annual report · memorialcare’s leadership in value-based care has led to improved health among...

Annual ReportFiscal Year 2019

MissionTo improve the health and well-being of individuals, families and our communities.

VisionExceptional People. Extraordinary Care. Every Time.

ValuesIntegrity Always holding ourselves to the highest ethical standards and values. Doing the right thing, even when no one is watching.

Accountability Being responsible for meeting the commitments we have made, including ethical and professional integrity, meeting budget and strategic targets, and compliance with legal and regulatory requirements.

Best Practices Requires us to make choices to maximize excellence, and to learn from internal and external resources about documented ways to increase effectiveness and/or efficiency.

Compassion Serving others through empathy, kindness, caring and respect.

Synergy A combining of our efforts so that together we are more than the sum of our parts.

President’s MessageHealth systems are under increasing pressure to deliver excellent clinical care and a simply better patient experience at the lowest possible cost. Nearly a decade ago, MemorialCare recognized that the most effective way to meet these objectives was through value-based care. We made sizable early investments in network expansion, technology, and the human capital necessary to deliver results in value-based care. In doing so, we’ve established ourselves as an industry leader.

• Today, our commitment to providing high-quality care in the most cost-effective way continues to be the driving force behind what we do.

• A central part of MemorialCare’s strategy to offer high-value healthcare is the expansion of our outpatient network. We’re opening new health centers across the region, making patient access easier and more convenient than ever.

• Together with our health plan partners, we continue to develop innovative health plan products that hold us accountable for performance – delivering exceptional quality and patient experience while reducing healthcare spending for employers and their employees throughout our region. This past year, we added three new value-based health plan offerings to our expanding portfolio.

• MemorialCare Health Alliance, our customized, Direct-To-Employer contract between MemorialCare and The Boeing Company has significantly reduced total cost-of-care for both the employees enrolled in the plan and for Boeing. As a result, Boeing and MemorialCare agreed to extend our partnership by another two years.

• In 2018, we developed the MemorialCare Clinically Integrated Network. Today that network, comprised of select physicians working collaboratively with our health system, is demonstrating quality and making dramatic improvements in efficiency, generating more than $7 million in cost savings in its first year.

MemorialCare’s leadership in value-based care has led to improved health among our patients, even better patient experience and reduced overall cost-of-care. As the healthcare landscape continues to transform, we will continue to lead the way in revolutionizing value. Please enjoy reading more about our developments in 2019 in this annual report.

Table of Contents

President’s Message .................................. 3

Leading Best Practice Care ...................... 4

Clinically Integrated Network .................. 4

Investing in Technology ............................ 4

Awards and Accolades .............................. 6

Value-Based Care........................................ 7

Network Growth ..............................................9

Advancing Access ......................................10

State-of-the-Art Facilities .........................11

MemorialCare Locations and Map ........ 12

Behavioral Health Integration ................. 14

Connecting with the Community ......... 15

2019 Financial Summary .......................... 18

Senior Executives and Boards of Directors ................................................. 20

Barry Arbuckle, Ph.D.President and Chief Executive Officer MemorialCare

3

Leading Best Practice CareEach year, MemorialCare sets Bold Goals for excellence. In FY 2019, we achieved:

Clinically Integrated NetworkMemorialCare’s Clinically Integrated Network (CIN) consists of select physicians and other individual health providers who work together and collaboratively with the health system to improve patient care, appropriately decrease costs and demonstrate value to the market.

Formed in 2018, our physician-led network is now well-established and already demonstrating the results it was created to achieve.

Among the network’s most effective initial efforts are its Hospital Efficiency Improvement Programs (HEIPs). HEIPs seek to improve patient care in the hospital setting by achieving specific quality and efficiency goals.

Thus far, our HEIPs have focused on select surgical and procedural specialty areas, including Anesthesiology, General and Colorectal Surgery, Gynecology, Procedural Cardiology, Spine, Total Joint and Vascular.

Working together with more than 230 network physicians, we have improved patient outcomes and generated more than $7 million in cost savings through such initiatives as our physician-led, systemwide approach to purchasing and use of select cardiac, orthopedic and spinal implantable devices and equipment.

