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May 2015

 

 

INTEGRIS Health Partners

INTEGRIS Health Partners

 

 


May 2015 Update

Inside this issue:

Letter from IHP President

2015 Metrics - Metro

2014 Clinical Performance Metrics Results - Metro

2014 Shared Savings Distribution Timeline

Advisory Board/Crimson Continuum of Care Project

Pharmacy Task Force Recommendations

New Physicians

Staff

 

Letter from the President

Recent floods, tornadoes, drought, train wrecks and an uncertain world serve as reminders that you can’t get comfortable with the “status quo”. Healthcare is no exception. The status quo only seems to last a short time in the medical field. INTEGRIS Health Partners leadership has attended several events recently that have really focused our attention on the accelerating rate of change in our industry.

Last month, we participated in a clinically integrated network collaborative meeting in Dallas with several regional medical groups and health systems. I am proud to report we are ahead of many of those systems as it relates to our development and results; however, there were a number of sobering conversations about what others are beginning to see in their markets. Some of those developments include: bundled payments, direct employer contracting with expectations on what services you will offer and how you will deliver them, and an overall downward pressure on reimbursement. The overlying themes were that consumers and employers want decreased costs, increased quality, and A+ customer service. What we have learned in the past four years puts us in a good position to deal with all the new expectations. As our competitors make plans to develop their own clinically integrated networks, we will see increased competition and market segregation in various forms. We may see a return of strategies reminiscent of the 1990’s narrow networks, but with different reimbursement methodologies and a concentration on quality and population health. We also see the continued emphasis on a “retail” approach to healthcare. Patients are more price-conscious and require greater transparency to aid in making healthcare decisions. With all of these factors affecting healthcare, it is comforting to know that INTEGRIS Health Partners is positioned to address these challenges and work with our physicians to be successful. 

The recent Medicare Sustainable Growth Rate fix has also set the stage for up to 50% of our pay to be value-based reimbursement, replacing fee-for-service reimbursement. Don't kid yourself – this is happening! The SGR fix was budget neutral and was mandated by law. The commercial market will not be a safe haven from this. Those who have chosen a strategy to avoid the coming changes by staying out of the government payment world will be confronted by payers who will be even more aggressive in pay-for-performance measures. The commercial payers see this payment system as the future and are demanding willing partners who can deliver. A collaboration of numerous large employers, several insurance companies and patient advocacy groups recently expressed an expectation of 70% of payment to be performance based within three years.

As I mentioned previously, change is inevitable. We were in a historic drought four weeks ago, but now we are flooded. Just like the weather, changes in healthcare will come quickly. Pay attention, be adaptable, and be open-minded. We have to be ready to meet these challenges. Rest assured that INTEGRIS Health Partners is well suited to help us address the possible changes and prepare us for the future. We will work hard to remain ahead of the curve.

Sincerely,

Carl Raczkowski, M.D.
President, INTEGRIS Health Partners


2015 INTEGRIS Health Partners Metrics – Metro

 

SPECIALTY

METRIC

GOAL

% OF SHARED SAVINGS

SURGERY

Attend one of two IHP education sessions (topic and date TBD)

Attendance is required to participate in shared savings

25%

Use CPOE for medication

75% or better

12.5%

Perform pre-surgical time-out

100% of the time

12.5%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

25%

Generic drug utilization

78.5% or better

25%

MEDICAL –INPATIENT-BASED

Attend one of two IHP education sessions (topic and date TBD)

Attendance is required to participate in shared savings

25%

Use CPOE for medication

75% or better

25%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

25%

Generic drug utilization

78.5% or better

25%

MEDICAL – NO INPATIENT (OFFICE-BASED)

Attend one of two IHP education sessions (topic and date TBD)

Attendance is required to participate in shared savings

33.34%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

33.3%

Generic drug utilization

78.5% or better

33.3%

PRIMARY CARE – FAMILY & INTERNAL MEDICINE

Attend one of two IHP education sessions (topic and date TBD)

