Regional Outreach Challenges

Shaun HernandezUniversity of Wisconsin

AASA National ConferenceOctober 6, 2015

Overview

• The Big Picture: The Wisconsin healthcare market and how UW Health fits in

• Goals, Strategy, and Results: Leveraging Outreach to drive regional success

• The Learning Curve: Challenges Faced

The Big Picture

The Wisconsin healthcare market and how UW Health fits in

The Big PictureThe Wisconsin Healthcare Market

Total Region Population =6.8 Million

UW Health Has Concluded…1. Consolidation in the region is accelerating and UW Health must

seek innovative partnerships to achieve the appropriate scale to create a vibrant clinical enterprise and support our academic mission

2. An effective population base of 2-3 million lives is necessary to effectively manage population health, support tertiary / quaternary service lines, and achieve academic goals

3. A multi-pronged approach is required to protect current markets while proactively seeking partners with access to new markets

4. Significant growth is required and focusing solely on local and ring markets will be insufficient

Our Focus is to Move From “Why” We Need to Grow to “How” and “With Whom”

The Big Picture

Unity Point1.2M

Gundersen 135K

UW Health550K

SSM312K

Froedtert310K

Aurora1.2M

ThedaCare117K

Bellin106K

Aspirus140KMarshfield/

Ministry500K

Large, Established Systems Are Entrenched Across the Entire Region

Mayo220K

The Big PictureThe Wisconsin Healthcare Market

2-3 Million Lives = success

Problem: No one has this yet

Goals and Strategy

Our Focus is to Move From Why We Need to Grow to How and With Whom

Goals, Strategy, and Results

Leveraging Outreach to drive regional success

Leveraging “Outreach” to drive regional success

Goal: Increase Population Base of Patients Served

Strategy: Develop collaborative, sustainable, and service-oriented partnerships with individual providers, physician groups, and hospitals/health systems throughout the region

This strategy is the foundation of the UW Surgery Outreach Program

Goals, Strategy, and Results

Leveraging Outreach to drive regional success Goals, Strategy, and Results

Goals, Strategy, and ResultsLeveraging Outreach to drive regional success

Tactics• Physician Relations/Communication• Regional Outpatient Services• Call and elective services at regional facilities • Full-time regional practices

Goals, Strategy, and ResultsLeveraging Outreach to drive regional success

New Regional Coverage Locations Since 2013

Financial Models• “Traditional” Outreach

Services– Department/UW medical

group responsible for professional billing

– Billing providers keep revenue less full assessment

– UW Health provides per diem support to supplement/incentivize outreach services

• Purchased Services/Assigned Billing– Contracted hospital

responsible for professional billing

– Contracted hospital retains all professional revenue received

– Contracted hospital pays department a fixed rate per unit time (hour, day, month, etc.)

– Faculty keep revenue less a reduced assessment

Leveraging Outreach to drive regional success Goals, Strategy, and Results

Financial Models• Calculation of Purchased Services Rate

UW Medical Foundation developed standard “Blended Benchmark” calculation for all relevant specialties+ University and Foundation fringe+ Reduced assessment (corporate and department overhead)/number of days per year = daily rate

Leveraging Outreach to drive regional success Goals, Strategy, and Results

(2014) (2015)

Leveraging Outreach to drive regional success Goals, Strategy, and Results

Totally New Revenue Stream to Department

The Learning Curve

Challenges Faced

The Learning Curve Challenges Faced

• Faculty Buy-Ino Does all this really work?o One more responsibility on top of manyo Opportunity cost (local practice, family, research)o Academic surgery is not community surgeryo Who goes and who doesn’t? Non-accredited fellows?

• Show me the money!o Who gets assessment? Department only? Division?o Are we charging too little? Too much?o What to do with faculty on guarantee?

• Cost vs. Benefito Finance, Licensing/Credentialing, Admin Support, IT, Business Planning-

time is moneyo Is there a downstream benefit? How to calculate this?

• Supply and Demando How much work is “enough”?o Catch-22: Need + FTE to expand but need to expand to justify + FTE

Thank You