University of Utah Healthcare Value Management System Bob Pendleton MD FACP Chief Medical Quality Officer
Apr 02, 2015
University of Utah HealthcareValue Management System
Bob Pendleton MD FACPChief Medical Quality Officer
Goal: Exceptional Value
INPATIENT: Rate this Hospital 1-10 (% total patients choosing 9-10)UHC National %tile Rank
UUHC: Becoming the Provider of Choice
UHC
Natio
nal %
tile R
ank
2008 2009 2010 2011 2012 2013 2014YTD0
25
50
75
100
18
39
65 6478 75
94
UUHC: Nationally Ranked Outcomes
* UHC Quality & Accountability Annual Scorecard
2008 2009 2010 2011 2012 2013
947
1
37
50
*Ranking out of >98 National AcademicMedical Centers
Use of ColorPayers of Healthcare & a sample of Value related Initiatives
EmployersGovernment Insurers (e.g. Regence, etc.)
Medicare(CMS) Medicaid
IPPS OPPS
PQRI
CMMI
IQR VBP HAC HRRP MU
OQR MU
HEDIS
Public
Direct &Rankings
Direct Contract
ACO
PQRS MU
277 measures
402 measures
464 measures
614 measures
700Measures
& counting…
Growth of National Value Metrics
Value Management System:
Service Delivery
System Management
Resource Management
Measure, Analyze, Improve
Inputs OutputsService DeliveryService Delivery
Safety Committee (QM.8)
QMOC (QM7)
Document Control Cmt
Value Creation Team
Support Services
Value Council (GB.1)
HCEC
Medical Board
Hospital Board
Clinical Services
Management Review:Audit resultsCorrective actionsMeasurementAnalysis
Governing Body:Operational oversight of clinical delivery system
Basic Structure of our VMS
Value Core (QM.7)
Clinical Services
Value Council (GB.1)
Chief Value OfficersRob Glasgow - SurgeryPeter Yarbrough - MedicineChris Pelt- OrthopedicsSusan Baggaley - NeurologyMeic Schmidt - NeurosurgeryJohn Bohnsack -PediatricsJerry Hussong- PathologyHoward Sharp – OB GYNBernadette Kiraly – Family MedicineMark Eliason - DermatologyJim Ashworth- Psychiatry Dave Gaffney- Rad Oncology
GMEValue Council
• System alignment• System goals• System mgt.
Measure & Analyze at the Department level…
Standard value
Entitlement
• Typical approach to system performance & improvement:
• BUT- isn't every patient entitled to optimal performance?
Poor value Optimal value
Average value
Value Management System: Focus on Improving Processes
• Focus on Results Problem Solving (Reaction)
• Focus on Process Problem Prevention
Fix Problem 1
Fix Problem 2
Fix Problem 3
Redesign Process to Prevent Problem 1
Build Standard Work & Forcing Functions Monitor Results Improve Process
Further
Redesign Process to Prevent Problem 2
Build Standard Work & Forcing Functions Monitor Results
Redesign Process to Prevent Problem 3
Build Standard Work & Forcing Functions
How?
Value Improvement Methodology:1. (re-)Define2. Problem & Goals3. Analyze & Investigate4. Design & Implement5. Impact
Improve Value
1
2
3 4
5
Improve Value
1
2
3 4
5
Improve Value
1
2
3 4
5
Improve Value
1
2
3 4
5
VALUE SUMMARY
YOU (& your residents) voice & input is critical:
GMEC sponsored group to facilitate two-way input on UUHC value efforts
Coordination with the CVO in your Departments Should CRIT (empowered CMRs) remain a vehicle? System use of Value Summary Core training from Value U Safety event reporting & subsequent management