QUALITY HEALTHCARE THROUGH A PHYSICIAN-LED HOSPITAL PARTNERSHIP

UPDATE

We are pleased to announce that Dr. Georgean deBlois will be joining VQCP as the Chief Medical Officer. Dr. deBlois has served as Chief Medical Officer of CJW Medical Center since April 2012. She served on the Clinical Integration Steering Committee begun in July 2011 and is an inaugural member of the VQCP Board of Managers.

“Dr. deBlois brings a unique perspective because of her years of work as an independent physician as well as her most recent work in hospital administration,” said Theresa Noë, Vice President, Clinical Integration, VQCP. “She has been instrumental in shaping the network from its inception and will be collaborating across specialties to build our care management program supporting patients under network care.”

Dr. deBlois spent 23 years at CJW Medical

Gigi deBlois, MD Chief Medical Officer 804-887-2177 or georgean.deblois@virginiaqualitycarepartners.com

Theresa Noë, MBA, CPA Vice President, Clinical Integration 804-887-2188 or theresa.noe@virginiaqualitycarepartners.com

Sherri Miller, BSN, RN, MBA Director, Quality and Clinical Effectiveness 804-887-2146 or sherri.miller@virginiaqualitycarepartners.com

Karen Shiner, MSHA, CPC Director of Operations 804-887-2141 or karen.shiner@virginiaqualitycarepartners.com

Becky Gallo, BSN, RN, CPHQ Quality Analytics Manager 804-887-2148 or rebecca.gallo@virginiaqualitycarepartners.com

Chris Barker, MHA Project Manager, Crimson and Technology 804-887-2142 or christopher.barker@virginiaqualitycarepartners.com

Cathy Soffin Marketing Manager 804-887-2143 or catherine.soffin@virginiaqualitycarepartners.com

Nancy Rob Executive Assistant 804-887-2140 or nancy.rob@virginiaqualitycarepartners.com

Sherri Miller, BSN, RN, MBAMiller joins VQCP as the Director of Quality and Clinical Effectiveness. She has over 25 years of experience in business development and operations in a diverse array of healthcare organizations. Before joining VQCP, Miller was the president of Proactive Health Strategies, Inc. designing care delivery strategies and care management programs for integrated delivery systems, vendors and providers. In addition, she provided input in health information technology design and implementation to support physician practice adoption and operational

efficiencies. She received her MBA from UVA’s Darden Graduate School of Business Administration and her BSN from UVA.

Becky Gallo, BSN, RN, CPHQGallo joins VQCP as the Quality Analytics Manager. She has been with HCA at the CJW Medical Center for 25 years where she served as the Quality Data Coordinator for over 5 years and Manager of Quality and Compliance since 2010. Gallo has experience as a staff nurse, case manager and infection control practitioner. She received her BSN from VCU, Medical College of Virginia.

October 2013

Glenn Giessel, MD and Georgean deBlois, MD

Introducing VQCP Clinical Staff

Becky Gallo

Medical Office Building II 7650 E Parham Road, Suite 300 Richmond, Virginia 23294804-887-2140

www.virginiaqualitycarepartners.com

Board of ManagersGlenn Giessel, MD

Chair

W. Philip Morrissette III, MD Vice Chair

JT Christmas, MD Secretary

Cary Gentry, MD Treasurer

Shawn Borich, MD Sheila Clasbey, MD Peter Condro, MD Rob Daniels, MD Georgean deBlois, MD Michael Franks, MD Jay Galeski, MD Tim McManus , FACHE Clifford Morris, MD Thomas Shelton, MD Pete Sowers, MD Anthony Spensieri, MD John Turner, MD William Wagnon III

Quality CommitteeSheila Clasbey, MD

Chair

Mitesh Amin, MD Ray Beauchamp, MD Richard Bennett, MD Sara Breeden, MD James Bush, MD Matt Cohen, MD Adam Cook, MD Clifford Deal, MD Georgean deBlois, MD Phillip Duncan, MD Melanie Fidler, MD Donald Glazer, MD Nathan Guerette, MD

