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2 0 1 6 H E A LT H L E A D E R S M E D I A I N D U S T R Y S U R V E Y

Ready, Set, When? The Drawn-Out Shift to Value

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2016 Industry Survey Premium Edition

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This report outlines the top challenges providers are facing in the transition to value-based care. Explore what your peers are experiencing and if your organization is in line with trends.

In this report, gain insight and answers to key strategic questions such as:

• How can data analytics help organizations dramatically improve clinical and financial outcomes?

• How will your organization fuel financial growth over the next five years?

• What area the industry is focusing on for increased investment?

JANUARY 2016 | Managing Misalignment and Positioning for Change PAGE 14TOC

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12%

33% 30%

6%

10%

4% 3%

1%

Not pursuing Investigating Underway with pilot efforts

Pilot efforts completed, full

rollout not scheduled


rollout underway

Full rollout nearly done

Full rollout complete

Don’t know

Base = 69

CEO responses

9% 5%

73%

5% 0%

5% 0%

5%

Not pursuing Investigating Underway with pilot

efforts

Pilot efforts completed, full rollout

not scheduled

Pilot efforts completed, full rollout underway



Don’t know

Base = 22

1–5 (small)

NUMBER OF SITES

0%

7%

44%

22%

10% 10% 5%

2%


efforts


not scheduled




Don’t know

Base = 41

6–20 (medium)

1%

17%

43%

12%

19%

0%

6% 1%


efforts


not scheduled




Don’t know

Base = 69

21+ (large)

9%

29%

35%

5%

10%

3% 3%

7%


efforts


not scheduled




Don’t know

Base = 175

Hospital

SETTING

2%

12%

48%

14% 13%

4% 5% 2%


efforts


not scheduled




Don’t know

Base = 132

Health system

7%

32%

26%

5%

14%

5% 7% 4%


efforts


not scheduled




Don’t know

Base = 76

Physician org. (MSO, IPA, PHO, clinic)

9%

30% 34%

6% 4% 3% 2%

12%


efforts


not scheduled




Don’t know

Base = 98

1–199 (small)

NUMBER OF BEDS

9%

29% 33%

4%

20%

4%

0% 0%


efforts


not scheduled




Don’t know

Base = 45

200–499 (medium)

6%

25%

41%

0%

13%

3%

9%

3%


efforts


not scheduled




Don’t know

Base = 32

500+ (large)

11%

36%

31%

4% 8%

4% 2%

6%


efforts


not scheduled




Don’t know

Base = 225

$249.9 million or less (small)

NET PATIENT REVENUE

3%

16%

50%

12% 11% 5% 3%

0%


efforts


not scheduled




Don’t know

Base = 94

$250 million–$999.9 million (medium)

2%

12%

40%

11%

20%

3% 7%

4%


efforts


not scheduled




Don’t know

Base = 98

$1 billion or more (large)

13%

28% 26%

4%

14%

4% 5% 5%


efforts


not scheduled




Don’t know

Base = 95

West

REGION

6%

24%

38%

4%

16%

4% 2%

6%


efforts


not scheduled




Don’t know

Base = 111

Midwest

8%

27%

36%

8% 8% 5% 4% 4%


efforts


not scheduled




Don’t know

Base = 172

South

8%

19%

39%

12% 11%

1% 4%

6%


efforts


not scheduled




Don’t know

Base = 93

Northeast

TAKEAWAYS• More than one-third (35%) say their organizations are

underway with pilot efforts intended to help them make the transition from fee-for-service to providing value-based care. Another 27% have completed pilots or are in some phase of rollout.

• Smaller percentages of low-revenue organizations are involved in the switch to value-based care: nearly half (47%) of those with net patient revenue lower than $250 million are not pursuing or are only investigating a transition, compared with just 19% of medium-revenue and 14% of high-revenue organizations with such limited involvement.

• Only 18% of low-revenue organizations have completed pilots or are in some phase of a rollout, compared to 31% of medium-revenue organizations and 41% of high-revenue organizations.

WHAT DOES IT MEAN?When comparing the response to last year’s findings, we see only slight shifts, which reinforces both the magnitude of the task and leaders’ reluctance to make a full commitment while details of emerging but still largely unknown payment models are unresolved.

8%

25%

35%

7%

12%

4% 4% 5%

Not pursuing Investigating Underway with pilot efforts


rollout not scheduled


rollout underway



Don’t know

Base = 471

Total responses

FIGURE 1 | Status of Providing Value-Based Care

Q | What is your organization’s status regarding making the transition from providing care on a fee-for-service basis to providing value-based care?

