MGMA 2014 Annual Conference 10/27/2014 Las Vegas, NV
Aligning Physician Compensation
Plans Towards Pay for Value
Presented by: Rick Cameron, Navigant Consulting Malcolm Isley, Greenville Health System Shon Brink, GHS University Medical Group
LEARNING OBJECTIVES
»
This session will provide you with the knowledge to:
› Create your own approach to evaluate and change compensation
plans
› Integrate governance, leadership and management tools throughout
the process
› Establish, integrate and sustain support for the desired outcomes
throughout the process
2
AGENDA
I.
A Bit of History: Greenville Health System
University Medical Group
II.
Compensation Plan Articulation
III.Compensation Plan Redesign Process
IV.Convert Planning Into Actions
V.Lessons Learned
Malcolm W. Isley Vice President, Strategic Services
GREENVILLE HEALTH SYSTEM OVERVIEW
4
Fast Facts
• More than 12,000 employees
• $1.7 million per week on our own
employee health care Academics
• 202 medical residents and fellows in
8 residency and 7 fellowship programs
• USC School of Medicine Greenville – first and second class matriculated • USC medical students receive 3rd
and 4th year training at GHS
• More than 1,350 nursing students
receive part of their training at GHS each year
• Training for multiple allied health professions FY ‘13 Actual FY ‘14 Budget Revenue* $1,807.6 $1,855.1 Expenses* $1,745.8 $1,800.8 Discharges 46,897 50,875 Patient Days 308,644 325,632 Outpatient Visits 2,883,297 3,097,703 Data Snapshot *In Thousands
(These statistics include Baptist Easley Hospital data)
GHS: A Critical Community Resource
5
BIRD’S EYE VIEW
• 8 Campuses •1,756 beds* • 12 Specialty Hospitals • 746 bed Tertiary Care Center • More than 170 Practice Sites (and growing) *Includes Baptist Easley 4 6 2 3 7 1 5 8 1. Greenville Memorial Medical Campus 2. Greer Medical Campus 3. Laurens County Memorial Hospital 4. North Greenville Medical Campus 5. Oconee Medical Campus 6. Patewood Medical Campus 7. Simpsonville Medical Campus 8. Baptist Easley Hospital 6
Our Vision
Transform health care for the benefit of the
people and communities we serve.
Our Mission
Heal compassionately. Teach innovatively.
Improve constantly.
Our Values
Together we serve with integrity, respect,
trust and openness
WHO WE ARE AND WHAT WE STAND FOR
7
HEALTHCARE IS CHANGING
Traditional Fee
for Service…
At-Risk
Payment…
8
GHS INNOVATION CYCLE
Freestanding Hospital
Hospital System
Academic Health Center
GHS Organizational Evolution O rgani zat ional Success -A ch ie vin g t h e V isio n – Q u a lit y – M a rk e t P re s e n c e – A ff o rd a b ilit y – V a lu e -C om m uni ty Im pac t -G ro w th Regional/ Statewide Network
Integrated Delivery System
Regionalization and Growth System Integration
Clinical University Risk Capable Operation
VISION/MISSION/VALUES TO ANNUAL GOALS
Management Staff Goals
Management Priorities AnnualVP Goals / Chair Goals
Executive Priorities Annual Multi‐Year Strategies Bridge annual system goals and strategic plan 3‐5 Years System Goals/Pillar Goals Organizational Priorities AnnualStrategic Plan
Organizational development, markets, products, platforms, partnerships, customers 5‐8 yearsVision, Mission, and Values
Why we exist; who we serve 10+ years Strategy to Annual System Goals 10CREATING A RISK CAPABLE ORGANIZATION
Multi-Year Strategy What the SC Market Will Look Like in 2020
Total Health Organization
GHS will be part of a Clinically Integrated Network that includes providers across South Carolina representing more than 250,000 lives under population health agreements
Health Care Value Leader
Populations actively managed by GHS and the Clinically Integrated Network have better quality outcomes and cost
payers less than un-managed populations