In the coming year, MemorialCare’s CIN will more than double in size to include select networks of Primary Care and Obstetric physicians focused on opportunities to improve care across all settings.

Investing in Technology

MemorialCare made significant investments in advanced surgical innovations during FY 2019:

• ExactechGPS® provides real-time, 3D visual guidance in total shoulder replacement surgery.

• ExcelsiusGPS® combines navigation and robotic-assisted technology for minimally invasive spine surgery.

• SAVI SCOUT® uses radar during lumpectomy procedures, enabling surgeons to locate target tissues within 1 millimeter of accuracy.

• Hybrid Operating Room combines imaging equipment with a multifunctional surgical table, allowing clinicians to diagnose and treat in a single workspace, improving patient safety while reducing costs.

• Mako® Robotic-Arm Assisted Technology uses computed tomography (CT) scan information to create 3D images to help doctors personalize each patient’s joint replacement surgery.

Sepsis survival:71% improvement

Colorectal cancer screening: 26% higher than IHA average

Blood pressure control: 16% higher than IHA average

Immunizations for adolescents: 42% higher than Integrated Healthcare Association (IHA) average

Diabetes care: 9% better than IHA average

Cesarean section delivery: California Honor Roll (all hospitals)

26% higher colorectal cancer

screening than IHA average

71% improvement in sepsis survival

4 5

Value-Based CareMemorialCare participates in more value-based health plan offerings than any other health system in Southern California. Through enhanced care coordination, chronic disease management, pharmacy cost reduction and caring for patients in the most appropriate settings, we significantly reduced employers’ healthcare costs.

MemorialCare Proven Value-Based Products

Product Name Type of Product

MemorialCare Health AllianceDirect-To-Employer Contract with Boeing

Vivity Anthem HMO

Aetna Whole Health HMO, PPO

United Alliance HMO

Blue Shield Trio HMO

Blue Shield Tandem PPO

Awards and Accolades

Long Beach Medical Center

2019 U.S. News & World Report Best Hospitals:

Highest ranked in Greater Long Beach Region

Top 6 in Los Angeles County

Top 9 in Orange and Los Angeles Counties

Top 15 in California

High Performance status in Cancer, Cardiology & Heart Surgery, Heart Failure, Heart Bypass Surgery, Orthopedics, Geriatrics, Neurology & Neurosurgery, Colon Cancer Surgery, Gastroenterology & Gastrointestinal Surgery, and more

Magnet® designation by American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program® for nursing excellence

Miller Children’s & Women’s Hospital Long Beach

2019 Southern California Super Doctors Report

More than 20 physicians recognized in the top 5 percent of their fields by the Southern California Super Doctors Report, which surveyed 30,000 physicians in Southern California

2019 Baby-Friendly® designation: ranked in top 10 percent of U.S. hospitals and birth centers by Baby-Friendly USA, Inc.


Disease Specific Certification in Pediatric Asthma from The Joint Commission for excellence in asthma care

Orange Coast Medical Center


High Performance status in Gastroenterology & Gastrointestinal Surgery, Geriatrics, Nephrology, Neurology & Neurosurgery, Orthopedics, Pulmonology & Lung Surgery, and Urology

2019 The Orange County Register’s Best of Orange County: ranked #1 hospital in Orange County


Saddleback Medical Center


Top 12 in Orange and Los Angeles Counties

Top 22 in California

National ranking in Orthopedics

High Performance status in Heart Bypass Surgery, Heart Failure, Geriatrics, Hip Replacement, Knee Replacement, Gastroenterology & Gastrointestinal Surgery and Urology

2019 The Orange County Register’s Best of Orange County: ranked #2 hospital in Orange County


Geriatric Emergency Department Accreditation by the American College of Emergency Physicians

MemorialCare Medical Group

Integrated Healthcare Association (IHA) Excellence in Healthcare Award, California’s top honor for physician organizations

