AHA Solutions Webinar Jointly presented by KaufmanHall and Holy Family Memorial outlined a reform preparedness framework applicable today!

1. Thank you for participating in today’s event!
We’ll be starting shortly…
Is Your Hospital Ready for Healthcare Reform?
Positioning Your Organization for Success
Featuring a case study by
Holy Family Memorial Medical Center
November 19, 2009
To access the audio portion of this webinar, please dial:
1 (866) 710-0179
Intl Callers should dial (334) 323-7224
When prompted by the operator, give the Passcode: 53939
1

2. Is Your Hospital Ready for Healthcare Reform?
Positioning Your Organization for Success
Featuring a case study by
Holy Family Memorial Medical Center
November 19, 2009
To access the audio portion of this webinar, please dial:
1 (866) 710-0179
Intl Callers should dial (334) 323-7224
When prompted by the operator, give the Passcode: 53939
2

3. Agenda and Speakers
• Introduction: AHA and AHA Solutions – Polly Mulford, Director, AHA
Solutions
• Strategic Challenges Facing Hospitals and Health Systems
- Mark P. Herzog, President and Chief Executive Officer, Holy Family Memorial, Inc.
- Mark E. Grube, Partner, Kaufman, Hall & Associates, Inc.
• Questions and Answers – moderated by Polly Mulford, Director, AHA Solutions
3

4. Agenda
• Strategic Challenges Facing Hospitals and Health Systems
• Healthcare Reform/ New Era Discussion
– Required Provider Core Competencies
• New Era Readiness Assessment – A Tool for Self Evaluation
• Holy Family Memorial Hospital: Readiness Case Example
– Overview
– Physician Integration
– Care Coordination
– Information Systems
– Service Distribution Systems
– Financial Position and Capital Capacity
– Scale
• Moving from Assessment to Readiness
• Questions and Discussion
4

5. About AHA Solutions
AHA Solutions, Inc. is a resource to hospitals pursuing operational excellence.
As an American Hospital Association (AHA) member service, AHA Solutions
collaborates with hospital leaders and market consultants to conduct product
due diligence and identify solutions to hospital challenges in the areas of
finance, human resources, patient flow and technology. AHA Solutions provides
related marketplace analytics and education to support product decision-
making. As a subsidiary of the AHA, AHA Solutions convenes people with like
interests for knowledge sharing, centered on timely information and research.
AHA Solutions is proud to reinvest its profits in the AHA mission: creating
healthier communities.
5

6. Strategic Challenges Facing
Hospitals and Health Systems
Mark P. Herzog, President and Chief Executive Officer,
Holy Family Memorial, Inc.
Mark E. Grube, Partner, Kaufman, Hall & Associates, Inc.
6

7. Has your hospital started to prepare for reform and the
new era?
7

8. Please rate your organization’s reform/new era readiness
as “weak” “medium” or “strong” in the following areas?
8

9. Strategic Challenges Facing Hospitals and Health Systems
(Right Now)
• Declining inpatient and outpatient volumes (in many markets)
• Deteriorating payor mix
• The rise of “super insurers” with 50%+ market share
• Falling operating and EBIDA margins
• Reduced liquidity
• Financing problems for many and increased cost of capital
• The growth and development of statewide and multistate systems
• Significant capital needs related to physician, facility, and information technology
strategies
• Uncertainty regarding healthcare reform
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10. Healthcare Reform/ New Era Discussion
– Required Provider Core Competencies
10

11. Healthcare Reform – The Ultimate Market Dynamic
Proposed Legislation Is Uncertain, but Principles of Reform Have
Been Articulated
• More stability and security for those who have insurance
• Expansion of the total population that is insured – insurance mandate, business
mandate subsidies for the poor, excludes illegal aliens
• Budget neutral – $830 B to $1T price tag (over 10 years) covered through reduced
costs/ elimination of waste
• Greater provider accountability with a focus on value
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12. Healthcare Reform
– Key Potential Mechanisms to Achieve the Stated Cost Savings Goals
• Payment based on “best practice” levels of value (quality/ cost)
• Bundled payments
• Quality incentive payments
• Reductions in readmission rates
• Reductions in premium increases for Medicare Advantage plans
• Reductions in home health, imaging, and other “high margin” service payments
• Medicare drug discounts
• Accountable care organizations
12

