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2019

VA L U E R E P O R T


A healthy Michigan at an affordable cost.

MISSION We collaborate with

CONTENTS

VISION

patients, colleagues and community partners to relentlessly improve the quality and costeffectiveness of health care.

GOALS Better health and affordable cost through clinical transformation. More covered lives and shared rewards through health plan partnerships.

DE AR COLLE AGUES,

1

Message from the CEO

2

By the Numbers

6

Fueling the Fire for Transformation

8

Data Analytics

• Post-acute care program reduction of Skilled Nursing Facility Days per 1,000 ACO beneficiaries by 19%

10

Clinical Transformation

Affirmant’s return on investment is approximately 200% since our formation in 2015!

12

Health Plan Partnerships

14

Our Member Systems

20

Engagement

22

The Future is Bright

24

Board and Committees

The needs and opportunities driving our collaboration continue to accelerate. Health care expenses are the leading cause of personal bankruptcies in the U.S. and 55% of Americans report worrying “a great deal” about health care availability and affordability. Both Medicare and Blue Cross Blue Shield of Michigan are pushing us to accept downside financial risk for total cost of care for our patients; even as these same payers are making it more challenging for us to earn shared savings. Finally, the challenges of the COVID-19 pandemic led your Affirmant team to reimagine how we collaborate and use our network and scale to share best practices and resources in orders to mitigate the effects of this public health emergency for our Members, Chapters and physicians. Within weeks, the team created a web-based resource hub with relevant clinical, financial and labor resources; provided telehealth support; and took a lead role in health plan advocacy, including a virtual gathering of 13 physician and physician-hospital organizations from across the state.

28

Why Affirmant?

29

Meet the Affirmant Team

2019 was another record-breaking year for Affirmant Health Partners. Highlights for the year include: • First full year of Epic Constellation, with integrated electronic health record and claims data on 850,000 attributed lives

• Care management program reduction of 5% in overall inpatient admissions per 1,000 • Ninth in the nation Federation ACO Medicare savings of $36 million for 2018, with over $15 million distributed to our Members and Chapters

Now, more than ever, we believe Affirmant is an extraordinary opportunity for us to succeed together in bending the cost curve and sharing in the rewards. Together we have the ability to: • Pool downside contract risk for more predictable financial performance and lower cost of excess risk insurance

• Use our collective influence with health • Identify and rapidly adopt best plans to negotiate our fair share of practices from across our providers savings we create, and and health systems

We have a demonstrated track record in each of these areas and have identified key priorities to enable our success—post-acute care, care management, risk capture, and in-network utilization. Our challenge for the coming year is to remain laser-focused on these priorities and to redouble our efforts to adopt high-value best practices, while also mitigating the extraordinary impact of COVID-19 on our communities, patients, providers and Members. We have so much to be proud of in all we have created and accomplished thus far. Your Affirmant team looks forward to continuing to collaborate with you to achieve our vision of a healthy Michigan at an affordable cost. Sincerely,

Bill Mayer, MD, MPH President and CEO

1


A healthy Michigan at an affordable cost.

MISSION We collaborate with

CONTENTS

VISION

patients, colleagues and community partners to relentlessly improve the quality and costeffectiveness of health care.

GOALS Better health and affordable cost through clinical transformation. More covered lives and shared rewards through health plan partnerships.

DE AR COLLE AGUES,

1

Message from the CEO

2

By the Numbers

6

Fueling the Fire for Transformation

8

Data Analytics

• Post-acute care program reduction of Skilled Nursing Facility Days per 1,000 ACO beneficiaries by 19%

10

Clinical Transformation

Affirmant’s return on investment is approximately 200% since our formation in 2015!

12

Health Plan Partnerships

14

Our Member Systems

20

Engagement

22

The Future is Bright

24

Board and Committees

The needs and opportunities driving our collaboration continue to accelerate. Health care expenses are the leading cause of personal bankruptcies in the U.S. and 55% of Americans report worrying “a great deal” about health care availability and affordability. Both Medicare and Blue Cross Blue Shield of Michigan are pushing us to accept downside financial risk for total cost of care for our patients; even as these same payers are making it more challenging for us to earn shared savings. Finally, the challenges of the COVID-19 pandemic led your Affirmant team to reimagine how we collaborate and use our network and scale to share best practices and resources in orders to mitigate the effects of this public health emergency for our Members, Chapters and physicians. Within weeks, the team created a web-based resource hub with relevant clinical, financial and labor resources; provided telehealth support; and took a lead role in health plan advocacy, including a virtual gathering of 13 physician and physician-hospital organizations from across the state.

28

Why Affirmant?

29

Meet the Affirmant Team

2019 was another record-breaking year for Affirmant Health Partners. Highlights for the year include: • First full year of Epic Constellation, with integrated electronic health record and claims data on 850,000 attributed lives

• Care management program reduction of 5% in overall inpatient admissions per 1,000 • Ninth in the nation Federation ACO Medicare savings of $36 million for 2018, with over $15 million distributed to our Members and Chapters

Now, more than ever, we believe Affirmant is an extraordinary opportunity for us to succeed together in bending the cost curve and sharing in the rewards. Together we have the ability to: • Pool downside contract risk for more predictable financial performance and lower cost of excess risk insurance

• Use our collective influence with health • Identify and rapidly adopt best plans to negotiate our fair share of practices from across our providers savings we create, and and health systems

We have a demonstrated track record in each of these areas and have identified key priorities to enable our success—post-acute care, care management, risk capture, and in-network utilization. Our challenge for the coming year is to remain laser-focused on these priorities and to redouble our efforts to adopt high-value best practices, while also mitigating the extraordinary impact of COVID-19 on our communities, patients, providers and Members. We have so much to be proud of in all we have created and accomplished thus far. Your Affirmant team looks forward to continuing to collaborate with you to achieve our vision of a healthy Michigan at an affordable cost. Sincerely,

Bill Mayer, MD, MPH President and CEO

1


BY THE NUMBERS Affirmant Health Partners

Affirmant Health Partners is a super clinically integrated network – that means we bring together thousands of physician leaders from across the state to identify and promote best practices and programs that will have an impact on reducing the cost of health care and improving the health of Michigan residents. Coming together as Affirmant gives us the opportunity to take advantage of our collective strength while still preserving the independence of our Member organizations and Chapters.

5,400+ physicians 850,000 attributed lives 75% of lower Michigan counties covered $14 million total investment over 4 years 214,000 lives under value-based arrangements $30 million — return on investment — 200% in 4 years

Total returns

2

3


BY THE NUMBERS Affirmant Health Partners

Affirmant Health Partners is a super clinically integrated network – that means we bring together thousands of physician leaders from across the state to identify and promote best practices and programs that will have an impact on reducing the cost of health care and improving the health of Michigan residents. Coming together as Affirmant gives us the opportunity to take advantage of our collective strength while still preserving the independence of our Member organizations and Chapters.

5,400+ physicians 850,000 attributed lives 75% of lower Michigan counties covered $14 million total investment over 4 years 214,000 lives under value-based arrangements $30 million — return on investment — 200% in 4 years

Total returns

2

3


BY THE NUMBERS Federation ACO

The Federation ACO saved Medicare over $51 million in two years

How did we achieve success?

Affirmant Health Partners’ Federation ACO earned $17.4 million in shared savings from the Medicare Shared Savings

SCALE

CPC+

in the program. Over these two years of program participation, the Federation ACO has saved Medicare over $51 million.

By working together to serve

As a result of our collective efforts

Through Epic Constellation, we

Savings earned were shared with Affirmant’s local clinically integrated networks and physicians affiliated with the ACO—

approximately 80,000 Medicare

to promote and facilitate CPC+

analyzed Quality Measure and

Bronson Network, Covenant HealthCare Partners, Jackson Health Network, Lakeland Care Network, Sparrow Care Network.

beneficiaries, we qualified for

applications and CMS acceptance of

Utilization metrics on the performance

.

the lowest possible threshold for

all Federation ACO providers who

of each of our chapters.

receiving earned shared savings.

applied, we have 2.7 times the

Program (MSSP) in 2018 and was ninth in the nation in earnings out of 548 participating ACOs; it was the ACO’s second year

AFFIRMANT 2017

AFFIRMANT 2018

$36.5M

Medicare Shared Savings

$15.9M

ACO earned shared savings distributed to members

97.2%

Quality scores

A C O S I N T H E U N I T E D S TAT E S

548 $739.4M 205 (38%)

4

ACOs participating in 2018 MSSP Earned shared savings ACOs earning shared savings

D ATA

state-wide proportion of providers participating in CPC+.

