Information Technology for Economic and Clinical Health Act (HITECH Act) is another important law protecting patient privacy.

RewardsLouis DeFreeze, social media coordinator, KentuckyOne Health System, and Jason Yount, director of Digital Media, Kentuc-kyOne Health System give a first-person account of the rewards of social media. Both agree that if your organization does not have a strong social media presence, you are miss-ing out on reaching thousands of people.

“Social media gives companies the ability to have their voices heard from an organi-zational standpoint,” said DeFreeze. “So-cial media is really a two-way conversation. Traditional marketing was more one-way, using brochures, outdoor boards, etc. That was one-way communication. Social media allows you to hear directly from your audi-ence base and get immediate feedback. It’s changed the marketing playing field.”

At one time, KentuckyOne had three dif-ferent Facebook pages created by member hospitals. Over a two-year period, the Digi-tal Communications department integrated those pages into one “System” page.

“Our team is really a marketing team,” said Yount. “We established policy to ad-dress the changing face of social media, and we continue to try to understand what re-sources need to be brought in to deal with the marketing and non-marketing, public relations, and crisis communications issues that we are now faced with in social media.” According to Yount, “It’s not easy, but it’s worth it. Our social presence is a major part

of our marketing and public relations strat-egy, and there are a lot of departments and individuals who are engaged in making it a valuable resource.”

“We’ve taken customer engagement to the social media platform,” he said. “To-day, more than ever, nearly everyone, if not everyone who works for your organization is a part of your brand voice; they are sales-people for your organization. They can use their own Facebook page to share positive stories, new advertisements, and marketing material with everyone in their network. The results can be extremely valuable.”

As Defreeze sees it, “If you don’t have a Facebook page, you’re missing out on what people are saying about your business, since you get check-in options with Facebook and other social platforms. Interpretation of the business brand is being created for you. It’s much better to listen to the conversation and monitor chatter on your page rather than have the discussions occurring on another page where you are oblivious to what is being said.”

“Your social media channels can drive keyword-rich content to optimize your SEO programs,” said Doug Oakes, of Tallahassee-based DO Design. “If it helps attract search engines, it will boost your search ranking results and increase the amount of traffic to your page. Have well-structured content on your pages, optimize landing pages for search, and promote across all your social channels is a solid strategy for success.”

While there are certainly risks with so-cial media, there are risks in just about any marketing endeavor you choose to pursue. A key to using social media successfully is as-signing the appropriate resources to manage your presence. Social media oversight is not a part-time job anymore…It’s a full-time gig.

Rick W. Smith, Sr., MBAMedia & Crisis Communication Consultant

System Director, Communications

KentuckyOne Health System

Louisville, KY

[email protected]

1Pew Research Center. 2013. “Social Media Update 2013.” www.pewinternet.org/2013/12/30/social-media-update-2013/2Pew Research Center. 2014. “Social Networking Fact Sheet.” www.pewinternet.org/fact-sheets/social-networking-fact-sheet/3Actiance. 2011. “Legal Aspects of Social Media.” http://info.actiance.com/e/10822/cial-Media-Legal-Issues-US-pdf/8DU5/150002881

Exhibit 1. A Measure of SuccessThe table below represents a comparative analysis of physician satisfaction metrics based on a state-wide physician satisfaction survey conducted by Bruno & Ridgway Research, Inc. in 2010 and 2012. The baseline scores were developed in 2010. The results in this table indicate the percentage improvement in physician satisfaction scores in 2012 compared to 2010.


As the healthcare field continues to evolve with new models of care, a strategically based, formally organized physician liaison team can generate substantial dividends to any hospital or health system.

By Mike Slusarz

In today’s highly dynamic market-place, hospitals and health systems across the nation are realizing how important it is to cultivate, engage, and sustain strong relationships with physicians as our industry continues to transform.

As the healthcare marketplace continues to evolve and new models of care are de-veloped, it becomes increasingly important for hospitals to create programs to maintain positive, interactive, and mutually beneficial relations with their medical staff. A strategi-cally developed physician relations program will ensure a high level of physician satisfac-tion, drive volume, support the hospital’s business development goals, and assist in the development of system-based programs to manage the health of populations.