13. Follow the Money
– Industrial Organization Is a Function of the Underlying Economic Model:
For Hospitals and Health Systems, the Business Model Is Driven by the
Prevailing Reimbursement Mechanism
Prevailing reimbursement
Industry reaction Government reaction
mechanism
• 1960s – cost-based/ cost plus • Building boom • Health Systems Agencies
(HSAs) and Certificate of Need
(CON)
• Mid 1980s – discharge/ activity- • Drive admissions and outpatient • Modify payment levels
based procedures, manage length of
stay (LOS)
• Future? – outcomes-driven/ • Focus on care management • Modify outcomes targets?
bundled payments/ accountable capabilities, physician
care organizations (ACOs)/ integration, information
capitation-like structures technology (IT)

14. Implications for Providers: The Reform Continuum
Typical community hospital The Feds want you
here
Low
X Level of hospital/ physician
X High
integration and care management • Geisinger Health System
capability • Mayo Clinic
• Kaiser Permanente
Critical Questions that Need to Be Answered: • Group Health of Puget
• Where are you on the reform continuum? Sound
• What more do you need to do?
• Cleveland Clinic
• What resources will you need to get there?
• Do you have the size/ scale/ capital (human and financial) to move
along the reform continuum on its own?
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15. Reform Readiness Assessment
Typical Community Hospital More Prepared
Independent/ Employed physicians with
unaligned staff “reform compatible” compensation models
Physician Integration
Limited or no Extensive use of
protocols/ EBM protocols/ EBM
Care Coordination
Infrastructure
Limited historical care Strong historical care
management orientation management orientation
Care Coordination
Culture
No EMR, limited EMR, IT distributed throughout system, sophisticated
connectivity care management and monitoring software
Information System
Sophistication
Poor primary care access, extensive Highly accessible primary
unnecessary service duplication care, rationalized upper-level
Balanced Service care
Distribution System
Insufficient Sufficient
Capital Capacity
Smallest in Market Largest in Market
Scale
Weak Strong
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Composite Position

16. Holy Family Memorial: Readiness Case Example
16

17. HOLY FAMILY MEMORIAL
Sponsored by the Franciscan Sisters of Christian Charity, Holy Family Memorial
(“HFM”) is an integrated delivery system including a hospital, a large employed
multispecialty group practice, and retail services
Medical Center – 87 Staffed beds, full range of acute care
Physician Network – 80 providers, 50% primary care,
50% specialists; Regional Orthopedic Program
Retail and Outreach Services – Wellness Center,
pharmacies, DME, occupational health
• Highly competitive local and regional market
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18. MANITOWOC, WISCONSIN
Holy Family Memorial
City of Manitowoc
41,066 people
(Level since 2000)
Manitowoc County
81,717 people
(Level since 2000)
80 miles north of Milwaukee
35 miles southeast of Green Bay
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19. Volume Trends 2009-2011
TRUE VOLUME TRENDS
GROSS REVENUE GROWTH
(PRICE ADJUSTED)
$400
Millions
$300
$200
$100 2009
2010
$0 2011
INPATIENT OUTPATIENT CLINICS TOTAL
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20. Volume/ Revenue Breakdown 2012
Gross Revenue YTD 2012
24%
33%
IP
OP
Retail
Phys
4%
39%
20