$15.4M $7.7M 100% ACOS IN MICHIGAN

20

ACOs participating in 2018 MSSP (3.6% of ACOs in the US)

$97.5M 13

(65%)

Earned shared savings

QUALITY REPORTING

AWA R E N E S S

CHAPTER MOMENTUM

We earned a quality score of 97%.

Our collective work at the Chapter

The work of our Chapters to

This was accomplished through our

and Affirmant levels to communicate

improve cost and quality of care

collaboration with Primaris and Press

with and engage our providers has

began in 2016 and has continued

Ganey for quality data gathering and

raised awareness of the importance

throughout the years. Their initiatives

submission.

of improving total cost and quality of

build momentum for improving

patient care and the opportunity to

performance.

receive shared savings.

(10% of MSSP payments)

ACOs earning shared savings 5


BY THE NUMBERS Federation ACO

The Federation ACO saved Medicare over $51 million in two years

How did we achieve success?

Affirmant Health Partners’ Federation ACO earned $17.4 million in shared savings from the Medicare Shared Savings

SCALE

CPC+

in the program. Over these two years of program participation, the Federation ACO has saved Medicare over $51 million.

By working together to serve

As a result of our collective efforts

Through Epic Constellation, we

Savings earned were shared with Affirmant’s local clinically integrated networks and physicians affiliated with the ACO—

approximately 80,000 Medicare

to promote and facilitate CPC+

analyzed Quality Measure and

Bronson Network, Covenant HealthCare Partners, Jackson Health Network, Lakeland Care Network, Sparrow Care Network.

beneficiaries, we qualified for

applications and CMS acceptance of

Utilization metrics on the performance

.

the lowest possible threshold for

all Federation ACO providers who

of each of our chapters.

receiving earned shared savings.

applied, we have 2.7 times the

Program (MSSP) in 2018 and was ninth in the nation in earnings out of 548 participating ACOs; it was the ACO’s second year

AFFIRMANT 2017

AFFIRMANT 2018

$36.5M

Medicare Shared Savings

$15.9M

ACO earned shared savings distributed to members

97.2%

Quality scores

A C O S I N T H E U N I T E D S TAT E S

548 $739.4M 205 (38%)

4

ACOs participating in 2018 MSSP Earned shared savings ACOs earning shared savings

D ATA

state-wide proportion of providers participating in CPC+.

$15.4M $7.7M 100% ACOS IN MICHIGAN

20

ACOs participating in 2018 MSSP (3.6% of ACOs in the US)

$97.5M 13

(65%)

Earned shared savings

QUALITY REPORTING

AWA R E N E S S

CHAPTER MOMENTUM

We earned a quality score of 97%.

Our collective work at the Chapter

The work of our Chapters to

This was accomplished through our

and Affirmant levels to communicate

improve cost and quality of care

collaboration with Primaris and Press

with and engage our providers has

began in 2016 and has continued

Ganey for quality data gathering and

raised awareness of the importance

throughout the years. Their initiatives

submission.

of improving total cost and quality of

build momentum for improving

patient care and the opportunity to

performance.

receive shared savings.

(10% of MSSP payments)

ACOs earning shared savings 5


FUELING THE FIRE for Transformation

The Fire Triangle is a metaphor we use to describe what we are doing together through Affirmant Health Partners. Just as we cannot light a fire without oxygen, fuel and heat working together at the same time, we cannot transform health care in a meaningful way without data analytics to measure our success; clinical transformation to improve performance, and health plan partnerships to share in the value we create.

6

Affirmant Health Partners

7


FUELING THE FIRE for Transformation

The Fire Triangle is a metaphor we use to describe what we are doing together through Affirmant Health Partners. Just as we cannot light a fire without oxygen, fuel and heat working together at the same time, we cannot transform health care in a meaningful way without data analytics to measure our success; clinical transformation to improve performance, and health plan partnerships to share in the value we create.

6

Affirmant Health Partners

7


DATA ANALYTICS Through data analytics, we are able to make better informed decisions for our

F O R A D M I N I S T R AT I V E L E A D E R S

FOR PROVIDERS

The Cost and Utilization Dashboard (CUD) displays cost and utilization

Affirmant is the first multi-health system clinically integrated network in the nation to implement Epic Constellation,

trends based on claims data for specific contracts.

with integrated electronic health records and claims data on 850,000 lives attributed to our primary care physicians. Constellation provides real-time web access to patient clinical quality data at the level of the patient, provider,

patients, practices, Chapters

practice and Chapter levels.

and communities. Affirmant has worked closely with Epic to provide evidencebased insights for providers and administrative leaders.

Predictive Model Scores

• Risk of ED visits and inpatient hospitalization

• Diabetes risk of complications • Asthma risk of ED visits and inpatient admissions

Cost and Utilization Dashboard Highlights • Dashboards for Affirmant (including the Federation ACO, Henry Ford ACO, POMACO for MidMichigan Collaborative Organization and Priority Health Medicare Advantage)

Opportunity to manage: • Per Member per month cost by patient, provider and Chapter

• The Affirmant CUD is populated with claims data for our Medicare attributed patients

• Out of Network leakage

• Preventable emergency department visits • Post-acute care utilization • HCC scores to capture risk of high cost

Electronic health records and claims data on 850,000 attributed lives Quality Measures Dashboard with 14 standardized, reliable and valid quality measures approved by our Chapters and available to our providers

• Preventable inpatient admissions 8

9


DATA ANALYTICS Through data analytics, we are able to make better informed decisions for our

F O R A D M I N I S T R AT I V E L E A D E R S

FOR PROVIDERS

The Cost and Utilization Dashboard (CUD) displays cost and utilization

Affirmant is the first multi-health system clinically integrated network in the nation to implement Epic Constellation,

trends based on claims data for specific contracts.

with integrated electronic health records and claims data on 850,000 lives attributed to our primary care physicians. Constellation provides real-time web access to patient clinical quality data at the level of the patient, provider,

patients, practices, Chapters

practice and Chapter levels.

and communities. Affirmant has worked closely with Epic to provide evidencebased insights for providers and administrative leaders.

Predictive Model Scores

• Risk of ED visits and inpatient hospitalization

• Diabetes risk of complications • Asthma risk of ED visits and inpatient admissions

Cost and Utilization Dashboard Highlights • Dashboards for Affirmant (including the Federation ACO, Henry Ford ACO, POMACO for MidMichigan Collaborative Organization and Priority Health Medicare Advantage)

Opportunity to manage: • Per Member per month cost by patient, provider and Chapter

• The Affirmant CUD is populated with claims data for our Medicare attributed patients

• Out of Network leakage

• Preventable emergency department visits • Post-acute care utilization • HCC scores to capture risk of high cost

Electronic health records and claims data on 850,000 attributed lives Quality Measures Dashboard with 14 standardized, reliable and valid quality measures approved by our Chapters and available to our providers

• Preventable inpatient admissions 8

9


CLINICAL TRANSFORMATION

Clinical Transformation System 2.0

GOAL

Through clinical transformation, we are delivering better quality care at a lower cost to our patients

• Pharmacy and Safety Subcommittee First-Year Priorities Approved • Clinical Transformation 3-5 Year Plan Approved - The Clinical Transformation Committee approved the clinical priorities for the coming years – building off of the priorities identified in 2016. Now we are putting structure and tactics in place.

• Heart Failure Best Practices Approved - Under the guidance of the Evidence Based Best Practice (EBBP) subcommittee, Affirmant representatives have agreed on best practices in Heart Failure. Best Practice recommendations are reviewed by four Affirmant committees and two boards before approval. • Clinical Transformation System 2.0 Launched (see facing page)

• Post Acute Care Workgroup - In this third year of our Post Acute Care journey, our Chapters worked to operationalize their plans. • Patient Attribution to Specialists and Chapters Applied to Epic Constellation • Retrospective Risk Capture - Patient charts were reviewed in partnership with Episource, improving HCC risk capture for performance year 2018.