System Integration GHS participates, either as a single system or through a
collaborative with others, in a SC-based initiative
Innovations in Academics
GHS Clinical University trains a significant portion of our workforce skilled in delivering Total Health, attracts biomedical
interests that advantage our patients, and brings new revenue streams to the system and the region
Sustainable Financial Model
GHS is able to make a sustainable margin on Medicare
fee-for-service, commercial capitation, exchange products, Medicaid
and other lines of business through standardized care processes and efficient operations
11
WE WILL MAKE VALUE-BASED CARE WORK IN THE
UPSTATE; AND WE NEED TO CONNECT STATEWIDE
Upstate Midlands
Low Country Pee Dee
CAREFUL CONSIDERATIONS
13
5-Year to 10-Year Time Horizon
Op eratin g Marg in ($s) Fee-for-service Value-based Reimbursement Transition Zone
Early Stage Pilots and Payer Demonstrations (e.g., employees)
Completing Transition to a New Model Preparing for a Change in
the Basis of Payment
Managing Transition Economics in a Market Moving to Value-based Reimbursement
Well-Timed Transition Lagging Transition Early Transition
Cost of Moving Too Fast
Cost of Moving Too Slow (and growing)
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System Optimization
Advancing on 2 Axes of Integration Over Time
Enterprise health system-to-health system integration H O R I Z O N T A L I N T E G R A T I O N Integration of services Optimize Integrate Align Aggregate
Expanded shared services & joint clinical program
development Upstate’s Value Leader 14 Physician Organization Development UMG Laurens/Oconee MDs Primary/Specialty MDs CIN Advancement MyHealth First –Greenville –Laurens –Pickens –Oconee –Greenwood GHS employees BlueChoice MSSP Health Facilities M&A V E R T I C A L I N T E G R A T I O N PopulationsServing
Becoming a Risk-Capable Organization
System-Wide Cost Reduction Initiatives Right-Sizing the System EPIC Ambulatory Network Development –Spartanburg –Anderson Contracts w/ Major Employers Achieving Economies of Scale & Scope Initiant Health Collaborative
Laurens Oconee
UMG’s Transformation into a
High Performance Medical
Group
Physician Extenders
Extender # Extenders
Advanced Practice RN 2 Audiologist 5 Certified Nurse Midwife 7
CRNA 142
Doctor of Philosophy 4 Doctor of Psychology 5 Doctor Podiatric Medicine 2 Nurse Practitioner 111 Occupational Therapist 5 Physicians Assistant 69 Registered Dietician 1 Social Worker/Counselor 9 Speech Pathologist 2 TOTAL 364
UNIVERSITY MEDICAL GROUP (UMG)
16 Specialty Physicians Specialty # MDs Cardiology 25 Emergency Medicine 52 Hospitalists 46 Neurology 8 Neurosurgery 6 OB/GYN 22 Oncology 27 Ophthalmology 2 Ortho/Sports Medicine 39
Other Medicine Specialties 56
Otolaryngology 9 Pediatrics 55 Physiatry 10 Psychiatry 15 Pulmonary 16 Radiology 39 Surgery 62 Urology 9 TOTAL 498 Community Practice Physicians Specialty # MDs Family Medicine 47
General Internal Medicine 55 MD360 28
OB/GYN 31
Pediatrics 89
Primary Care Sports
Medicine 4
TOTAL 254
Source: SyMed Database, dated 6.06.14
818 Total MDs
(752 employed and 66 contracted)
1,185 Total Providers
Contracted Physicians
Specialty # MDs
Anesthesia 41
Neonatal Intensive Care 8
Pathology 17 TOTAL 66 Contracted Extenders Extender # Extenders Pathologist Assistant 3 TOTAL 3
UNIVERSITY MEDICAL GROUP PHYSICIAN EXPANSION
AS OF 6/06/14
*Estimate 42 70 73 76 75 104 125 148 166 178 185 208 258 84 141 155 193 208 238 271 326 376 392 443 478 498 126 211 228 269 283 342 396 474 542 688 752 813 822 0 100 200 300 400 500 600 700 800 900 2002* 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Contracted Specialty Care Primary Care Total Ph ys ic ian C ount Fiscal Year 17WHAT IS UMG?
