Transforming data into health system growth potential

So once again, thank you everybody for joining today's webinar. We are very excited to have Medical Center health system with us today to share they how they have partnered with Optum to drive strategic growth in their market. I will allow them to introduce themselves in a little bit, but before we do get into today's content, I do just want to talk through. Through a couple of housekeeping items on the next slide that you will see during the webinar. Now, as far as managing your Webex, there are two primary ways that you can log in and listen to this webinar. The 1st is through your telephone, and this is the method that usually has the most success with clear audio. However, you do also have the microphone and speakers on your computer available as well. So if you can hear me right now, that's great, but I will leave the screen up for just a second in case anybody is having difficulty at this time. And while we do leave this screen up, I also want to highlight your ability to ask questions throughout the webinar. So within your Webex panel, on the far right of your screen, you should see a Q and A section. Towards the bottom of that panel. If there are any questions throughout today's presentation, please feel free to go ahead and type them and send them to us. We will be monitoring that throughout the session and saving time for that at the end as well. And now hopefully everybody can, feel prepared and see our screen. But with that, I will go ahead and turn it over to our presenters for today. Matt Garrett, Sasha, and Jake, thank you all so much for joining us today. Thank you. I appreciate it. To cover a brief agenda and then we'll pass it over to all the panelists for introduction, we'll be covering a welcome and overview of, not only our colleagues and peers in Matt and Garrett, but also about their health system and the market that they're focused in. And we'll dive into some of those use cases, as well as how MCHS is really collaborating with optum solutions and then reviewing kind of what are the impacts of that partnership and some of the next steps for the future. So with that, I'll pass it over to Matt and Garrett to give some introductions. Okay. Thank you Jake, I guess I'll start. I'm Matt Collins. I'm the chief operating officer here at Medical Center Hospital. Been in this role almost 13 years and in healthcare about 25 years, so good afternoon to everyone. Thanks Matt. Garrett. Thanks Jake. Hello everybody. Glad you're joining us today. We appreciate your time this afternoon. My name's Garrett Davis. I'm the VP of strategic initiatives here for Medical Center Health System. I have been in healthcare for healthcare management for about 13 years. And collectively with a Medical Center health system for about ten, and so my background's primarily in ambulatory and hospital operations and the past three years serving in this role, service line optimization strategy. So glad you all are with us today. Wonderful. Well, thank you so much Matt and Garrett for walking us through, your health system and your org and how we partnered together. I'll pass it over to Sasha for an introduction. Hey y'all, my name is Sasha Pubble. I lead our provider strategy consulting business and I've had the privilege of working with Matt and Garrett and our friends at Medical Center for the past several years on a number, number of initiatives that we'll learn more about today and in general, I spent a lot of my time partnering with Jake and his colleagues serving provider organizations across the country helping them on growth initiatives, service lines, and certainly incorporating data and insights into the decision making. So thanks everyone for being here today and Jake back to you. Thanks so much, Sasha. Yeah I suppose I should have introduced myself as well. I'm Jake Rockingback. I lead the Opta Market advantage value management team, which is a team of advisors that support our clients directly in maximizing utility and value out of the OMA solution. And I've had the privilege of working with Matt and Garrett over the last couple of years on a number of these projects as well. So really excited to have the opportunity to present. With that, I will pass it over to Matt to give a bit more of an overview of Medical Center Health System. Thank you Jake. Good afternoon, everybody, and thanks again for sharing your lunch hour with us. Really excited to be here. In fact, I was up half the night thinking about this webinar, and then it finally dawned on me. So ready to get going. Alright, understand this webinar is really aimed at highlighting the use of data to transform organizations, particularly in the area of in the area of strategy. So I'd like to tee this up a little bit by telling you about the health system and then give you a glimpse into the creation and then we'll kind of work backwards into the data to help develop our, our plan and how that data supported the plan. So, it may seem a little all over the map. At the beginning but I promise we'll, we'll, we'll, we'll tie this all up and it all makes sense. So medical health medical center health system, if you go to the next slide Jake, we are out in the middle of West Texas. I don't have a, a cursor here that I can use, but if you look to the left of that Texas map, where it says J rack. That is about where we are. Literally five mi 5 h from anywhere by car to Dallas, Austin, San Antonio or El Paso. This is oil field country, so oil and gas industry really rules the desert here. We have a pretty unhealthy population. In fact, we're on the leaderboard for just about everything, chronic conditions such as diabetes, obesity, alcohol abuse, motor vehicle accidents, we have. A lot of high speed interstate highways here, and a lot of large