Academy Health Research Meeting
Transforming the Health System to Get Care Right
the First Time
June 29, 2009
Glenn Steele Jr.,, MD,, PhD
President and CEO
Heal • Teach • Discover • Serve
Geisinger Health System
Last updated 03/20/09
Geisinger Inpatient Facilities
Geisinger Medical Groups
Geisinger Specialty Clinics
Geisinger Health System Hub and Spoke Market Area
Careworks Convenient Healthcare
Geisinger Health Plan Service Area
Non-Geisinger Physicians With EHR
Geisinger Health System
An Integrated Health Service Organization
Provider
Facilities
• Geisinger Med. Ctr. (+ Janet
W i Children’s
Weis
Child
’ Hospital)
H
it l)
• Geisinger Wyoming Valley Med.
Ctr. w/ Heart Hosp. & Henry
Cancer Ctr.
• Geisinger
g South Wilkes-Barre Hosp.
p
• Marworth Drug & Alcohol
Treatment Center
• 2 ambulatory surgery centers
• > 40K admissions, ~700 licensed in-pt
beds
Physician
Practice Group
• Multispecialty group
• ~ 800 physicians
• 38 comm
comm. practice sites
• > 1.5 million outpatient visits
• 264 residents and fellows
Managed Care
Companies
• ~235,000 members
• Diversified products
• >18,000 contracted physicians
Transformation Initiatives
Initiatives*
• ProvenHealth Navigator (Advanced Medical
H
Home)
)
• Chronic Disease Care Optimization
• ProvenCare® for acute episodic care (the
“warranty”)
• Transitions of Care
*Achievable only through innovation
Heal • Teach • Discover • Serve
®
ProvenCare CABG: Reliability
ProvenCare CABG
% patients
receiving all
ProvenCare
p
components
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
*Feb
Feb
Q1 Q2
2006
Q3 Q4
Q1 Q2
2007
Q3
Quarter
*Single month of data
Heal • Teach • Discover • Serve
Q4 Q1 Q2
2008
Q3
Quality/Value - Clinical Outcomes (18 months)
Before
B
f
ProvenCare®
(n=132)
In-hospital mortality
Patients with any complication (STS)
Patients with >1 complication
Atrial fibrillation
Neurologic complication
Any pulmonary complication
Blood products used
Re-operation
Re
operation for bleeding
Deep sternal wound infection
Readmission within 30 days
With
ProvenCare®
(n=181)
1.5 %
38 %
7.6 %
23 %
1.5 %
7%
23 %
3.8 %
0.8 %
6.9 %
V l - Financial
Value
Fi
i l Outcomes
O t
•
•
•
•
Average total LOS fell 0.5 days (6.2 vs. 5.7)
Hospital net revenue grew 7.8%
Contribution margin of index hospitalization grew 16.9%
30-day readmission rate fell 44%
Heal • Teach • Discover • Serve
0%
30 %
5.5 %
19 %
0.6 %
4%
18 %
1.7 %
0.6 %
3.8 %
% Improvement/
I
t/
(Reduction)
21 %
28 %
17 %
60 %
43 %
22 %
55 %
25 %
44 %
ProvenCare®
C ® Portfolio
f i
–
–
–
–
–
–
–
–
–
Heal • Teach • Discover • Serve
CABG
Angioplasty
Angioplasty + AMI
Hi replacement
Hip
l
t
Cataract
EPO
Perinatal
Bariatric surgery
Low back
C
Caveats
t
•
•
•
•
•
Scalable?
Applicable to non-IDS?
Applicable in absence of real-time
real time EHR?
Applicable in fee-for-service settings?
Pending wider use in marketplace
Heal • Teach • Discover • Serve