18 Anesthesia Pathology Psychiatry Medicine Ob Gyn Surgery Orthopaedics and Neurosurgery Pediatrics Radiology Family Medicine Emergency MedicineHISTORICAL PERSPECTIVE
»
UMG was based upon a Department model
› Facilitated rapid growth in clinical and academic affairs, and alignment within medical staff affairs
› Chairs had significant responsibility and authority of their departmental activities
»
And this was all good, but created silos that did not advance
System/UMG priorities
»
UMG is NOT a faculty practice plan or foundation model: it is part of
the System
19
The primary business of UMG Board
• Ambulatory and Acute Care practice • Practice operations/business • Growth and regionalization • Service and access • Patient and employee satisfaction • Faculty composition • Compensation models and practices • Clinical Quality Clinical University • Research • Clinical • Education • GME • CME • UME Medical Executive Committee • Credentialing and privileging • Medical Staff policies • Regulatory and Accreditation Compliance
Clinical
Affairs
Medical
Staff
Affairs
Academic
Affairs
THE ROLE OF THE CHAIRS
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WHY CHANGE?
There is a better way….
»
To care for and serve our patients and families
› Serve the needs of the patient across the continuum through clinical integration › Provide interdisciplinary evidence-based protocol-driven standardized care › Identify and fill gaps in care and service profile»
To bring more value to health care
› Payment model is changing to focus on outcomes rather than inputs › Eliminate inefficiencies found in silos› Engage with businesses, payors and patients who look at us horizontally rather than vertically › Focus physicians on system goals and alignment with the hospital: patient safety, quality, cost, growth
»
To create a healthier Upstate
› Expand collaborations across Greenville and the Upstate to improve community health status › Leverage a multidisciplinary team to tackle previously intractable issues that drive health disparities › Create opportunities for community engagement in developing a healthier Upstate
THE JOURNEY TO A HIGH PERFORMANCE
MEDICAL GROUP
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Graphic: HCAB
WHAT IS THE UMG BOARD?
»
Decision-making body for University Medical Group; Governance is
through GHS Board of Trustees
»
Comprised of all 11 department chairs, Executive Vice President
Clinical and Academic Services, Vice President and President of GHS
Clinical University, VP Clinical Integration/CMO, UMG Chief
Administrative Officer, Executive Vice President and COO of GHS
»
Activities are informed by a set of Guiding Principles and bylaws
developed by the members
23
UMG COMMITTEES: STRATEGIC AND POLICY
ORIENTED
» Executive Committee
› Policies and procedures; bylaws › Agendas and priorities
› Leadership development and succession planning ; nominations
» Finance Committee
› Operating budget › Capital
› Reimbursement and revenue cycle › Alternative payment; pay for performance » Provider Workforce and Compensation Committee
› Manpower planning › Compensation models and standards
› Physician services contracting » Information Technology and Data
› Information systems › Data flow and integrity » Academic Affairs – Academic Council » Medical Staff Affairs - MEC
» Clinical Operations › Practice operations › Administrative Structure › Quality › Human resources » Commitment to Excellence
› Employee and patient satisfaction › Patient experience › Communication strategies and mechanisms » Clinical Practice and Value Based Health Care
› Evidence-based care › Professional standards and conduct › Value based health care » Market and Business Development
› Clinical priorities, marketing priorities › Network development/expansion › Regionalization and affiliations › Growth
› New business and product development
WHAT THE UMG BOARD IS NOT
»
The Board will NOT run the departments»
The individual Chairs will retain responsibility for:› Implementing policy and strategy decisions within their own departments › Conducting professional practice evaluations for physicians
› Serving as clinical role model and leader of the department and promoting teamwork both within a department and between/among other departments
› Ensuring quality
› Focusing attention on physician recruitment and retention
› Promoting research, academics and education within their own department
»
System will invest in UMG and Departmental support structures to ensure success› Vice Chairs, Division Chiefs, Medical Directors, Academic Support, Administrative support, etc.
