health Volume 11 • No. 1 Spring 2017 Dr. Kurt Ransohoff Sansum Clinic: 96 Years of Innovative Healthcare, p.12 How Will “Repeal and Replace” Affect My State?, p.14 Preparing for MACRA: Leading Physicians Through Change, p.27 For your organization, KNOWING is transformative. Today, the right lab is far more than a lab. It’s a source of insight and innovation. It’s a catalyst for change. It’s a valuable resource you use to elevate everything you do. It’s a true partner in the pursuit of better outcomes—in the care you provide and the business you operate. Contact [email protected] to schedule a visit with a representative. Get to know us better. Visit QuestForHealthSystems.com. © 2016 Quest Diagnostics Incorporated. All rights reserved. 5616 Mitigate financial risk. Improve outcomes and value. Transition your most complex patients to VITAS Healthcare and our enhanced continuum of care for advanced-disease patients. VITAS addresses the concerns physician groups • Rapid, seamless transitions of patients from have about their “at risk” populations—their most hospitals and other post-acute care settings to complex, medically compromised patients. home, by dedicated VITAS admissions staff But we know you are also concerned with • Improved physician RVU benchmarks providing the optimum in patient-centered, • Clinical criteria of hospice eligibility via the coordinated and accountable care. That’s why VITAS app VITAS offers: • 24/7 access to our Care Connection Center • Personalized care plans that improve patients’ quality of life, resulting in higher CAHPS® • Interoperability and customized patient data scores and impacting multiple HEDIS® indicators exchange • Hospice education and collaterals available to • Benefits of participating as attending when your our partners patient elects the hospice benefit Transition your most complex patients to VITAS Healthcare. SINCE 1980 800.93.VITAS • VITAS.com ON the Cover 12 Dr. Kurt Ransohoff sansum clinic: 96 Years of Innovative Healthcare table of contents health DepartmeNtS FeatUreS Publisher Valerie Okunami Editor-in-Chief Don Crane 6 27 Editorial Advisory Board From the president preparing for maCra: how to lead Lura Hawkins, MBA Amy Nguyen Howell, MD, MBA through Change Mary Kay Payne, Arch Health Partners 8 Managing Editor Daryn Kobata Names in the News 30 Editorial Assistant California healthcare 2017: Nelson Maldonado Fasten Your Seatbelts and Keep Contributing Writers 10 Jim Agronick Your hands Inside the Car! Bill Barcellona Upcoming events Don Crane Mara McDermott Amy Nguyen Howell, MD, MBA Kurt Ransohoff, MD 32 Stephen L. Rivetti 14 Best practices: Disability Income policy Briefing: how Will protection for medical CAPG Health Magazine is published by “repeal and replace” affect Valerie Okunami Media Group physicians PO Box 674, Sloughhouse, CA my State? 95683 Phone 916.761.1853 capghealth.com Please send press releases and 16 editorial inquiries to capghealth@ Federal policy Update: capg.org or c/o CAPG Health, 915 Wilshire Blvd., Suite 1620, Los aftermath of the Angeles, CA 90017 For advertising, please send email to 2016 election [email protected] Subscription rates: $32 per year; $58 two years; $3 single copy. 18 Advertising rates on request. Bulk third class mail paid in Jefferson CapG member list City, MO Every precaution is taken to ensure the accuracy of the articles published in CAPG Health Magazine. Opinions expressed or facts supplied by its authors are not the responsibility of CAPG Health Magazine. © 2017, CAPG Health Magazine. All rights reserved. Reproduction in whole or in part without written permission is strictly prohibited. 4 l capg health Spring 2017 CAPG Ad Jan2017_FINAL.indd 1 12/15/2016 3:17:25 PM From the president a messaGe FrOm DonalD CraNe, presideNt and CeO, CAPG CAPG members and Friends: this spring finds us several months into a new presidential administration and a volatile healthcare environment. Immediately after the inauguration, the trump administration began acting to repeal and replace the affordable Care act as promised. as of this writing, the proposed replacement bill, the american health Care act, is under intense scrutiny, with all stakeholders—physicians, health plans, consumers, policy experts, and legislators—furiously weighing in. Donald Crane, CAPG President and CEO What does all this mean for the movement to value-based healthcare? From CAPG’s perspective, it means we’re more committed than ever to staying the course. the quest to achieve better health outcomes and control costs is bipartisan, as we saw in the near-unanimous Congressional passage of MACRA (the medicare access and ChIp reauthorization act). While republicans and Democrats fight over subsidies, credits, and taxes, both sides largely agree that