trucks, some of which hall enormous amounts of sand, so some of the mvas are very, very serious out here. We are the regions. Safety net receiving center. We operate 402 beds. Our region encompasses 17 counties, so almost 800 mi 800 sq mi worth of outreach, so many, for many rural and frontier taxes were in. That as far as a hospital goals. We're doing ok. We hold our own as a hospital. We are a level two trauma center. We have a level three NICKU and a platinum certified cardiac program. And we're also having affiliation with Texas tech, Health Science university. So we are a. Academic teaching center. We have a bit of a unique structure here. We are a district hospital, so we do have some taxing authority, but that revenue generates far less in support than what is needed for our uncompensated care. So continually up against financial. Challenges just like everyone else out there, I'm sure. We're governed by a seven member electric elected board and of course they all have competing priorities. And probably the most unique thing is here we're not associated with any other major health system, so. That's kind of good and bad, the the challenging part of it and and maybe the good part of it is the autonomy that's associated with that. But we certainly don't have a corporate playbook, you know, a floor. Of cubicle working strategists to help us out. So we, we really, all of the decisions we make concerning operations and strategy, we all have to kind of do under our own power and, and live with those decisions. But it certainly does. Make strategy all that much more critical for us. So, with that said, it's been a, it's been a good decision for us to partner with Optum as we really needed some help and guidance in formulating our strategic plan and probably even some more help in executing that. So. Optum's an excellent partner in helping us develop those priorities, and we've had a long standing relationship probably over five years with them. So with that said, I'm gonna turn this over to Garrett and he will tell us a little bit about our strategic plan. Yeah, thank you Matt. So as you can see, we, you know, we've, we've partnered with Optum for many years and over the course of those years we have essentially adopted a structured annual strategic planning cycle, and really the purpose kind of as Matt alluded to is really to develop and advance. That's our, our hospital strategy out here in the desert. And so as you can see on the screen, the hospital, the strategic plan process is broken down into these these five different phases. And essentially, the process begins in the spring where we define the fact based. This includes analyzing internal and external data. To really understand our market and our positioning in the market. I want to really identify what what does MCH bring to the table versus everybody else and where can we capitalize on our opportunities? And so then we move into the the next that next phase, the leadership retreat, so our our executive board and our executive team, we meet annually for our retreat, and this is where we align our priorities. And then followed by following that several months of. Strategy refinement, really sharpening and focusing on various business imperatives and various opportunity for, for growth and development into that market. And then by August, that, that August September range, the cycle really tie ties directly to our budgeting and our our goal setting. And this is really helpful to ensure that our resources align with our, our strategy plan for that for that next year. As you know, resources are, are finite in the healthcare business and so we like to present our, our strategic plan priorities to our CFO and make sure we get those resources allocated. And finally from September through about March, the organization, we, we. Monitor our progress, report, we report outcomes internally and externally, and we refine our plan as needed. Essentially creating a, a continuous loop of improvement and accountability. And we'll go on to the next one, Jake. And so within our strategic plan, it's essentially, it consists of five different five primary pillars. And this is really where we start turning our plans and visions into action. These pillars, as you can see on the screen. Are made up of our finance pillar where we focus on balancing cost management and revenue growth, and then our growth pillar where we build different differentiated services and partnerships to strengthen our our market. Our quality, we want to ensure we're providing the safest and the highest quality care to the Permian base in the areas we serve, and our experience pillar where we create a culture of passion, excellence, and continuous improvement. And of course our people, we wouldn't have a business without people. We are in the people business. So we certainly like to foster engagement and strong physician and staff alignment. And so, together all these initiatives ensure that we're doing really three main things. Strengthening our financial performance, advancing our clinical excellence, and building a sustainable patient centered organization. And also a really important part of of this strategic plan here is the ownership and accountability part. As you can see in the middle of the screen here, each pillar is assigned a set of executives really to reinforce. It's the accountability and execution of all of the strategic initiatives that are wrapped into that pillar. So that is a breakdown of our, our strategic plan and how it's built. Thank you, Garrett. Appreciate that. If you go back one jake. So kind of narrowing down here yesterday, today Garrett can give a big picture overview of our strategic plan, the structure with those pillars, and today we'd like to hone in on one of the pillars and that's growth. And if you look