MOMENTUM - Illinois Critical Access Hospital Network

ICAHN Newsletter

December 2014
MOMENTUM
Moving critical access hospitals and their rural communities forward
Illinois Rural Community Care Organization:
Named new Medicare Shared Savings Program ACO
89 NEW ACCOUNTABLE CARE ORGANIZATIONS JOIN PROGRAM TO IMPROVE CARE FOR MEDICARE BENEFICIARIES
The Illinois Rural Community Care Organization (IL-RCCO) is an LLC under the Illinois Critical Access
Hospital Network, which was formed in May of 2014. The IL-RCCO is a collaborative of committed
rural hospitals, clinics, physicians, and other providers who recognize certain healthcare and social
services are best delivered and supported at the local level and that innovation and sharing of
resources, as well as talent, will guide providers to build clinically integrated systems of care,
placing special effort to ensure that the patient is the center of all services. ICAHN will serve as
management of the IL-RCCO at this time.
communication, beneficiaries’ rating of their doctors, and screening for high blood
pressure. ACOs also outperformed group practices, reporting quality on 17 out of
22 measures. ACOs are also demonstrating promising results on cost savings with
combined total program savings of $417 million for the Shared Savings Program
and the Pioneer ACO Model.
PRINCETON, IL– The Illinois Rural Community Care Organization LLC (IL-RCCO) has
been selected as one of 89 new Medicare Shared Savings Program Accountable
Care Organizations (ACOs), providing approximately 1.6 million additional Medicare
beneficiaries with access to high-quality, coordinated care across the United States,
the Centers for Medicare & Medicaid Services announced Dec. 23rd. That brings the
total to 405 Shared Savings Program ACOs serving over 7.2 million beneficiaries.
While CMS is encouraged by what they have seen so far, they also understand there
are opportunities to improve the program to make it stronger. Earlier this month, they
published a proposed rule to update the guidelines for the program. CMS is looking
forward to receiving comments from ACOs, beneficiaries, and their
advocates, providers, and other stakeholders interested
in seeing
the ACOs
succeed
long-term.
Doctors, hospitals and health care providers establish ACOs in order to work together
to provide higher-quality coordinated care to their patients, while helping to slow
health care cost growth.
The IL-RCCO will be
one of 405 ACOs par- “The Illinois Rural Community Care Organization will be
ticipating in the Shared joining a program that is one part of this Administration’s
Savings Program as
vision for improving the coordination and integration of
of this January 1st.
care received by Medicare beneficiaries...We look forward
Beneficiaries seeing
to continuing this partnership with IL-RCCO in increasing
health care providers
value and care coordination across the health system.”
in ACOs always have
– Sean Cavanaugh, Deputy Administrator and Director,
the freedom to choose
Center for Medicare
doctors inside or
Pictured: Pat Schou and Dr. Gregg Davis, IL-RCCO Chief Medical Officer
outside of the ACO.
ACOs share with Medicare savings generated from lowering the growth in health care
costs when they meet standards for high quality care. ACOs are groups of doctors,
hospitals, and other health care providers that work together to give Medicare beneficiaries in Original Medicare (fee-for-service) high quality, coordinated care. ACOs can
share in any savings they generate for Medicare, if they meet specified quality targets.
“The Illinois Rural Community Care Organization will be joining a program that is one
part of this Administration’s vision for improving the coordination and integration of
care received by Medicare beneficiaries,” said Sean Cavanaugh, Deputy Administrator
and Director, Center for Medicare. “We look forward to continuing this partnership with
IL-RCCO in increasing value and care coordination across the health system.”
ACOs are also
just one way that CMS is working to reduce the rate of growth in Medicare spending
while improving care. Medicare spending per beneficiary was essentially flat in
nominal dollars in fiscal year 2014, and from 2010 to 2014, Medicare spending
per beneficiary grew at a rate that was two percentage points per year less than
growth in GDP per capita. While the recent slow cost growth has multiple causes,
our reforms in the Medicare and Medicaid programs are meaningful contributors to
these gains and are improving quality as well. Preliminary data for 2013, for example,
indicates improvements in patient safety has resulted in 50,000 fewer deaths, 1.3
million fewer patient harms, and $12 billion in avoided health care spending. Recent
research implies that many of these reforms may be generating savings in the private
sector as well.
Since ACOs first began participating in the program in early 2012, thousands of
health care providers have signed on to participate in the program, working together
to provide better care to Medicare’s seniors and people with disabilities. The 89 new
ACOs will bring approximately 23,000 additional physicians and other providers into
the ACO program starting January 1st.
Ultimately, today’s announcement is about delivering better care, spending dollars
more wisely, and having healthier people and communities. ACOs drive progress in
the way care is provided by improving the coordination and integration of health care,
and improving the health of patients with a priority placed on prevention and wellness.
