Edie Vaughn, R.N., reacts after being presented a Credo Award by Jeff Balser, M.D., Ph.D., right, Aaron Hirsh, left, and Andy Peterson at last week’s Leadership Assembly. (photo by Susan Urmy)
Leadership Assembly explores implications of health reform
Leaders at Vanderbilt University Medical Center expect a bit of a shake-up in health care over the next few years as the reforms adopted into law this year by Congress begin to be felt.
Vanderbilt's response to health care reform was the main topic at the Sept. 2 Leadership Assembly at Langford Auditorium.
Some 800 VUMC managers and faculty leaders attend these quarterly management seminars.
At the last assembly, the group examined the broad outlines and implications of reform; this time they proceeded to consider Vanderbilt's response in a bit more detail.
Onstage at Langford, determination mixed with downright enthusiasm.
VUMC leaders foresee cost pressure increasing significantly as more Americans enter insurance exchanges and acquire health coverage that mimics aspects of Medicare.
But they also see a possibility of significant new advantages accruing to those providers who can monitor and manage health across entire patient populations so as to lower reliance on more costly acute care.
Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine, spoke briefly in reference to “how we're going to weather the storm, if you will, of declining reimbursement in health care.
“Frankly, I reject the notion that cutting costs will reduce quality. I think that's neanderthal.
“Vanderbilt will cut costs by improving quality.”
Balser introduced an initiative to lower costs for the Vanderbilt Health Plan, in part by applying population-based strategies similar to those of My Health Team at Vanderbilt.
My Health Team is a new initiative that draws on VUMC strengths in clinical information technology to expand care beyond the clinic and transform outpatient management of certain major chronic conditions.
Hypertension, for example. Some 10,000 patients with hypertension are currently seen at Vanderbilt.
According to Balser, among this patient group alone, just in terms of reduced rates of stroke and heart attack, early results from the pilot show a cost savings opportunity of $15 million over five years. (What's more, better control of chronic conditions will improve the earnings margin in the clinic by opening new capacity for more intensive new-patient visits.)
“A lot of people around the country are going to take the old-fashioned approach to cost cutting. And we're not,” Balser said.
“We'll succeed for two reasons: culture and creativity.
“We can innovate because our clinical enterprise, educational enterprise and research enterprise can work as one. Everybody working here must be thinking about innovation. That's how we're going to thrive in this environment.”
The initiative also involves increased promotion of exercise and good nutrition, increased use of generic drugs, and increased financial incentives for Vanderbilt's 50,000 health plan beneficiaries to seek care from VUMC rather than from other area providers.
David Posch, CEO of The Vanderbilt Clinic and executive director of Vanderbilt Medical Group, delivered the keynote address at last week’s Leadership Assembly. (photo by Susan Urmy)
David Posch, CEO of The Vanderbilt Clinic and executive director of Vanderbilt Medical Group, began the day's keynote address by forecasting greater cost transparency in health care, falling prices per unit of service, and a general movement away from fee-for-service, with providers assuming a greater share of economic risks for health outcomes.
Marshalling statistics, Posch identified the nation's health system's main problems as lack of coordination across the continuum of care, failure to reliably execute care in accordance with known science, and failure to engage the patient and family in the care process.
“The resolution of health care costs is truly embedded in solving these problems,” he said. “We're well on our way, with the right structure and resources to succeed. How do we take advantage of what we have?”
Under a new value-based care initiative, pilot projects will test new payment models and evaluate associated quality and cost outcomes.
C. Wright Pinson, M.D., MBA, deputy vice chancellor for Health Affairs and senior associate dean for Clinical Affairs, began the day with a detailed report on VUMC performance in the fiscal year that ended on June 30 and clinical enterprise goals for the new fiscal year.
Staff and faculty are encouraged to review all these presentations online at the elevate website (www.mc.vanderbilt.edu/elevate, employee log-in required).