25
COMPENSATION PLAN ARTICULATION
(JUNE – SEPT 2012)
› This was one of the outcomes of Chairs Leadership Integration
› GHS Strategy - how does changing physician compensation plans impact strategy
•
Recognized that healthcare landscape was changing•
Needed to have closer coordination of System and physician goals•
Had 25 variations of legacy compensation plans which incented differentbehaviors
› UMG BOD formed Work Force and Compensation Committee – 3 year term
•
Very large Committee - 20 members•
Department representatives, administrative leaders•
Had non-employed specialties(ED/ Anesthesiology/Pathology) also, as efforttoward System Integration
•
No Department Chairs other than Chair of Committee•
Compensation Consultant provided expertise, insight and guidance throughoutthe Compensation Planning process
26
COMPENSATION PLAN ARTICULATION
(JUNE – SEPT 2012)
› The formal charge of the Compensation Committee with regard to Physician Compensation was:
•
Create guiding principles for compensation models that advance GHS strategies,priorities, vision and mission
•
Inventory all compensation models within each department, evaluateeffectiveness and alignment with guiding principles, and develop approved UMG-wide compensation models with implementation plan and timeline
WORK FORCE AND COMPENSATION COMMITTEE
(SEPT 2012 – MAY 2013)
› Twice a month 2 hour meetings with 1 day Retreat near end (17 total meetings).
•
Basic education for members on plan design principles and legal environment•
All Department Chairs/Directors prepared and presented their existing plans in astandardized format (2 months)
•
Presentations by internal content experts on payer relationships, GHS strategiesand network development, and medical education funding associated with Physician Compensation
•
Developed Principles and Behaviors to be incented through a compensation plan•
Developed initially 4, and ultimately 2, compensation plan templates that wereused by each department/division to craft specific plans
28
WORK FORCE AND COMPENSATION COMMITTEE
(SEPT 2012 – MAY 2013)
› Leadership updates and connections/how and why they worked
•
Schedule was developed and followed•
Committee Chair (Chair of Psychiatry) reported regularly to UMG Board•
Key recommendations approved as developed rather than whole plan as package•
Larger physician leadership group of approximately 100 physicians had 3-4special meetings with inside and outside presenters to keep information flowing-no surprises
•
GHS management provided updates to GHS Governance Committee – the boardcommittee responsible for compensation oversight
29
SHARED PRINCIPLES AND BEHAVIORS TO INCENT
› Committee developed and the UMG Board approved the following Compensation Plan Design Principles:
•
Overall Goal– Attract and retain quality physicians – Align compensation with services delivered – Aligns with system direction, goals and performance
•
Integration and Alignment– Recognizes individual and group performance
– Rewards activities in academics, quality, growth, and outcomes – Promotes integration and cooperation across departments and medical
specialties
› Committee developed and the UMG Board approved the following Compensation Plan Design Principles:
•
Structure and Application– Easy to administer, understandable, and manageable number of plans – Fair market value and commercially reasonable
– Plan changes have adequate time for transition
•
Economics– Financially sustainable
– Internally equitable and externally competitive
– Sensitive to changing reimbursement and payment landscape
SHARED PRINCIPLES AND BEHAVIORS TO INCENT
31
SHARED PRINCIPLES AND BEHAVIORS TO INCENT
› From the Principles and an understanding of GHS strategies, the following behaviors were identified that the new compensation plans should incent:
•
Higher Priority Behaviors to Incent– Physician Productivity – Work RVU – Physician Productivity – Access
– Revenue Cycle Support (chart completing, coding, etc.) – Group Based Outcomes/Quality
– Group Based Clinical Cost Effectiveness – Practice Operational Performance/Budget Management
•
Other Behaviors to Incent– Patient and Employee Satisfaction – Academic and Research Contributions – Division/Department Participation
32
COMPENSATION MODEL TEMPLATES
› Phase A – Committee formed 4 subgroups to consider plan designs “unique” to each of 4 specialty-based “groupings”
•
Primary Care Model (Internal Medicine, Family Medicine, Pediatrics, OB/GYN)•
Hospital-Based Specialty Care with Ongoing Program Support Model(Hospitalists, Inpatient Psychiatry, Radiologists, MD360 Physicians, Psychiatrists, Pediatric Sub Specialists)
•
Hospital- Integrated Specialty Care Model (Cardiology, Surgery, Pulmonary)•
Specialty - Outpatient Based Model (Dermatology, Allergy, Rheumatology)› Three items became apparent as the 4 Plans were developed