over to one of the elements of the growth pillar is service line structure. So, Opton helped us, helped us to identify that we really needed to start looking at our delivery systems as service lines. So if you go to the next slide, one of the opportunities that we believed we were facing. Intuitively was our cardiovascular service line. But one of the 1st steps in moving that forward was to make sure that we just weren't feeling it, but we had the data to support it. So we went through some work using some of the tools that were available to us. What you're seeing here is a market. Share that's really broken down by claim data. So we were able to see in that left hand pie graph that in our primary service area, just our county, we were seeing approximately 36 % leakage. And then that grows as you had the secondary service area and then the tertiary service area, up to 61 % of our potential market, we were not, we were not serving or or getting those patients to us. So we wanted to put together some initiatives to help improve. Next slide Garrett. So we did talk in depth about a service line approach. This is a nice illustration of what we thought that could look like. It's a mountain. We're kind of going from a foundational set of circumstances and certainly want to get it to a transformational program. I'd say we were about halfway up that. Mountain, but what we knew we needed to do was work on the five items that are illustrated on that graph below. And that's structure and governance, the acute care operations, cap lab, et cetera, the physician practice itself and the outpatient clinic setting. Improving quality and then organizing support functions. What we had is we have all of these things somewhat in place, but it was very siloed and and teams were just not working together to look at this through the patient journey. Me and make this more seamless and efficient. So next slide Jake, the 1st step in this, and this seems very, very fundamental, but very, very important was to establish goals for the service line. Simply stated there it was to improve access to cardio care. Improve quality, improve our financial position, improve our workplace environment and our patient satisfaction. And I I can't tell you the number of times that we've had to go back and pull this slide up because as you do your work, people can certainly get. Sidetracked on different initiatives and different goals, but these were the ones that we decided on for our committee and we still have them today, two years later, so that's working very well. Next slide. So what I'm hoping to do now is just give you a few highlights of the. Work that we're doing or did inside that service line. This is certainly not all of it, but I think it'll give us a good idea of how that program is running. If you go to the next slide Jake. The 1st step in this was to perform a gap analysis. Optum did do this for us. They were on site for the better part of a week, and talked to just about everybody and looked in every closet, and then organized this very well with where they. Believe there are opportunities are for further developing that service line. Now, some of this was very hard to hear and look at, you know, in fact, I thought they were at the wrong hospital when they did this assessment, but it was not. We had a chance to look in the mirror, which turned out to. Do very well. Basically what we were seeing was a very unorganized system that needed some government, you know, there was very little communication between departments and areas that support the service line. Denials for the service were off the chart. Employee engagement was low. Patient engagement was low, expenses weren't in line with benchmarks and on and on and on and on. So we, we completed this, and I can, I'll just give you a little story about why this is important. When we 1st started working with the physicians on the development of the service line, we were talking about the areas of improvement that were necessary to make us successful. One of the physicians proceeded to speak up and say, Well, the biggest problem we. We have in this hospital is that the resident's leaf crumbs on my keyboard in the charting room when I'm not there. So a true story, so this we go back to this all the time to keep us thinking at a much higher level than just those. Irritants that people want to wanna solve. So very, very helpful. The next slide is we created a governance structure to help us manage this. At the top is what we call a CV advisory council. That includes the physicians, administration, support staff, other department directors, but there are eight voting members of this council, four physicians and four members of administration on the hospital side. And this council is. Designed to set priorities, identify the performance improvement initiatives that are necessary to move the the service line forward and also to come to consensus on what those priorities are and we'll talk about how we do that in a minute. Under that advisory council is an operations council. This has many of the same people, but it also has the nuts and bolts people that are subject matter experts. There's people from finance in there, marketing. Support services even housekeeping that are all aimed at improving the initiatives for the, for the program. You can kind of see the makeup there or the clinics cap lab cardiac rehab et cetera. So move on to the next slide. Okay, here are a summary of projects performance improvement initiatives that we've worked on in the last couple of years. So the governance council pretty much sets these priorities, then these performance improvement teams go off and do the work. Work execute the work, then come back and report to that governance council. Governance council, of course, gives them directions, resources, and