Skilled Nursing Facility Days per 1,000 beneficiaries for Federation ACO over three years

10

Of all Affirmant patients are assigned to a Chapter based on primary care and specialty providers

9% Reduction in acute hospital inpatient admissions per 1,000 over two years of care management program

OUTPUTS

97%

Optimization

Identify evidence based best practices that improve patient outcomes, efficiency and lowers costs

Create a plan that supports and inspires continuous improvement, high reliability and rapid adoption

Continuously improve process and reward physicians and providers in ways that speak to both intrinsic and extrinsic motivation

• Literature Review

• Education and Training: Best Practices,

• Performance Recognition:

• A3 Process : Business Case, Current

Workflows, Data Capture and Reporting,

Intrinsic motivation (Mastery,

State, Future State, Prioritization

Standard Interventions, Core Processes,

Autonomy, Purpose) Extrinsic

Epic Embedded Programing,

Recognition (Financial)

• Dimensions of Change : Magnitude, Type, Timing, Impetus, Popularity

Safety Culture • Community Partnerships

• Executive Leadership

• Affirmant Committees

• Chapter Leadership

• Affirmant Committees

• Chapter Leadership

• Physicians and Providers

• Affirmant Core Team

• Physicians and Providers

• Affirmant Core Team

• Subject Matter Experts

• Clinicians and Office Staff • Affirmant Core Team

OUTCOMES

31%

Execution

Evaluation and feedback loop

KEY ACTIVITIES

• Care Management Workgroup First-Year Priorities Established and Approved

ROLES

HIGHLIGHTS

Development

• Engagement Plan

• Physician Engagement Tools

• Rewards

• Education Plan

• Communication Tools

• Performance Checks

• Implementation Plan

• Formulary Tools

• Scorecards

• Communication Plan

• Guidelines

• Physician Spotlight

• Metrics

• Proactive Outreach Tools

• Incentive Distribution

• Best Practice Protocol

• Care Team Tools

• Playbook

• Referral Tools

• Feedback Plan

• Standard Workflows • Data Capture and Reporting • Chapter Support and Coaching

11


CLINICAL TRANSFORMATION

Clinical Transformation System 2.0

GOAL

Through clinical transformation, we are delivering better quality care at a lower cost to our patients

• Pharmacy and Safety Subcommittee First-Year Priorities Approved • Clinical Transformation 3-5 Year Plan Approved - The Clinical Transformation Committee approved the clinical priorities for the coming years – building off of the priorities identified in 2016. Now we are putting structure and tactics in place.

• Heart Failure Best Practices Approved - Under the guidance of the Evidence Based Best Practice (EBBP) subcommittee, Affirmant representatives have agreed on best practices in Heart Failure. Best Practice recommendations are reviewed by four Affirmant committees and two boards before approval. • Clinical Transformation System 2.0 Launched (see facing page)

• Post Acute Care Workgroup - In this third year of our Post Acute Care journey, our Chapters worked to operationalize their plans. • Patient Attribution to Specialists and Chapters Applied to Epic Constellation • Retrospective Risk Capture - Patient charts were reviewed in partnership with Episource, improving HCC risk capture for performance year 2018.

Skilled Nursing Facility Days per 1,000 beneficiaries for Federation ACO over three years

10

Of all Affirmant patients are assigned to a Chapter based on primary care and specialty providers

9% Reduction in acute hospital inpatient admissions per 1,000 over two years of care management program

OUTPUTS

97%

Optimization

Identify evidence based best practices that improve patient outcomes, efficiency and lowers costs

Create a plan that supports and inspires continuous improvement, high reliability and rapid adoption

Continuously improve process and reward physicians and providers in ways that speak to both intrinsic and extrinsic motivation

• Literature Review

• Education and Training: Best Practices,

• Performance Recognition:

• A3 Process : Business Case, Current

Workflows, Data Capture and Reporting,

Intrinsic motivation (Mastery,

State, Future State, Prioritization

Standard Interventions, Core Processes,

Autonomy, Purpose) Extrinsic

Epic Embedded Programing,

Recognition (Financial)

• Dimensions of Change : Magnitude, Type, Timing, Impetus, Popularity

Safety Culture • Community Partnerships

• Executive Leadership

• Affirmant Committees

• Chapter Leadership

• Affirmant Committees

• Chapter Leadership

• Physicians and Providers

• Affirmant Core Team

• Physicians and Providers

• Affirmant Core Team

• Subject Matter Experts

• Clinicians and Office Staff • Affirmant Core Team

OUTCOMES

31%

Execution

Evaluation and feedback loop

KEY ACTIVITIES

• Care Management Workgroup First-Year Priorities Established and Approved

ROLES

HIGHLIGHTS

Development

• Engagement Plan

• Physician Engagement Tools

• Rewards

• Education Plan

• Communication Tools

• Performance Checks

• Implementation Plan

• Formulary Tools

• Scorecards

• Communication Plan

• Guidelines

• Physician Spotlight

• Metrics

• Proactive Outreach Tools

• Incentive Distribution

• Best Practice Protocol

• Care Team Tools

• Playbook

• Referral Tools

• Feedback Plan

• Standard Workflows • Data Capture and Reporting • Chapter Support and Coaching

11


HEALTH PLAN PARTNERSHIPS Through our health plan partnerships we will grow our patient population and share in the value we create by more efficiently and effectively managing their care.

$17.4

HIGHLIGHTS

million

2018 net earned performance payment for the Medicare Shared Savings Program

$36 Million in Savings to CMS through the Medicare Shared Savings Program in 2018

Priority Health MA Agreement Pathways to Success Program – Track B

First gain-sharing contract for

With projections and analytics from expert actuaries, we successfully

Affirmant kicked off January 1, 2019

227%

Shared saving growth from 2017 to 2018

applied for and were accepted into CMS’ newest shared savings program

$51 million

Covered Lives Increased from 204,000 to 214,811

Two year savings total for Medicare

We are growing due to multiple factors: • Addition of rural hospitals to Covenant HealthCare Partners in the clinically integrated network • Addition of Bronson’s South Haven location in the clinically integrated network • More lives through the new Priority Health contract

HAP MA Agreement

Negotiated, approved and executed - Effective January 1, 2020

100%

MIPS Score

Primaris Partnership We engaged in gathering and reporting on quality data from 3,500

Providing all Federation ACO providers with maximum uplift in Medicare fee schedules

beneficiaries chosen by CMS for CMS-mandated quality reporting for ACO/Medicare Shared Savings Program (MSSP) and Merit-based Incentive Payment System (MIPS) participation. 12

Affirmant Health Partners

13


HEALTH PLAN PARTNERSHIPS Through our health plan partnerships we will grow our patient population and share in the value we create by more efficiently and effectively managing their care.

$17.4

HIGHLIGHTS

million

2018 net earned performance payment for the Medicare Shared Savings Program

$36 Million in Savings to CMS through the Medicare Shared Savings Program in 2018

Priority Health MA Agreement Pathways to Success Program – Track B

First gain-sharing contract for

With projections and analytics from expert actuaries, we successfully

Affirmant kicked off January 1, 2019

227%

Shared saving growth from 2017 to 2018

applied for and were accepted into CMS’ newest shared savings program

$51 million

Covered Lives Increased from 204,000 to 214,811

Two year savings total for Medicare

We are growing due to multiple factors: • Addition of rural hospitals to Covenant HealthCare Partners in the clinically integrated network • Addition of Bronson’s South Haven location in the clinically integrated network • More lives through the new Priority Health contract

HAP MA Agreement

Negotiated, approved and executed - Effective January 1, 2020

100%

MIPS Score

Primaris Partnership We engaged in gathering and reporting on quality data from 3,500

Providing all Federation ACO providers with maximum uplift in Medicare fee schedules

beneficiaries chosen by CMS for CMS-mandated quality reporting for ACO/Medicare Shared Savings Program (MSSP) and Merit-based Incentive Payment System (MIPS) participation. 12

Affirmant Health Partners

13


Leaders MEMBER and Learners OUR SYSTEMS We are a network of “leaders and learners.” Since our formation in 2015, our Chapters have shared some significant best practice programs.

BRONSON Bronson Healthcare is a not-for-profit, community-governed health system serving nine counties in southwest and south central Michigan. With 8,500 employees, four acute care hospitals, more than 1,400 medical staff members, and 836 licensed beds, Bronson is the largest employer in southwest Michigan. Bronson offers a full range of services from primary care to critical care across more than 100 locations. The system provides care in virtually every specialty with advanced capabilities as a Level I trauma center, Joint Commission certified comprehensive stroke center, accredited chest pain emergency center, American College of Surgeons accredited community hospital comprehensive cancer program, and the only high-risk pregnancy center and Children’s Hospital in southwest Michigan. Bronson Network works directly with independent and employed physicians in southwest Michigan to improve clinical outcomes, cost and quality of care.

