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Sutter Medical GroupMedical FoundationsState, Regional, and LocalThe National Accountable Care Organization CongressLos Angeles, CaliforniaOctober 27, 2010Don Wreden MDPresident/CEO1
Our PremiseThe Critical Componentsof Accountable Care Organizationsare being built within Sutter Health2
Our PremiseMedical Foundationsare a critical component to thedevelopment of AccountableCare Organizationswithin Sutter Health3
Sutter Health(Before 1995)Hospital Company4
Sutter Health(After 1995)Integrating Health CareDelivery System5
We’re Creating Northern California’sFinest Health Care Network Serving more than 100 cities and townswith:26 acute care hospitals3,400 physicians (7 physician medicalfoundations)Approximately 41,000 employeesMore than 800 community trustees 6.7 billion in revenues (2005) 6.5 billion in assets (2005)Home health & hospice, and long-term careservicesMedical research and medicaleducation/training24 Fundraising organizations; 60- 80million raised each year6
Sutter Health’sEvolving Physician NetworkMedical FoundationsParticipating IPAsSutter Medical FoundationSutter North Medical FoundationSutter Gould Medical FoundationPalo Alto Medical FoundationSutter Medical Foundation North BaySutter Regional Medical FoundationSutter East Bay Medical FoundationSutter Physician Foundation CPMCSutter Independent PhysiciansAlta Bates Medical GroupMarin IPAMills-Peninsula Medical GroupCentral Valley Medical Group7
Growing Contribution byMedical FoundationsSutter Health100% 7890% 619 15818% 2,031 25%80%net operatingrevenue(in millions)70%60%50%40%2000 - 2008 2,771 6,09230%20%10%0%2000Acute Care2008Medical FoundationOther8
Our New Region Structure9
Sutter HealthSacramento Sierra Region10
Sutter Health Sacramento Sierra Region11
Regional Department Evolution1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008Palliative Care ProgramDiagnostic Imaging SystemsClinical EducationHR Data ProcessingMail ServicesSutter Select EPO Case ManagementPension administrationEmployee HealthRegional SafetyAncillary Services from SMCExpand EICUIT Reorg/ConsolidationExpanded Case ManagmentSutter DifferenceRegional WebRegional LearningEICUDecision-supportDisability MngmtCBORecruitmentIT/CIOQuality ManagementCase ManagementService LinesAccountingAncillary ServicesSupport ServicesHuman ResourcesSecurityCredentialingMarketing, Comms., Busuness Dev.Family Practice Res.XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX12
Sutter Medical GroupSutter Medical Foundation13
Sutter Medical GroupSutter Medical FoundationHistory14
Sutter Physicians tionSutter Physicians AllianceSutter MedicalGroupSutter WestMedical Medical GroupClinically Integrated Network Common approaches to managing population Allows for integrated quality of care programs Creates efficiencies similar to financial risk sharing15
Sutter Medical GroupSutter Medical FoundationSuccesses– Service and Quality– Patient Satisfaction– Access– Clinician Satisfaction– Growth– Affordability16
Value of Medical Foundation(in ACO world)Or"Are Medical Foundations just ahospital ployto preserve control/market?"17
Value of Medical Foundation(in ACO world)Together with Sutter Health's MedicalFoundations, physicians arecoordinating care and removingbarriers to improve Quality,Affordability, and the Experience ofpatient care.18
Physician perspectiveon Medical FoundationsDownsideDecreased "autonomy"- Economic- Strategic- Staffing19
Physician perspectiveon Medical FoundationsValue1. Capital not on backs of physicians(increasingly unpalatable)Buildings, infrastructure, EMR, etc-Enables creation of new facilities (patient centric)-EMR - EPIC use very highCommon record for all to be informedProtocolsMy Sutter OnlineeMessagingReal-time communication – Doctors Lounge 20
Physician perspectiveon Medical FoundationsValue1. Capital2. Framework to Integrate Inpatient andOutpatient Care- essential for patient centered care21
Physician perspectiveon Medical FoundationsValue1. Capital2. Integrate IP and OP3. Aligned goals in Strategic PartnershipLeadership Training and Education22
Physician perspectiveon Medical FoundationsValue1. Capital2. Integrate IP and OP3. Strategic Partnership4. Physician Freedom (relatively) to focuson care, quality, improvement23
Physician perspectiveon Medical FoundationsValue1. Capital2. Integrate IP and OP3. Strategic Partnership4. Physician Freedom5. Multispecialty Medical Group nurturesclinically rich experience- Supports Primary Care- Immediate communication- Aligned incentives as colleagues24
Physician perspectiveon Medical FoundationsValue6. AffordabilityWe have gained experience managing riskChronic Care Management TeamsCHF ProgramLow back painHospitalists25
Physician perspectiveon Medical FoundationsValue1. Capital2. Integrate IP and OP3. Strategic Partnership4. Physician Freedom5. Nurtures Multispecialty MedicalGroup6. Affordability26
Blue Ribbon Team IIPatient Centered Care at the Core ofObserved Best ipsOperational ovementMethodologyCultural CharacteristicsFinancialAlignmentExecution27
Building a System of Coordinated Care28
Value of Medical Foundation(in ACO world)Together with Sutter Health's MedicalFoundations, physicians arecoordinating care and removingbarriers to improve Quality,Affordability, and the Experience ofpatient care.29
Questions?Comments?30
Sutter Select EPO Case Management Pension administration Employee Health Regional Safety Ancillary Services from SMC Expand EICU IT Reorg/Consolidation Expanded Case Managment Sutter Difference Regional Web Regional Learning EICU Decision-support D