21. What’s Unique About HFM?
• Nationally recognized for extensive application of ambulatory/ hospital information
technology (IT)
• Rapid adoption of clinical best practices and highly integrated inpatient/ outpatient
quality improvement
• Ability to swiftly adapt to current and future business models due to complete
integration of hospital with outpatient, clinic, employer-based, and retail business
units
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22. Ready for the Future
Strategic Positioning 2001-2009
• 2001-2005: Concentrated on building a strong foundation through a Strategy
and Facilities focus
• 2005-2009: Shaped a cutting edge infrastructure through focus on Systems and
Processes (IT, LEAN, Innovation, Safety) and reconfirming HFM’s Mission,
Vision, and Values
• 2009 and Beyond:
– Expanding the high performance environment focus on cultural
transformation and innovation
– Strategic Program Unit Review
– Operations best practices benchmarking
22

23. HFM 2009: A Preview of Health Reform
• Significant drop in patients with insurance
• Common knowledge: many are delaying needed care because of uncertainty
• Gross revenues down nearly 10%, net 12%
• Proactive leadership and shared sacrifice early on positioned HFM for third
consecutive year of improved gain from operations
• For many organizations these pressures can create an unfortunate short-term
search for relief…..
23

24. 24

25. Holy Family Memorial’s Response
• HFM board, executive, and physician leadership anticipated these challenges and
did not seek medication!
• A 12-month planning process in 2008 produced a new strategic plan and an
updated Mission and Vision; in 2009 senior leadership was reorganized around
this new vision
• To “stress test” HFM’s strategic and organizational positioning, Kaufman Hall was
retained in July 2009 to conduct a financial and operational analysis, and assess
our “readiness for reform”
• Overall, a much more proactive approach than the other option…
25

26. Preparing for Healthcare Reform:
The “Wait and Hope” Option
26

27. A Readiness Assessment Framework
27

28. Reform Readiness Assessment
Typical Community Hospital More Prepared
Independent/ Employed physicians with
unaligned staff “reform compatible” compensation models
Physician Integration
Limited or no Extensive use of
protocols/ EBM protocols/ EBM
Care Coordination
Infrastructure
Limited historical care Strong historical care
management orientation management orientation
Care Coordination
Culture
No EMR, limited EMR, IT distributed throughout system, sophisticated
connectivity care management and monitoring software
Information System
Sophistication
Poor primary care access, extensive Highly accessible primary
unnecessary service duplication care, rationalized upper-level
Balanced Service care
Distribution System
Insufficient Sufficient
Capital Capacity
Smallest in Market Largest in Market
Scale
Weak Strong
28
Composite Position

29. Physician Integration
29

30. What Is Physician Integration?
• Physician integration is defined as having a collaborative relationship between the
hospital and the medical staff supported along multiple dimensions:
– Organizational structure and governance
– Citizenship and leadership from broader medical staff
– Medical staff support infrastructure
– Financial incentives
• Physician employment does not beget physician integration; integration does not
necessarily require employment (though it can be difficult to achieve without)
• Through proper integration, physicians and the hospital work together toward
common goals and objectives
– The biggest challenge will be integrating independent physicians under future
reimbursement conditions
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31. The Path to Physician Integration Will Require a
Pluralistic Physician Model
• Not all physicians are seeking employment
• Though the market is driving employment, hospital systems can take advantage of
physician independence by structuring pluralistic alignment models
Independent physicians Clinically integrated physicians Employed physicians
• Independent physicians will • Hospital systems will seek to • Multispecialty groups
likely continue to practice partner with independent organized around driving
through a transition period physicians to drive quality and highest quality healthcare
effectiveness through a series of
partnerships, particularly clinically-
focused co-management and
contracting strategies
• Maintaining this hybrid strategy gives hospitals time to build capital and adequate
practice management capabilities