the value movement must continue. the underlying imperatives of economics are driving this need. healthcare costs continue spiraling upward, now reaching almost 18 percent of the U.S. gross domestic product (GDp). that trajectory is not just unsustainable. It’s arguably a potential threat to our national security and economic well being, if healthcare co-opts increasing shares of the federal budget that would otherwise go toward education, defense, and other essential sectors. at CAPG, we believe the market inevitably will reward those that deliver higher quality healthcare at lower cost, and that capitated and alternative payment models are the best bet for achieving both results. While many are predicting a bumpy future for healthcare, we see the opposite: those who are best prepared to continue the move to value will reap the benefits. If you’re on the journey or just starting, you’re in a good position—and we’re here to support you. It’s our mission. march onward, coordinated care. o SAVE THE DATE! Colloquium 2017 November 8-10, 2017 Hyatt Regency on Capitol Hill Washington, DC 6 l capg health Spring 2017 Ventegra = Truth and Integrity It is our name. It is our core. It is how we do business. • We EMPOWER OUR CLIENTS to lower costs with our innovative solutions. • We are your VALUE-ADDED SOLUTION to Pharmacy Services Administration. • We help you STEER INTEGRATION of medical and pharmacy for enhanced quality of care. • We offerTRUE TRANSPARENCY on our services demonstrating true costs savings. Let us show you how Ventegra’s TRUTH and INTEGRITY can work for you. Ventegra, Inc., a California Benefit Corporation 450 North Brand Boulevard, Suite 600, Glendale, California 91203 858.551.8111, Ext. 109 • www.ventegra.com Client: Ventegra #2549 Created by: GSS Communiqations, 323.939.1181 Publication: CAPG 2017 / Ad #1 Dimensions: 8.125” x 10.875” trim Agency contact: Andrea Graham [email protected] Client contact: Peggy Frank ([email protected]) Names in the News “I’m extremely proud of our member groups selected by Welcome to our NeWest members CmS as Next Generation participants,” said Donald Crane, CAPG’s CeO. “CAPG stands ready to do all we can to CAPG warmly welcomes these members who have advance accountable care organization models and other recently joined: innovative payment and delivery approaches in the future.” Organizational Members the CAPG Next Generation participants are: advantage medical Group, llC, Orlando, Fl • Allina Integrated medical Network (minnesota and Canopy health, emeryville, Ca Wisconsin) Central Oregon IPA, Bend, Or • Arizona Care Network, llC (arizona) Comprehensive Geriatric Care of San Juan, • DaVita medical aCO California, llC (California) San Juan, PR • Hill physicians medical Group (California) east Coast medical Services, Inc., Fajardo, PR • KentuckyOne health partners, llC (Indiana and Innovare health advocates, St. louis, mO Kentucky) Jefferson health, philadelphia, PA • MemorialCare regional aCO, llC (California) Key medical Group, Inc., Visalia, Ca • Monarch health plan (California) managed Care management and educational, llC, • Optum accountable Care Organization (arizona) San German, PR • Physicians of Southwest Washington (Washington) medicos Selectos del Norte, Inc., Vega alta, PR • Prospect aCO Ca, llC (California) methodist le Bonheur healthcare, Nashville, tN • Prospect aCO Northeast, llC (Connecticut and Oak Street health, Chicago, Il rhode Island) pediatric associates, plantation, Fl • Regal medical Group dba heritage California aCO privia medical Group, llC, arlington, Va (California) Signature partners Network, Falls Church, Va • Sharp healthCare aCO – II, llC (California) • Triad health aCO Inc. (North Carolina) Corporate Partner Continuum health alliance JenniFer JAckman NAmed CEO oF edinger Associate Partners medicAl GrouP Natera, Inc. edinger medical Group, an Soleo health, Inc. award-winning physician-owned practice serving Orange County, Affiliate Partners California patients for over 50 Canvas medical years, has appointed Jennifer Financial recovery Group, Inc. Jackman as chief executive U.S. advisors, Inc. officer. Jackman, a highly respected healthcare leader and public policy advocate for physician organizations, has over 25 years of experience FourteeN cAPG members selected in the healthcare industry. previously, she was COO of As 2017 Next GeN ACOs memorialCare medical Foundation, overseeing strategy the Centers for medicare & medicaid Services and operations of the Foundation, memorialCare has confirmed more than 350,000 clinicians will medical Group, Greater Newport physicians IPA, participate in four alternative payment models in memorialCare regional accountable Care Organization 2017: the medicare Shared Savings program, Next (aCO),