2015 washington state of reform health policy conference hilton seattle airport conference center...
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2015 Washington State of Reform Health Policy Conference
Hilton Seattle Airport Conference CenterJanuary 8, 2015
Physicians of Southwest Washington, LLCIndependent Physician Association established 199590 physician Unit Holders, both primary care and
consultantsNetwork of 400+ physicians, hospitals and other
providers in Thurston and Lewis CountiesModel: Global Capitation Risk Agreements, Medicare
and Commercial HMOs including delegated credentialing, medical management and claims processing
Current Agreements: MA only – Humana and Soundpath Health ~ 6000 risk lives
Separate Non-Profit Foundation: Healthy Communities
PSW Mission Statement
The mission of Physicians of Southwest Washington is to support the physician-patient relationship in the independent practice of medicine through:
Fair contracting;Responsible resource utilization; and Prudently adopted innovations in health care
delivery.
PSW is committed to quality improvement, clinical integration and meaningful measures of value
PSW Financial Strategies
Engaged, Informed, Motivated Physician LeadershipRisk Adjusted, Capitated, Primary Care
ReimbursementClinical Integration Improved Clinical Care TransitionsProvider Office Support for Accurate Documentation
and Associated Risk Adjusted CodingExpanded and diversified ‘value’ and ‘risk based’
contractingInformed and Empowered Patients
2015+ Health System Challenges
Reimbursement:- Uncertainty about pace of reimbursement
transitions from volume to value- Near term reductions in FFS
Delivery System Consolidations and Definitions
Limitations in clinical data sharing among EMR’s
Pending Provider ShortagesVarying Definitions of ‘Waste’
2015 Strategies
Expanded payor contractsExpanded role of Chief Medical OfficerImplementation of clinical integration software
platform to enhance population management capacity
Expanded nurse case management programSupport services for implementation of new ‘clinic
without walls’ Investment in medical and administrative
leadership development and succession planningLiquidation of equity interest in MA health plan
RecommendationsBusiness Concepts to Consider:
-New Employee Motto #1: Flexible or Former-New Employee Motto #1: Failure Isn’t An Option -Bigger may not be better – ability to move quickly may be
more important -Financial “Risk” is an OK four letter word
Focus on Quality Not CostSeek Long Term Partnerships Across Blended
Spectrum of Health IndustryData Transparency
- Demand it from All Partners - Lets share what worked and what failed