ACOs are starting to see promising results. This fall, CMS released the early findings
from the ACOs who started the program in 2012. ACOs improved on 30 of the
33 quality measures in the first two years, including patients’ ratings of clinicians’
To date, the Illinois Rural Community Care Organization has 21 critical access hospitals participating. Those hospitals are outlined on Page 2. For more information about
the Shared Savings Program, click here.
IN THIS ISSUE:
• ICAHN receives Telligen Community Initiative Grant – Page 3
• Getting your physicians engaged and ready for the future – Page 3
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ICAHN Newsletter

December 2014
Illinois Rural Community Care
Organization Participants
•Boyd Healthcare
•Carlinville Area Hospital
•Community Memorial Hospital
•Crawford Memorial Hospital
•Dr. John Warner Hospital
•Fayette County Hospital
•Gibson Area Hospital &
Health Services
•Hillsboro Area Hospital
•Kirby Medical Center
•Lawrence County Hospital
•Midwest Medical Center
•Morrison Community Hospital
•Memorial Hospital, Carthage
•Pana Community Hospital
•Paris Community Hospital
•Perry Memorial Hospital
•Pinckneyville Community
Hospital District
•Salem Township Hospital
•Sarah D. Culbertson
Memorial Hospital
•Sparta Community Hospital
•Wabash General Hospital
First steps in the process
Hospital Readiness Assessment Tool identifies gaps in patient care
As the Illinois Rural Community Care Organization begins its efforts to more
effectively manage the patient through all aspects of care, IL-RCCO Coordinator
Angie Charlet outlines next steps. These steps follow ICAHN’s distribution of a
hospital readiness assessment tool, in which gaps in care were assessed, and a
practice evaluation designed to help hospitals and other practices set the stage
of readiness at all levels. Each hospital has built its own care transition team and
21 hospitals have been approved to participate.
The top three gaps identified in the hospital readiness assessment tool included:
• The need for hospital board education
• Operation of care coordination in general, and specifically,
how to accomplish this in the outpatient setting
• Creation of the IT infrastructure for the data collected
In addition to the Medicare Shared Savings Program, Blue Cross Blue Shield has
contracted with IL-RCCO to provide the Intensive Medical Home model for ICAHN
members. “We (IL-RCCO team of 21 CAHs) are still in the incubation stage of
this project. We’re just learning how to implement everything by building on best
practices,” said Charlet.
Hospitals can participate in the MSSP and the Blue Cross Blue Shield Intensive
Medical Home plans to best help manage high risk patients. “We will be hiring a
nurse care manager to oversee and help coordinate efforts for those hospitals and
practices participating,” said Charlet. “This person will be dedicated to that high risk
population.” The nurse care manager will head each practice’s care team, which
may include a health coach, social worker, behavioral health counselor/therapist,
and dietitian, along with administrative support.
Regarding the need for a care coordination team, it has been determined that
10 percent of all patients drive more than 65 percent of all medical costs incurred,
according to Blue Cross Blue Shield. Common patient characteristics include
multiple chronic diseases, poor management of lifestyle choices (including but not
limited to) obesity and smoking on through mental health and substance abuse
issues.
Each nurse care manager will be responsible for monitoring the health of up to 250
patients, offering them supervised visits at their homes (if needed) and customized
strategies of care, including medical and psychosocial support, coordination, and
the assurance that all care is directly connected to a physician. More information
about the Shared Savings Program is available at https://www.cms.gov/Medicare/
Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html?redirect=/
sharedsavingsprogram/. For a list of the 89 new ACOs announced, visit: http://
www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/News.html.
ICAHN Rural Nurse Residency Program registration continues through Dec. 29
The ICAHN Rural Nurse Residency Program consists
of four onsite meetings, monthly support, and clinical
story-sharing using computer-based live broadcasts,
and online discussion boards on topics of relevance
to nursing practice. The Southern ICAHN Rural Nurse
Residency Program will be meeting on January 6,
2015; April 7, 2015; July 7, 2015; and October
6, 2015. The deadline to register is December 29,
2014.
ICAHN adapted the SOAR-RN (Supporting Onboarding And Retention of Rural Nurses) program from
Marquette University to meet the needs of critical
access hospitals in Illinois.
Illinois Critical Access Hospital Network • www.icahn.org
ICAHN developed a model to provide an evidence-based, customized program to help new
nurses acquire the necessary knowledge and skills
to provide autonomous, safe care. Cost to participate
is $550 per nurse. Nursing CEUs are available. To
register, click here. For more information, call Mary
Jane Clark at (309) 331-4472.