Chiwon Hahn, MD Rakesh Jain, MD Nagesha Kasinath, MD Ravinder Kohli, MD George Maughan, MD Jim Miller, MD W. Paul Murphy, MD Tiffany Ramsey, MD Philip Rizk, MD Keith Thompson, MD Anthony Spensieri, MD Scott Woogan, MD

Performance CommitteeJamie Hey, MD

Chair

Ted Abernathy, MD Boyd Clary, MD Peter Condro, MD Ken Haft, MD Rakesh Jain, MD George Maughan, MD Jim Miller, MD David Trent, MD

Payer CommitteeCary Gentry, MD

Chair

Ted Abernathy, MD Ramzi Aboujaoude, MD Julius Hurwitz, MD Joseph Nuara, MD Mike Petrizzi, MD John Siedlecki, MD George Wedd, MD

Credentialing CommitteeJT Christmas, MD

Chair

Georgean deBlois, MD Glenn Giessel, MD

VQCP Staff:

New Video Availablefrom the

VQCP 2013 Annual Meeting

Population Health Management: VQCP’s System of Care

Featuring Shawn Griffin, MD Chief Quality and Informatics Officer

MHMD – Memorial Hermann Physician Network, Houston, Texas

To access video, go to www.virginiaqualitycarepartners.com/news/

October 2013 1

VQCP Announces New CMOkey positions on committees ranging from infection control to quality. She is immediate past president of the Richmond Academy of Medicine and a past president of the Virginia Society for Pathology. She received her BA, MS and MD degrees from Wayne State University and is board certified in Anatomic and Clinical Pathology.

“This opportunity will allow me to partner with our network physicians to enhance care for our patients and improve outcomes that over time can help reduce rising costs for our patients, providers, employers and payers,” said Dr. deBlois. “I look forward to helping shape a response to the

changing healthcare landscape as VQCP leads the market in innovative ways to support physicians and their patients.”

Dr. deBlois and the VQCP clinical staff will be working with the Board of Managers, committees and the network physicians to develop a care management program by measuring and monitoring clinical data built on evidence-based medicine. This unprecedented effort represents a real opportunity to influence the quality of care in Central Virginia and provides a strong value proposition as the market moves toward population health management.

Glenn Giessel, MD Chair, Board of Managers

Center in private practice as a pathologist and served her last year as Medical Director of the Johnston-Willis Laboratory. She served as Chief of Staff from 2008-2010, and has held

Sherri Miller

The Performance Committee is responsible for monitoring and evaluating the ongoing clinical performance of physicians in the network and providing education and support for physicians whose clinical outcomes are below network benchmarks. Crimson was successfully implemented throughout the network before the July 1, 2013 reporting deadline requiring participating physicians to:

• Report quality data based on their specialty’s measures• Login once a month to review their data vs. network benchmarks

An individual physician scorecard reflecting this data is available by logging in to Crimson and will also be provided to each physician. We began monitoring clinical outcomes versus benchmarks in August.

The Quality Committee is focused on 2014 Quality program development including:

• Evolution of clinical measures and benchmarks to reflect areas where outcomes can be improved

• Development of a care management model for contracted covered lives with a focus on selected patients with chronic conditions

VQCP’s Annual Physician Open Enrollment for participation in 2014 contracts closed on September 13. We targeted physicians in specific specialties and geographies to help round out the network.

Sheila Clasbey, MDChair, Quality Committee

Jamie Hey, MDChair, Performance Committee

Cary Gentry, MDChair, Payer Committee

JT Christmas, MDChair, Credentialing Committee

October 2013 32 October 2013

Influence – Participation in Central Virginia’s only physician-led, hospital-supported clinically-integrated network with the ability to improve outcomes and reduce costs

Quality Data Transparency Through Crimson – A “first look” at publicly reported quality data and the ability to see trends in performance and outcome improvement across the continuum

“Every day I am learning more about what Crimson brings to the table. Not only does it provide opportunities to see where patients fall with other ‘like’ patients by DRG, severity, etc., but it also identifies variations within a practice that are contributing to outcomes. Crimson is not a

What is VQCP Value for Participating Physicians?