14

C O V E N A N T H E A LT H C A R E Enhanced Performance Reporting Improves Care at Bronson Bronson’s focus in 2019 was improving quality performance through the establishment of a quality reporting system. Transparency in clear definitions for provider identified measures, detailed validation of data, and documented pathways to success has led to improvement for all measures. The Primary Care Ambulatory Dashboard changed the conversation around quality measures in primary care FROM confusion about definitions and documentation TO discussions for improvement. Provider engagement has improved and the approach to quality has been standardized across primary care resulting in better care for patients. This project is a collaborative effort of Bronson Network, Bronson Medical Group, IT, and Quality and Safety in teams focused on aligning quality work across the system. The design of the reporting system allows for everything from system level analysis of trends supporting identification of best practice opportunities to detailed patient reports that can be utilized by practices and providers for proactive outreach to engage patients in their care.

From moms-to-be, to babies, to great-grandfathers, the Covenant HealthCare mission is to provide extraordinary care for every generation. The Saginaw-based health system leads in offering a broad spectrum of programs and services for the entire family, including high-risk obstetrics, neonatal and pediatric intensive care, acute care, a Level II Adult and Pediatric Trauma Center, cardiology, oncology, orthopaedics, robotic surgery, stroke care and more. Extraordinary care goes beyond outstanding medical services, it’s a compassionate and caring team that makes the difference. The Covenant team lives our WE CARE values— putting patients at the center of every decision. Covenant is proud to work with local physicians and providers to bring world class health care close to home. Covenant HealthCare Partners, the PHO partnership of independent providers and Covenant HealthCare, provides patients with the extraordinary care they need to stay healthy.

Covenant Emergency Care Center Named “Team of the Year” Press Ganey’s Team of the Year Award was given to Covenant HealthCare Emergency Care Center (ECC) for its unique and purposeful “One Team Approach.” This approach embodies patient-centered care as physicians and nurses routinely enter a patient’s room together, resulting in enhanced communication and expectations for care, caregiver alignment, and patient engagement. “The ECC sees almost 100,000 patients annually and consistently performs in the top decile, 95th and even 99th percentile for patient experience across the nation in their peer group,” said Executive Vice President/Chief Nursing Officer, Beth Charlton. “In addition, they continually surpass quality targets and clinical outcome measures as well as promote the fiscal success of the organization. They celebrate individual and team triumphs and shoulder challenges as a collective whole and promote the highest levels of employee and physician engagement. This team is the epitome of what we have defined as necessary for not only meeting but exceeding our mission of Extraordinary Care for Every Generation.” The Press Ganey Team of the Year Award honors a team that demonstrates outstanding care coordination and teamwork in pursuit of delivering safe, high-quality, compassionate care.

15


Leaders MEMBER and Learners OUR SYSTEMS We are a network of “leaders and learners.” Since our formation in 2015, our Chapters have shared some significant best practice programs.

BRONSON Bronson Healthcare is a not-for-profit, community-governed health system serving nine counties in southwest and south central Michigan. With 8,500 employees, four acute care hospitals, more than 1,400 medical staff members, and 836 licensed beds, Bronson is the largest employer in southwest Michigan. Bronson offers a full range of services from primary care to critical care across more than 100 locations. The system provides care in virtually every specialty with advanced capabilities as a Level I trauma center, Joint Commission certified comprehensive stroke center, accredited chest pain emergency center, American College of Surgeons accredited community hospital comprehensive cancer program, and the only high-risk pregnancy center and Children’s Hospital in southwest Michigan. Bronson Network works directly with independent and employed physicians in southwest Michigan to improve clinical outcomes, cost and quality of care.

14

C O V E N A N T H E A LT H C A R E Enhanced Performance Reporting Improves Care at Bronson Bronson’s focus in 2019 was improving quality performance through the establishment of a quality reporting system. Transparency in clear definitions for provider identified measures, detailed validation of data, and documented pathways to success has led to improvement for all measures. The Primary Care Ambulatory Dashboard changed the conversation around quality measures in primary care FROM confusion about definitions and documentation TO discussions for improvement. Provider engagement has improved and the approach to quality has been standardized across primary care resulting in better care for patients. This project is a collaborative effort of Bronson Network, Bronson Medical Group, IT, and Quality and Safety in teams focused on aligning quality work across the system. The design of the reporting system allows for everything from system level analysis of trends supporting identification of best practice opportunities to detailed patient reports that can be utilized by practices and providers for proactive outreach to engage patients in their care.

From moms-to-be, to babies, to great-grandfathers, the Covenant HealthCare mission is to provide extraordinary care for every generation. The Saginaw-based health system leads in offering a broad spectrum of programs and services for the entire family, including high-risk obstetrics, neonatal and pediatric intensive care, acute care, a Level II Adult and Pediatric Trauma Center, cardiology, oncology, orthopaedics, robotic surgery, stroke care and more. Extraordinary care goes beyond outstanding medical services, it’s a compassionate and caring team that makes the difference. The Covenant team lives our WE CARE values— putting patients at the center of every decision. Covenant is proud to work with local physicians and providers to bring world class health care close to home. Covenant HealthCare Partners, the PHO partnership of independent providers and Covenant HealthCare, provides patients with the extraordinary care they need to stay healthy.

Covenant Emergency Care Center Named “Team of the Year” Press Ganey’s Team of the Year Award was given to Covenant HealthCare Emergency Care Center (ECC) for its unique and purposeful “One Team Approach.” This approach embodies patient-centered care as physicians and nurses routinely enter a patient’s room together, resulting in enhanced communication and expectations for care, caregiver alignment, and patient engagement. “The ECC sees almost 100,000 patients annually and consistently performs in the top decile, 95th and even 99th percentile for patient experience across the nation in their peer group,” said Executive Vice President/Chief Nursing Officer, Beth Charlton. “In addition, they continually surpass quality targets and clinical outcome measures as well as promote the fiscal success of the organization. They celebrate individual and team triumphs and shoulder challenges as a collective whole and promote the highest levels of employee and physician engagement. This team is the epitome of what we have defined as necessary for not only meeting but exceeding our mission of Extraordinary Care for Every Generation.” The Press Ganey Team of the Year Award honors a team that demonstrates outstanding care coordination and teamwork in pursuit of delivering safe, high-quality, compassionate care.

15


H E N R Y F O R D H E A LT H S Y S T E M

M I D M I C H I G A N H E A LT H

As one of the nation’s leading comprehensive, integrated health systems recognized for clinical excellence and innovation, Henry Ford provides both health insurance and healthcare delivery, including acute, specialty, primary and preventive care services backed by excellence in research and education.

Headquartered in Midland, Michigan, MidMichigan Health is affiliated with Michigan Medicine, the healthcare division of the University of Michigan. The health system covers a 23-county region with medical centers in Alpena, Alma, Clare, Gladwin, Midland, Mt.Pleasant and West Branch. In addition to our medical centers, MidMichigan Health also offers both home health care and physician services, and has a strong commitment to medical education. MidMichigan Physicians Group provides urgent care and medical offices in more than 30 specialties and subspecialties.

Henry Ford Physician Network (HFPN), founded in 2010, is a physician-led Henry Ford clinically integrated network (CIN), comprised of the Henry Ford Medical Group, Henry Ford hospital-employed and private practice physicians. The 2,200+ members of this CIN focus on delivering high quality care while reducing medical costs. Jackson Health Network is a collaboration between healthcare leaders, community leaders and physicians working together to improve patient outcomes and safety, and reduce overall costs through an integrated system of care.

Henry Ford Physician Network

Jackson Health Network

HFPN Invests in Physician Relationship Management

Improving Provider Satisfaction

The Henry Ford Physician Network (HFPN) introduced a comprehensive Physician Relationship Management (PRM) tool in 2019. This tool supports alignment, engagement and communication to all HFPN providers, most importantly its hundreds of independent physicians. It also supports the opportunity for future physician organizations to join the clinically integrated network. The encompassing strategy of PRM also included building out the team responsible for ongoing management and usage of the tool – adding a PRM manager, and application and analytics specialists.