•
Particular physician practices may not fit into the model plan initially conceived forthe specialty grouping
•
Need to assure that compensation was aligned with system initiatives and havingupside potential be based on maximizing same behavior types across all plans
•
Desire to accommodate different specialty physicians/groups = resulted in moreCOMPENSATION MODEL TEMPLATES
› Therefore, Committee determined that 2 plans were appropriate – one based on a salary model and one based on a productivity model
•
Was important to ”seek simplicity” for ease of use going forward•
Also determined that wRVUs were preferred productivity measure until such time aspopulation health contracts became a “material part” of any UMG practice
•
Further determined that relative weighing on various activities needed to be establishedannually by the department and potentially at the group/practice level as well – Ranges were established which may vary across and within departments
» Example: difference in practice and system needs for IM physicians practicing in a community setting versus IM physicians more closely aligned with teaching, or which takes a lead in risk based contracting
•
Flexibility provided to departments to develop detailed plans unique to circumstancesusing the 2 plan templates
•
To achieve consistency across departments, a Compensation Management Committeewas also established to oversee ongoing development/application
34
COMPENSATION MODEL TEMPLATES
› Model Plan “A”
•Individual/Group Productivity Based Earned Income (70%-95% of total clinical
compensation)
•System Initiatives (30% - 5% of total clinical compensation)
•Pool for Upside Potential (up to 10% extra for, first, hitting two “affordability triggers” and
then, maximizing system initiatives and/or shared savings distributions under health plans)
•Non-Clinical Base Salary (for teaching, medical directorships, administration)
•Total compensation will comply with relevant federal laws and regulations
› Model Plan “B”
•Base Salary from Historic wRVU or other Appropriate Measure (80%-90% of total clinical
compensation)
•System Initiatives (20% - 10% of total clinical compensation)
•Pool for Upside Potential (up to 10% extra for, first, hitting two “affordability triggers” and
then, each group decides how to divide their portion of pool)
•Non-Clinical Base Salary (for teaching, medical directorships, administration)
•Total compensation will comply with relevant federal laws and regulations
35
MODEL PLAN “A” (DESIGNED AND ADMINISTERED IN COMPLIANCE WITH RELEVANT
LAWS AND REGULATIONS )70% - 95% 30% - 5% +10% Will Vary
$ per wRVU earned pool with quarterly reconciliation; potential other measures of productivity such as panel size for medical home
Based at Practice Unit Level This column is payable only if the following two triggers are met: 1. Only payable if payment of
aggregate earned Pools for Upside Potential by UMG would not result in a system operating margin of less than an amount to be established by the GHS Board of Trustees and
1. Group meets system stretch goal metric
Offset base % for teaching, administration or medical directorships Use of faculty portfolio as work standard and update annually Revenue Cycle Support with coding and
charge capture standards and consistency Separate payments for specific initiatives established at the beginning of each year, such as:
1) Quality 2) Patient Satisfaction 3) Achieving Budget at Practice or
Group Level 4) Access improvement at
practice/unit level 5) Others as established at the
department Examples of measures include: CMS All Care Measures, Containment Initiatives, CGCAPS, HCAPS, use of appropriateness and Evidence-Based criterim for care. Annual System Quality Initiatives or System Clinical Cost Containment Initiatives Each group decides how to divide
production based pool Can earn up to 10% based on maximizing system initiatives and/or shared saving distributions under health plans.
Administrative $ paid per agreement with specified duties Adjust $ per wRVU annually
(methodologies could include historic collections wRVU; third party benchmarks; others)
Each group decides how to divide pool Medical Director $ paid per agreement with specified duties Examples include maximizing access
improvement goal established as a system initiative
Shared savings which offset utilization losses in $ wRVU Productivity would be incorporated into this pool
Other potential stretch goals could include group/UMG budget performance or patient medical home financial performance
36 Individual/Group
Productivity Based Earned Income
System Initiatives Pool for Upside Potential Non-Clinical Based Salary (if applicable)
Notes:
•Primary goals of this model are to incent productivity, access and system alignment.