Attendance is required to participate in shared savings

25%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

10%

Generic drug utilization

78.5% or better

25%

Diabetic patients age 18-75 have annual HgA1c

91% or better

10%

Diabetic patients age 18-75 have annual LDL-C

85% or better

10%

Female patients age 40-69 with mammogram in past 24 months

70.6% or better

10%

Patients age 50-75 have appropriate colorectal cancer screening

63.2% or better

10%

PRIMARY CARE – PEDIATRICS

Attend one of two IHP education sessions (topic and date TBD)

Attendance is required to participate in shared savings

25%

Complete IHP physician satisfaction survey

Must be completed to achieve metric

25%

Generic drug utilization

78.5% or better

25%

Patients have 6 well child exams by age 15 months

90% or better

25%

 


2014 Clinical Performance Metrics Results – Metro

INTEGRIS Health Partners is proud to announce the exciting news that all 2014 clinical performance metrics were met! Congratulations and THANK YOU to our hard-working physicians and their staff for providing the highest quality care to INTEGRIS employees and their dependents. Results are as follows:

METRIC

GOAL

2014 RESULTS

Generic drug utilization

 

75%

79.4%

Diabetic patients age 18-75 have annual HgA1c

83%

91.2%

Patients age 50-75 have appropriate colorectal cancer screening

63.2%

63.9%


2014 Shared Savings Distribution Timeline

Although the 2014 fiscal year for INTEGRIS Health Partners concluded December 31, 2014, there are several steps required prior to distributing any potential shared savings:
  1. March 31, 2015 - 2014 claims roll-out concluded and processed by third party                       administrator, WebTPA
  2. April – June, 2015 - final costs and savings to the network evaluated and audited by             internal and external experts
  3. July 2015 - savings, if any, announced, and physicians’ scorecards examined to  determine   individual portions of shared savings
  4. August – September 2015 - shared savings distributed for those who qualify for                   participation; by check for independent providers and through payroll for employed             providers

Now is the time for all independent providers to submit a current W9 to ensure seamless processing of shared savings checks. Fill out, sign, and submit by fax to 405-949-3477 or scan completed document and submit by email.

Questions? Contact Administration by phone 405-713-4476 or email.


Advisory Board/Crimson Continuum of Care Project

In April, the INTEGRIS Executive Leadership Team signed a contract with the Advisory Board Company to install and utilize its Crimson Continuum of Care product. Crimson Continuum of Care is a product that aims to provide structure for hospital-physician collaboration. Its model utilizes physician-specific and case-specific level data to drive changes in practice patterns and resource utilization. In the past, these changes were often dictated by administration with a severe lack of physician involvement. This program, however, allows physicians and administrators to work together in root-cause analysis. 

Key roles include:

  • Executive Project Sponsors – Carl Raczkowski, MD, President, INTEGRIS Health Partners and Jim White, MD, System Chief Medical Officer
  • Operational Project Sponsors – Jeff M. Brown, Vice President, INTEGRIS Health Partners and Greg Meyers, System Vice President of Revenue Cycle and Managed Care Contracting
  • Physician Champions – INTEGRIS Health Partners Inpatient Collaborative
  • Value Lead – Lisa Anderson, Assistant Vice President – Care Coordination
  • Project/Value Lead – Evan Galt, Operations Manager – INTEGRIS Health Partners
  • Super Users – INTEGRIS Care Coordinators and Physician Leaders
  • Technical Subject Matter Experts: Nikki Watters - INTEGRIS Decision Support Manager, Keith Stephens, RN - INTEGRIS Administrative Director Quality, Harry Wetz - INTEGRIS Director of Quality and Patient Safety, Nadine Rayan - INTEGRIS System Manager Quality, and Micah Parker - INTEGRIS Assistant Vice President of Supply Chain

This project will be key in moving INTEGRIS forward in its ability to provide higher-quality care at a lower cost. Implementation work has begun on project planning and data acquisition. A site build will take place soon. Physician engagement is key to ensure long-term success in providing the best possible care for our patients. Please keep an eye on future IHP ONEmails, newsletters, and our website for upcoming information about how to stay involved with the Continuum of Care project. For questions or additional information contact Evan Galt.