ICAHN Newsletter

December 2014
3
Telligen Community Initiative awards $49,639 grant
ICAHN, i-Net will use funds to develop statewide workforce academy
Telligen Community Initiative (TCI) and the Illinois Critical Access Hospital Network celebrate a
$49,639.00 grant award to help fund a new Critical
Access Hospital Workforce Academy. The project is a
collaboration of ICAHN and I-Net (Illinois Network for
Education and Training) and will be used to develop
a statewide Workforce Academy that will promote job
retention, employee satisfaction, and an improved
practice environment in Illinois’ critical access
hospitals.
Funds will be used to design and implement e-learning capabilities that can be used for training and
educating rural health providers. “We are very excited
about this project because it will directly support
learning opportunities for nurses and allied health
professionals at critical access hospitals and their
partners,” said Pat Schou, ICAHN Executive Director.
The ICAHN project was one of only 24 grants across
Iowa and Illinois selected for funding by the Telligen
Community Initiative, a non-profit foundation that
seeks to improve the health of Illinoisans, Iowans, and
their communities.
Through its most recent grant cycle, TCI received
more than 230 grant requests from various organizations seeking support for health-focused community
projects. Telligen Community Initiative awarded a
cumulative total of $1,121,758 to these 24 organizations to both build upon existing efforts and kick
new projects off the ground.
“This grant allows support to ICAHN and i-Net to create a statewide Workforce Academy that specifically
targets the training and ongoing educational needs
of nurses and allied health professionals in smaller,
rural hospital settings. The use of simple technology
will help this to happen more easily while helping
create a supportive, learning community,” said Matt
McGarvey, TCI Executive Director.
Telligen Community Initiative seeks to empower
organizations and citizens to improve their individual
and overall community health.
TCI’s funding support is designed to initiate and
support innovative and forward-looking health-related
projects aimed at improving health, social well-being
and educational attainment.
Get your physicians engaged and ready for the future
When building new care systems, such as Accountable Care Organizations, we find that many hospitals
are working with their independent physicians before
working with their employed physicians. When asked
why hospitals are not involving their employed physicians from the start, administration indicates that their
hospital-owned groups are primarily focused on wRVUs
(compensation model focused on volume) in a way that
diminishes their ability to be engaged as clinical change
makers. This line of thinking is a sure way to threaten
your organizational culture, causing employees and physicians to lose confidence in their capability to make an
impact. However, with careful guidance and leadership,
you can help your physicians view themselves as
positive change makers. Below are some actions you
can take to encourage contributions and collaboration in
your healthcare community.
Schedule Monthly Clinic Meetings: Physicians
need to meet with their respective peers regarding their
clinic business operations and patient care processes.
The agenda should include financial performance review, operational topics, quality matrix benchmarks and
marketing/growth strategy. To build a successful culture,
these meetings need to be led by hospital and/or clinic
leadership regarding the agenda and the preparation only. To better engage your physicians in these
discussions, coach your physicians to present and offer
their thoughts in these meetings. Eventually, you want
your physicians engaged in these discussions doing the
majority of the speaking. Successful meetings of this
type are held monthly and last approximately one hour.
Ask questions and develop a common vision regarding
the future and the necessary change.
Balance Business & Clinical Discussions: Have
a balance in these meetings between business operations, work schedules and clinical operations.
Develop Expectations & Invite Participation:
Build a participative culture for new physicians that
you recruited to your community. Encourage them to
participate in your clinic monthly meetings and offer
suggestions and ideas. Remember, your new physicians
need to understand business standards such as how
many patient contact hours they have per week, as
well as operational and diagnostic details, like the
clinical elements they should be measuring for Type 2
Diabetes. Actively invite comments, and encourage their
participation in making business and clinical decisions.
Improve your healthcare community by investing in
your physicians’ development and making them your
partners for positive change in your community.
Bill Clayton is Healthcare Consultant within Clark
Schaefer Hackett. Mr. Clayton focuses on compensation modeling and multiple types of physician success
strategies for your organization. Clark Schaefer Hackett
is a longstanding strategic partner of ICAHN providing
physician and hospital solutions to our ICAHN hospitals.
For more information, contact wclayton@cshco.com.
SAVE
THE DATE!
Build Consensus: Effective medical groups build consensus between the physicians in the clinic. Physicians
need to practice and develop interpersonal communication skills regarding the business and clinic environment.
Illinois Critical Access Hospital Network • www.icahn.org
2015 ILLINOIS
MINORITY CONFERENCE
Creating & Sustaining
Healthy Communities
MARCH 25-26, 2015
SPONSORED BY: Illinois Department of Public Health Center for
Minority Health Services and Illinois Public Health Association
HILTON
LISLE/NAPERVILLE
3003 Corporate West Drive | Lisle, Illinois 60532
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ICAHN Newsletter

December 2014
New Chief Executive Officers named at Illinois CAHs
Ferrell, St. Francis and Massac Memorial announce new leadership
Three new Chief Executive Officers were named to leadership roles at their respective hospitals
within the last few months. They include Joe Swab, CEO/President, at Ferrell Hospital, Eldorado;
Patricia Fischer, CEO/President, at St. Francis Hospital, Litchfield; and Tony Pfitzer, CEO, at
Massac Memorial Hospital, Metropolis.