•Goals in System Initiatives should be set so they are reasonably attainable in a given year. Upside potential goals should be stretch goals awarded for maximizing System Initiatives. •Reset % allocations between buckets 1-4 at beginning of each subsequent year. In the initial year, it is contemplated that the total of columns 1, 2 and 4 will be cost neutral for UMG as a whole. Special payer arrangements may impact productivity in different specialties in different ways. Where those arrangements decrease productivity, offsetting savings would be recognized in the “System Initiative” and “Upside Potential” payments
MODEL PLAN “B”
(DESIGNED AND ADMINISTERED IN COMPLIANCE WITH RELEVANT LAWS AND REGULATIONS)80% - 90% 20% – 10% +10% Will Vary
Use appropriate minimum work standard to earn salary 1) Hours per year 2) Shifts per year 3) Panel size 4) Other standards appropriate for
specialty Standards set at Department level
Based at Practice Unit Level This column is payable only if the following two triggers are met: 1. Only payable if payment of
aggregate earned Pools for Upside Potential by UMG would not result in a system operating margin of less than an amount to be established by the GHS Board of Trustees and 1. Group meets system stretch
goal metric
Offset base % for teaching, administration or medical directorships
Revenue Cycle Support with coding and
charge capture standards and consistency Separate payments for specific initiatives established at the beginning of each year, such as: 1) Quality 2) Patient Satisfaction 3) Achieving Budget at Practice or
Group Level 4) Access improvement at
practice/unit level 5) Others as established at the
department Examples of measures include: CMS All Care Measures, CGCAPS, HCAPS, use of appropriateness and Evidence-Based criterim for care. Annual System Quality Initiatives or System Clinical Cost Containment Initiatives
Each group decides how to divide Pool
for Upside Potential Use of faculty portfolio as work standard and update annually
Additional payment for excess shifts Examples include maximizing access improvement goal established as a system initiative
Administrative $ paid per agreement with specified duties Other potential stretch goals could
include group/UMG budget performance or patient medical home financial performance
Medical Director $ paid per agreement with specified duties
37 Base Salary from Historic wRVU
or other Appropriate Measure System Initiatives Pool for Upside Potential
Non-Clinical Based Salary (if applicable)
Notes:
•This model provides some stability to alary based on work standard performance. Secondary goals are to provide Department Chair with ability to align system goals. •Reset % allocation between buckets 1-4 at beginning of each subsequent year. In the initial year, it is contemplated that the total of columns 1, 2 and 4 will be cost neutral for UMG as a whole
COMPENSATION PLAN PROVISIONS
Common characteristics for model plans for all groups:
•
Each has a component based on Practice unit quality and cost effectiveness,which is annually earned based on specific targets set for each Practice
•
Percentages of total compensation earned in each of the four “buckets” areexpected to be modified annually to align with GHS goals and external market
•
The 4thbucket (Individual Non-Clinical Based Salary) is for compensationassociated with teaching, medical directorships, medical administration and research. Specific accountabilities will be established for each physician who earns compensation for these activities.
•
Productivity and incentive earned pools can be divided among physicians basedon pre-approved distribution methodologies.
