Performance Management at Intermountain Healthcare
Nick Bell BMBA511 Operational Excellence
5/08/2012
CASE STUDY THREE
Performance Management at Intermountain Healthcare Key Points Operational focus - strategy rather than management. How will the organization prepare for the future if their primary customer (government) reduces spending? How will they address decreasing revenues caused by their increasing effiencies?
Key People/Structures Dave Burton, & Brent James - Clinical Management System Design Linda Leckman – CEO Medical Group Nancy Nowak – Chief Nursing Officer Brent Wallace – Chief Medical Officer Guidance Councils – one for each of nine care areas – ensure CPMs are implemented Development Teams - developing of and responsibility for Clinical Process Models (CPM) Bill Nelson – CEO Intermountain Healthcare
Timeline
1995 – launch data driven approach to managing health care 2004 – focus to improve relationships with non-employed physicians 2006 – new reporting format for Balanced Score Card 2007 – first year employee retention key goal defined 2007- sentinel node biopsy initiative
Performance
6000 5000 4000 3000 2000 1000 0 2006 2007 2008 Profit Operating Revenues 350 300 250 200 150 100 130000 520000 127500 125000 490000 122500 2006 2007 2008 Patient Days Admissions 480000 510000 500000 132500 540000 530000
50
0
Page 1 of 2
Nick Bell BMBA511 Operational Excellence
5/08/2012
Profit (excess of revenue over income) has reduced significantly while admissions and patient days continue to rise. Clinical performance improvements (example; by keeping the caesarean section rate low) have resulted in revenue losses (as patients then require less expensive care). The organization is heavily focused on these improvements so this trend will continue.
Exhibit 14 relates to only one type of guideline (Pneumonia) but shows that in some cases Intermountain receives less reimbursement for each patient treated than they spend on treating them (net loss). Given that they
5/08/2012
CASE STUDY THREE
Performance Management at Intermountain Healthcare Key Points Operational focus - strategy rather than management. How will the organization prepare for the future if their primary customer (government) reduces spending? How will they address decreasing revenues caused by their increasing effiencies?
Key People/Structures Dave Burton, & Brent James - Clinical Management System Design Linda Leckman – CEO Medical Group Nancy Nowak – Chief Nursing Officer Brent Wallace – Chief Medical Officer Guidance Councils – one for each of nine care areas – ensure CPMs are implemented Development Teams - developing of and responsibility for Clinical Process Models (CPM) Bill Nelson – CEO Intermountain Healthcare
Timeline
1995 – launch data driven approach to managing health care 2004 – focus to improve relationships with non-employed physicians 2006 – new reporting format for Balanced Score Card 2007 – first year employee retention key goal defined 2007- sentinel node biopsy initiative
Performance
6000 5000 4000 3000 2000 1000 0 2006 2007 2008 Profit Operating Revenues 350 300 250 200 150 100 130000 520000 127500 125000 490000 122500 2006 2007 2008 Patient Days Admissions 480000 510000 500000 132500 540000 530000
50
0
Page 1 of 2
Nick Bell BMBA511 Operational Excellence
5/08/2012
Profit (excess of revenue over income) has reduced significantly while admissions and patient days continue to rise. Clinical performance improvements (example; by keeping the caesarean section rate low) have resulted in revenue losses (as patients then require less expensive care). The organization is heavily focused on these improvements so this trend will continue.
Exhibit 14 relates to only one type of guideline (Pneumonia) but shows that in some cases Intermountain receives less reimbursement for each patient treated than they spend on treating them (net loss). Given that they