creating a winning team buzz - ajas · 3/14/2019 · the webinar focuses on operational...

Confidential ©MatrixCare 2017Presentation Name | Presenter’s Name Confidential ©MatrixCare 2017 1

And Presenter’s Name & Date

Creating a Winning Team BuzzKevin Keith Whitehurst

SVP Skilled Nursing Solutions

March 14, 2019


Executive Leadership

Kevin Keith Whitehurst, SVP Skilled Nursing

Denise Wassenaar, Chief Clinical Officer

Lee Kilmer, VP Product Management

Amy Ostrem, VP SNF Solution Strategy

Kim Broyer, VP Professional Services

Louis Lenzmeier, VP Partner Eco Systems

Ed Scott, Chief Revenue Officer

“Creating a Winning Team Buzz”

The webinar focuses on Operational Excellence, Managing Risks and Critical success

factors for tomorrows Long Term Care leaders. During the webinar, Kevin Keith will

share insights on empowering cross-trained staff with the most powerful and easiest-

to-use-tools and building a culture of Excellence and Performance. MatrixCare recently

hosted an executive forum and Kevin Keith will also be able to share insights from over

30 CEO’s of organizations leveraging MatrixCare technology. Finally, Kevin Keith will

discuss key insights into which macro factors leaders can control, and how MatrixCare

powered providers outperform.


• Introduction – About MatrixCare

• Objectives of Webinar

• How AJAS members can position for success In PDPM

• Leadership DNA to excel in the market

• Why Technology Partnership matters even more

• US Healthcare Evolution

• The Fork in the Road for LTPAC Providers

• Adopting a Health Management Mindset for Senior Care

• Critical Success Factors for Tomorrow’s LTPAC Providers

• Tech-Enabled Operating Models to Address Workforce Challenges

• MatrixCare Powered Providers well Prepared

• Q&A / Discussion


Kevin Keith Whitehurst has been a key player in Long-Term Post-Acute Care technology since 1990. He is the current SVP, Skilled Nursing Solutions. Having spent the last 29 years in the industry, Kevin Keith has been fortunate to be part of an organization providing technology solutions for every sector of Out-of-Hospital care – Skilled Nursing, Assisted/Independent Living, Life Plan Communities, and Home Health and Hospice. Kevin Keith has spent the majority of his career leading the Skilled Nursing technology sector of MatrixCare focusing on value-add solutions for providers, unmatched services, solid return on investment, and long-term partnerships.

MatrixCare is the fastest growing technology provider in the U.S., recently acquired as a wholly owned subsidiary of ResMed. ResMed is a global leader in connected health, solving the pain points in provider/physician/patient ecosystem. MatrixCare market share has grown 62% in the last 2 years, while other vendors are losing market share.

MatrixCare measures their success by performance of their customers, who are leading the way in operational excellence.


Executive Leadership

Kevin Keith Whitehurst, SVP Skilled Nursing

Denise Wassenaar, Chief Clinical Officer

Lee Kilmer, VP Product Management

Amy Ostrem, VP SNF Solution Strategy

Kim Broyer, VP Professional Services

Louis Lenzmeier, VP Partner Eco Systems

Ed Scott, Chief Revenue Officer


US Skilled Nursing Market Share Growth (Q1-2016 to Q1-2018)

1,263

397

(1,677)

62%

5%

-27%

-40%

-30%

-20%

-10%

0%

10%

20%

30%

40%

50%

60%

70%

(2,000)

(1,500)

(1,000)

(500)

0

500

1,000

1,500

MatrixCare PointClickCare All Other EHR Vendors

Net Facilities Added (Lost) % Change

Source: CMS MDS Submission Vendor File Dates – 02/01/2018, 02/01/2016


MatrixCare-Powered Providers Outperform

Source: CMS File Date 1/1/2018, Average Overall Five Star Rating, % of Facilities at 5 Stars, MatrixCare Elite Package

Can you afford to be worse than average when exceptional

clinical performance is the key to your future?