38
COMPENSATION PLAN PROVISIONS
Compensation per wRVU to compensate for productivity is preferred method, being mindful that
•
Individual productivity based compensation based directly on compensation perwRVU is OK, but UMG would prefer the creation of a group/practice pool from which $ are distributed to participating physicians
•
Compensation per wRVU rate should be evaluated annually•
A UMG-wide set of measures for physician revenue cycle performance will beused
•
Budget estimates of productivity will be used to set salary “draws” with quarterlyMID-LEVEL PROVIDER INTEGRATION
»
Effective use of mid-level providers is important to providing cost effective patient care»
Incentives will be provided to physicians to use mid-level providers40
KEY ISSUES FOR IMPLEMENTATION
(JULY 2013 TO PRESENT)
› Development of a detailed compensation plan in one of 2 models at practice/subspecialty level which translates existing compensation model to new plan
› Attempting to be both budget neutral and also not create big winners or losers at the individual physician level
› In parallel, doing testing for reasonableness and other compliance issues prior to final review and implementation
› Development of System Initiative Quality metrics and associated compensation components
41
CONVERT PLANNING INTO ACTIONS
› Roll out and communication with Department Administrative Directors and Financial Analysts
•
Series of Departmental Meetings with Consultants assistance•
Template Excel Models of Plan A and B developed with Consultants assistancefor use in detailed plan development (see examples starting next page) › Plan decisions including proposed Compensation per work RVU done at
department and division and physician levels
•
System Initiative dollars identified, with specific criteria to be developed› Ongoing internal assistance meetings from UMG Finance and Consultants
•
Periodic meetings to monitor progress› Reconciliation of submitted/proposed new compensation plans using two Models
•
Draft plans at Division/physician level were reviewed both internally by UMGFinance and by Consultants
•
Consultants did reasonableness testing and provided results to UMG Finance forselective further review
REAL EXAMPLE, PRACTICE COMP PLAN INPUTS,
PAGE 1/2
43 43
REAL EXAMPLE, PRACTICE COMP PLAN INPUTS,
PAGE 2/2
44 44
DETAILED DESCRIPTION, PRACTICE COMP PLAN
INPUTS, PAGE 1/2
DETAILED DESCRIPTION, PRACTICE COMP PLAN
INPUTS, PAGE 2/2
46 46
CONVERT PLANNING INTO ACTIONS
› Development by a separate physician led process of System Initiatives with metrics and integration with electronic medical record based measurement processes › Communication and updating new compensation plans at division levels conducted
by Chairs/Administrative Directors › Shadow period status/results
•
Originally hoped to run old and new plans in parallel after fully developed for 3 ormore months
•
Some Departments had either less change to deal with or more capacity to makechanges. As a result, some have moved into parallel/shadow testing. Some have determined that the changes are minimal enough that no parallel/shadow testing is necessary.
› Official effective date(s)
•
October 1, 2014 with renewal of physician contracts47
LESSONS LEARNED
› Though a large Committee can be unwieldy, buy-in is better with a broad cross-section of physicians represented
› Changing compensation plans is a very detailed time consuming process. The dual goals of being budget neutral and not trying to harm existing physician compensation developed in a totally different plan can be very difficult to achieve. › It is hard to have exact plans replicated across Departments in a large organization.
Allowances were made to have Department-specific measures and incentives. › Being purposeful and deliberate on creating and implementing a transparent and
inclusive process paid huge dividends.
› Consistency and Commitment of UMG and System Leadership to working together to achieve changes vitally important to the Organization’s future success was most important.
QUESTIONS / ANSWERS
49
NAVIGANT/GHS/UMG TEAM
Thank you!!
Rick Cameron
Managing Director, Navigant Healthcare [email protected] 314-308-4986
Malcolm Isley
Vice President, Physician and Strategic Services, Greenville Health System [email protected]
864-455-8797 Shon Brink
Executive Director, Finance and Business Operations, GHS University Medical Group [email protected]
864-797-6102
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UMG GUIDING PRINCIPLES
»
Is committed to creating a high performing, patient-centered, multispecialty medicalpractice focused on optimizing patient access, enhancing health care value and improving regional health status
»
Is responsive to the healthcare needs of its individual patients and the entire regionserved, recognizing the imperative to balance needs and resources
»
Is committed to leading the transformation of health care within a diverse, dynamicenvironment, which will require embracing change
»
Is committed to providing the best health care through inter-professional teams withstrong patient engagement
»
Is committed to continuous improvement, innovation, professionalism, strategicgrowth, and increasing the value of health care
52
UMG GUIDING PRINCIPLES
»
Realizes that the individual departments within the group are of significantimportance, but none rise above the interests of the entire group and the health system
»
Is committed to seeking mutually beneficial solutions when conducting its operations;striving to authentically engage all potential stakeholders
»
Is committed to medical education that advances the clinical enterprise, contributesto growth, improves the quality of care, and positions GHS as an integrated academic health system