Joe Swab was named Ferrell Hospital’s CEO/President on September 15th. Serving as a Director of
Finance for Lourdes Hospital, Paducah, KY, from
1998-2005, he was named Chief Financial Officer at
Crittenden Health Systems in Marion, KY.
Serving Crittenden Health Systems for more than five
years, Mr. Swab was then named CFO at Iroquois
Memorial Hospital, Watseka, IL in 2011 and CFO at
Quorum Health Resources (QHR) in Brentwood, TN,
for a further eight months.
Mr. Swab then took the CFO position at Muhlenberg
Community Hospital in Muhlenberg, TN, from September 2011 to June 2014 before being named Interim
CFO for Carroll County Memorial Hospital in Carrollton, KY. He served in that position until September of
2014 when he was named Chief Executive Officer at
Ferrell Hospital in Eldorado.
In his first few months as CEO, Mr. Swab said he
“continues to focus on making the hospital more
financially viable and trying to recruit physicians”
and that he and his administrative team are nearing
completion on Ferrell Hospital’s strategic plan.
“I most appreciate the very good work ethic of all the
employees and physicians here at Ferrell Hospital,” he
added. “And the community in general is wonderful.
Makes this job a rewarding one.”
Hospital Sisters Health System (HSHS) named
Patricia Fischer, RN, MBA, FACHE, as President
and CEO of St. Francis Hospital, Litchfield, on August
18th. Fischer, who has more than 20 years of health
care leadership experience, succeeds Daniel Perryman, who in March was appointed as President and
CEO of St. Mary’s Hospital in Decatur, IL. She most
recently had served as Vice President, Physician Services, for Saint Anthony’s Health Center in Alton, IL.
Patricia Fischer, CEO/President
St. Francis Hospital
Tony Pfitzer was named Chief Executive Officer of
Massac Memorial Hospital in Metropolis on October
28th. Born in Indianapolis but raised in suburban
St. Louis, Pfitzer graduated from St. Louis University
High School in 1975 and St. Louis University School
of Business in 1979. In 1981, he obtained his first
Master’s Degree at St. Louis University Medical
Center in Healthcare Administration, followed by a
Master’s Degree in Business Administration in 1985
from Southern Illinois University at Edwardsville.
His first job, from 1981-1986, was in Jefferson
City, MO, as an Assistant Administrator of Support
Systems for St. Mary’s Health Center. He later moved
to Cape Girardeau, MO, to work as Vice President of
Professional Services at St. Francis Medical Center
until 1989. For approximately 12 years, Mr. Pfitzer
During her career, Ms. Fischer has successfully led
teams involved in physician recruitment, practice
management, professional services, strategic planning
and business development. Since joining Saint Anthony’s in 1991, Fischer was responsible for various
aspects of hospital operations, including medical staff
development, ambulatory services, and cardiovascular
Joe Swab, CEO/President
Ferrell Hospital
services. Fischer began her career as a staff nurse
at JFK Memorial Hospital in Atlantis, FL. She has a
nursing diploma from St. Luke’s School of Nursing in
St. Louis, MO, a Bachelor’s Degree in Finance from
Florida Atlantic University in Boca Raton, FL, and an
MBA from Washington University in St. Louis, MO.
“You have some great doctors here at St. Francis
Hospital,” said Fischer. “Most are Illinois-trained and
that’s a great testament. I have been in health care
my entire career, and I believe it’s the perfect place to
make a difference not only in the lives of individuals
but also in the surrounding community.
“I am thrilled to join St. Francis Hospital and be a part
of a thriving organization committed to high quality
care and an exceptional patient experience.”
worked in both Decatur and Effingham. From there,
he was first named Chief Operating Officer and later
named President and CEO of a small medical system
in Bryan College Station, TX – made up of a 350-bed
flagship hospital, three smaller hospitals in communities surrounding the city, and two nursing homes
– employing 100 physicians and a total of 2,500
support staff.
“We have some rebuilding to do here at Massac,”
said Pfitzer. “One of the things the Board and I have
to work on is to have a more defined strategic plan
for the organization. We need to figure out where we
want the organization to be and the steps to get there.
This industry is in evolution, and we need to provide
the support to our doctors, whatever that may be, to
help them be successful.”
Illinois Critical Access Hospital Network • www.icahn.org
Tony Pfitzer, CEO
Massac Memorial Hospital
2014
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