Pharmacy Task Force Recommendations

The INTEGRIS Health Partners Pharmacy Task Force met April 9 and May 14. Please consider the following exchanges. For additional information about the exchanges, please access the following website: http://integrisok.com/ihp/drug-interchanges

  • Nexium to omeprazole 20mg twice daily
  • Lyrica to gabapentin
  • Pristiq ER to venlafaxine HCL ER

The Task Force also reviewed reports relating to costs of Medrol versus prednisone. They decided to send the following letter to network physicians with the attached taper schedule, which can be given to patients:

The INTEGRIS Health Partners Pharmacy Task Force is reviewing pharmaceuticals prescribed to the INTEGRIS Health Partners members. The goal of the task force is to promote the appropriate use of high quality and cost-effective pharmaceuticals for our members. An opportunity for savings that the task force has identified and would like to recommend is the drug Medrol 4mg dose pack. The task force is recommending the following interchange – prednisone 5mg instead of Medrol 4mg dose pack.

Medrol 4mg dose pack costs more to prescribe than the alternate prednisone 5mg. Our data shows that in a six month period the INTEGRIS Health Partners plan paid $1,733 for prescriptions of Medrol dose packs in comparison to $58 for prednisone 5mg. Included with this letter is information for dosing regimens - linked here - that can be given to your patients in order to make it easier for them to comply with your dosing instructions.

If medically appropriate, please consider making the change from Medrol dose packs to prednisone.  If you have any questions about the task force or its recommendations please contact INTEGRIS Health Partners Care Coordination at 405-951-2504 or toll free at 855-582-3003.


New Physicians

Rachel Dalthorp MD

Psychiatry

1105 SW 30th Court

Moore, OK 73160

405-378-2727

G. Paul Digoy MD

Pediatric Otolaryngology

10914 Hefner Pointe Drive, Suite 200

Oklahoma City, OK 73120

405-608-8833

Robert S. Glade MD

Pediatric Otolaryngology

10914 Hefner Pointe Drive, Suite 200

Oklahoma City, OK 73120

405-608-8833

Michael D. John MD

Dermatology

620 W 15th Street

Edmond, OK 73013

405-359-0551

Gregory W. Johnston MD

Anesthesiology

4131 NW 122nd Street

Oklahoma City, OK 73120

405-775-9350

Todd A. Krehbiel MD

Internal Medicine/Pediatrics

2117 N Kelly Avenue

Edmond, OK 73003

405-726-2701

William J. Perkins MD

Anesthesiology

19500 N Indian Meridian

Luther, OK 73054

405-947-4610

Rodric M. Phillips MD

Anesthesiology

1111 N. Lee Avenue,

Suite 236

Oklahoma City, OK 73103

405-524-4105

Derek J. Shadid MD

Plastic Surgery

13820 Wireless Way

Oklahoma City, OK 73134

405-755-4451

 


Staff

Administrative Leadership Team

Carl Raczkowski, MD, President

405-642-4340 or carl.raczkowski@integrisok.com

Jeffrey Cruzan, MD, Medical Director

405-773-6415 or jeffrey.cruzan@integrisok.com

Jeff M. Brown, FACHE, Vice President

405-552-0413 or
jeff.brown@integrisok.com

Lisa Anderson, Assistant Vice President

405-951-2529 or lisa.anderson@integrisok.com

Mindy Eggleston, Executive Assistant

405-713-4476 or mindy.eggleston@integrisok.com

Evan Galt, MHA, Operations Manager

405-951-2553 or
evan.galt@integrisok.com

Kari Govier-Brown, MHA, Provider Relations Consultant

405-312-7605 or
kari.govier-brown@integrisok.com

Deidre R. Horn, MHR, Provider Relations Consultant

405-550-3499 or
deidre.horn@integrisok.com


Care Coordination Team

Susan Adams, RN, Care Coordinator

405-552-2854 or susan.adams@integrisok.com

Tabatha Black, RN, Care Coordinator

405-713-5582 or tabatha.black@integrisok.com

Tonia Garner, RN, Care Coordinator

405-552-2852 or tonia.garner@integrisok.com

DeAnn Jackson, RN, Care Coordinator

405-552-0864 or deann.jackson@integrisok.com

IntegrisHealthPartners@integrisok.com

integrisok.com/ihp

405-713-4476



© 2017 INTEGRIS Health Pencil
Oklahoma's largest hospital network
3300 N.W. Expressway
Oklahoma City, OK 73112 Phone: (405) 951-2277
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