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Ready, Set, When? The Drawn-Out Shift to Value

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JANUARY 2016 | Ready, Set, When? The Drawn-Out Shift to Value PAGE 3TOC

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This is a summary of the Premium Edition of the report. In the Premium

report, you’ll find a wealth of additional information. You’ll read:

• A Foreword by Chris Van Gorder, president and CEO of Scripps

Health in San Diego, and Lead Advisor for this Intelligence Report

• An Executive Summary drawing on the data, insights, and analysis

from this report

• A 10-point Meeting Guide with questions to help you challenge your

team to develop and execute on strategy

In addition, you’ll get expanded survey data and insights about the

data. (See Figure 1 on Page 13 for an example.) For each question, the

Premium Edition includes:

• A series of bullet-point Takeaways

• A concise What Does It Mean paragraph on the significance of the

survey responses

• A breakdown of responses by various factors: setting (i.e., hospital,

health system, physician organization), number of beds (for

hospitals), number of sites (for health systems), net patient revenue,

region, and by CEO title. In addition, some figures include trending

data based on previous years’ results.

About the Premium Edition




Table of Contents

Foreword

Executive Summary

Analysis 5

Survey Results 13

Locked items are available in the Premium version only.

Meeting Guide

Methodology 14

Respondent Profile 15

Fig. 7: Operating Margin

Fig. 8: 2016 Financial Forecast

Fig. 9: Areas That Will Have Greatest Positive Influence on Reaching Financial Targets in Next Three Years

Fig. 10: Fueling Financial Growth Next Five Years

Fig. 11: No. 1 Ranked Healthcare IT Area in Strategic Importance to Reaching Financial Targets Next Three Years

Fig. 12: No. 1 Ranked Strategic Service Lines Three Years From Now

Fig. 13: Overall Performance for Various Groups

Fig. 14: Performance for Various Areas

Fig. 15: Performance for Various Functions

Fig. 1: Status of Providing Value-Based Care . . . . . . . . . . . . . . . . . . . . . . 13

Fig. 2: Main Industry Hurdle Preventing Transition to Value-Based Care

Fig. 3: Main Internal Hurdle Preventing Transition to Value-Based Care

Fig. 4: Threats and Opportunities

Fig. 4a: Threats From Provider Consolidation

Fig. 4b: Benefits From Provider Consolidation

Fig. 5: Investment Areas Over Next Three Years

Fig. 6: Job Satisfaction




In many aspects of healthcare, we see indications of change, with movement

toward new payment models and investments in infrastructure to support

the delivery of value-based care. While the direction is clear, it is also clear

that many of today’s providers lean more toward positioning for change than

toward implementing change.

It’s not a matter of foot-dragging or lack of understanding. Providers face two

cold financial realities. First, the payment models that are to replace fee-for-

service compensation are still emerging. Providers make cautious forays into

new territory—it’s financially prudent not to extend too far. Second, for many,

pursuing new models for delivering care requires significant investments,

which places demands on both capital and personnel.

Chris Van Gorder, president and CEO for Scripps Health, a nonprofit health

system that serves the San Diego area through five hospitals with a total of

1,369 licensed beds, explains, “There are huge dollars to be spent retooling,

and, topline, there are inadequate incentives to do that. So it’s going to be a

very slow process.”

If you’re not doing it, you should be thinking about doing it. While the

financial picture may dictate slow movement, movement nonetheless is

required. According to the 2016 HealthLeaders Media Industry Survey, more

than one-third of respondents (35%) are underway with pilot programs that

Here are selected comments from leaders regarding their appraisal of industry consolidation as an opportunity or threat.

“Consolidation provides an opportunity for improved cost-per-case control

and improved communication to all providers across an episode of care.

We are looking to develop a universal care plan across the continuum.”

—Vice president of clinical services for a large health system

“We are an academic medical center and are concerned about being ex-

cluded from payer contracts by better geographically dispersed systems.

We can mitigate that by developing and expanding a better clinically

integrated network geographically.”

—Chief financial officer for a medium health system

“The threat comes from a loss of leverage to negotiate base rates and

outlier payments. We can mitigate that through a demonstration project

on a medical home model for the chronically disabled.”