2019 PAS survey: 98th percentile for Overall Rating of Care, third in the state

APG Standard of Excellence Elite Status

IHA Medicare Advantage – 4.5 stars out of 5

Greater Newport Physicians

IHA Excellence in Healthcare Award, California’s top honor for physician organizations



Edinger Medical Group

IHA score: 90th percentile in Achievement Scores for Clinical Quality



6 7

Counting on Our Care

9,500 babies delivered

1,349 licensed beds

288,000 patients in value-based plans

275,000 patient days (including newborns)

600,000 medical group visits

183,000 emergency department visits

60,500 patient discharges

63,000 ambulatory surgeries

30,000 hospital-based surgeries

707 average daily census

145,000 home health visits

Network GrowthOur Expanding Network

MemorialCare continues to enhance our geographic footprint by adding more community-based outpatient locations, close to where our patients live and work. In 2019, MemorialCare opened new health centers in Rancho Mission Viejo and Tustin, added to our growing network of breast centers with new locations in Irvine and Los Alamitos, as well as a new dialysis center in Huntington Beach. MemorialCare will open additional locations covering a wide range of services including urgent care, breast care, primary care with pediatrics, obstetrics/gynecology and imaging by the end of 2020.

By the Numbers:

4 leading hospitals

2 award-winning medical groups

27 health centers

28 ambulatory imaging centers

8 outpatient surgical centers

9 urgent care centers

2,600+ physicians

7 hospital-based breast centers

13 community-based dialysis sites

7 home-based dialysis programs

1.7M patients each year

14,000+ employees and physicians

8 9

Advancing AccessMemorialCare is transforming the patient experience by utilizing the latest digital tools to create a better patient experience. We’re constantly innovating:

Navigation Center

The MemorialCare Navigation Center provides a single point of contact for patients and their families to communicate with a Patient Navigator for any matter related to the MemorialCare network. This includes making or changing appointments, obtaining test results, locating a physician in any specialty, and speaking to a telephone advice nurse, to name a few. Extended hours are provided to meet the needs of patients’ busy lifestyles.

Amazing Scheduling

Making appointments is convenient with these scheduling options:

• Navigation Center• memorialcare.org• MemorialCare myChart app • In person at any of our medical group locations

Reserve Your Spot

Through memorialcare.org, patients can check the wait times and reserve a same-day appointment at any of our nine urgent care centers.

Virtual Care

MemorialCare’s latest advancements include video visits with behavioral health specialists and access to SilverCloud, an online therapy program.

Epic Refresh

Set for completion in 2020, Epic Refresh improves our electronic medical record system, standardizes workflows, enhances provider-to-patient communication and makes the myChart app more user-friendly.

Wellist

Wellist maps out many social services, like grocery delivery and laundry assistance, in patients’ neighborhoods.

36 pediatric

specialties

Opening in

2021

MemorialCare is invested in improving existing facilities and breaking ground on new ones, including:

Emergency Pavilion Expansion at Orange Coast Medical Center

• Doubled the size of the Emergency Department, added 13 private treatment rooms, fast track stations and bedside registration, among other improvements.

Cherese Mari Laulhere Children’s Village Groundbreaking

• Named in memory of Cherese Mari Laulhere, in acknowledgment of a transformative financial gift provided by the Cherese Mari Laulhere Foundation, the Village brings together 36 pediatric specialties in one location. Opening in 2021.

State-of-the-Art Facilities

10 11

Laguna CoastWilderness Park

Santa Ana Mountains

Aliso and

Wood Canyons

Regional Park

Long Beach

Anaheim

Yorba Linda

Dana PointSan Clemente

Torrance

FountainValley

HuntingtonBeach

NewportBeach

MissionViejo

LagunaNiguel

LagunaHills

Irvine

Westminster5

5

5

15

605

405

105

110

710

91

74

91

57

22

55

73

241

241

133

261

1

1

1

Los Angeles County

Orange County

COMING SOON

COMING SOON

COMING SOON

Children’s Specialty Care Centers

Urgent Care Centers

MemorialCare Medical Group

MemorialCare Shared Services

Miller Children’s & Women’s Hospital Long Beach

MemorialCare Medical Centers

Breast Centers

Hospital-Based Imaging Centers

Community-Based Imaging Centers

MemorialCare Surgical Centers

Dialysis Centers

A�liated Physician Groups(Includes Greater Newport Physicians)

Breast Center, Los Alamitos

MemorialCare Breast Center in Los Alamitos offers a convenient breast imaging satellite location for residents of north Orange County. The easily accessible location features a spa-like environment and the latest advanced technology, as well as expert all-female,sub-specialized breast radiologists.