In response to increasing expectations, burnout and turnover, Jackson Health Network (JHN) emphasized collaboration and education to support the local medical community in 2019. Key components included:

This was part of the overall physician engagement strategy of the HFPN, which is also enhanced by doubling (from two to four) the number of practice transformation specialists who work directly with all independent providers. These individuals focus on keeping the lines of communication open between our members, while also focusing on services to help them improve their practices and overcome any value-based delivery hurdles they may be facing.

16

• The Clinical Integration Team held bi-monthly collaborative meetings to engage primary care and specialty care office managers in conversations about care delivery processes as well as review Network performance results. • An assigned Practice Transformation Specialist rounded monthly on each clinic to provide education and guidance through the transformation from fee-for-service to fee-for-value. • A variety of learning and support opportunities were offered to help providers deliver meaningful, patient-centered care (e.g., JHN’s Provider Quality Champion meetings, annual strategic retreat, online training modules).

MidMichigan Collaborative Care Organization The MidMichigan Clinically Integrated Network (CIN) is organized and governed within MidMichigan Collaborative Care Organization, the health system’s platform for population health and value based programming.

Care Variation Bundles Show Improvements, Lives Saved MidMichigan Health has placed a significant focus on Care Variation in 2019 which has impacted many lives. Care Variation, an improvement program, is reducing unnecessary variation in clinical practice while improving healthcare safety, experience and quality while reducing cost of providing that care. • Care Variation wave design is completed over 24 weeks with two bundles in each wave. These bundles are based on areas with the greatest opportunity to improve quality, patient experience, and financial sustainability. Since its inception in August 2018, the Care Variation program has completed five separate bundles: sepsis, cardiac cath, arrhythmia, hip and knee and one call acceptance for Inter-facility transfers. Currently in implementation is work on two additional bundles: Maternity/ Newborns and COPD/Pneumonia. • The team for each bundle, including providers, nurses and frontline care staff; starts off with mapping existing care process in the area(s) of focus. Direct input is obtained from front-line staff, physicians and leaders while transparently sharing performance data on quality and cost. Ideas and solutions for improvements are solicited from staff, leaders and published best practices.

• After approval from an established governance process, care redesign of processes and the Epic EMR begin, followed by educating and re-training clinicians on the redesigned process. Key performance indicators on patient experience, employee and provider engagement, quality and cost of care are monitored transparently with the teams during design and implementation to ensure compliance with the new process. • The Sepsis Bundle included goals for earliest possible detection and treatment, e.g. ensuring timely lab tests and timely administration of intravenous fluids and antibiotics, implementation of a predictive model in the EMR and education for staff in community skilled nursing facilities. • This focus on the continuum of care, to include Skilled Nursing Facilities education, aligns with our addition of Community as one of our key elements. Result: Mortality rates for all sepsis patients remain below baseline which equates to approximately nine lives saved over the course of the past year and decreased length of hospitalization and intensive care.

17


H E N R Y F O R D H E A LT H S Y S T E M

M I D M I C H I G A N H E A LT H

As one of the nation’s leading comprehensive, integrated health systems recognized for clinical excellence and innovation, Henry Ford provides both health insurance and healthcare delivery, including acute, specialty, primary and preventive care services backed by excellence in research and education.

Headquartered in Midland, Michigan, MidMichigan Health is affiliated with Michigan Medicine, the healthcare division of the University of Michigan. The health system covers a 23-county region with medical centers in Alpena, Alma, Clare, Gladwin, Midland, Mt.Pleasant and West Branch. In addition to our medical centers, MidMichigan Health also offers both home health care and physician services, and has a strong commitment to medical education. MidMichigan Physicians Group provides urgent care and medical offices in more than 30 specialties and subspecialties.

Henry Ford Physician Network (HFPN), founded in 2010, is a physician-led Henry Ford clinically integrated network (CIN), comprised of the Henry Ford Medical Group, Henry Ford hospital-employed and private practice physicians. The 2,200+ members of this CIN focus on delivering high quality care while reducing medical costs. Jackson Health Network is a collaboration between healthcare leaders, community leaders and physicians working together to improve patient outcomes and safety, and reduce overall costs through an integrated system of care.

Henry Ford Physician Network

Jackson Health Network

HFPN Invests in Physician Relationship Management

Improving Provider Satisfaction

The Henry Ford Physician Network (HFPN) introduced a comprehensive Physician Relationship Management (PRM) tool in 2019. This tool supports alignment, engagement and communication to all HFPN providers, most importantly its hundreds of independent physicians. It also supports the opportunity for future physician organizations to join the clinically integrated network. The encompassing strategy of PRM also included building out the team responsible for ongoing management and usage of the tool – adding a PRM manager, and application and analytics specialists.

In response to increasing expectations, burnout and turnover, Jackson Health Network (JHN) emphasized collaboration and education to support the local medical community in 2019. Key components included:

This was part of the overall physician engagement strategy of the HFPN, which is also enhanced by doubling (from two to four) the number of practice transformation specialists who work directly with all independent providers. These individuals focus on keeping the lines of communication open between our members, while also focusing on services to help them improve their practices and overcome any value-based delivery hurdles they may be facing.

16

• The Clinical Integration Team held bi-monthly collaborative meetings to engage primary care and specialty care office managers in conversations about care delivery processes as well as review Network performance results. • An assigned Practice Transformation Specialist rounded monthly on each clinic to provide education and guidance through the transformation from fee-for-service to fee-for-value. • A variety of learning and support opportunities were offered to help providers deliver meaningful, patient-centered care (e.g., JHN’s Provider Quality Champion meetings, annual strategic retreat, online training modules).

MidMichigan Collaborative Care Organization The MidMichigan Clinically Integrated Network (CIN) is organized and governed within MidMichigan Collaborative Care Organization, the health system’s platform for population health and value based programming.

Care Variation Bundles Show Improvements, Lives Saved MidMichigan Health has placed a significant focus on Care Variation in 2019 which has impacted many lives. Care Variation, an improvement program, is reducing unnecessary variation in clinical practice while improving healthcare safety, experience and quality while reducing cost of providing that care. • Care Variation wave design is completed over 24 weeks with two bundles in each wave. These bundles are based on areas with the greatest opportunity to improve quality, patient experience, and financial sustainability. Since its inception in August 2018, the Care Variation program has completed five separate bundles: sepsis, cardiac cath, arrhythmia, hip and knee and one call acceptance for Inter-facility transfers. Currently in implementation is work on two additional bundles: Maternity/ Newborns and COPD/Pneumonia. • The team for each bundle, including providers, nurses and frontline care staff; starts off with mapping existing care process in the area(s) of focus. Direct input is obtained from front-line staff, physicians and leaders while transparently sharing performance data on quality and cost. Ideas and solutions for improvements are solicited from staff, leaders and published best practices.

• After approval from an established governance process, care redesign of processes and the Epic EMR begin, followed by educating and re-training clinicians on the redesigned process. Key performance indicators on patient experience, employee and provider engagement, quality and cost of care are monitored transparently with the teams during design and implementation to ensure compliance with the new process. • The Sepsis Bundle included goals for earliest possible detection and treatment, e.g. ensuring timely lab tests and timely administration of intravenous fluids and antibiotics, implementation of a predictive model in the EMR and education for staff in community skilled nursing facilities. • This focus on the continuum of care, to include Skilled Nursing Facilities education, aligns with our addition of Community as one of our key elements. Result: Mortality rates for all sepsis patients remain below baseline which equates to approximately nine lives saved over the course of the past year and decreased length of hospitalization and intensive care.

17


S PA R R O W Sparrow is a not-for-profit, community focused, comprehensive health system and major teaching hospital. Providing quality care to tens of thousands of people each year, Sparrow has two Lansing campuses plus Sparrow Clinton Hospital, Sparrow Ionia Hospital, Sparrow Carson Hospital, and Sparrow Eaton Hospital (formerly Hayes Green Beach Hospital). The health system also includes dozens of satellite care centers and the only hospital-based health club in mid-Michigan, the Michigan Athletic Club.

Sparrow Care Network In 2014, Sparrow and Physician leaders initiated the creation of Sparrow Care Network (SCN), a Physician-led Clinically Integrated Network. SCN includes approximately 610 independent and employed Physicians who care for over 250,000 lives across seven mid-Michigan counties. In partnership with 8 hospitals, 13 preferred Skilled Nursing Facilities and several Community Resources, SCN Physician Partners continue to demonstrate their commitment to providing high quality and efficient care to the populations that they serve.