—CEO for a small hospital

“Greater collaboration between systems in some areas represents an

opportunity for more rational acquisition of technology, improved access

for patients across all payers, greater buying power, and greater ability

to balance resources with areas of need, such as investment in data col-

lection, analysis, and reporting for all purposes.”

—Vice president of operations for a large health system

“We are threatened because this physician group historically has been built

on maximizing the independence of each physician. We can mitigate con-

solidation by convincing physicians they are better off as a unified group.”

—Vice president of operations for a small hospital

WHAT HEALTHCARE LEADERS ARE SAYING

INDUSTRY SURVEY ANALYSIS

Positioning for Change BY MICHAEL ZEIS




support their transition from providing care on a fee-for-service basis to

providing value-based care, and another 25% are investigating this (Figure

1). In addition, more than one-quarter (27%) say their organization has

completed pilot efforts, which includes the 20% of respondents who are in

some stage of a full rollout. That leaves very few, 8%, who are not pursuing

the transition at all, and most of those are from organizations with low net

patient revenue.

Says Diane Holder, executive vice president of UPMC and CEO of UPMC

Health Plan, a Pittsburgh-based insurance services division owned by UPMC

with a network that includes UPMC, more than 125 hospitals, and more

than 11,500 physicians throughout Pennsylvania and parts of Ohio, West

Virginia, and Maryland, “Most providers, unless they’re very unusual, are

living in a combination of a fee-for-service environment and some kind of

value-based payment environment. And even if the fee-for-service world

dominates, they’re increasingly seeing a requirement to think more in terms

of populations.”

Survey responses for the question about an organization’s shift to value-

based care revealed few differences between this year’s response profile

and last year’s, indicating that a rapid transition is not occurring and may be

unlikely. For one thing, changes in delivering healthcare must move forward

in step with changes in financing healthcare. Holder says, “Even though

there are a lot of programs that are looking at different initiatives, I think

that it’s very difficult to get enough critical mass to tip the whole thing over

unless providers have different insurance infrastructures and so payers can

put more dollars out there to try

to encourage providers to change

their approach to care delivery.”

Inadequate incentives from

payers is the item mentioned most

frequently as the main industry

hurdle keeping the industry from

pursuing value-based care with

more vigor (23%, Figure 2). The

hurdle mentioned second most

frequently—by 15%—is doubt

about the emergence of new

revenue streams, a related issue.

Many of the programs aimed at delivering value-based care are initiatives

from the Center for Medicare & Medicaid Services. With such a

dominant payer introducing value-based structures and revenue streams,

movement occurs. Half of the respondents (51%) see the CMS’ value-

based payment efforts as an opportunity, while 33% say they see them

as threats (Figure 4). Holder describes how Medicare reimbursement

practices prompt change: “When I look at how Medicare payments will

flow to providers over the next several years, increasingly they’re paying

for outcomes and patient satisfaction, not process measures. Providers

are not going to get the points they need if they’re focused on the things

they were focused on before. When I look at the average system, it’s

Analysis (continued)

“There are huge dollars to be spent retooling, and, topline, there are inadequate incentives to do that. So it’s going to be a very slow process.”

—Chris Van Gorder




going to be really hard to make any money at all in Medicare unless you’re

getting your quality bonus payments.”

Positive appraisal of the role of CMS is size-related. Nearly two-thirds

(65%) of organizations with net patient revenue of $1 billion or more see

opportunity in the CMS value-based programs, compared to 45% of those

with net patient revenue below $250 million. It may be that a portion of

those who see threats in the CMS value-based payment efforts are, indeed,

seeing a high share of reimbursement penalties.

Two-thirds (63%) also see opportunity in shared risk, shared reward

payment programs, while 22% say they see a threat. As with the CMS

programs, a higher percentage of high-revenue organizations (74%) than

low-revenue organizations (57%) see opportunity in shared risk, shared

reward programs. One-third (33%) see opportunity in industry movement

toward full capitation, the end point in risk-bearing arrangements, while

47% say there is a threat in full capitation, and 20% say they don’t know.

Matt Ebaugh, vice president and chief strategy officer for King’s Daughters

Health System, a nonprofit covering six counties in Kentucky and Ohio

with a 465-bed acute care facility in Ashland, Kentucky, and a 34-bed

medical center in Portsmouth, Ohio, says today’s rewards are not aligned

with the commitment that full capitation implies. “What we still have in

healthcare is a misalignment. We have a lot of carrots that we’re offering

organizations to change behaviors that drive costs, but the sticks are

difficult to implement.”