Health Center, Tustin

From routine wellness screenings to health conditions that require specialized care, the award-winning doctors at our Tustin health center deliver the highest quality primary and pediatric care to our community.

Health Center, Rancho Mission Viejo

If you are looking for top-rated physicians to keep your family healthy, MemorialCare delivers. Our new, two-story, 26,000 square foot health center provides everything you need, including primary care and specialty care services, to the residents of south Orange County.

Dialysis Center, Huntington Beach

Our Huntington Beach-based dialysis center, operated in partnership with Fresenius Kidney Care, provides dialysis and offers free classes about kidney disease.

Breast Center, Irvine — Sand Canyon

The Irvine – Sand Canyon location offers convenient breast cancer screening, early detection, diagnosis and treatment. All our breast imaging services use the most advanced technology, including 3D tomosynthesis and DEXA bone density testing. Two more locations will open in 2020.

Expanding Outpatient

Services

Behavioral Health Integration MemorialCare introduced our Behavioral Health Integration program which allows our primary care physicians to provide care options for patients with behavioral health needs. The program includes:

• An embedded clinical social worker at each location

• Instant referral to needed services

• Access to a trained psychiatrist via Telehealth

• Televideo visits to patients enrolled in the program

• Online patient self-management tools through our partner, SilverCloud

Our Behavioral Health Integration program is available at nine locations with more to be added in 2020.

Connecting with the Community In addition to providing exceptional healthcare, MemorialCare partners with local organizations to promote the health of the entire community. Highlights include:

Official Healthcare Partner of Angels Baseball

Through our Angels partnership, we’ve connected with baseball fans around Orange and Los Angeles Counties to raise awareness of life-altering conditions including pediatric and adult cancer, and cardiac health, as well as provide support for living a healthy lifestyle. Also, as part of the Angels Partnership, we gathered as a MemorialCare community to clean, garden and spruce up the local Boys and Girls Club of Huntington Valley.

Naming the Cherese Mari Laulhere Child Life Program

MemorialCare christened our award-winning Child Life Program at Miller Children’s & Women’s Hospital Long Beach, the Cherese Mari Laulhere Child Life Program. The new name honors the legacy of local student, Cherese Mari Laulhere, and acknowledges the financial support provided by the Cherese Mari Laulhere Foundation to fund the program.

March for Babies

For more than a decade, MemorialCare has been a primary sponsor of the March of Dimes® annual March for Babies. We are passionately committed to supporting the March of Dimes mission to improve the health of babies, prevent premature birth and infant mortality, and make sure moms and babies are given the best possible care.

Servicing our community

with health education classes and events

85% reduction in depression

symptoms in an average

of 31 days

472 patients accepted into

program in 2019

Now in 9 primary care locations

14 15

Health and wellness classes to nearly

280,000 seniors

Cancer support groups for more than

2,300 people

Prenatal, childbirth and parenting classes for

13,500 parents

Community Benefit

MemorialCare’s mission is to improve the health and well-being of individuals, families and our communities. Through the free and low-cost community health services our four hospitals provide, we helped enhance the health – and lives – of nearly half a million people in FY 2019.

These include our senior health and wellness education classes covering topics such as safety, injury prevention, balance and conditioning, which reached nearly 280,000 seniors. Our cancer support groups guided more than 2,300 people as they navigated the journey from diagnosis to treatment. Through our prenatal, childbirth and parenting classes, MemorialCare helped 13,500 parents-to-be get ready for the impending birth of their baby and provided advice, strategies, and tools on how to raise their little one once he or she arrived.