3.10

3.15

3.20

3.25

3.30

3.35

3.40

3.45

US Skilled NursingAverage Five Star Ratings by EHR

21.00%

23.00%

25.00%

27.00%

29.00%

31.00%

33.00%

35.00%

US Skilled Nursing% of Five Star-Rated Homes by EHR


MatrixCare-Powered Providers Outperform

Source: CMS February 2018; Potentially Preventable 30-Day Post-Discharge Readmission Measure - MatrixCare Elite Package

“MatrixCare helps us partner

better with external health

care providers.”Frank Caruso

Bridgemark Healthcare

Senior Director of Post-Acute Services

Don’t be on the wrong side of narrowing networks

18.00%

18.50%

19.00%

19.50%

20.00%

20.50%

21.00%

21.50%

22.00%

22.50%

23.00%

All EHRs AHT/CPSI PointClickCare MatrixCare

US Skilled NursingReadmission Rates by EHR



Webinar Objectives

Positioning

for Success

with PDPM

Leadership DNA

to Excel in the

Market

Technology

Partnerships

Matter


•Not very long ago, 1000’s of hospitals

•Many attempts nationwide to scale, yet most proved to be unsuccessful

•Today there are 171 integrated acute care delivery systems

•They have taken all independent players and combined them

•They are blurring the lines between payers and providers

Lessons from Acute Care – “The First Movie”


Lessons from Acute Care – “The First Movie”

300+

Academic

Medical

Centers

1,500+

Community

Hospitals

200,000+

Private

Physician

Practices

2,500+

Critical Access

Hospitals

20,000+

Outpatient

Clinics

Standalone / Local

Chains

Standalone / Local

Chains

Standalone / Local

Chains

100s of

Payers

~170 Regionally-Based, Fully-Integrated

Acute Care Delivery Systems

Highly fragmented value chain with

1000s of independent care settings,

providers, and payers

Evolution

Healthcare is Local Regional.


Post Acute Care Technology Evolution

Compliance - (2007)

• Avoidance of poor state surveys and “if it isn’t documented it isn’t done (or paid for)” gives rise to clinical systems

Efficiency (2012)

• Care gap and staffing challenges emerge

• Challenge of best of breed systems drives a preference for integrated clinical and financial systems

Risk Management (2017)

• Fee for value, major staffing issues, PAC networks, declining lengths of stay driving profitability challenges and need to take on and manage risk


How the Movie Ends for LTPAC

Standalone / Local Operators

Chains


Chains


Chains

100s of

Payers

X00 Regionally-Based, Fully-Integrated

LTPAC Delivery Systems

Highly fragmented value chain with

10,000s of independent care settings,

providers, and payers

Evolution

15,500+

Skilled Nursing

Facilities

40,000+ Senior

Living Facilities

2,000 CCRCs

/ Life Plan

Communities

20,000+

Home Health /

Home Care

Agencies


Chains

3,000+ Geriatric-Focused

Private Physician Practices

4,000+

Hospice

Agencies



A Fork in the Road for Providers

Lead

Assume and Manage

Risk in Care Delivery

Follow

Be a Commodity

Supplier

to Those who Lead


Care Evolution evidenced by Paradigm Shift

Time Stage of Care

1965-2004 EPISODIC CARE: Multiple Episodic Care States in Fee-for-Service

(provider paid to fix a condition caused by an Episodic Incident

2004-2016 LEGISLATIVE & REGULATION CARE: following President Bush’s

Executive Order to Digitize Healthcare, other regulations (ACA, HITECH,

IMPACT ACT, 21st Century Cures Act)

2017 – 2021 PREDICTIVE CARE: Predictive Care State where alerts are built from

existing clinical data to predict a clinical incident requiring intervention.

Future 2022 PREVENTATIVE CARE: Preventative Care State where trending clinical

data over time is analyzed, incorporated into eDesision software, and

presented to the professional provider to make an intervention to prevent a

potential incident with a focus on wellness and quality of life.