Ebaugh says he expects the

percentage who see opportunity

in capitation to increase and the

percentage seeing threats with

capitation to decrease over the

next several years. “How do you

influence behavior?” he asks. “More

progressive organizations are

finding ways to influence behavior,

which means they are going to

change costs.” In-depth familiarity

with cost factors and the ability

to predict and control cost factors are important elements in making

capitation work.

Finances: Most are healthy, some are not. Nearly three-quarters (70%)

report a positive operating margin (Figure 7), while 15% say their

organization has a negative operating margin. Included in this overall 15%

are 20% of the organizations with net patient revenue lower than $250

million. These low-revenue, negative-margin enterprises are not in a good

position to participate in healthcare reform.

Ebaugh observes that smaller organizations may lack the scale to offer a

full range of care services. “The smaller hospitals are oftentimes not capable

of delivering full services,” he says. “If you’re not able to provide full service,

including sub-specialties, it will be very difficult to go after a full at-risk


“When I look at the average system, it’s going to be really hard to make any money at all in Medicare unless you’re getting your quality bonus payments.”

—Diane Holder




contract. When health insurance companies are looking at your ability to

deliver care for a patient population and you don’t have certain services,

that would be a problem. It is about scale right now.”

By a considerable margin, the area that organizations include most

frequently among the leading influencers of their ability to reach their

financial targets is cost control, mentioned by 46% (Figure 9). Says Van

Gorder, “We all know that we’re in an environment of flat to even declining

revenues for a variety of different reasons, so it doesn’t surprise me that

we’re all talking about cost control.”

While the attention of healthcare leaders may be directed toward cost

control now because of declining revenue and the need to make substantial

investments in infrastructure, the prospect of risk-bearing contracts

suggests to Ebaugh that attention to cost will increase and not diminish

under new payment models. He says, “When you’re under full risk, you get

your payment up front. So it’s not a revenue stream so much as it is being

in a cost-containment model as a result of that revenue stream. And your

revenue is based on the number of covered lives.”

Expanding outpatient services, which often provides lower cost of service

and more convenient access to care, is the mechanism mentioned most

frequently to fuel financial growth over the next five years (56%, Figure 10).

Such an effort is a way that hospitals and health systems can compensate

for the pressure on revenue that comes along with being more efficient at

operating acute care facilities. Says Van Gorder, “We’re actually working

against ourselves. While we’re

doing everything we can to lower

utilization and lower length of stay

(which obviously means more empty

beds), and to keep people healthy in

an ambulatory environment where

it’s less expensive, we still have to

have enough volume to cover at

least our fixed costs on the hospital

side. That means we have to grow

overall and grow market share, so

that’s why you see 56% expanding

outpatient services.”

Invest to enhance infrastructure. This year, substantially greater

percentages of organizations than last year say they expect to begin or

increase investments in patient experience improvements (up 14 points

to 65%, Figure 5), care redesign (up 11 percentage points to 64%), and

ambulatory care network expansion (up 11 points to 51%). All three

areas are related to patient care, and indicate growing acceptance of the

fundamental nature of the changes required to shift away from earning fees

for service to delivering value-based care.

Larger organizations are expected to lead in that effort. For example, higher

percentages of medium-revenue (78%) and high-revenue organizations


“What we still have in healthcare is a misalignment. We have a lot of carrots that we’re offering organizations to change behaviors that drive costs, but the sticks are difficult to implement.”

—Matt Ebaugh




(80%) than low-revenue organizations (55%) expect to begin or increase

investments in care redesign over the next three years. “Organizations that

are larger may be able to pull out more resources to focus on care redesign,

while smaller organizations may not even have the funds,” says Van Gorder.

“It’s a very expensive process to engage your staff and your physicians in

care redesign.”

Based on his own experience retooling care at Scripps Health, Van Gorder

says he sees both direct and indirect costs when redesigning care. Last

year, Scripps took on more than 10 rapid improvement efforts. “To do that

it takes 30 to 50 people out of their workplace for a week for each rapid

improvement event, and then you have to sustain it.” The principal direct

cost is for IT, he says. “It costs a lot of money to put in the information

systems to give those people the tools and information they need to

redesign care.”

