Becker's Hospital Review

10 Sign up for the COMPLIMENTARY Becker's Hospital Review CEO Report & CFO Report E-Weeklies at www.BeckersHospitalReview.com or call (800) 417-2035 degree programs now compared to only a handful in the 1990s. While physician executives add a textured expertise to their role and strategic thinking, progressive hospitals go one step further and formalize physician leadership within their governance structures. In meeting rooms, physicians sit sideby-side with the hospital CEO and other executives, creating a finer balance between business and medicine in decision making. San Diego-based Scripps Health is one system that boosted physicians' role in decision making remarkably well. When he took the reins in 2000, president and CEO Chris Van Gorder shook up Scripps' governance model. He established the system's Physician Leadership Cabinet, which acts as an advisory group and includes chiefs of staff and CEOs from each hospital campus, along with the corporate vice president of nursing. The cabinet strengthens collaboration between Scripps administrators and physicians as they develop strategies to improve quality and efficiency while reducing costs and clinical variation. In 2011, Scripps adopted a similar cabinet approach for ScrippsCare, which is comprised of Mr. Van Gorder, physician leaders from seven Scrippsaffiliated medical groups, the system CMO, community stakeholders and a payer relations executive. These individuals make evidence-based decisions to redesign care delivery and make it more efficient, high-quality and costeffective. So far, ScrippsCare has standardized procedures for its admissions orders, lab tests, coronary angioplasty treatments and chemotherapy. Redesigns such as those saved $77 million in 2011 and another $66 million in 2012 — a figure Scripps expects to match in 2013. 7. They are serious about hospitality and have chief experience officers in the C-suite. Progressive hospitals are doing more than paying lip service to patient satisfaction. Forward-thinking hospitals are borrowing best practices from the retail, marketing and hospitality industries. Those hospitals are also dedicating more resources and employees to these efforts, including the appointment of "chief patient experience officers," or CXOs. CXOs are senior administrators who ensure patient satisfaction improvements are consistent, methodical and prominent throughout the organization. CXOs often lead efforts to educate hospital management and staff on hospitality and patient communication, especially in high-contact moments of care delivery, such as waiting rooms and bedside conversations. Often, the CXO role is part of an entire department dedicated to the patient experience. Cleveland Clinic, which claims to be the first academic medical center to appoint a CXO, was one of the first health systems to launch an Office of Patient Experience. The PPACA put some fangs into the concept of "patient experience" by tying it to a portion of hospitals' bonus reimbursement. Patient experience Register Today! Becker's Hospital Review CEO Strategy Roundtable November 14, 2013 The Ritz-Carlton Chicago Co-chaired by Scott Becker, Publisher, Becker's Hospital Review, and Chuck Lauer, Former Publisher, Modern Healthcare To register, visit www.BeckersHospitalReview.com/novhospitalevent.html, email registration@beckershealthcare.com or call (800) 417-2035. ratings will determine 30 percent of hospitals' total bonus payments under the federal Value-Based Purchasing program. Those ratings are determined by patients' answers on HCAHPS surveys, which pose a variety of questions, including one in which they must rank their hospital stay on a scale from 1 to 10. Denise Beaudoin, vice president of customer engagement, and Sven Gierlinger, vice president of hospitality and service culture, jointly manage patient satisfaction and experience for the six hospitals within Detroit-based Henry Ford Health System. Mr. Gierlinger says it seems every hospital is creating a patient experience department, if it hasn't done so already. Ms. Beaudoin says her and Mr. Gierlinger's roles have allowed Henry Ford to take a more systematic approach to patient satisfaction. "The pressures of value-based purchasing really raises the level of how we should treat patients [and brings it] to the C-suite," she says. "Before, we could quantify how many patients have left in our system and how much that costs, but [VBP penalties are] literally actual dollars we walk away from." More transparent hospital prices will likely help patients cost-compare their options, which will leave a hospital's patient experience as the deciding factor for patients who are on the fence. Mr. Gierlinger, who has a background in the hospitality industry, says he only expects demand for CXOs to grow. "Attention has traditionally been very much on quality and safety, and the experience aspect continues to rise in importance as social media plays a bigger role," he says. "Patients are becoming more and more consumers with healthcare services — they are making more decisions and not necessarily going just where the doctors tell them to go." 8. They partner with employers. Despite how frequently it peppers conversations in healthcare, the term "population health" is still somewhat daunting and undefined for many hospitals. Does it refer to enrollees within an accountable care organization? An entire geographic population? ACOs are one model for hospitals to take on population health, but some health systems are also partnering with employers to improve outcomes, lower costs and reduce clinical variation for a defined group of patients. Hospital-employer partnerships may proliferate in the next few years as large employers face more pressure to trim healthcare costs, better manage employees' health coverage or completely revise their benefit plans in light of the PPACA. One health system pioneering direct contracting relationships with employers is Cleveland Clinic. In 2010, the system struck a direct-to-employer deal with the Mooresville, N.C.-based home improvement giant Lowe's. Under that agreement, more than 225,000 employees and their dependents enrolled in Lowe's self-funded health plan can travel to Cleveland Clinic for heart procedures. Lowe's covers all medical deductibles, coinsurance payments, travel costs and lodging for the patient and a companion. Cleveland Clinic has struck similar deals with Bentonville, Ark.-based WalMart Corp. and Seattle-based Boeing for cardiac care. A Cleveland Clinic spokesperson said the system is in active discussions with many employers, and it anticipates "many more" direct-to-employer relationships. 9. They let patients have access to their personal health information. Many hospitals have enough difficulties with electronic medical records, but a few pioneers have mastered the technology enough to let patients access their PHI. This can improve patient engagement, transparency, medication adherence, and patients' understanding of medical issues and their choice of providers. In May, Danville, Pa.-based Geisinger Health System let more than 100,000 patients access their physicians' notes for the first time. Patients will be able to view notes from more than 500 Geisinger physicians in primary care, pediatrics and more than 10 specialties. The initiative stems from Geisinger's participation in the 12-month Open-

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