“Today this Paradigm Shift is an Evolution but if you don’t get started

it will become a Revolution”


U.S. HealthCare System

By 2030 estimated that

over half people will

have at least one

Chronic Disease

The growing population

further stresses a

Provider’s Viability

Caregivers have Limited

Access to Information when

they need it

Care is more ComplexPatients often

do not get care they need


Hospice ??

U.S. HealthCare Financial Crisis

National

Expenditures

on Medicaid

totaled

577.7 Billion

in 2016

Medicare provided coverage to

57.1 million seniors in 2016 –

project to grow to

82 million by 2030


CSFs for Tomorrow’s LTPAC Providers

Clinical, Financial & Operational Excellence are now the starting line

• Leveraging enterprise-wide business

intelligence to inform executive decision-

making

• Ability to drill down to root cause of

variance on KPIs, core metrics

Having a Clear Visor Overpowering Your Peers• Marketing performance and value to

sources of patient/resident flow• Readmission Rates

• Five-Star Ratings

• Satisfaction Ratings

• Driving occupancy and managing patient/resident

flow• Ensuring robust, intelligent patient/resident inflow and placement

• Maintain occupancy in a declining LOS environment• Managing transitions of care

seamlessly and successfully• Exchanging Personal Health Data

• Reducing litigation from botched care transitions

• Collaboratively managing health and

wellness• Engaging virtual care teams, empowering Seniors

to participate in their wellness management

Merging Successfully

Creating the Winning Team Buzz• Empowering cross-trained staff with the most

powerful and easiest-to-use tools• Less pointing and clicking, more impactful care

• Building a Culture of Excellence and Performance• Winners on a winning team


What Can We Change / Control?

Immigration Constraints?

CNA/MT/RN

Production Constraints?

Wage Inflation Pressures?

Declining Reimbursements?

Current Labor Shortage?

Operating Models?

Margin Requirements?


• Reliance on sheer size of labor

force and supply chain

• Basic training

• Rudimentary tools and tactics

• Little to no teamwork

• Limited information sharing

• Centralized authority and decision

making

• Assumption of mass casualties

• Low morale, low pay

• Virtually no career path…

Which operating model is more impactful?


Which operating model is more impactful?

• Small labor force seeking a position of

extreme prestige

• Extreme vetting during onboarding

• Constant training and development,

specialization and multi-role

• State-of-the-art technology / tools and

advanced tactics

• Team-based execution with shared goals

• Real-time information visibility and

sharing across entire team

• Delegated authority and real-time mission

support

• Zero tolerance for casualties

• High morale, relatively high pay

• Clear career path with attractive long-

term career options


Tech-Enabled Operating Models – Fewer Soldiers, More Impact

• Simple ordering of activity –

sequential, alphabetical, etc.

• No correlation between need

and order/priority

• Two-dimensional (latitude,

longitude) interventions

• Randomized impact to outcomes

• No caregiver leverage / margin

impact

Arbitrary

Population

Coverage(powered by paper,

whiteboard,

Gen1 HIT)

Arbitrary Population Coverage


Tech-Enabled Operating Models – Fewer Soldiers, More Impact

• Need-driven ordering of

activity

• Incorporating both actual and

predicted need

• Three-dimensional (latitude,

longitude, TIME)

interventions

• Direct impact to outcomes

• Maximum caregiver leverage

/ margin impact

Dynamic

Population

Coverage(powered by MatrixCare

Connected Health,

Azure Machine

Learning,

CareAssist mobile)