feedback on how those initiatives are moving along. Next slide. Alright, each, each, this is, this is where the data part of this comes in. Each of those meetings, we have a core set of metrics that we review that tie back to the goals that we set earlier, and we review these for performance at every single meeting, and this is what keeps us focused. So I'm gonna run through these really quick. Keep in mind it's it's the data that drives the program here. So there are five finance market, quality, patient experience, and employee engagement. So Jake, if you go to the next one, we'll walk through these. This is a finance data that we use at every meeting. You can see if you look closely, at the representative line graphs, it illustrates our volume both inpatient and outpatient. It illustrates our revenue and then puts the expenses against them. As far as outcome, I can tell you, we've improved our net revenue and our margin by about $5 million a year for two years straight now, which is, which is an enormous success for us, but we still are yet to capture the full potential of the market. Next slide. Alright, this is our our our market today. We are giving away still $20 million of market to our competitors, but this, this slide's right up with the graphs that we saw earlier with $32 million that we weren't giving away, so. Making very, very good progress here. Next. Not sure what this is but it's next one? Yeah, this is patient satisfaction. Some of the titles didn't come through, but as you can see, we're making really good progress on how our patients perceive us in this, in this service line. Next. Alright, this is the Cathlab patient experience. Very, very good. Next. All right. I am going to end here, but if you don't get anything out of this webinar, get two things. Having a strong strategic partner when it works is very beneficial, and this tool, which we call our consensus voting tool. So I I know you've all been there in a room of surgeons or other doctors and administrators. And it is very, very difficult to come up with alignment on both sides without one side winning and one side losing. So this tool helps us judge the will of the group or the consensus as you will. So any issue, I mean I think the issue that we voted on at the last meeting was whether to engage in temporary labored travelers for for the cath lab. So four of the doctors get to vote, four of the administrators get to vote, and the vote is negative three through positive three. Starting at the far right hand side of that spectrum, a positive three is a we must. Technically clinically and emotionally do this, we're all in. And then that varying degrees moved to the left till you get to a zero, which is, I don't really have. Have an opinion. And you move farther to the left with a negative one, it's not the greatest thing to do, but I'll support it if I have to. As you move farther to the left, it's we should not, this is a terrible idea and furthest to the right is a negative three, which is. We can't. It's just a terrible idea. The point being here is if you get to negative two or negative three, you don't have a consensus and you should not move forward with that initiative. And the good thing about it is if you do vote negative two or negative three, you just can't. Dig your heels into the dirt and say NO, we've agreed that if you do choose one of these two options, you have to provide an alternative solution. So although you know you added all up and divide by the number who voted and then you get a numerical value that. Indicates the consensus or the strength or weakness of the decision. And this has just been very, very helpful. You know, in our environment with our five oh one A and our employed physicians, they legally can't set strategy and determine wage rates and things like that. But as we move through this. That gives the physicians a chance to participate in the decision making and have a stake in their destiny. And as I talk with more and more physicians, this is something that they, they really, really appreciate. They just want to be part of the, you know, the fix, and this is an opportunity to do that. So I think I can close here. I suppose there's not time for questions till the end, but go ahead Jake, whoever's next. Oh, thanks so much Matt. I appreciate it. I think that was a wonderful review of the processes and governance structure put in place. What I wanted to do now was just briefly walk through along with Sasha on where we've leaned in on the optum side in terms of collaboration. With you on your journey, and so when we think about what can a solution like OMA and and services around our optim advisory team support, we're really here to help you understand all of your performance and influence and inform some of those future strategies. So when we think about the buckets of capabilities that we have experienced solutioning within our partners would be around like market analysis, some of the bread and butter, understanding our external. Environment, what our share is, what our competitors are doing and where and who's performing business and really how does that align with our population that we're trying to serve? What does that look like from a growth forecasting perspective? So a lot of the basics of Intel that you would imagine you might wanna have across a strategic planning environment, but then really driving that. Forward into some more of the nuance around scenario planning. How can we help individuals with data and with expertise in terms of service line growth? How do we actually prioritize what services we should focus on or rationalize the services that we currently have clinical capacity within? How does that lend into our site of care strategy? An ambulatory footprint expansion, and how do we put data to work to enable a