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Surf’s Up! Pursuing Excellence in a Decade of Health Care Reform

Surf’s Up! Pursuing Excellence in a Decade of Health Care Reform. Why Now? Using Baldrige to Meet the Challenges of Healthcare Reform Era. Steve Durbin Durbin Consulting – Healthcare Quality Strategies Member, WSQA Board of Directors . Breakout Session Objectives.

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Surf’s Up! Pursuing Excellence in a Decade of Health Care Reform

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  1. Surf’s Up! Pursuing Excellence in a Decade of Health Care Reform Why Now? Using Baldrige to Meet the Challenges of Healthcare Reform Era Steve Durbin Durbin Consulting – Healthcare Quality Strategies Member, WSQA Board of Directors

  2. Breakout Session Objectives Learn from two leading healthcare organizations on their use of Baldrige to pursue performance excellence Learn from ideas on how Baldrige can be used to help prepare care providers for an era of healthcare reform, and its potential application across “aligned” care provider organizations and communities

  3. Waves of Change - Hunker Down or Surf with the Waves • A very challenging, changing economy impacting healthcare markets • Reductions in payment for health care services • Emergence of providing value in delivery of health care as a necessity of staying in business • Convergence of six plus years of national initiatives in quality measurement, care coordination and payment reform • And now, a Healthcare Reform law that brings many of these trends together • And increased demand thru expanded insurance coverage

  4. Healthcare Reform Implications for Providers Pricewaterhouse Coopers Report: • New reimbursement models favor hospital and physician alignment, including physician employment, over the traditional private practice model. • Bundled payments, accountable care organizations, medical homes, reduced readmissions, and quality based reimbursement require hospitals and physicians to become partners in payment. • Beginning in 2015, a 300-bed hospital with poor quality metrics could be penalized by more than $1.3 million per year.

  5. What Does “Alignment” Mean? Key Premise – hospitals, physicians, and other components of a local care system will need to have true coordination and integration of clinical care. • Partnerships can’t be just paper and legal arrangements to garner revenue, with providers continuing to operate in their silos • Implies a need for an operating structure and systems designed to deliver improved quality, efficiency and value Its what patients and families expect care providers to do!

  6. Why Baldrige for Aligned Care Provider Organizations (ACOs?) and Communities? • Baldrige is a framework for assessing and planning how things will work • Mission, Strategies and Results – What are they trying to achieve, how will the joint mission be deployed across aligned organizations? • How will the aligned organization operate? • Assess Process, Customer, Workforce, Knowledge & information management

  7. Assess Care Processes Across Currently Fragmented, Siloed Local Care Systems

  8. Resources and Contacts • WSQA Preferred Consultants • WSQA Learning Opportunities • Lite Assessment Application Process for Quality Award • Online Assessment Survey Tool • WSQA offers workshops • Introduction • Self Assessment • Case Study • Preparation for Application

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