Dynamic Population Coverage


6+ Million Connected

Health Devices for

managing Chronic

Sleep and

Respiratory diseases


Our Mission: Leveraging technology to improve the quality of life for America’s

seniors and those who care for them

MatrixCare Mission & Core Values

• We Deliver Superior Customer Care– Expectations matter

• We Are Accountable– Outcomes matter

• We Act with a Sense of Urgency– Speed matters

• We are Winners on a Winning Team– Respect matters

• We Revel in our Work and in our Lives– Happiness matters


MatrixCare & Microsoft

Unlimited scalability, availability, security & performance• MatrixCare provisioning from the Azure hypercloud

• Elastic cloud architecture provides the horsepower necessary to make

Deep Machine Learning and Big Data analysis available in near real-time

True Big Data analysis capabilities on a robust LTPAC data set• Joint development/deployment of PowerBI

• Gartner Magic Quadrant BI solution

• Powering MatrixCare MyData and MatrixCare MyAnalytics

Fueling innovation to increase collaboration and efficiency• Embedding Microsoft Teams into CareCommunity portals for secure live

collaboration amongst virtual care team members

• Embedding Azure Deep Machine Learning into MatrixCare Clinical Decision

Support to augment best-practice recommendations

Powering the next-generation of Senior Care


Summary

• LTPAC is evolving as acute care did

• There will be winners and losers

• Workforce challenges seem

insurmountable

• The Winning Team Buzz is real

• We have limited control / ability to

change macro factors

• Tech-enabled operating models can

achieve more impact with fewer

soldiers

Q&A /

Discussion


Major 2019 Trends

1. Success through Quality & Payment for ValueWhile quality has always been important, however the consequences to poor are dramatic. Documented quality is essential to payment and remining on the right side of narrowing networks. Drill down to root cause of variance on KPIs, core metrics (ex: CMS QMs).

Payors are calling the shots, even CMS is being nimble. The old reimbursement model has ended. The new payment models are changing everything from how Medicare calculates rates, to expansion of Medicare Advantage and Managed Medicaid, to payment risk under value-based payment and hospital readmission penalties.

2. Staffing: Closing the care gap in a competitive labor market

The demand for qualified staff has never been greater. The supply has never been tighter. High turnover is a vicious cycle that leads to increased turnover and reduced quality of care. In the SNF market there is a new level of SNF oversight with PBJ reporting.

3. Engaged Personal Wellness: Enabling aging in placeThe new senior is not the old senior. Putting the person at the center begins and ends in their home, extends across episodes and encounters, includes personal goals, activities and person-generated data and outcomes, managing chronic conditions and preventing acute events. Switching from treating sickness to advancing health is a complete change in how healthcare providers run their business. Health has always been part of the story, now it is the story.

4. Integrated Care: Care Coordination & Transitions of

Care, Optimal Care Setting (Placement)As payment and quality increasingly spans care settings and crosses provider organizations, it is no longer enough to provide good and efficient care within your scope, but to partner in ways that maximize care coordination and minimize the risks of care transitions. Virtual teams partner with each other and the patient.

5. Winners and Losers: Regional, Diversified, Integrated Delivery SystemsA new wave of strong and growing providers are thriving in this time of change. They are using their combination of local presence and regional scale to succeed in all the above trends; leveraging enterprise-wide business intelligence to inform executive decision-making. They outperform their peers on quality, payment, staffing and patient satisfaction. They have mastered high acuity, short length of stay and greater patient turnover. They are taking on risk through payment models (BPCI) and health plans (managed care plans and SNP)s

6. IT Vendors Are Business PartnersProvider scale and diversity demands partners who do more than sell products, and products that are more than a single niche. To thrive, healthcare providers need enterprise-class information platforms that are open and support innovative third-parties.



How MatrixCare Powered Providers are Positioned for PDPM Success

March 6, 2019


PDPM – The Market is a Buzz!!!


MP D P

MatrixCare PDPM Solution


MatrixCare PDPM Solution

What is

MatrixCare

Doing about

PDPM??