Aligning Community-Based Physicians Barnabas Health, New Jersey’s largest

health care system, with a medical staff that represents one-fifth of the state’s prac-ticing physicians, implemented a system-wide physician relations program in 2005. While the program has evolved over the years in response to local and industry-wide changes, it remains a vital element of our continued success.

Program DevelopmentThe creation of the Physician Liaison Pro-gram presented a unique opportunity to formalize a process to deliver key strategic messages directly to a receptive target audi-ence. The program is driven from the system level with common metrics, segmentation programs, physician satisfaction bench-marks, and alignment strategies. However, it is customized for each of our individual acute care facilities, ambulatory surgery cen-ters, outpatient facilities, and post-acute care providers based on their respective goals.

Several core principles provide the un-derlining factors for success, including a complete understanding of physician satis-faction drivers; real-time data; market-based

metrics; key messaging; online measure-ment tools; and access to, as well as, sup-port from the C-suite.

Program BasicsAn organized approach to creating a physi-cian relations program is the key to success and ensures consistency in effort and policy making. Starting with a defined program structure with clear guidelines, goals, and rules will help empower staff to make the necessary decisions that are prompt and in the best interests of the hospital and its re-lationships with its medical staff.

At Barnabas Health, we found over the years that there are many elements to a suc-cessful program; but the following should be part of any initial endeavor.

●● Staffing—Decide if new staff will be hired or existing resources be used.

●● Research—Create a research strategy that sets a benchmark for physician satisfaction.

●● Targets—Choose your targeted physi-cians based on service line growth, geog-raphy, specialty mix, and referral patterns.

Physician Satisfaction Improvement at Barnabas Health, 2010–2012

Metrics examined in surveys % increaseCommunication between you and the hospital administration 22%

Degree to which hospital administration has positioned the hospital to deal with changes in the healthcare environment 13%

Degree to which this hospital has enhanced your practice 9%

Overall satisfaction with facility 9%

Likelihood you would recommend facility to patients 9%

Would you recommend this facility to other physicians 8%

Degree to which facility makes caring for your patients easier 7%

Quality of care at this facility 5%

Degree to which facility provides timely clinical information 5%

P H Y S I C I A N R E L A T I O N S


Physician SpecificInitial Unscheduled Visit 32Follow-Up Unscheduled 31Initial Scheduled Visit 24Follow-Up Scheduled 20Phone Call/E-mail 10

Barnabas Health Management Services Date range: March 2014

Event 4Office Manager Event 1Grand Total 122

Initiative Specific DetailsDiscussion Topics - Top 10 # of DiscussionsSurgical Services 44General 13Robotic 13Orthopedics 11Women's Services 9Bariatric 8Spine 5Cath 4Sleep Center/EEG 3Gyn/Onc 2

26 25

108

6

InternalMedicine

Obstetrics &Gynecology

General Surgery General &Family Practice

OrthopedicSurgery

Top 5 Specialties Visited

Surgical Services

General

Robotic

Orthopedics

Women's Services

Bariatric

Spine

Cath

125

36

122

Jan Feb Mar

# of Physician Visits - 3 Month View

Exhibit 1. Example of a Monthly Dashboard

●● Communication and education—Sched-ule and plan logistics for regular com-munication activities.

●● Measurement—Develop tools such as monthly performance dashboards, phy-sician satisfaction studies, and monthly volume indicators by service line.

●● Web-based solutions—Track and report on physician liaison activity.

Physician CommunicationOur program began with the creation of a baseline physician satisfaction study. After surveying more than 850 members of our medical staff, we concluded that the key drivers of satisfaction included the ability to improve communication and respon-siveness; timely notification of changes; and openness to physician involvement in program development.

We learned early that each hospital li-aison program could address communica-tion challenges through a liaison model built on practice support and issue resolution. While there are other models, we believed our best investment would be in aligning more closely with our medical staff in terms of communication, relationship building, program development, patient/office staff education, and timely reporting.

Bear in mind that the physician should not be your only point of contact. Rela-tionships should also be cultivated and maintained with office staff, many of whom have great influence in the decisions made by the practice.