32. How Well Positioned Is HFM’s Physician Workforce and Management Capability?
Integration Current
Key Elements of Most Prepared
Attributes Capabilities
• Physician led councils/committees that report to senior • Structure supports growing physician
leadership or the board involvement in HFM direction
Organizational
• Greater physician leadership in service
Structure and • Significant physician membership on the board planning and development needed
Governance • Physician involvement in service line planning and
management
• Within the employed group many
• A proactive physician community that is able to share relationships are fragmented; more a
Citizenship and concerns and drive organizational initiatives “confederation of practices” than one large
Leadership from medical group
Broader Medical Staff • Independent physicians aligned through clinical integration
models
• Strong and trusted physician group
• Strong, physician-led practice management and leadership leadership; need for enhanced
empowerment and development
• Seamless provision of billing/contracting/other back-office
• HFM exposed to erosion of specialty breadth
Practice Management functions as physicians retire/succession plans
• Transparent reporting of outcomes and business decision challenging
making
• Clear and transparent expectations and incentive structure • Production-based compensation ensures
group performance
Compensation Models • Multidimensional incentives (including production, outcomes,
• Citizenship incentive system in place, but
citizenship, cost management, and others) needs more sophistication
• Opportunity to improve group incentives
Lower Higher
32

33. Care Coordination Infrastructure and Culture
33

34. What Is Care Coordination?
• Established protocols for procedures
• Established protocols for chronic disease
• Protocol adherence, monitoring and accountability mechanism
• Formalized mechanisms for coordinating care though physician-
directed management of patients
34

35. More Than Semantics: Case Management vs. Care Coordination
Case Management Care Coordination
Objective Contain cost Facilitate access/ deliver value
Target Population High cost/ high use patients High-risk populations
Problem solving and process
Functional Orientation Prior authorization
improvement
Context Incident Longitudinal
Work across various
Work within a single organization
Nature of Coordination organizations/ providers
providing medical care
providing care
Note: Adapted from Colorado Department of Public Health; Kaufman Hall analysis.
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36. How Well Positioned Is HFM to Support Care Coordination?
Program Current
Key Elements of Most Prepared
Attribute Capabilities
• Patient centeredness is a goal for the
organization, but incompletely practiced
• Patient navigation through nurse navigators and • Downstream navigation/ guidance through
Patient social workers system can be strengthened
Centeredness • Alignment of downstream services to expedite
treatment (e.g., PT after surgery) • IT connectivity exists; integrating it into the care
coordination culture is the next step
• Limited patient access to medical records/ IT
• IT connectivity across provider spectrum (i.e.,
Harnessing MD offices to all HFM sites)
platform; though improving
Technology
• Patient-facing accessibility • Physician communication has improved; but
coordination across the continuum can improve
Integration of • Physician communication (e.g., tumor boards) • Care protocols in place and expanding
Capabilities and
Communication • Consistent care protocols across sites
• Process improvement initiatives have been
• Quality and Outcomes Measurement successful
• Standing admission orders and measurement
Measurement • Analysis to identify readmission drivers (such as through CPOE
poor prescription management) • Good physician accountability
• Care directed to the lowest cost setting possible
Cost with consideration to quality and access
• Physicians are accountable for practice costs
• Utilization management and cost controls are
Management
• Supply chain management strong
• Opportunity to improve supply chain
Lower Higher management
36