S P E C T R U M H E A LT H L A K E L A N D SCN Primary Care Chapters In the 4th quarter of 2019, Sparrow Care Network established 7 Primary Care “Chapters” across their Clinically Integrated Network. Chapters are cohorts of SCN Primary Care Physicians that meet quarterly to discuss their quality and cost performance and work collaboratively to provide optimal care to all patients. Physician placement into a Chapter is determined by Physician practice similarities and geographic region. Each Chapter has a practicing Physician as its lead who guides the group in reviewing the quality and efficiency data and leads the discussion in best practices. The purpose of the Chapter initiative is to ensure success from a quality and financial performance standpoint as healthcare moves further into value-based reimbursement contracts. The role of the Primary Care Chapter is to: • Promote best practice sharing amongst SCN physicians • Review quality and cost performance data • Identify operational successes, opportunities and barriers • Drive data transparency and informational usage The SCN Primary Care Chapters are expected to strengthen SCN’s Clinical Integration program, which will be accomplished by driving performance related to quality and efficiency.

18

Spectrum Health Lakeland is a not-forprofit, community-owned health system serving Southwest Michigan and Northern Indiana with a full continuum of care and wellness services including three hospitals, an outpatient center, a cancer center, and 48 physician practices. Lakeland is a division of Spectrum Health with 31,000 compassionate professionals, 4,600 medical staff experts, 3,300 committed volunteers and a health plan serving one million members. Lakeland was named a 15 Top Health System® and 100 Top Hospital® by IBM Watson Health™ in 2019.

Lakeland Care Network Lakeland Care Network is the largest physician hospital organization (PHO) in Southwest Michigan consisting of a comprehensive health care network of hospitals, physicians, and providers who share a commitment to excellence. The organization’s provider panel includes over 130 primary care physicians and 500 specialty physicians.

Virtual Reality Helps Enhance Care Experience To improve patient experience, the infusion centers at Spectrum Health Lakeland introduced virtual reality (VR) into the clinical setting. Through an interactive computer-generated simulation, patients receiving chemotherapy and other infusion services are exposed to a variety of experiences while helping relieve some of the current stresses of their situation. “Medical technology continues to change faster than ever before and Lakeland is committed to staying on the forefront of these changes, especially as we work to improve the overall patient experience,” said Barbara Schmidtman, PhD, manager, radiation oncology and ambulatory infusion, Spectrum Health Lakeland. “Most infusion sessions last around three hours. By using VR technology, we are able to help patients pass the time while reducing their anxiety and stress levels.” In addition to the success of the program at Lakeland, the work group has developed a clinical study to assess patient anxiety levels in hopes this technology will help patients in other communities as well. The program was honored in August 2019 with the Innovation Award by the American Cancer Society at the annual Coaches vs. Cancer Night of the Stars event.

19


S PA R R O W Sparrow is a not-for-profit, community focused, comprehensive health system and major teaching hospital. Providing quality care to tens of thousands of people each year, Sparrow has two Lansing campuses plus Sparrow Clinton Hospital, Sparrow Ionia Hospital, Sparrow Carson Hospital, and Sparrow Eaton Hospital (formerly Hayes Green Beach Hospital). The health system also includes dozens of satellite care centers and the only hospital-based health club in mid-Michigan, the Michigan Athletic Club.

Sparrow Care Network In 2014, Sparrow and Physician leaders initiated the creation of Sparrow Care Network (SCN), a Physician-led Clinically Integrated Network. SCN includes approximately 610 independent and employed Physicians who care for over 250,000 lives across seven mid-Michigan counties. In partnership with 8 hospitals, 13 preferred Skilled Nursing Facilities and several Community Resources, SCN Physician Partners continue to demonstrate their commitment to providing high quality and efficient care to the populations that they serve.

S P E C T R U M H E A LT H L A K E L A N D SCN Primary Care Chapters In the 4th quarter of 2019, Sparrow Care Network established 7 Primary Care “Chapters” across their Clinically Integrated Network. Chapters are cohorts of SCN Primary Care Physicians that meet quarterly to discuss their quality and cost performance and work collaboratively to provide optimal care to all patients. Physician placement into a Chapter is determined by Physician practice similarities and geographic region. Each Chapter has a practicing Physician as its lead who guides the group in reviewing the quality and efficiency data and leads the discussion in best practices. The purpose of the Chapter initiative is to ensure success from a quality and financial performance standpoint as healthcare moves further into value-based reimbursement contracts. The role of the Primary Care Chapter is to: • Promote best practice sharing amongst SCN physicians • Review quality and cost performance data • Identify operational successes, opportunities and barriers • Drive data transparency and informational usage The SCN Primary Care Chapters are expected to strengthen SCN’s Clinical Integration program, which will be accomplished by driving performance related to quality and efficiency.

18

Spectrum Health Lakeland is a not-forprofit, community-owned health system serving Southwest Michigan and Northern Indiana with a full continuum of care and wellness services including three hospitals, an outpatient center, a cancer center, and 48 physician practices. Lakeland is a division of Spectrum Health with 31,000 compassionate professionals, 4,600 medical staff experts, 3,300 committed volunteers and a health plan serving one million members. Lakeland was named a 15 Top Health System® and 100 Top Hospital® by IBM Watson Health™ in 2019.

Lakeland Care Network Lakeland Care Network is the largest physician hospital organization (PHO) in Southwest Michigan consisting of a comprehensive health care network of hospitals, physicians, and providers who share a commitment to excellence. The organization’s provider panel includes over 130 primary care physicians and 500 specialty physicians.

Virtual Reality Helps Enhance Care Experience To improve patient experience, the infusion centers at Spectrum Health Lakeland introduced virtual reality (VR) into the clinical setting. Through an interactive computer-generated simulation, patients receiving chemotherapy and other infusion services are exposed to a variety of experiences while helping relieve some of the current stresses of their situation. “Medical technology continues to change faster than ever before and Lakeland is committed to staying on the forefront of these changes, especially as we work to improve the overall patient experience,” said Barbara Schmidtman, PhD, manager, radiation oncology and ambulatory infusion, Spectrum Health Lakeland. “Most infusion sessions last around three hours. By using VR technology, we are able to help patients pass the time while reducing their anxiety and stress levels.” In addition to the success of the program at Lakeland, the work group has developed a clinical study to assess patient anxiety levels in hopes this technology will help patients in other communities as well. The program was honored in August 2019 with the Innovation Award by the American Cancer Society at the annual Coaches vs. Cancer Night of the Stars event.

19


ENGAGEMENT COMMIT TEE

172

80

80%

15

166.5

22

Committee members

Committees

LEADERSHIP R E T R E AT

3.5/4

Rating for breakout session

20

Meetings

Meeting hours

210

Meeting attendance

In-person meetings

3.6/4

Attendees

Rating for general session presentations

92%

100%

Strongly agreed or agreed the retreat exceeded their expectations

Likely to come to the next retreat

21


ENGAGEMENT COMMIT TEE

172

80

80%

15

166.5

22

Committee members

Committees

LEADERSHIP R E T R E AT

3.5/4

Rating for breakout session

20

Meetings

Meeting hours

210

Meeting attendance

In-person meetings

3.6/4

Attendees

Rating for general session presentations

92%

100%

Strongly agreed or agreed the retreat exceeded their expectations

Likely to come to the next retreat

21


THE FUTURE IS BRIGHT

2020 will be another successful year for Affirmant Health Partners. Our vision of a healthy Michigan at an affordable cost is coming into focus and the future’s bright.

Data Analytics Enhancing current Cost and Utilization Dashboard and Healthy Planet Constellation capabilities

Clinical Transformation Engaging our stakeholders in advancing clinical transformation in Post-Acute Care, Care Management, Risk Capture and Chronic Diseases Management

Health Plan Partnerships Moving to risk sharing agreements with Pathways to Success and Priority Health, while engaging in new contracts with HAP

22

23


THE FUTURE IS BRIGHT

2020 will be another successful year for Affirmant Health Partners. Our vision of a healthy Michigan at an affordable cost is coming into focus and the future’s bright.