strategic vision there? And then on the far right, you will excuse me, start to bleed into some of the physician network optimization capabilities with the insights at the provider level to really define and refine what is our our patient leakage and how do we have opportunities to perhaps shore up the patients that we have in system that ultimately leading to better quality. Quality of care for that patient and then lead that into our strategic guidance and inform that across the strategic planning process and decision support, much of like what Matt just walked through a few moments ago. And so when we think about the full gamut and nuts and bolts of what can optum support across Optu market Advantage and our advisory services, this does a real. Really nice overview of where we typically lean in. I will pass it over to Sasha to give a spotlight on the advisory services. Awesome, thanks Jake and so great to hear directly from you Matt and Garrett on how we've worked together and certainly the progress y'all have made as an organization. What these graphics here help to illustrate is how our team in collaboration with our friends at medical center use the market advantage data and insights to inform not only current positioning but also foundation for identifying those strategic initiatives that we had a chance to review just a moments ago. And so as Garrett had mentioned. Of the annual planning cycle, we get together with the board once a year and as part of that effort, we have a market landscape where we identify and demonstrate the total market size and market share. We look at share and performance by service line. We look at in and outpatient capabilities, we look at leakage. Matt had shared with us some information about. How much of the cardiology business is leaving the service area for care which creates opportunities to to keep care local. So the data and insights from market advantage coupled with our strategic frameworks and and decision making, our consulting capabilities and certainly in partnership with our clients like medical centers. And enables us to set the foundation for these important strategic initiatives to be to be born insights like these are used for the strategic pillars. We use them in executive forms like the board retreat and also educating that elected board on what the healthcare landscape is really like and the challenges and opportunities in front of us. So just a small snapshot in terms of some of the. The analytics hostpower and jake, I think on the next page you're gonna show us some even more details of some of the work that we've done. Yeah, that's exactly right, Sasha. Thank you. And yeah, just wanted to highlight another example. I think a theme of the day is frameworks, right? How do we operate within the right frameworks for success? And this is just another example of leaning in on that cardiovascular use case to really say across the entire market using data driven or data. Data to really drive our decision making process, but how do we take all of these different variables of insights to really paint the full picture of what's going on in the market? And this is just one small example of some additional data points out of the OMA tool and where we partnered with our friends at MCHS to really drive towards some of that prioritization in the. Cardiovascular space and not to steal each other but also orthopedics moving forward. So it's taking things like what is our market opportunity in those growth rates and our market share and that out migration figure and putting that into the right framework to really say what is the greatest opportunity for us as an organization and where we wanna. Move so just a really nice example of some additional data and Sasha I know you have some more towards the ambulatory expansion. That's right. I appreciate the opportunity to share some additional work that we have done together with medical center really thinking about and taking advantage of the insights we've learned over time and probably experienced as operators that carries transitioning from that inpatient to the ambulatory setting. And sometimes. Anything we have opportunities to consider net new service delivery sites and or what might go into an service. And so here again we had the opportunity to use data and insights from after market advantage around market size and share. We use our advisory board market scenario planner to project out. A five year future demand for services, and we also use market advantage to identify splitter revenue and out migration revenue for each of these service lines to help us understand how might we select the right service lines for the right reasons to have a a potential to capture some of that important patients. And in in our service area that we aren't seeing today. And so what this graphic here that you're all looking at right now shows not only some of the the framework that we use and the key takeaways from that analysis, but also an indication of what that output produced. So this is a tool that we use. It's sort of the math, if you will, it's fine. Before we got to the art to decision making, but it was one of the tools that we use together to hone in on what might those outpatient services be that we would put in an ambulatory site, what has the greatest potential, where might be, where might we be challenged in our endeavors here and then ultimately what are those services that will decide on? Derek or Jake, I think you got one more. I think that's all I have. I'm actually gonna pass it back over to Garrett, but thank you so much Sasha. Hopefully that was helpful to outline where the data really starts to influence the success of driving towards our strategic initiatives, and Garrett I'm gonna pass it over to you. You to dive into some of the partnership