37. Information Systems
37

38. Information Technology Infrastructure
• Having integrated, sophisticated IT systems will become increasingly important for healthcare providers
• Organizations that invest not only in the actual hardware and software, but also in staff development and
expertise are more likely to use their system(s) effectively and to maximum potential
• IT across the spectrum of health system functions will be necessary for HFM to actively manage its business
and remain competitive
Clinical IT Solutions Non-Clinical
Clinical Care Disease Management Organization Operations Planning Accounting Finance
Sample IT Solutions
Electronic Medical Record Physician Practice Program/ Service Patient Billing Budgeting Systems
CPOE Management Performance Systems
PACS Management
Clinical Info. Mgmt.
Protocols/ EBM
Telemedicine
Ability to communicate among patients, physicians, and hospital Note: Bold font denotes historical HFM emphasis; regular font denotes
(e.g., schedule tests, make appointments online, receive test results, etc.) future emphasis.
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39. How Well Positioned Is HFM’s Information Technology?
Integration Current
Key Elements of Most Prepared
Attributes Capabilities
• Electronic Medical Record (EMR)
Clinical Care • Computerized Physician Order Entry (CPOE) • Near complete adoption and integration of
Coordination and IT into clinical workflow
Disease • Picture Archiving and Communication System
• Telemedicine used for home health;
Management (PACS) opportunity to expand outpatient disease
• Post-discharge Disease Management System management systems
• Physician Practice Management Systems • IT based and operational process
Organizational
• Program/ Service Line Performance improvements underway
Operations and
Management • Service line performance management
Planning systems and processes not fully
• Capital Planning Systems implemented
Accounting and • Patient Billing Systems • Implementation of centralized billing in
process
Finance • Budgeting Systems • Inadequate analysis of true costs
• Difficult to identify profitability trends for
services across the network
Lower Higher
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40. Service Distribution System
40

41. Characteristics of a Well-Organized Service Distribution System
• Ready access (in person, by phone, online) to care coordinators (PCPs, NP/ PAs)
• Distributed ambulatory capacity (primary care, specialty care, outpatient diagnostic
and testing services)
• Concentration of highly specialized technologies and clinical resources (e.g., super
specialists) to support quality and cost considerations
• Effective linkages and transfer protocols with “downstream” providers (Home
Health, SNF, Rehab, etc.)
• Strong communication connectivity across the entire delivery spectrum
41

42. Holy Family Memorial Service Distribution Studying clinic
expansion to Kewaunee
(20 mi NE)
 PT and Wellness
 Family Practice  Pharmacy
 Walk-In Care
 Pediatrics Clinic
 Orthopaedics
 GI Clinic
 ENT Clinic  Internal Medicine Clinic
 Pediatrics Clinic  Pharmacy  Urology Clinic
 HME  Lab
 Diabetes
Studying clinic
expansion to Chilton
(20 mi SW)  Behavioral Health Clinic
 Neurology Clinic
 Dialysis
 Orthopaedics Clinic
 Family Practice Clinic
 PT and Wellness
  Inpatient Services
Walk-in Care  Chiropractic Clinic
  Diagnostic Center of Excellence
Lab  Podiatry Clinic
  Cancer Care Center
Nutrition Counseling Orthopaedics Clinic  Endocrinology Clinic
  Heart and Vascular Center
Well Spa in Sheboygan  Women’s Health Clinic
 Pain Center
(20 mi south)  Pediatric Therapy
 General Surgery
 Lab
 Wound Clinic
 Sleep Lab 42
 Main Laboratory

43. How Well Positioned Is HFM Delivery System?
Program Key Elements of Well Prepared Small/ Current
Attribute Rural Providers Capabilities
• Relatively large number of employed primary
• Physicians care physicians
Accessible
• Mid-level providers • Very accessible care locations and schedules
Primary Care • Market slow to respond to innovative care
• Urgent Care, Retail, etc. delivery mechanisms (i.e., retail clinics)
Logical Grouping • Imaging and Lab
• Minimal redundancy of diagnostics or other high
of Highly • Cardiology, CVS, Pulmonary capital services across local service area
Interrelated • Medical/ Radiation/ Surgical Oncology and
Services others • Significant facility consolidation efforts under
way
• Concentration of higher cost acute care • Outreach based on clinics; though there is some
Single Site Acute
services; geographic footprint based on lower redundancy of clinic space within local region
Care Center
acuity services and diagnostics • Coordination of referrals through network
• Well established and coordinated referral generally smooth
Strong Referral • Very little telemedicine or outreach from tertiary
relationships with tertiary providers, SNF, rehab
Relationships centers in Green Bay to supplement current
and home health specialists
Contemporary • “Clean”, modern, contemporary physical plants • Aged main inpatient plant
Facilities and • Competitive diagnostic technology and service • Clinical technology and diagnostics very
Equipment portfolio competitive for the market
• Facility master plan being updated to show
replacement options
Lower Higher
43