6+ Million Connected

Health Devices for

managing Chronic

Sleep and

Respiratory diseases


MDS & ICD-10 Coding Accuracy

Clinical Documentation

Reporting/Analytics

Intake Management/ TOC

Billing/Financial

Education/Communication

Areas of

PDPM focus

MatrixCare Approach: Core Areas of PDPM Focus


MatrixCare PDPM Architecture –MDS & ICD10 Coding Accuracy

PDPM

New MDS items

New Codes

New Rates

New Schedules

Functional Status

Clinical Categories

Section GG Revisions

Clinical

Category

Mapping

Tool

PDPM MDS

Data

Access

Embedded

Rate

Calculator

PDPM

Diagnosis

Reports

Real Time

Monitoring

ICD10 Code

Accuracy

Real Time

MonitoringNTA Code &

DocumentationMDS Data

Entry

Alerts in

Real Time

Interim

Payment

Assessment

Tools

PDPM RUGS

Comparison

tool


MatrixCare PDPM Architecture –Clinical Documentation

PDPM

Clinical Categories &

Primary Diagnosis

Change in Condition

Restorative

PDPM Assessments

Assessment

Schedules

Task

Management

Tools

Template

Assessments

& Progress

Notes

Discharge

Planning

Workflows

Change in

Condition

Alerts

Mobile

Solutions for

Physician

and

Pharmacist

Mobile

Charting

Enhanced

Restorative

Nursing


MatrixCare PDPM Architecture –Reporting / Analytics

PDPM

New Rates

Clinical Categories

Primary Diagnosis

MDS Reporting

Diagnosis Reporting

Cost

of

Care

Readmission

Rates by

Admitting

Hospital

Length of

Stay

Therapy

Utilization

Access to

UB 04 data

PDPM

Category

using Billing

information

MyData

MyAnalytics


MatrixCare PDPM Architecture –Intake Management/Transitions of Care

PDPM

Admission

assessment

Post Discharge

management

Quailty Outcomes

Pre-

Admission

Screening

Care

Community

Discharge

Planning

Med

Reconciliation

CCD

Connect Now

Pre-

Admission

Assessment

tools

Cost of Care

Scoring and

Calculation


MatrixCare PDPM Architecture –Billing/Financial

PDPM

VPD – Variable Per Diem

HIPPS Codes

Interim Payment

Assessment

New Rates

New Calculations

Upper Payment Limit

Calculation

PDPM Payment / AIDS

patients

PDPM Reports

By Payor

By Resident

By Date Range

Seamless

integration

HIPPS

Scores

Charge Calculator

Billing Retro

Billing, Retro MDS

Adjustments

Length of

Stay

Calculation

UB Claims

Requirements

3 day

interrupted Stay

Provision

Complex Payor

Reimbursement

Reports


MP D P

PDPM TASK FORCE SUPPORT


Are you Current with All the Releases – Both Clinical/Financial

Are you working smart with Care Plan Templates

Are you leveraging MatrixCare to Reduce Hospital Readmissions

Have you implemented an Audit process to Drive Results

Have you implemented the Best workflows for Pharmacy Integration

Have you streamlined your MDS workflows

Is your entire staff trained and savvy with MatrixCare

Days Sales Outstanding – are you satisfied with Collections

Support for Your PDPM Task Force


Support for your PDPM Task force Continued

Are you Leveraging all the Widgets?

Have you maximized the interdisciplinary communication process

Are you maximizing the use of (Observations & Events)

For multi-sites, have you standardized across facilities

Do you have a process for determining root cause analysis

Have you leveraged MatrixCare for Managed Care functionality

Are you satisfied with quality of CNA charting? Are you capturing

everything?


MatrixCare Conference – Sign up for Directions


MatrixCare CIO Summit


MatrixCare – Where to See Us

2019 AJAS Annual Conference

March 31 - April 3

https://ajas.org/event-detail/2019-ajas-annual-conference/


MatrixCare Press Releases


Q&A


Thank You

See you at the AJAS Conference Mar 31 – April 3

creating a winning team buzz - ajas · 3/14/2019 · the webinar focuses on operational...

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