Data Analytics Enhancing current Cost and Utilization Dashboard and Healthy Planet Constellation capabilities

Clinical Transformation Engaging our stakeholders in advancing clinical transformation in Post-Acute Care, Care Management, Risk Capture and Chronic Diseases Management

Health Plan Partnerships Moving to risk sharing agreements with Pathways to Success and Priority Health, while engaging in new contracts with HAP

22

23


BOARD AND COMMITTEES

COMMIT TEE STRUCTURE

Affirmant Board of Managers

Federation ACO Board of Managers

EXECUTIVE OFFICERS

Chapter Operations Committee

Diane Postler-Slattery, PhD MidMichigan Health Chairperson

Bruce Muma, MD Henry Ford Health System Vice Chairperson

Kevin Albosta Covenant HealthCare Treasurer

Scott Larson, MD Bronson Healthcare Secretary

Clinical Transformation Committee

Care Management Workgroup

Communications and Education Committee

Finance and Contracting Committee

Information Technology and Business Intelligence Committee

Evidence Based Best Practice Subcommittee Measures Development Subcommittee

Affirmant Board of Managers (by Health System) Kevin Albosta Covenant HealthCare

Scott Larson, MD Bronson Healthcare

Ken O’Neill, MD Spectrum Health Lakeland

Paula Autry (Advisor) Henry Ford Allegiance Health

Wright Lassiter, III Henry Ford Health System

Diane Postler-Slattery, PhD MidMichigan Health

Douglas Edema, MD Sparrow Health System

Madhura Mansabdar, MD MidMichigan Health

Joseph Ruth Sparrow Health System

Loren Hamel, MD Spectrum Health Lakeland

Bill Mayer, MD, MPH Affirmant Health Partners

Michael Slavin, MD Covenant HealthCare

Courtland Keteyian (Advisor), MD Henry Ford Allegiance Health

Bruce Muma, MD Henry Ford Health System

Post-Acute Care Workgroup

Thank you for your leadership Best wishes in your retirement!

Federation ACO Board of Managers (by Chapter) Kevin Albosta Covenant HealthCare Partners

David Halsey, MD Jackson Health Network

Bill Mayer, MD, MPH Affirmant Health Partners

Jerry Booth, DDS Jackson Health Network

Courtland Keteyian, MD Jackson Health Network

Ken O’Neill, MD Lakeland Care Network

Sharon Deskins, MD Lakeland Care Network

Ray King, MD Jackson Health Network

Mike Tobin Sparrow Care Network

Douglas Edema, MD Sparrow Care Network

Scott Larson, MD Bronson Network

Nancy Vannest Bronson Network

Ron Gonzales (Chairperson), MD Covenant HealthCare Partners 24

Frank Sardone President and CEO, Bronson Healthcare, Founding Board Member for Affirmant

Georgia Fojtasek, RN President and CEO, Henry Ford Allegiance Health, Founding Board Member for Affirmant

Ray King, MD President and CEO, Jackson Health Network, Founding Board Member and Treasurer 25


BOARD AND COMMITTEES

COMMIT TEE STRUCTURE

Affirmant Board of Managers

Federation ACO Board of Managers

EXECUTIVE OFFICERS

Chapter Operations Committee

Diane Postler-Slattery, PhD MidMichigan Health Chairperson

Bruce Muma, MD Henry Ford Health System Vice Chairperson

Kevin Albosta Covenant HealthCare Treasurer

Scott Larson, MD Bronson Healthcare Secretary

Clinical Transformation Committee

Care Management Workgroup

Communications and Education Committee

Finance and Contracting Committee

Information Technology and Business Intelligence Committee

Evidence Based Best Practice Subcommittee Measures Development Subcommittee

Affirmant Board of Managers (by Health System) Kevin Albosta Covenant HealthCare

Scott Larson, MD Bronson Healthcare

Ken O’Neill, MD Spectrum Health Lakeland

Paula Autry (Advisor) Henry Ford Allegiance Health

Wright Lassiter, III Henry Ford Health System

Diane Postler-Slattery, PhD MidMichigan Health

Douglas Edema, MD Sparrow Health System

Madhura Mansabdar, MD MidMichigan Health

Joseph Ruth Sparrow Health System

Loren Hamel, MD Spectrum Health Lakeland

Bill Mayer, MD, MPH Affirmant Health Partners

Michael Slavin, MD Covenant HealthCare

Courtland Keteyian (Advisor), MD Henry Ford Allegiance Health

Bruce Muma, MD Henry Ford Health System

Post-Acute Care Workgroup

Thank you for your leadership Best wishes in your retirement!

Federation ACO Board of Managers (by Chapter) Kevin Albosta Covenant HealthCare Partners

David Halsey, MD Jackson Health Network

Bill Mayer, MD, MPH Affirmant Health Partners

Jerry Booth, DDS Jackson Health Network

Courtland Keteyian, MD Jackson Health Network

Ken O’Neill, MD Lakeland Care Network

Sharon Deskins, MD Lakeland Care Network

Ray King, MD Jackson Health Network

Mike Tobin Sparrow Care Network

Douglas Edema, MD Sparrow Care Network

Scott Larson, MD Bronson Network

Nancy Vannest Bronson Network

Ron Gonzales (Chairperson), MD Covenant HealthCare Partners 24

Frank Sardone President and CEO, Bronson Healthcare, Founding Board Member for Affirmant

Georgia Fojtasek, RN President and CEO, Henry Ford Allegiance Health, Founding Board Member for Affirmant

Ray King, MD President and CEO, Jackson Health Network, Founding Board Member and Treasurer 25


BOARD AND COMMITTEES Board and Committee Members by Health System as of December 31, 2019 Bronson Healthcare Bronson Network

Covenant HealthCare Covenant HealthCare Partners

Henry Ford Health System Henry Ford Physician Network

Henry Ford Allegiance Health – Jackson Health Network

Spectrum Health Lakeland Lakeland Care Network

MidMichigan Health MidMichigan Collaborative Care Organization

Sparrow Health System Sparrow Care Network

Jill Beison, BSN, MSN, RN

Kevin Albosta

David Allard

Dawn Anderson-Meier

Tim Calhoun

Rachel Aultman, ACM-RN, BSN, RN

Karen Bennett, RN

Sheila Britney

Ken Arnold, RPh

Eugene Berezovsky

Nancy Arce, LMSW

Sharon Deskins, MD

Laurie Babinski

Megan Black

Ken Buechele

Gayle Biederman

Jodi Buchholz, LMSW

Paula Autry

Samantha Fell

Brad Choi-De Young

Amy Blaising Wallace, DO

Meghan Cole

Bethany Charlton, BSN, RN

Sue Craft, RN, BSN

Jerry Booth, DDS

Victoria Felton, RN

Steven Frazier, RN

Kathy Bouchard-Wyant, RN

Stephen Connellee

Dan Cramer

Lisa Foley, RN, BSN, CCM

Margaret Brown, RN, CCM

Beth Fiskars, RN

Mary Greeley, RD

Thomas Bres

Becky East

Larry Daly

Matt Hussmann

Molly Fleming, MSN, RN

Michael Getty

Pankaj Jandwani, MD

Ilene Cantor

Chip Falahee

Michelle Easton, BSN, RN

Melissa Kurtz

David Halsey, MD

Candace Graham, MSN, RN

Madhura Mansabdar, MD

Anthony Dehn

Ash Goel, MD

Frank Fear

Cyndy Lambert

Jenifer Hamilton, MSN, RN

Tim Grove

Matthew Mitchell

Rachel Doerschuk

Paula Grudt, RN

Ron Gonzales, MD

Wright Lassiter, III

Courtland Keteyian, MD

Melinda Gruber, PhD

Francine Padgett

Douglas Edema, MD

Laura Hamann, RN

Samantha Krause, BSN, RN

Joyce Leon, MD

Ray King, MD

Loren Hamel, MD

Diane Postler-Slattery, PhD

Smita Jha

Jane Janssen, RN

Ed Patnode

Dan Moore, MD

Jia Li

Lowell Hamel, MD

Raimee Schertzberg, BSN, RN

Morgan Martin

Aaron Lane Davies, MD

Eric Pierce

Bruce Muma, MD

Joe Maher

Kenneth Lomonaco

Diane Shields

Gregory Meece

Scott Larson, MD

Kimberly Ross

Matthew Pinks

Megan Piotrowski

Andrew Luecke

Erin Stern

Anna Melville, RD

Jamie Leigh

Michael Slavin, MD

Gloria Rey, PA-C

Arvind Prabhu, MD

Debbie Lull, BSN, RN

Sarah Travis

Joseph Ruth

Dercio Mendonca, MD

Alan Spencer

Jane Thornhill, MSA

Philicia Richmond, FNP-C, MSN

Ken O’Neill, MD

Brenda Turner, RD

Kevin Sharp

Lynne Norman, RN

Mindy Stokoszynski

Amy Vandecar

Amy Schultz, MD

Sandra Plank, DNP, RN

Kay Wagner, DHA, MSN, RN

Kathleen Smith

Kelley Peterson

Michael Sullivan, MD

Suma Varma

Jonathan Sykes, MD

Holly Schewe

Dan Waltz

Mike Tobin

Christopher Pieratt

Michael Williams, DO

Anish Wadhwa, MD

Furqan Siddiqi, MD

Lydia Watson, MD

Cindy Reistroffer, RN

Aaron Wootton

Kendall Troyer

Frank Sardone

Caitlin Yanakeff, LMSW

Megan Yore

Nancy Vannest Paul Vitantonio Susan Watts

Chairperson Vice Chairperson 26

27


BOARD AND COMMITTEES Board and Committee Members by Health System as of December 31, 2019 Bronson Healthcare Bronson Network