44. Financial Position and Capital Capacity Assessment
44

45. How Well Positioned Is HFM Financially?
Program 2009 Position • Moderate growth in net patient service revenue (3.6% compounded annual growth) from 2005
Attribute Relative to Medians to 2009; however consistent year to year margin improvements despite national trend
• Operating performance has varied greatly over the last five years, from a $1.7 million loss in
2006 due to employee health claims to a projected high point of $6.1 million in 2009
Profitability • The variability in operating performance has lead to variability in underlying operating EBIDA
margins, from a low point of 7.9% in 2006 to a projected high point of 13.5% in 2009
• HFM’s liquidity decreased significantly in 2008, most likely due to the high level of capital
spending and negative performance from the investment markets
Liquidity • As such, cash to debt levels remain below targets
• Projected days cash on hand of 135 days for 2009 are in-line with appropriate credit median
levels
Leverage and • Relative to equity and cash, HFM is leveraged slightly higher than “BBB+” medians
Capital Capacity • Debt service coverage has remained relatively consistent and is currently in line with “BBB+”
medians
• HFM is anticipating approximately $40.6 million in building, MIS, contingency, and equipment
capital expenditures from FY2010-2014
Lower Higher • HFM has no major projects planned requiring access to the debt markets. However like most
smaller healthcare organizations, HFM will have difficulty in accessing debt in the current
lending environment at favorable rates
45

46. Scale
46

47. Scale: A Requisite for Success in the Future Healthcare Market?
Organizations that attain a greater scale can better leverage their fixed cost
base, deliver higher quality care, achieve variable cost efficiencies, build
market leverage, diversify risk across markets or a broader base of
programs/ services, preserve long-term access to capital, and ensure
ongoing viability though the attraction and recruitment of top talent.
47

48. How Well Positioned Is HFM in Terms of Scale? • HFM has been able to retain talent
• HFM has a highly tenured work force
Integration Current and a typical hospital culture. An
Key Elements of Most Prepared intentional culture shaping process is
Attributes Capabilities
in place to spur innovation and
• Broad and deep clinical and management talent from a variety of backgrounds change capacity
Talent • Empowerment throughout a large part of the organization to take risks; ability • Opportunity exists to encourage risk
taking within the organization
to absorb impact from those risks
• Ability to leverage scale (in terms of facilities and volume) to reduce variable • Membership in GPOs are the extent
costs and efficiently deploy routine capital to which HFM can leverage scale in
Purchasin – Shared purchasing
purchasing
g Power • Evaluating leverage options with
– Lab potential regional strategic partners
– Back office
• Sustained negotiating ability with payors • Major competitors are large players
in the broader regional market
• Ability to drive change in the market
Market • Ability to draw patients to Manitowoc
Influence – Advancement of technology (e.g., drive adoption of 64-slice CT) limited by HFM’s size relative to
– Advancement of service models and expectations within market (e.g., others in the market
emergency room wait guarantees/ transparency) • HFM market influence has pockets
of strength, especially with
• Clinical employers and regional orthopedics
Innovation • Operational
• Technological • Organization size challenges R&D
• Cost advantage resource investment to optimally
Access to support innovation
• Favorable terms and conditions
Capital
• Flexibility
• Limited capital excess given current
Lower Higher system position
48

49. Conclusions and Summary
49

50. Reform Readiness Assessment
Typical Community Hospital Most Prepared Organizations
Independent/ Employed physicians with
unaligned staff “reform compatible” compensation models
Physician Integration
Limited or no Extensive use of
protocols/ EBM protocols/ EBM
Care Coordination
Infrastructure
Limited historical care Strong historical care
management orientation management orientation
Care Coordination
Culture
No EMR, limited EMR, IT distributed throughout system, sophisticated
connectivity care management and monitoring software
Information System
Sophistication
Poor primary care access, extensive Highly accessible primary care,
unnecessary service duplication rationalized upper-level care
Balanced Service
Distribution System
Insufficient Sufficient
Capital Capacity
Smallest in Market Largest in Market
Scale
Weak Strong
50
Composite Position

