Takeaways that Take Us Closer to Healthcare Transformation

Thursday, April 26, 2018 | Lori Walsh

I’ve been attending MedAxiom conferences for well over 10 years and each time I leave impressed (and a little overwhelmed) with all the great work being done across the country by our members. The spring conference was no exception. I can honestly say that each presentation, both general and breakout sessions, touched on one of the top CV challenges our members face. I hope you were at the conference—there is nothing like the live experience and exchange of ideas—but in case you couldn’t make it, here are some of the highlights.

On day one, attendees had the option of two pre-conference sessions—either practice culture and physician leadership or developing an ambulatory strategy around an ASC or OBL. The physician session, moderated by Dr. Warren Levy of Virginia Heart, and featuring Rebekah Apple of the American Medical Student Association, focused on understanding and influencing culture and leading organizations through potential changes in culture in a relationally healthy way. This is a topic that continues to be a high priority for our members, and one that we will continue to explore at our conferences.

Another common theme in cardiovascular programs and practices today is the need for a procedural ambulatory strategy. The agreement around this concept is almost unanimous, but how to successfully develop this concept is a challenge for most programs. Attendees at this session, facilitated by the MedAxiom Consulting team at Marc Toth of ACA Cardiovascular, were offered guidance on how to determine what their needs are, understand what attributes drive success, key in on economics and important first steps, and avoid pitfalls.

Joel Sauer, VP MedAxiom Consulting, opened the conference with a panel discussion on “CV Healthcare Landscape Right Now.” His panelists included Dr. Ed Fry of St. Vincent Heart Center, Mike Mytych of Health Information Consulting and Marc Toth. Joel started by covering some of the recently published MedAxcess data, including slides showing: integrated and private group compensation is getting closer together, Nuclear SPECT continues to trend downward, total caths per FTE physician are flat, and the percent of PCIs to cath are trending upward. The panel talked at length about the current CV environment and how the healthcare industry will be changed by outside forces (like Amazon and Apple) unless we can come together as a community and lead the change.

Dr. Ed Fry ended day one with an outstanding presentation on Achieving the Quadruple Aim. He presented some great data from Medscape on physician burnout and how engagement is the antidote to burnout. Dr. Fry concluded his talk with a few takeaway points: engagement is the key to achieving the Quadruple Aim, engagement maintains a culture of professionalism, and engagement is a choice. It takes work to achieve the Quadruple Aim, but it is essential for us to sustain the health of our physicians and the satisfaction of our patients.

Jim Daniel, Attorney with Hancock, Daniel, Johnson & Nagle, discussed the legal perspective on physician compensation and care team models, specifically around Advanced Practice Providers (APPs). Jim and Joel talked about a few approaches, including the net income model, as well as the legal aspects of Stark. Overall, they made clear that most programs are underutilizing their APPs because the physician compensation model prohibits a true care team. Joel and Jim laid out a great argument for trying something new (see below) that is a win-win for everyone involved.

The final general session presenter of the conference was Dr. Mark Chang, President of Ballad CVA Heart Institute (formerly Wellmont). Dr Chang gave a case study update on the compensation plan for CVA Heart Institute, including how the physicians have adapted to the changes over the last 5 years. His model has moved the physician from a nearly 100% RVU model to a base plus incentive pool with the base getting smaller and smaller each year and the incentive pool growing. Dr. Chang’s key message for making a major compensation plan change was to start slow, engage the physicians and review the incentives yearly to be certain the group goals are aligned. This was a much talked about session, as you can imagine.

Dr. Chang’s key message for making a major compensation plan change was to start slow, engage the physicians and review the incentives yearly to be certain the group goals are aligned.

Space does not allow me to cover all the great topics and speakers that we experienced in an amazing three days in Ponte Vedra, FL. As always, it was both an impressive and inspiring event. Learning about real programs making real and positive change gives us all hope that we can, in fact, transform the delivery of healthcare. Don’t miss out on the next conference, to be held October 11-13, 2018, in Austin, TX. Registration is now open (and an early registration discount is available), so get this important event on your calendar: http://cvtransforum.com/

 

 

Illustration: Lee Sauer

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