At Barnabas Health, we created an in-novative, leading-edge best practice eight years ago to align our office managers through an Office Managers Association

Key Elements in Building Physician Relationships

●● Timely Communications

●● Responsiveness

●● Engagement

●● Practice Solutions

●● Technology recommendations

●● Knowledge of Hospital Resources

●● Business Development


(Continued on page 10)

Physician SpecificInitial Unscheduled Visit 32Follow-Up Unscheduled 31Initial Scheduled Visit 24Follow-Up Scheduled 20Phone Call/E-mail 10

Barnabas Health Management ServicesDate range: March 2014

Event 4Office Manager Event 1Grand Total 122

Initiative Specific DetailsDiscussion Topics - Top 10 # of DiscussionsSurgical Services 44General 13Robotic 13Orthopedics 11Women's Services 9Bariatric 8Spine 5Cath 4Sleep Center/EEG 3Gyn/Onc 2

26 25

108

6

InternalMedicine

Obstetrics &Gynecology

General Surgery General &Family Practice

OrthopedicSurgery

Top 5 Specialties Visited

Surgical Services

General

Robotic

Orthopedics

Women's Services

Bariatric

Spine

Cath

125

36

122

Jan Feb Mar

Number of Physician Visits 3-Month View


Priorities


SHSMD AdvantageHighlighting the benefits of membership

Futurescan 2015: Healthcare Trends and Implications 2015–2020Developed by SHSMD and the American College of Healthcare Executives, this annual environmental assessment delivers insights and predictions that will help guide your organization’s strategic planning for years to come. In Futurescan 2015, a panel of industry thought leaders addresses eight key issues regarding healthcare change and transformation:

●● Developing more cost-effective delivery systems

●● Seizing opportunities for transparency

●● Addressing the decline in reimbursement

●● Choosing a strategy for value-based competition

●● Achieving effective ambulatory-hospital integration

●● Gauging the impact of private insurance exchanges

●● Implementing advanced care planning

●● Adopting individualized medicine

SHSMD members receive one complimentary copy per membership year. (Members as of December 2014 will be mailed a copy of Futurescan 2015 in January.) Make the most of this popular publication by visiting www.shsmd.org/futurescan15 to order additional copies for your leadership team.

SHSMD DatebookMarch 3–4Executive DialogueAmelia Island, FL

October 11–14SHSMD Connections 2015, SHSMD’s Annual Educational Conference and Exhibits Washington, DC

For other news and updates on upcoming professional development opportunities, go to www.shsmd.org.

Aligning Community(continued from page 9)

program. Today, the program has more than 1,000 participating managers. We built a micro-site where association mem-bers can access system-wide forms, EHR information, educational programs, health library content, and support services, and ask questions related to pertinent industry issues or their local facility.

Involve OthersYour physicians and liaison team should not be the only groups aware of your pro-gram and its goals. Staff throughout the hospital must also support your program and embrace their role in creating and maintaining positive relationships with your medical staff. Hospital leadership must maintain a dialogue with your medi-cal staff that taps into their knowledge and gives them a voice in your facility’s strategic growth initiatives.

Metrics and MeasurementThe way you measure the progress and suc-cess of your program will depend on the size of your hospital or health system, the number of physicians you chose to track, and the overall amount of resources you dedicate to the project. However, the most important thing to remember is that you cannot accurately measure your success without gathering pre-launch data and using the results to create dashboards and benchmarks against which future data is interpreted.

Several measures can be used to evaluate your liaison team, including the number of office visits or contacts, the percent-age of scheduled appointments, the top-ics discussed, the specialties visited, the percentage of physicians with back-office numbers, and physician profiles com-pleted in your call center as well as your online physician locator.

Long-term metrics may include call center or online-directed referral growth

rates with new patient referrals to selected service lines. Also, in today’s dynamically changing environment, outpatient and ambulatory surgery volume should be measured and any new changes in split-ter activity, physician acquisitions, or new physician development.

As our industry continues to evolve with new models of care, a strategically based, formally organized physician liaison team can generate substantial dividends to any hospital or health system. Your team can provide the market intelligence to build partnerships, adjust to competitive chal-lenges, and enhance long-standing rela-tionships with your medical staff, ensuring the continued success of your organization.

Mike SlusarzVice President Marketing & Corporate

Communications

Barnabas Health

West Orange, NJ

[email protected]


●● Organization is key—An activity track-ing system is crucial to the process, best kept secure, but accessible to liaisons and managers.