51. Summary of Key Points
Care HFM has the pieces in place for sophisticated care management (especially for its size). A broad array of protocols and
Coordination information systems, as well as clinical leadership in decision making allows the Network to adequately track and audit its
Infrastructure care processes and errors.
Care The culture of independence in physician practice at HFM will be among the largest hurdles for the organization.
Coordination Historically, physician practice patterns have complicated the management of downstream and post-discharge care.
Culture Additionally, the physician culture’s risk averse nature can limit empowering physician extenders to fullest potential.
Past physician employment initiatives have paid off for HFM. Despite a lack of depth in some specialties, HFM’s physician
Physician
workforce is more aligned than most comparable hospitals. Opportunities to improve alignment lie in continued
Integration
development of physician leaders and greater alignment of compensation systems and incentives.
A full complement of clinical IT systems position HFM for success in this respect. HFM has an opportunity to be a regional
Information
leader. Quick and efficient IT planning, implementation, and adoption show that the Network can adapt to change with
Systems
strong leadership.
Service Balanced service distribution system in the local market. Despite this, HFM is weighed down by legacy assets and is under
Distribution increasing competitive pressures. Opportunities exist to better leverage clinical outreach sites. Additionally, a lack of clinical
System scale (i.e., volume) limits HFM’s ability to fully leverage efficiencies and demonstrate quality.
HFM faces significant challenges from its limited size and scale. In addition to challenges identified in other areas of the
Scale report, lack of scale limits its ability to control the market and maintain the breadth and depth of top management and
clinical talent to serve in the challenging reform environment
Capital Limited capital capacity. Like most similar organizations, HFM must focus on improving operating performance to continue
Capacity its growth and maintain its leadership position related to physician integration and information systems.
51

52. Key Takeaways
• The old business model is “dead” regardless of the reform outcome
• Early movers will be rewarded
• An incremental approach to change and adaptation is not sufficient in the new era
• Effective physician integration and care management capabilities will define future
success for hospitals and health systems
• More than one success model will emerge – not all organizations can evolve into
a Mayo, Geisinger, or Kaiser type of provider
• Evaluate and “grade” your readiness right now
• Start taking the required steps toward success
52

53. Moving from Assessment to Readiness
• Size alone is insufficient
• Start building the systems and programs for success
• The emerging success model requires:
– Scale
– A strong position in the geographies served
– Multiple operations in a connected geography
– A solid, integrated physician platform
– A care, cost, and quality management culture
– Sophisticated IT and care management infrastructures
– Acute attention to operations and business portfolio management
53

54. Question & Answer Session
To submit a question via your phone, please dial *1 on your keypad.
You will be placed in queue, your phone line will be opened by
operator when it’s your turn. (To be taken out of queue, press *1
again.)
54

55. Upcoming: AHA Solutions Signature Learning Series
Webinars:
HIE: Assimilating Patient Data to Leverage Your Technology and Applications to
Meet “Meaningful Use” Requirements
Featuring a case study by West Tennessee Healthcare
Thursday, December 10 1 - 2pm Eastern Time
Creating Quality Initiatives through Policies & Procedures:
Best Practices for Adherence and Management
Featuring Eastern Idaho Regional Medical Center
Tuesday, December 15 3 - 4pm Eastern Time
To learn more or to register, call 1.800.242.4677 or visit aha-solutions.org
55

56. About This Webinar
• This educational webinar has been developed by AHA Solutions in partnership with
Kaufman, Hall & Associates, Inc.
• Kaufman Hall has the exclusive endorsement of The American Hospital Association for its
Integrated Planning and Capital Markets Solutions.
2009. Kaufman Hall has
been ranked #1 for the
sixth consecutive year by
Thomson Reuters as the
country’s top financial
advisor to healthcare
providers.
56