In fact, 74% of respondents say they expect to begin or increase

investments in data analytics over the next three years, an increase of 12

points over last year’s measure (Figure 5). “There is a lot of retooling that

takes place to be successful in value-based care,” says Van Gorder. “If you’re

going to be effective lowering your cost through utilization management

through your independent practice associations and others, you’re going to

have to add data and information, and that’s very expensive. And if we don’t

do it, we know we’re not going to be successful in value-based care. And

we’ve got to get those electronic records in independent physician offices

one way or another, as well.”

Clinical IT, which can help

providers deliver targeted and

more efficient care, is the area of

IT ranked first in strategic financial

importance by 28% (Figure 11).

One-quarter (25%) say that EHR

interoperability, a cornerstone

of delivering team-based care, is

the first-ranked area within IT in

strategic financial importance. Van

Gorder says medical equipment should be included in EHR interoperability

discussions.

“Interoperability is becoming more and more important,” he says. “If

you’re going to tie to your physicians out there and get their information,

you’ve got to have interoperability. And there’s the whole issue of medical

equipment in the hospital being interoperable. Right now the pumps don’t

necessarily talk to the electronic healthcare record, and manual transfer of

information is required.”

Healthcare leaders are aware that infrastructure enhancement is a

significant task. Ten percent say that inadequate IT infrastructure and

tools are the main hurdle preventing their organizations from pursuing

value-based care (Figure 3). The figure is even higher—15%—among

organizations with $1 billion or more in net patient revenue. For many,

the challenges go beyond the ability to fund the improvements. Having


“It’s a very expensive process to engage your staff and your physicians in care redesign.”

—Chris Van Gorder




staff with the right skills is an issue, too. When appraising the strength or

weakness of various groups in their organizations, 17% say their IT staff is

weak or very weak, and 29% say their data analytics staff is weak or very

weak (Figure 13).

Advances in other disciplines such as predictive analytics will be required as

interoperability improves. Says Holder, “I think we’re going to see predictive

analytics become increasingly important as we move into being better with

interoperability.” She says she sees data-driven knowledge of patient health

factors (seen as No. 1 in strategic financial importance by 11%, Figure 11)

and telehealth (cited as No. 1 by 10%) moving forward, as well.

“To me, it’s a basic blocking and tackling problem,” Holder says. “We have

to build the foundations before we can do the more esoteric stuff, so the

interoperability is critical. Supporting your clinical processes is very, very

critical. If that isn’t done well, then probably telehealth is less important. But

once you get those basic things done, then some of these things that are a

little lower down are going to move up.”

Align with physicians, align with payers. Physician-hospital alignment is

included by 38% of respondents as one of the top three influencers of their

organization’s efforts to reach financial targets (Figure 9), but only 49%

profess to be very strong (14%) or strong (35%) at physician alignment

(Figure 14). A higher percentage of high-revenue organizations (71%) than

low-revenue (41%) or medium-revenue organizations (51%) claim strength

in physician alignment.

Holder says, “Larger systems have

more financial wherewithal to

attract physicians and compensate

in ways that allow physicians to be

aligned. They have more exposure

to building networks and building

a full horizontal continuum, which

includes aligning doctors, the

hospital, outpatient care—all the

different components of care. That

takes some financial resources

to do.”

In addition to compensation and employment, larger organizations

often offer IT infrastructure as part of the alignment formula. Holder

adds, “Alignment often comes in the form of supporting the needs of the

physicians with electronic capability and other kinds of support. Those, too,

are resource-intensive requirements.”

As attention focuses on revenue sources, providers are working to become

more aligned with payers, as well. Employers are beginning to exert more

influence on both payers and providers. “There’s a lot of pressure coming

from the employer community,” says Holder. “We’re leaving the era where

the average employer said they wanted the largest network possible so that

nobody would complain. It used to be that there wasn’t much appetite for

what a lot of people now call narrow networks or value networks.”

“I think we’re going to see predictive analytics become increasingly important as we move into being better with interoperability.”

—Diane Holder





She observes that “large insurers are creating tiered network plans,

essentially creating subgroups of providers that start to be treated

differently by the payer.” The industry is entering an era where consumerism

and customer choice are important, and employees are joining employers

in decisions about plans and pricing. “In metropolitan areas,” Holder says,

“networks will be offered to companies in a way that allows the employer to

offer different kinds of products to their employees depending upon what

price point employees want to pay.”

In light of such influences, 63% say that payer consolidation is a threat

(Figure 4). “When competition lessens,” says Holder, “it makes it threatening

for the provider community. They have to buckle under at times and accept

whatever the insurer is offering. I think that’s not something the provider

community is excited about.”