Patient Satisfaction Data

I act as the liaison between our hospital and our vendor for the

patient satisfaction survey process. I oversee the reporting process and how the data is being utilized by our manag-ers and communicated to staff. Can you share your organization’s procedures for using your patient satisfaction data?

One of our strongest initiatives is “The Weekly Huddle.” This CEO-

led, accountability-based meeting brings together department leaders in a joined effort to improve the care and service we are providing. During this meeting our emergency department, surgery, and high- and low-scoring inpatient areas report on current scores and initiatives, and ask for assistance, if necessary. In the six months following the first meeting, we saw our scores rise by 12 percent. Weekly satisfaction reports are broken down by service and units. Scores are reported weekly, quarterly, and yearly by section. Monthly reports are posted on the intranet for all employees to see at their convenience. Scorecards are also

generated for each service, department, and category, showing a 12-month trend, per-centile rank, goals, good-to-very good per-centiles, top priorities for organization and unit, and unit-specific yearly analysis along with the names that were mentioned in the surveys for each area. These are printed on 12”x18” posters and posted in each area monthly.

Measuring Community Outreach Efforts

In today’s healthcare environment, there is an interest in community

health improvement as well as business development growth. How does your hospital/health system evaluate and measure the impact and success of your community health and outreach efforts?

Under the ACA, hospitals will be rewarded for improving the health

status of the people in the community. And now, hospitals that improve community health are able to reduce readmissions and improve revenues. This requires that hos-pitals work more closely with their public health department (state and local) as well as with schools, businesses, neighborhood associations, faith organizations, and others. Every community health initiative should have a call-to-action that can be measured, such as emails received, number of visits to table, documents distributed, and number of appointments set. When the patient has their first visit, they should be asked how they found out about the practice/hospital, and this should be recorded in the system so that it can be pulled with charge and demographic information.

Note: The excerpts above may have been edited for clarity and length.

Edited by Gina SchlagelDirector of Integrated Marketing

NSLIJ-Staten Island University Hospital

Staten Island, NY

Building Referring Provider Relationships

We’ve been going back and forth about how to build better relation-

ships with referring providers. I’m won-dering if and how you are building and maintaining these relationships. Does Marketing coordinate?

Traditional “physician relations” is getting more complicated by the

changes to physician status (independent vs. employed), changes with insurance plans accepted, and more. What works best for us:

●● Boots on the ground—Face-to-face visits to physicians from a hospital’s physician liaison build relationships and help gather market information. Often based out of the marketing office or the CMO office, the physician liaison team can include members of management.

●● Become a valued resource for the physi-cian—More than promoting your hospi-tal’s services to the referring community, your goal should be to remove any ob-stacles they face when using your facility.

The following questions and answers come from some of the most active discussions on SHSMD’s listservs. SHSMD’s four members-only listservs—Marketing, Physician Strategies, Strategic Planning, and Public Relations/Communications—offer lively forums for peer-to-peer exchange.

If you are interested in editing an edition of “Community Connections,” please write [email protected].

C O M M U N I T Y C O N N E C T I O N S

2015 SHSMD Executive Dialogue: Creating Paths for Action

March 3–4, 2015 | Omni Amelia Island (FL) Plantation Resort

Healthcare strategy and marketing leaders must stay ahead of the changing landscape, frame issues, ask provocative questions, and move organizations to take action.

Join your senior healthcare strategy peers in a fresh exploration of the changing consumer-driven healthcare landscape. Attendance at this meeting will provoke the thinking—and action—your organization needs.

The 2015 SHSMD Executive Dialogue schedule will include discussions around:

• New Models ... for Price Transparency • New Models ... of Payment

• New Models ... in Primary Care

Guest speakers include: Jennifer Schneider, MD, MSVP, Strategic AnalyticsCastlight Health

Alan MurrayFounder, President and CEONorth Shore-LIJ CareConnect

Michael Hochman, MD, MPHMedical Director for InnovationAltaMed Health Services

Register today at WWW.SHSMD.ORG/EXECUTIVEDIALOGUE, and start making your plans to attend the 2015 SHSMD Executive Dialogue.

Spectrum Article Kevorkian Jan 2105

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