impacts. Yeah, thank you Jake. Appreciate it. I have to say working with the opt in group has has been a a real pleasure. These groups are very intelligent. They are very professional, and they offer just a wealth of knowledge and and big industry picture things that, that we just wouldn't normally get. Access to here in in West Texas. And so we definitely appreciate the partnership. I'll kind of stick on this cardiovascular service line theme, really want to highlight this impact. Matt outlined the tremendous work and the structure that we've, that we've done within and put in place within the cardiovascular service line. The. Really the culmination of this work and structure has said a major impact along with the partnership with, with Jake and Sasha and their teams. And this has led us to be awarded platinum platinum performance in in the realm of chest pain and MI registry. And also this year we we were. Also awarded a national distinction of excellence for heart care centers by the American College of cardiology. So we're very proud of, of, of these awards and very, proud of the work, all the behind the scenes, items that, that have gone into making this a possibility. So again, just pointing back to our partnership, they bring a wealth of knowledge to the table and have really helped us up our game and, and set us on a path for success. And Jake will move it on to Matt. Matt, you maybe on mute. Yeah, you're right about that. Thank you Jake. Garrett, that's right. This is a great achievement. It's a platinum level certification. I mean we kind of say tongue in cheek are. Competitors down the road, maybe Onix gold, maybe bronze, but we've we've achieved the platinum level there in cardiac care. So I guess in, in summing this up, what do we do next? What is the. Future initiatives look like here at Medical Center. There are two initiatives that we are kicking off this year. One is an orthopedic service line, which is going to build on the success of the cardiovascular service line. And we're hoping to replicate to a degree, you know, a set the same product as far as a service line goes, but in a different, a different care area. So we're up against a very similar problem here. We have about $31 million. Worth of leakage that is leaving Hector County, some cases leaving Midland county, which is our secondary service area and into our tertiary area. So again using the data sources, we were able to come up with a reasonably good understanding of where the. That patient business is going, now we're going to have to put systems in place to attract that so people do not have to go to Austin Dallas, San Antonio for HIP and knee replacements. We're perfectly capable of doing that here without burdening patients with the travel. 2nd area that we're gonna be working on is we believe, and I think most, health systems hospitals believe that there is going to be a significant shift, if not already to ambulatory sites of care. Including, surgical procedures that are appropriate for such a level of care. So we do have an ambulatory surgery center, on. The books to be developed and we've secured some funding for that. This will have four surgery suites to operate the procedure side and we're gonna combine this with radiology services on the 1st floor. I don't know, we're not gonna get too much into geography here, but our site here is in the east side of Odesa, which sits pretty much right in between the towns of Midland and Odesa and we believe that we will be able to incorporate some patients from midland. The county to use this surgery center as it's not too far from Midland county. So we are going to be leaning on Optum heavily. This is a big investment for us. It's approximately $28 million to make sure we have the market assessment nailed down and that we do have the new business to be able to support it. But all initial indicators are good and we believe we'll be moving this project forward in the next four to six months. Alright, jake. I think that's all we have from the medical center side, so we will stand down and answer questions or whatever else your team would like to do here. Thank you so much Matt and Garrett. I think that was a phenomenal review of all of the work we've done together. I know it didn't get as deep as we could go. We could spend a lot of time on it, but I think that's gonna be tremendously impactful for all of the, the members of the audience reviewing today. So thank you so much for taking your time to help kind of review where our partnership has led towards success for your entire enterprise. At this point in time, I think we can actually open it up to any questions that may have come in through the chat. Nina, has there been any? I have not seen any up to now, but I do want to encourage anybody who is still on to please leave your questions, feel free to leave them in the chat. And then I do want to just thank our presenters today. That was a really great job and thank you to all of our attendees who joined us today. So as we finish up here and you leave any questions in the chat, just some final housekeeping before you go, a survey is going to pop up automatically as you. Who are leaving the session. It is very brief, but it's super important that you fill that out as we are reading what you write. We do take the time to go through your feedback and adjust our future webinars as a result. We want to make sure that we're delivering valuable materials overall and making good use of your time. So overall, if that is it, if nobody has any questions, I just want to thank everybody once again for joining and I wish you all a great rest of your week. Wonderful. Thanks so much, Matt and Garrett, and thank you, Sasha. Pleasure, thanks so much everybody. Look forward to hearing from you soon. Take care. Bye. Okay, everybody. Okay. Okay.