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Defining tomorrow’s care

IU Health Quality Partners

IU Health Quality Partners interdependent relationships

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Physician-led and managed clinical integration program

Currently more than 2,500 physicians statewideIndiana

University Health

CollaboratingHospital Partners

Independent Physicians

Employed Physicians

Risk contracts

Pay for performance

Accountable care organizations

Bundled payments

Fee for Service

Why is this program important?

Focus on measurable quality and efficiencyClinical integration is a key component of

these healthcare system quality initiatives

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Clinical integration

“An active and ongoing program to evaluate and modify practice patterns of the network’s physician participants and create a high degree of interdependence and cooperation among the physicians to control costs and ensure quality.

This program may include: establishing mechanisms to monitor and control utilization of health care services that are designed to control costs and assure quality of care; selectively choosing network physicians who are likely to further these efficiency objectives; and the significant investment of capital, both monetary and human, in the necessary infrastructure and capability to realize the claimed efficiencies.”

“Enforcement Policy in Health Care” 1996 Federal Trade Commission/

Department of Justice Statements of Antitrust

Key Points

• Active and ongoing program

• Modify practice patterns

• Create interdependence between physicians

• Control costs and ensure quality

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Why clinical integration?

▼First step toward

an ACO

Physicians are critical to the

quality and cost of care

▼Establishes an

infrastructure for physicians to

collaborate and communicate

Creates uniform quality measures across the system

▼Illustrate quality

across the continuum of

care

Combines efforts of employed,

managed, and independent physicians

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Value to physicians

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√ B E N E F I T S

Higher degree of physician collaboration

Participate in establishing quality measures

Eliminate inefficiencies to reduce cost

Retain practice independence

Improve marketability of physician practices

Annual value report for payors

Receive financial benefit for high-quality service delivery

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Identify and adopt quality measures within each specialty

Example: the percentage of patients aged 50 years and older who receive an influenza immunization during flu season (September through February)

Data driven

Information is collected for each physician’s entire patient population from:

• Hospital facility and outpatient settings• Physician practices• Paid claims• Independent prescription networks• Independent laboratories• Regional health information exchanges• Children and Hoosiers Immunization Registry• Other clinical data sources

Technology & Tools

Virtual Physician Lounge

•‘One-stop shop’ for physician performance data

•Launches to 2 applications

Crimson

•Hospital data•Hospital

revenue cycle data sent monthly

MedVentive

•Ambulatory care data

•Practice billing data, CPT II codes, lab values, prescriptions, health plan claims

Crimson – “gas gauge” indicators

Crimson – drill down to each case

Crimson – timeline for each case

MedVentive - Patient management

Easy navigation from patient to patient

Segregation of process and outcome compliance

This view drives an optimal guideline compliant visit, 

supports coordination of care, and reduces redundant tests.

Demonstration data only

MedVentive - Actionable work lists

Integrated complete 

documentation

Easy to navigate to  all the detail

Demonstration data only

Measure Source Benchmark Your Score

1. Percent of eligible      women having mammograms every 2 years

Ambulatory/MedVentive

2. Percent length of stay above average 

3. Percent complication

4. Urine sample for nephropathy and diabetes 

5. Flu vaccine 

6. Readmit rates

Hospital/Crimson

Lab/Ambulatory/MedVentive

Ambulatory/MedVentive

Hospital/Crimson

Hospital/Crimson

Scorecard

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