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Tulare Regional Medical Center. Agenda. Key data Why change is necessary Ideal solutions Conclusion. Key Data. 112 bed, acute-care hospital 3 Rural Health Clinics , 2 more clinics opening Medical tower expansion Significant growth potential. Service Area Demographics.
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Agenda • Key data • Why change is necessary • Ideal solutions • Conclusion
Key Data • 112 bed, acute-care hospital • 3 Rural Health Clinics, 2 more clinics opening • Medical tower expansion • Significant growth potential
Service Area Demographics • Population estimate: 171, 438 • Average age: 30.3 • 57.9% Hispanic • High poverty rates
Why Change is Necessary • Lack of physician alignment • Quality perception • Disproportionate market share • Current payer mix
Physician Alignment • To remain competitive, physicians must be fully integrated into TRMC
Perceived Lack of Quality • HCAHPS lower than state and national averages • HCAHPS lower than Kaweah Delta Medical Center in almost every category
TRMC’s Current Market Share • 80% of patients participate in government insurance programs • 45% Medi-Cal • Poor quality perception is hurting patient retention • Potential patients directed elsewhere
Ideal Solutions • Physician alignment
Renegotiate Physician Contracts • Business development and physician communication • What do they want? • What do competitors offer? • Sizeable share of the newly insured • PPACA will increase commercial payers • Focus on community needs
Optimize TRMC’s Clinic Network • Maintain 3 Rural Health Clinics and 2 1206(d) clinics • RHCs • Higher Medi-Cal reimbursement rates • PPACA increasing Medi-Cal rates 2013-2014 • Patient access to care • Specialized care for the population
Optimize TRMC’s Clinic Network • 1206(d) Clinics • Hospitals • Higher Medicare reimbursement rates • 100-113% • Increased patient base • Reinforce physician-TRMC alignment efforts • Inpatient referrals
Optimize TRMC’s Clinic Network • Physicians • No overhead, focus on patients • New technology • Community • Increase quality perception • Bring access to health care • Programs for elderly
Establish Medical Foundation • Key component of physician alignment • Will help facilitate recruiting and retention • PPACA influential in the move toward collaborative care
Conclusion • Physician alignment with TRMC • Care for population health needs • Funnel patients to TRMC main campus • Increase revenue generation • 1206(d) and rural clinics are a first effort toward long-term Foundation goals
Mission Statement “A patient-centered organization that sets the standard for patient experience and quality of care by pushing the boundaries of technology in service to our community.”
References Abbott, D. (2009, March 12). Healdsburg hospital to partner with primary care. Sonoma West Times and News. Retrieved from http:// www.sonomawest.com/healdsburg/news Kaweah Delta Health Care District. (2012). Kaweah Delta welcomes second neonatologist to NICU. Retrieved from http://www.kaweahdelta.org/ news/view_details.asp?newsid=221 Mineful Demographics. (2010). Tulare household income. Retrieved from http://mineful.net/California/County/County_Income/ Tulare_County_CA_income_ignore.html Schiff, A. (2010). Hospital outpatient clinics--legal considerations impacting physicians. Retrieved from www.mdhealthlaw.com/ Studer Group. (2012). About Studer Group. Retrieved from http://www.studergroup.com/about_studergroup Taylor, M. (2006). California’s health care districts. Retrieved from http:// www.chcf.org
References Tulare County Association of Governments. (2008). Tulare county. Retrieved from http://www.tularecog.org/ Tulare Regional Medical Center. (2012). Tulare Regional Medical Center. Retrieved from http://www.tulareregional.org U.S. Department of Health and Human Services. (2006). Comparison of the rural health clinic and federally qualified health center programs. Retrieved from http://www.ask.hrsa.gov/downloads/fqhc- rhccomparison.pdf U.S. Department of Labor. (n.d.). General facts on women and job based health. Retrieved from http://www.dol.gov/ebsa/newsroom/ fshlth5.html U.S. House of Representatives. (2010). Compilation of patient protection and affordable care act. Retrieved from http://housedocs.house.gov/ energycommerce/ppacacon.pdf Weekly Probe. (2011). Hospitals use focus group to drive changes to surgical procedures. Retrieved from http://www.weeklyprobe.com/2011/12/ hospital-uses-focus-group-to-drive-changes-to-surgical-procedures/