57. Contact Information
Mark P. Herzog Mark E. Grube
President and Chief Executive Officer Partner
Holy Family Memorial, Inc. Kaufman, Hall & Associates, Inc.
920.320.3470 847.441.8780
mherzog@hfmhealth.org mgrube@kaufmanhall.com
For more information on
AHA Solutions or Kaufman Hall
please visit www.aha-solutions.org
57

58. Featured Speaker
Mark P. Herzog
Mark P. Herzog has served as President and CEO of Holy Family Memorial, Inc. (HFM) since 2001. Prior to
this, Mr. Herzog served as EVP/COO for 10 years at two hospitals in northwest Indiana. His 25 years of
experience also include leadership roles in health systems in Ohio and Pennsylvania. He was awarded an
MHSA degree from the University of Michigan, and is an ACHE Fellow.
HFM is a small-market, tightly integrated health delivery system located in Manitowoc, WI, serving a
population of nearly 100,000. It includes a hospital, an employed 80-practitioner multispecialty group
practice, a comprehensive outpatient campus (“healthcare village”) and a wide range of prevention-focused
retail services. HFM was an early adopter of clinical information systems and care management tools.
During the past five years, HFM has been named Solucient Top Performance Improvement Leader, has
received a Premier/ CareScience Select Practice National Quality Award, and has been recognized twice
nationally for Patient Safety Excellence, with designation in 2009 as a Top 25 Most Wired Small Hospitals,
and a Stage 6 EMR Adopter by HIMSS.
58

59. Featured Speaker
Mark E. Grube
Mark Grube, Partner, leads Kaufman Hall’s integrated strategic advisory practice. This practice provides strategic and financial
planning and implementation assistance related to enterprise-level strategies, clinical programs and service lines, physicians,
health facilities planning, competitive markets, joint ventures, mergers and acquisitions, and overall organizational growth.
Mr. Grube has more than 25 years of experience in the healthcare industry, as a consultant and as a planning executive with
one of the nation’s largest healthcare systems. He has worked extensively with a broad range of healthcare providers,
including community hospitals, specialty hospitals, regional and national health systems, and academic medical centers.
Mr. Grube is a frequent speaker and author on healthcare topics, including strategy development, sustainable revenue growth,
replacement facility development, and mergers and acquisitions. Over the past five years, Mr. Grube has published more than
two dozen articles and white papers. He received the Helen Yerger/L.Vann Seawell Best Article Award from the Healthcare
Financial Management Association (HFMA) in 2007 for his cover story in the May 2007 issue of hfm magazine titled “Growing
the Top Line: 5 Strategies to Expand Your Business,” and in 2009 for the article he co-authored in the May 2009 issue of hfm
titled “Ensuring Affordability of Your Hospital’s Strategies.”
Mr. Grube has presented at national meetings of the American College of Healthcare Executives (ACHE), The Governance
Institute, HFMA, and the Society for Healthcare Strategy and Market Development (SHSMD). Reflecting his serious
commitment to healthcare management and governance education, Mr. Grube presents frequently at hospital/health system
retreats and university graduate programs in health administration. He is a member of ACHE, HFMA, SHSMD, and the
Leaders Board for Healthcare Strategy and Public Policy.
Mr. Grube received an M.B. A. from the University of Chicago Graduate School of Business and a B.S., magna cum laude, in
Economics from Bradley University.
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60. Kaufman Hall: Who We Are
• Kaufman Hall is an independent consulting firm that offers integrated strategic,
capital, and financial advisory services and software to healthcare organizations
of all types and sizes
• National practice established in 1985
• Clients throughout the United States
• Offices in Chicago, Atlanta, Boston, Los Angeles, New York, and
San Francisco
• Impeccable industry credentials and national “gold standard” hospital and health
system client base
• To learn more visit http://www.kaufmanhall.com.
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61. Thank You
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