The survey shows (Figure 14) that nearly half (46%) characterize their

collaborations and relationships with payers as very strong (10%) or

strong (36%), and 12% say they are weak (11%) or very weak (1%). Says

Holder, “Figuring out how to get more payer/provider alignment will be very

important. As these new payment models strengthen, the alignment picture

may change, to some extent. But right now we’re still jockeying to see who’s

got more power in a market. Is the insurer more empowered? Or does the

provider have enough market share?”

A new view of patients and care. As stronger steps are taken toward

delivering value-based care, some directions are becoming apparent. While

fee-for-service continues as the

fundamental payment model,

we see signs that a new view of

patients and care is taking hold.

As mentioned earlier, more than

half (56%) expect to fuel financial

growth over the next five years

through expansion of outpatient services (Figure 10).

Advisors explain that such expansion can help offset declining acute care

revenue. Van Gorder says, though, that the faster way to gain market share

is through contracting efforts. So this year we see a narrowing of the gap

between outpatient expansion and some other growth methods upon which

organizations will rely. For instance, this year seven percentage points

separate expansion of outpatient services (56%) and participation in a

shared risk/shared savings effort (49%). Last year, the difference between

expansion of outpatient services (63%) and joining an ACO or PCMH (39%)

was 24 percentage points.

About this gap, Van Gorder says, “Other items are moving up as equal in

terms of priority.” Despite that new focus, 24% say that uncertainty about

revenue stream holds them back from pursuing the delivery of value-based

care with more vigor (Figure 3). And 12% say the difficulty linking financial

performance with value-based purchasing is the main internal hurdle.

Nonetheless, attention to factors such as physician alignment and integrated

“The race for a covered life really is the metric.”

—Matt Ebaugh





networks is an indication that the industry is beginning to understand that,

as Ebaugh says, “The race for a covered life really is the metric.”

Guiding the pursuit of new financial models and redesigning care delivery

systems are monumental tasks. Because the penalty for not moving forward

may be that the organization will be left behind, healthcare leaders face

serious strategic decisions. Once a path is identified, the executive team

faces tactical issues, must implement systems to monitor progress, and has

to make adjustments to the strategy.

This is not an environment for an executive team that is too fond of the

status quo. After years of slight declines, we see a sudden and sharp shift

of nine points in the percentage of healthcare leaders who say that, overall,

they are very satisfied with their jobs, up from 29% to 38%. Noting a

difference in CEOs’ appraisal of job satisfaction (48% very satisfied) and the

appraisal of non-CEO executives (36%), Van Gorder suggests that “CEOs

probably feel more in control than people who work for them, because that

is their responsibility. They are decision-makers, and that may give them a

sense of confidence that perhaps somebody below may not have.”

Van Gorder says that communication about objectives may help reduce the

disparity. “It’s important to teach the why, not just the what. I suspect that

a lot of people don’t understand why things are moving in the direction that

they’re moving.”

The majority of respondents (73%) characterize their organizations’

leadership teams as strong or very strong (Figure 13), while 10% admit

that their leadership team is weak or very weak. The remaining 17% are

neutral about the strength of their leadership team. Whether the sources

of dissatisfaction or weakness are due to, as Van Gorder notes, insufficient

understanding of the organization’s objectives, or whether it is due to other

factors, the issue needs attention because meeting the challenges ahead

requires a strong and enthusiastic executive team. Says Van Gorder, “To be

successful in a time of great change like this, it’s going to take people who

enjoy what they’re doing.”

Michael Zeis is senior research analyst for HealthLeaders Media. He may

be contacted at [email protected].





FIGURE 1 | Status of Providing Value-Based Care

Q | What is your organization’s status regarding making the transition from providing care on a fee-for-service basis to providing value-based care?

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DATA SEGMENTATION

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Methodology

The 2016 Industry Survey was conducted by the HealthLeaders Media Intelligence Unit, powered by the HealthLeaders Media Council. It is part of a series of monthly Thought Leadership Studies. In October 2015, an online survey was sent to the HealthLeaders Media Council and select members of the HealthLeaders Media audience. A total of 471 completed surveys are included in the analysis. The bases for the individual questions range from 417 to 471 depending on whether respondents had the knowledge to provide an answer to a given question. The margin of error for a base of 471 is +/-4.5% at the 95% confidence interval.