MemorialCare hospitals also held numerous community-based clinics that gave local residents access to healthcare services that they may not have otherwise, including blood pressure tests and screenings for heart failure, colorectal cancer and hepatitis. Flu shot clinics and behavioral health services were also provided to those in need.

MemorialCare is proud to support local residents by providing a variety of health education classes, special events and clinical services specifically tailored to meet the unique needs of the people in the surrounding communities.

Connecting with the Community (continued)

Clinician Mission Trips

MemorialCare physicians, nurses and clinicians are devoted to helping others in both their professional and personal lives. Each year, many MemorialCare team members go on mission trips around the world, providing support for groups including Aidchild and Otino Waa Children’s Village. Other activities have included hosting women’s conferences, cleaning water wells and teaching classes in impoverished nations.

Supporting Seniors

We partner with senior centers throughout our service area to provide resources that help them live their best lives. We offer information about their Medicare benefits and we introduce them to local MemorialCare doctors. We also offer a variety of classes, including Tai Chi and ATX cardio classes, a program which focuses on the needs of individuals with cardiovascular issues, and technology, smartphone and social media classes.

Local Chambers of Commerce

As part of MemorialCare’s ongoing mission to support business and help ensure the physical and economic health of the communities we serve, we have taken leadership roles in several local Chambers of Commerce, including Irvine, Long Beach, Fountain Valley, Huntington Beach and Anaheim.

16 17

2019 Financial SummaryStrong Financial Performance

In 2019, MemorialCare has strengthened our already robust financial performance by closely managing costs, increasing efficiency, leveraging our competitive position and securing more clients by expanding our value-based health plan offerings.

Our Philanthropic SupportLong Beach Medical Center Foundation and Miller Children’s & Women’s Hospital Long Beach Foundation

Fiscal Year ResultsTotal assets – $226,257,000

Saddleback Medical Center Foundation

Fiscal Year ResultsTotal assets – $143,677,000

Orange Coast Medical Center Foundation

Fiscal Year ResultsTotal assets – $402,000

Combined total philanthropic income growth and contributions back to the community across all foundations

Income/GrowthPhilanthropic gifts – $38,741,000Support groups – $502,000

Contributions back to the communityEducation, research, community benefit programs – $4,127,000

Capital and equipment – $9,319,000

Our Physicians and Employees

2,668 medical staff physicians

627 resident and fellow

physicians

10,572 total employees

320 medical students

1,237 volunteers

140,797.37 volunteer hours

Unpaid costs of Medicare $68,799,000

Unpaid costs of Medi-Cal $33,658,000

Charity care $9,624,000

Research and other for broader community $28,400,000

Total Expenses

$2,344,512,000Salaries, wages and benefits $963,430,000

Food, drugs, other medical supplies/services $1,034,024,000

Capitation claims expenses $202,900,000

Depreciation and amortization $112,699,000

Interest expenses $14,063,000

Other non-operating expenses $17,396,000

Total Revenue

$2,523,915,000Net revenue from patient services $1,916,150,000

Capitation revenue $410,132,000

Other operating revenue $112,493,000

Net investment income $85,140,000

Total Community Benefit*

$140,481,000

* Total quantifiable community benefit with Medicare and Seaside Health Plan included

Unpaid costs of Medicare

49%

Unpaid costs of Medi-Cal

24%

Charity care

7%

Research and other for broader community

20%

Fiscal Highlights Include:

Total assets: $3.8B

Total revenues: $2.5B

Continued strong operating cash flow

Fiscal Year Results Total assets

$3,758,918,000

Food, drugs, other medical supplies/services

44%

Capitation claims expenses

9%

Depreciation and amortization

4%Interest expenses

1%

Other non-operating expenses

1%

Salaries, wages and benefits

41%

Net revenue from patient services

76%

Capitation revenue

16%Other operating revenue

5%Net investment income

3%

18 19

MemorialCare Senior Executives

Barry Arbuckle, Ph.D. President and Chief Executive Officer

John Bishop Chief Executive Officer Long Beach Medical Center Miller Children’s & Women’s Hospital Long Beach