Covenant HealthCare Covenant HealthCare Partners

Henry Ford Health System Henry Ford Physician Network

Henry Ford Allegiance Health – Jackson Health Network

Spectrum Health Lakeland Lakeland Care Network

MidMichigan Health MidMichigan Collaborative Care Organization

Sparrow Health System Sparrow Care Network

Jill Beison, BSN, MSN, RN

Kevin Albosta

David Allard

Dawn Anderson-Meier

Tim Calhoun

Rachel Aultman, ACM-RN, BSN, RN

Karen Bennett, RN

Sheila Britney

Ken Arnold, RPh

Eugene Berezovsky

Nancy Arce, LMSW

Sharon Deskins, MD

Laurie Babinski

Megan Black

Ken Buechele

Gayle Biederman

Jodi Buchholz, LMSW

Paula Autry

Samantha Fell

Brad Choi-De Young

Amy Blaising Wallace, DO

Meghan Cole

Bethany Charlton, BSN, RN

Sue Craft, RN, BSN

Jerry Booth, DDS

Victoria Felton, RN

Steven Frazier, RN

Kathy Bouchard-Wyant, RN

Stephen Connellee

Dan Cramer

Lisa Foley, RN, BSN, CCM

Margaret Brown, RN, CCM

Beth Fiskars, RN

Mary Greeley, RD

Thomas Bres

Becky East

Larry Daly

Matt Hussmann

Molly Fleming, MSN, RN

Michael Getty

Pankaj Jandwani, MD

Ilene Cantor

Chip Falahee

Michelle Easton, BSN, RN

Melissa Kurtz

David Halsey, MD

Candace Graham, MSN, RN

Madhura Mansabdar, MD

Anthony Dehn

Ash Goel, MD

Frank Fear

Cyndy Lambert

Jenifer Hamilton, MSN, RN

Tim Grove

Matthew Mitchell

Rachel Doerschuk

Paula Grudt, RN

Ron Gonzales, MD

Wright Lassiter, III

Courtland Keteyian, MD

Melinda Gruber, PhD

Francine Padgett

Douglas Edema, MD

Laura Hamann, RN

Samantha Krause, BSN, RN

Joyce Leon, MD

Ray King, MD

Loren Hamel, MD

Diane Postler-Slattery, PhD

Smita Jha

Jane Janssen, RN

Ed Patnode

Dan Moore, MD

Jia Li

Lowell Hamel, MD

Raimee Schertzberg, BSN, RN

Morgan Martin

Aaron Lane Davies, MD

Eric Pierce

Bruce Muma, MD

Joe Maher

Kenneth Lomonaco

Diane Shields

Gregory Meece

Scott Larson, MD

Kimberly Ross

Matthew Pinks

Megan Piotrowski

Andrew Luecke

Erin Stern

Anna Melville, RD

Jamie Leigh

Michael Slavin, MD

Gloria Rey, PA-C

Arvind Prabhu, MD

Debbie Lull, BSN, RN

Sarah Travis

Joseph Ruth

Dercio Mendonca, MD

Alan Spencer

Jane Thornhill, MSA

Philicia Richmond, FNP-C, MSN

Ken O’Neill, MD

Brenda Turner, RD

Kevin Sharp

Lynne Norman, RN

Mindy Stokoszynski

Amy Vandecar

Amy Schultz, MD

Sandra Plank, DNP, RN

Kay Wagner, DHA, MSN, RN

Kathleen Smith

Kelley Peterson

Michael Sullivan, MD

Suma Varma

Jonathan Sykes, MD

Holly Schewe

Dan Waltz

Mike Tobin

Christopher Pieratt

Michael Williams, DO

Anish Wadhwa, MD

Furqan Siddiqi, MD

Lydia Watson, MD

Cindy Reistroffer, RN

Aaron Wootton

Kendall Troyer

Frank Sardone

Caitlin Yanakeff, LMSW

Megan Yore

Nancy Vannest Paul Vitantonio Susan Watts

Chairperson Vice Chairperson 26

27


WHY AFFIRMANT? THE CURRENT L ANDSCAPE The rising cost of health care is causing health plans to shift costs to patients in the form of higher premiums, deductibles and copayments, and to providers with fee schedules declining in real dollar terms.

Affirmant Team THE AFFIRMANT VA L U E Working together as Affirmant Health Partners, we have the power to take charge of health care for our patients and families, improving health while controlling the total cost of care.

Bill Mayer, MD, MPH President and CEO

We do this through:

1 in 4

skip medical treatment due to cost

45%

concerned a major health event could lead to bankruptcy

Rose Campbell Blackwood Executive Assistant

Erik Pye Executive Assistant

Sharing of reliable, valid, comparative data analytics Supporting and sharing best practices in care transformation

Karin Proos, Pharm D Director of Clinical Transformation

Lawrence Green, MA, MBA Director of Payer Strategy and ACO Operations

Katy Velten, MA Director of Communications

Paul Peabody IT/BI Executive

Jointly contracting to manage risk and improve payer terms

$88

15

billion

million

borrowed to cover health care costs in the past year

Americans forgo medicine for serious health conditions each year due to cost

Giving control back to physicians and their patients

Andrea Charmley, LMSW, MPH Clinical Transformation Consultant

Jeromy Timmer Clinical Transformation Consultant

AJ Johnson Communications Specialist

Meghan Gaertner Manager of Information Technology

Marla Beyer Clinical Analyst

Spanning a broad network and geographic coverage

SOURCE: Gallup, The U.S. Healthcare Cost Crisis, 2019 28

29


WHY AFFIRMANT? THE CURRENT L ANDSCAPE The rising cost of health care is causing health plans to shift costs to patients in the form of higher premiums, deductibles and copayments, and to providers with fee schedules declining in real dollar terms.

Affirmant Team THE AFFIRMANT VA L U E Working together as Affirmant Health Partners, we have the power to take charge of health care for our patients and families, improving health while controlling the total cost of care.

Bill Mayer, MD, MPH President and CEO

We do this through:

1 in 4

skip medical treatment due to cost

45%

concerned a major health event could lead to bankruptcy

Rose Campbell Blackwood Executive Assistant

Erik Pye Executive Assistant

Sharing of reliable, valid, comparative data analytics Supporting and sharing best practices in care transformation

Karin Proos, Pharm D Director of Clinical Transformation

Lawrence Green, MA, MBA Director of Payer Strategy and ACO Operations

Katy Velten, MA Director of Communications

Paul Peabody IT/BI Executive

Jointly contracting to manage risk and improve payer terms

$88

15

billion

million

borrowed to cover health care costs in the past year

Americans forgo medicine for serious health conditions each year due to cost

Giving control back to physicians and their patients

Andrea Charmley, LMSW, MPH Clinical Transformation Consultant

Jeromy Timmer Clinical Transformation Consultant

AJ Johnson Communications Specialist

Meghan Gaertner Manager of Information Technology

Marla Beyer Clinical Analyst

Spanning a broad network and geographic coverage

SOURCE: Gallup, The U.S. Healthcare Cost Crisis, 2019 28

29


950 Trade Centre Way Suite 200 Portage, MI 49002

(877) 232-3814

@Affirmant Affirmant Health Partners info@affirmant.com

www.affirmant.com

Profile for affirmant

Affirmant Value Report 2019  

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