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Johns Hopkins Community Physicians Presentation to MCMS October 25, 2012

Johns Hopkins Community Physicians Presentation to MCMS October 25, 2012. Presented by: Matt Poffenroth, MD, MBA Director of Clinical Integration, JHCP. JHM Organizational Structure ……… focusing on strategic interfaces. The Johns Hopkins Health System Corporation (JHHSC).

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Johns Hopkins Community Physicians Presentation to MCMS October 25, 2012

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  1. Johns Hopkins Community Physicians Presentation to MCMSOctober 25, 2012 Presented by: Matt Poffenroth, MD, MBA Director of Clinical Integration, JHCP

  2. JHM Organizational Structure………focusing on strategic interfaces The Johns Hopkins Health System Corporation (JHHSC) The Johns Hopkins University (JHU) Johns Hopkins Medicine (JHM) Johns Hopkins Bayview Medical Center, Inc. Suburban Hospital Healthcare System, Inc. The Johns Hopkins Hospital Johns Hopkins Community Physicians Howard County General Hospital School Of Medicine Suburban Hospital, Inc. Sibley Memorial Hospital Johns Hopkins Home Care Group Johns Hopkins Medicine International, LLC JH Ventures, LLC Johns Hopkins HealthCare LLC = Legal entity = Unincorporated board or division

  3. JHCP SectionsFY 12 • Each section with clinical chiefs and administrators

  4. JHCP FY 2012 • 36 outpatient sites • 11 counties, Baltimore City • 400+ providers • 1000 staff • 800 K encounters • 230 K patients ** Bayview Internal Medicine, practice managed by JHCP

  5. JHM Clinical Enterprise

  6. TRENDED VOLUME

  7. Provider Growth Summary

  8. JHCP Challenges In many ways, similar to private practice: • Insure access to growing volume of patients • Coordinate care for patients in a fragmented delivery system • Meet demands of payers to measure and report data • How to position ourselves for payment reform • Physician work:life balance

  9. How is JHCP meeting these challenges? • Strategically adding capacity, based on access needs • Partnering with other private practice physicians in the community • New models of care – PCMH, extended hours, etc. • Participating with various P4P programs • Implementing EPIC in April, 2013 • Evaluating physician compensation model

  10. Pay for Performance Programs at JHCP • Value Based Purchasing (JHHC) • Meaningful Use of EHR’s • Patient Centered Medical Home (PCMH) • Maryland Multi-Payer Pilot (MMPP)- 5 sites • CareFirst • USFHP • ACO-prepared • PQRS • ePrescribing • Maryland State-Regulated Payer EHR Adoption Incentive Program

  11. Future of healthcare in Maryland • Payment reform is happening – providers increasingly will be asked to take risk • Quality and transparency is be demanded by payers and patients • Shift towards population health management • Uncertainty about HSCRC waiver and how this could affect providers

  12. How will the system respond? • Continued and accelerated consolidation • Physicians increasingly seeking “safe haven” of employment • Hospitals increasingly reliant on physicians to meet access and quality needs • Bundled payments, shared savings programs, etc. • Alignment of incentives between providers, patients, payers and purchasers (is this a dream?)

  13. JHM Strategic Response • Developing an integrated delivery system is one of JHM’s Mission Imperatives • Alignment with private physicians is a JHM priority to achieve clinical integration • Strategies include: • Employment • Shared EHR • Accountable Care Organizations • Other

  14. Employment • Typically not “purchasing” practices • Not always an appealing option for either side • Financial risk • Culture • Requires a shared Mission and Vision

  15. Shared EHR • JHM begins transitioning to EPIC in April 2013, beginning with our ambulatory practices • JH Community Division to offer EPIC Community Connect to private practices • Full EHR and practice management system, without billing module • Marketing to begin late fall 2012, implementation fall 2013

  16. ACOs • CMMI grant approval for J-CHiP in June 2012 – “academic ACO” • Exploring community ACO model with intent to file letter of intent by June 2013 with implementation January 2014 • Success (i.e. improved quality at lower cost) will require: • Infrastructure • Resources • Expertise in population health management • Not all “ACOs” will succeed

  17. Other methods to enhance alignment • Improved access to JH clinics • Part-time faculty appointments • CME • Shared purchasing agreements • Networking with JH health plans • MSO services • “True” clinical integration model with shared contracting

  18. Questions? Matt Poffenroth, MD, MBA mpoffen1@jhmi.edu 240-235-9130

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