2013 HCA Performance PlanMetrics of Required Performance

doctor report card, but it is a catalyst for conversation between physicians about how we care for our patients.”

– Gigi deBlois, MD, Chief Medical Officer, VQCP

Practice Growth – Through benefit plan design, patients under network care often incented to use participating network practices

Enhanced Financial Opportunity – Potential incentives for the achievement of improved quality outcomes

Practice Manager Support:

• Implementation training for Crimson technology

• Quality coding and EMR workflow assistance through streamlining of processes and development of customized templates

• Resources to support office staff in administering benefits for patients under network care

• Crimson usage reports reflecting physician’s review of submitted quality data

• Monthly meetings for network practice managers to receive additional support and training including coding and network contract administration

HCA Physician

Attribution Model

Reminder…

Physician who dictated consult note

Consulting

Physician who performed procedure

(Op Note)

Performing

Physician who signed the

H&P

No signed H&P, then the physician

who wrote admit order

Attending

The Payer Committee provided oversight on the development of the 2013 HCA Performance Plan which was added as an amendment to the network participation agreement. As a reminder, physicians must login to Crimson and report their quality data to meet network participation requirements. (See page 2 for details.)

In July, members of the VQCP Board and committees attended an educational presentation by Mark Wysong, HCA’s VP for Managed Care, on the Richmond Payer Landscape. Discussions with several third-party commercial payers are in active negotiation, and we will continue to provide contracting and physician incentive design oversight as additional opportunities emerge.

The Credentialing Committee was created in response to feedback from the network to provide an alternative option for physicians who no longer require hospital privileges. We contracted with the Centralized Credentials Verification Service, Inc. (CCVS), a nonprofit certified by the NCQA who will administer a lower cost option. The Committee meets monthly to review and recommend credentialed physicians for subsequent board approval.

Committee ProgressClinical Integration

Metric 1. Adoption of Quality Coding Practices – This metric has a network-wide and an individual physician component: (a) on a network-wide basis 25% of all Network physicians must report the required level of data to the Crimson system on at least 5% of their applicable patients before any incentive payment is earned by anyone; and (b) to be individually eligible, physicians must report the required level of data to the Crimson system for at least 50% of their applicable patients.

Metric 2. Attention to Quality Scorecard – This metric has a network-wide and an individual physician component: (a) at least 25% of all Network physicians must log on to Crimson and check their dashboards during at least two of the six months comprising the Reporting Period; and (b) to be individually eligible, physicians must log on to Crimson at least once monthly during at least three of the six months to review individual scorecard and compare it to benchmarks. Checking during three of six months earns

50% payment; checking four of six months earns 75% payment; and checking five of six months earns 100%. To receive such payment, an individual physician must satisfy requirement Metric 1(b) above.

Metric 3. Flu Immunizations – This metric requires that all qualifying Network physicians (Family and Internal Medicine) report on at least 80% of applicable patients, for PQRS #110 Flu Immunization. An individual physician must satisfy requirement Metric 1(b) above.

Metric 4. Responses to Clinical Documentation/Service Inquiries – This metric provides that if Network physicians as a whole respond to at least 85% of HCA hospital inquires about clinical documentation/service issues, they can earn 50% of the incentive, and if they respond to 90% or more of the inquiries, they earn 100% of the incentive. To receive such payment, an individual physician must satisfy requirement Metric 1(b) above.

Each practice or independent physician signed an amendment outlining the Metrics of Required Performance for each physician to receive funds from the 2013 HCA Performance Plan as measured during the six-month reporting period July 1 – December 31, 2013. The Performance Plan is based on the following four metrics: