To better serve our clients, we are pleased to announce that two additional physicians, Daniel C. Cusator, M.D, MBA and Teresa J. Koenig, M.D., MBA, have joined our thought leadership team.

Daniel C. Cusator, M.D, MBA
Dr. Cusator is an expert on clinical integration, ACOs, hospitalist programs, physician-hospital alignment strategies, physician leadership development, healthcare strategy, and care delivery system redesign. He most recently served as chief medical officer, clinical integration for Providence Health & Services, Southern California where he was responsible for physician alignment and clinical integration across the California region.
Look for Dr. Cusator’s article on questions to expect when undertaking a clinical integration initiative in an upcoming issue of Payers and Providers.

Teresa J. Koenig, M.D., MBA
Dr. Koenig is an expert on designing and developing medical management programs for health plans and ACOs and specializes in utilization and quality management, including setting metrics to help organizations deliver accountable care. She most recently served as senior vice president and chief medical officer of SummaCare, Inc., Summa Health System’s health plan, where she was responsible for the operations, contracting, and clinical policy development for the organization and its 170,000 members.
Look for Dr. Koenig’s article on centralizing care coordination in an upcoming issue of H&HN Daily.

The Camden Group’s president, Steven Valentine, was intereviewd by U.S. News and World Report in the article, “For Hospitals, a Value Judgement.”

The I³ Healthcare Executive Summit 2011 is an exclusive event designed for C-suite executives of health systems, hospitals, and large medical groups. Attendees will gain insights from the nation’s top healthcare industry thought leaders, exchange ideas in discussion roundtables with peers, and leave inspired with new strategies for leading the transformation of the healthcare industry. We are pleased to announce the I³ speakers for 2011:

• Robert Margolis, M.D., Chairman, NCQA’s ACO Advisory Committee, Chairman and CEO, HealthCare Partners

• Jay Gellert, President and CEO, Health Net, Inc.

• Chris Van Gorder, FACHE, President and CEO, Scripps Health, Past Chairman, ACHE

• Emad Rizk, M.D., President, McKesson Health Solutions

• Lisa Goldstein, Senior Vice President and Team Leader, Healthcare Ratings, Moody’s Investors Service

• Gary Kaplan, M.D., Chairman and CEO, Virginia Mason Health System

• Keith Pitts, Vice Chairman, Vanguard Health Systems

Hosted by The Camden Group and Morgan Keegan, the I³ Healthcare Executive Summit will be held October 13-14, 2011 at ARIA Resort & Casino located in the heart of the CityCenter in Las Vegas, Nevada.

Join your industry colleagues at this unique event! For more information or to request an invitation, visit www.thecamdengroup.com/summit2011 or www.morgankeegan.com/HealthcareSummit.

Our SVPs James Smith, MBA, FACHE and Ronald Van Horssen, MSIA were interviwed by Health Plan Week in the article, “Insurers Seek Diversity Rather Than Scale in Acquiring Small, Savvy Firms.”  

To better serve our clients, we are pleased to announce the addition of Jessica Jarnot to our team.

Ms. Jarnot specializes in bundled payments, clinical service line development and integration, physician-hospital relations, and quality and performance improvement. She most recently served as project manager at Exempla Saint Joseph Hospital in Denver, Colorado where she was responsible for the Acute Care Episode cardiovascular services pilot program development, management, implementation, and evaluation. Ms. Jarnot is experienced in managing large data sets, quality and performance improvement, physician contracting, and physician on-call compensation plans. She can be reached at 310.320.3990, x6106 or by email at jjarnot@thecamdengroup.com.

For her latest article, please read April’s Top 10 on bundled payments!

by Kathleen Miodonski, RN

Read Ms. Miodonski’s latest article on case management!

To meet the growing needs of our clients to find innovative ways to improve healthcare quality and manage costs, we are pleased to announce the addition of Kathleen S. Miodonski, RN to our team.  Ms. Miodonski has led efforts within hospital and payer settings to improve care management programs.  She is skilled in chronic disease management programs and leading clinicians to improve quality outcomes for complex patient populations.

She can be reached at 312.775.1714 or by email at kmiodonski@thecamdengroup.com. Read her latest article on case
management here.

The Camden Group Foresees More Upheaval as Ongoing Cost, Quality and Market Share Pressures Trigger More Deals

Los Angeles, California, January 11, 2011—The sluggish economy and the farthest-reaching health reform in more than 50 years will continue to ratchet up pressure on U.S. providers to reduce costs and improve quality, setting the stage for The Camden Group’s annual Top 10 Trends in Healthcare in 2011. These pressures will trigger an avalanche of activity centered on accountable care organizations (ACOs), bundled payments, and patient-centered medical homes. At the same time, they will compel more physicians to seek employment with hospitals or large medical groups and spur more consolidation of hospitals and medical groups/independent practice associations.

“2011 is the year when a growing number of providers move forward with new care delivery models and run into the very real challenges posed by overhauling traditional ways of treating patients. The fundamental question is whether providers can manage costs and improve quality while maintaining provider choice and open access,” says Steven T. Valentine, president of The Camden Group. “As always, the devil is in the details.”

The Camden Group predicts the following Top 10 Trends will have major and continuing impact on the healthcare sector during 2011:

1. Insurance membership takes hit from slow recovery.  Few unemployed will take advantage of COBRA while employees, faced with paying more of their health plan premium, will select high-deductible, low-premium PPO plans, hurting HMOs.
2. No easing on payment pressure. Although health plan payments will keep pace with inflation and operating cost increases, they will not make up for declining or stagnant Medicaid and Medicare payments. 
3. Patients postpone care, hurting providers too. With high unemployment and underemployment and increased out-of-pocket costs, people will continue to put off treatment, keeping volumes at hospitals, ambulatory centers, and physician offices soft.
4. Cost is king. Soft volume, downward pressure on revenues, and deteriorating payer mix with increased bad debt will drive providers to seek more cost savings. However, unions, staffing ratios, and regulations will make cuts difficult. At the same time, health plans will begin to explore and increase the use of tiered networks and stratify payment to encourage use of lower-cost providers.
5. Capital remains elusive. As in 2010, most non-profit hospitals will find it difficult to access capital.  Lenders are requiring an increase in days cash-on-hand, coverage ratio, stronger EBITDA, and smaller borrowings.  Credit rating agencies want to see: 1) physician alignment strategy, 2) clinical integration and cost reduction action, 3) IT plan, and 4) plans to capture more market share.
6. Physicians make or break new care models. To improve outcomes and lower costs, hospitals and medical groups will focus on accountable care, bundled payments, patient-centered medical homes, and/or clinical integration. Reducing variation in care−primarily by physicians−will be central to any successful strategy. An effective bundled payment strategy, for example, requires specialists to address clinical resource consumption and supply cost and use while standardizing care protocols in conjunction with hospitalists and intensivists.
7. Construction focus is on fast returns. Construction projects will be scaled down, with a focus on regulatory compliance, enhancing throughput, improving care/outcomes, and if possible, capturing additional market share. Providers also will prioritize construction that generates superior returns, such as surgical services and imaging centers. Do not be surprised to see the growth of freestanding emergency departments to reduce the need for hospitals, increase access, and provide capacity for the newly insured.
8. IT becomes more pervasive—or else. Information technology underpins providers’ ability to shift to new care models, so IT moves to center stage with efforts to implement electronic medical records, (EMRs,) computerized physician order entry (CPOE), and health information exchanges (HIEs.) Provided, of course, medical facilities already have in place ePrescribing, PACS, and online results reporting and scheduling.

About The Camden Group

With offices in California, Illinois, and New York, The Camden Group is one of the nation’s leading healthcare business advisory firms. The firm provides a broad array of healthcare consulting services in areas ranging from strategic and business planning and financial advisory and compliance, to hospital operations improvement, hospital/physician alignment, clinical integration, and developing accountable care organizations.  Since its founding in 1970, The Camden Group has advised more than 1,000 hospitals, medical groups, outpatient facilities, and other healthcare organizations nationwide. For more information, visit us online at www.TheCamdenGroup.com.

Contact:

Sarita Choy, Marketing/Communications Director

The Camden Group

310.320.3990

schoy@thecamdengroup.com

www.thecamdengroup.com

The Camden Group was commissioned by California Healthcare Foundation to prepare a white paper on examining physician-hospital integration under healthcare reform. The paper includes observations by hospital, physician group, and health plan leaders and addresses the effect on patients, expected challenges with future integration, and implications for policymakers.

This publication was written by Mary Witt, MSW and Laura Jacobs, MPH and is now available on CHCF’s website. Please visit the website to download a copy n ow.

Our vice president Steven Nahm shares his thoughts on co-management with Hospitals & Health Networks.  Read the full article here:  http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/11NOV2010/1110HHN_FEA_clinical&domain=HHNMAG