Each figure presented in the Premium edition contains the following segmentation data: setting, number of beds (hospitals), number of sites (health systems), net patient revenue, region, and CEO. Some figures also have trending data from previous reports. Please note cell sizes with a base size of fewer than 25 responses should be used with caution due to data instability.

ADVISORS FOR THIS INTELLIGENCE REPORTThe following healthcare leaders graciously provided guidance and insight in the creation of this report.

Chris Van GorderPresident and CEO Scripps HealthSan Diego

Diane HolderExecutive Vice President, UPMCCEO, UPMC Health PlanPittsburgh

Matt EbaughVice President and Chief Strategy OfficerKing’s Daughters Medical CenterAshland, Kentucky

UPCOMING INTELLIGENCE REPORT TOPICS

FEBRUARY Analytics in Healthcare

MARCH Payer/Provider Strategies

APRIL Mergers, Acquisitions, and Partnerships

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Respondent ProfileRespondents represent titles from across the various functional areas, including senior leaders, clinical

leaders, operations leaders, finance leaders, marketing leaders, and information leaders. They are from a

variety of healthcare provider organizations.

Title

0

10

20

30

40

50

1% Information leaders

18% Clinical leaders

19% Operations leaders

50%Senior leaders

Senior leaders | CEO, Administrator, Chief Operations Officer, Chief Medical Officer, Chief Financial Officer, Executive Dir., Partner, Board Member, Principal Owner, President, Chief of Staff, Chief Information Officer, Chief Nursing Officer, Chief Medical Information Officer

Clinical leaders | Chief of Cardiology, Chief of Neurology, Chief of Oncology, Chief of Orthopedics, Chief of Radiology, Dir. of Ambulatory Services, Dir. of Clinical Services, Dir. of Emergency Services, Dir. of Inpatient Services, Dir. of Intensive Care Services, Dir. of Nursing, Dir. of Rehabilitation Services, Service Line Director, Dir. of Surgical/Perioperative Services, Medical Director, VP Clinical Informatics, VP Clinical Quality, VP Clinical Services, VP Medical Affairs (Physician Mgmt/MD), VP Nursing

Operations leaders | Chief Compliance Officer, Chief Purchasing Officer, Asst. Administrator, Chief Counsel, Dir. of Patient Safety, Dir. of Purchasing, Dir. of Quality, Dir. of Safety, VP/Dir. Compliance, VP/Dir. Human Resources, VP/Dir. Operations/Administration, Other VP

Financial leaders | VP/Dir. Finance, HIM Director, Director of Case Management, Director of Patient Financial Services, Director of RAC, Director of Reimbursement, Director of Revenue Cycle

Marketing leaders | VP/Dir. Marketing/Sales, VP/Dir. Media Relations

Information leaders | Chief Technology Officer, VP/Dir. Technology/MIS/IT

Base = 471

Base = 471

Type of organization

Hospital 37%

Health system 28%

Physician org. 16%

Long-term care/SNF 7%

Ancillary, allied provider 4%

Health plan/insurer 5%

Government, education/academic 3%

Base = 175 (Hospitals)

Number of beds

1–199 56%

200–499 26%

500+ 18%

Number of sites

Base = 132 (Health systems)

1–5 17%

6–20 31%

21+ 52%

8% Finance leaders

5% Marketing leaders

Number of physicians

Base = 76 (Physician orgs)

1–5 30%

6–20 28%

21+ 42%




Respondent Profile (continued)

Average age = 54 years

Age

35 or younger 4%

36–45 14%

46–55 32%

56–65 42%

66 or older 8%

31%Profit

69% Nonprofit

Profit/nonprofit

Base = 471

50%No

50% Yes

Rural hospital

Base =175 Among hospitals

40%Female

60% Male

Gender

Base = 471Base = 471

Region

WEST: Washington, Oregon, California, Alaska, Hawaii, Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming

MIDWEST: North Dakota, South Dakota, Nebraska, Kansas, Missouri, Iowa, Minnesota, Illinois, Indiana, Michigan, Ohio, Wisconsin

SOUTH: Texas, Oklahoma, Arkansas, Louisiana, Mississippi, Alabama, Tennessee, Kentucky, Florida, Georgia, South Carolina, North Carolina, Virginia, West Virginia, D.C., Maryland, Delaware

NORTHEAST: Pennsylvania, New York, New Jersey, Connecticut, Vermont, Rhode Island, Massachusetts, New Hampshire, Maine

37%

24%

20%

20%


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