Lorraine Booth Chief Human Resources Officer

Tammie McMann Brailsford, RN Executive Vice President Chief Operating Officer

Rick Graniere Chief Investment Officer

Scott Joslyn, Pharm.D. Chief Information Officer

Tom Leary Chief Legal Officer

Helen Macfie, Pharm.D. Chief Transformation Officer

Marcia Manker Chief Executive Officer Orange Coast Medical Center Saddleback Medical Center

Mark Schafer, M.D. Chief Executive Officer MemorialCare Medical Foundation

Karen Testman Chief Financial Officer

MemorialCare Board of Directors

Barry Arbuckle, Ph.D.

Sharon Cheever

Mark Cianciola, M.D.

Resa Evans

Eric Feldman, M.D.

James Gauss, Chair

James Leo, M.D.

Thomas Rogers

Robert Schack

Samuel Tang

Bill Webster, M.D.

MemorialCare Medical Foundation Board of Directors


Barry Behrstock, M.D.

Mark Cianciola, M.D., Chair

Steve Geidt

James Hillman

Patrick Kapsner

Larry Lambert

Frank Marino, M.D.

Keith Nelson

Myron Wacholder, M.D.

Seaside Health Plan Board of Directors

Barry Arbuckle, Ph.D., Chair

John Bishop

Maribel Ferrer

Patrick Kapsner

Larry Lambert

Long Beach Medical Center Miller Children’s & Women’s Hospital Long Beach Board of Directors


David Carver

Sathya Chey

Jane Close Conoley

Leslie Edrich, M.D.

John Fielder

Clifford Hancock, M.D.

Cynthia Herzog, M.D.

Stephen Hryniewicki, M.D.

Lorna McFarland, M.D.

Braden Phillips

Robert Schack

Bill Webster, M.D., Chair

James Wells, M.D.

Susan Anderson Wise

Senior Executives and Boards of Directors FY 2019

Orange Coast Medical Center Saddleback Medical Center Board of Directors


Sharon Cheever

Resa Evans, Chair

Thomas Feldmar

James Gauss

Catherine Han, M.D.

Tim Helgeson

Julio Ibarra, M.D.

Lalita Komanapalli, M.D.

Joel Lautenschleger

Thomas Rogers

Donna Rane-Szostak, Ed.D.

Lawrence Tran, M.D.

Myron Wacholder, M.D.

MemorialCare Physician Society Board of Directors

William Armstrong, M.D.

Marnie Baker, M.D.

Gregory Bush, M.D.

Karen Don, M.D.

Brooke LaDuca, M.D.

David Law, M.D., Chair

Monica Leff, M.D.

Helen Macfie, Pharm.D.

Frank Marino, M.D.

Hiren Patel, D.O.

Eric Ramos, M.D.

Adam Solomon, M.D.

Graham Tse, M.D.

William Wallace, M.D.

James Wells, M.D.

Andrew Wittenberg, M.D.

20

Long Beach Medical Center2801 Atlantic Ave., Long Beach, CA 90806(562) 933-2000

Miller Children’s & Women’s Hospital Long Beach2801 Atlantic Ave., Long Beach, CA 90806(562) 933-2000

Orange Coast Medical Center18111 Brookhurst St., Fountain Valley, CA 92708(714) 378-7000

Saddleback Medical Center24451 Health Center Drive, Laguna Hills, CA 92653(949) 837-4500

MemorialCare Medical GroupLocations throughout Los Angeles and Orange Counties877-MYMEMCARE (696-3622)

Greater Newport PhysiciansLocations throughout Los Angeles and Orange Counties(800) 553-6537

Seaside Health Plan17360 Brookhurst St., Fountain Valley, CA 92708(855) 833-7747

Shared Services/MemorialCare Medical Foundation17360 Brookhurst St., Fountain Valley, CA 92708(714) 377-2900

memorialcare.org

annual report · memorialcare’s leadership in value-based care has led to improved health among...

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