BPCI Advanced has just begun and many providers are already off to a great start. Staying organized, coordinated and on track from the beginning will set the pace for consistent performance.
Participants can ensure they’re ahead of the curve by following these three steps.
1. Conduct a steering committee kickoff meeting.
If you haven’t rounded up your steering committee yet, consider doing so. BPCI Advanced participants should convene a first meeting with this group to identify key goals and objectives in the short-term, mid-term and long-term.
An effective steering committee is strategic in ensuring the right people are in the room each time, including clinical, administrative and service line leaders (e.g. interdisciplinary). If possible, keep numbers small and rotate members in and out of the group as needed to maintain effective and productive meetings.
For physician participants who may be concerned about losing valuable clinical hours, consider allowing time spent in meetings to be “protected time” or administrative time versus additive. This is particularly helpful for clinicians with productivity goals (often measured in relative value units (RVUs)) tied to their compensation. Providing “protected time” or administrative time adjusts the individual physician’s productivity goals to account for time spent attending meetings. Making these types of adjustments communicates the importance of BPCI Advanced to participants while maintaining respect for everyone’s schedule.
2. Develop a charter and plan as an interdisciplinary team.
Build a team charter that defines primary responsibilities, identifies who is involved (interdisciplinary teams that include multiple clinical and operational representatives) and describes the scope of work, goals and milestones (including start and end dates). This document should include a timeline with tasks and owners to hold team members accountable and establish a cadence of meetings, as well as rules of operation, such as using a standard agenda.
To avoid “scope creep,” document the parameters of the project and establish what’s out of scope for the team. For example, specify that major joint lower extremity procedures are a part of the initiative, while all other orthopedic procedures are outside the scope of the team’s work.
It’s also important to jointly consider and discuss the quality metrics for forward momentum. All partners should understand how the metrics and goals align with incentives that are targeted around the project. Build understanding around how these goals factor into the profit or loss generated by them as an individual, as well as how their efforts shape the financial health from individual practice to organization level. Transparency will promote collaboration and accelerate performance.
Finally, all objectives determined and discussed must be shared objectives to avoid any steering committee meeting “hijacking,” due to a particular individual’s area of interest. If a topic is raised, that’s not part of the standing agenda, acknowledge the topic, but promptly place it in “park” for a future discussion. Revisit the appropriateness of the topic during off-meeting times to determine if it should be added to a future agenda or referred to a more appropriate forum.
3. Establish targeted analytics with tracking and reporting capabilities.
The ability to measure, monitor and evaluate current bundles performance, as well as forecast for the future, is critical for sustaining a successful bundled payment model. Detailed claims data are complex, but also a very rich resource, providing information about care across the continuum (inpatient, professional visits and post-acute care).
Claims analytics capabilities that provide targeted intelligence, such as Premier’s Bundled Payment Intelligence Platform, can enhance insights by sourcing data via an electronic medical record (e.g. patient identification, clinical protocols/order sets). Additionally, they are able to provide this data to key stakeholders (e.g. surgeons, physicians and post-acute partners). Access to this information should be a seamless part of day-to-day patient care and enable hospital leaders to continually drive higher levels of performance.
Don’t wait. Start now to avoid a “false start.”
Many organizations have experienced a “false start” to a performance improvement initiative. While it’s not uncommon, recovery after a false start is challenging. Ensuring plans are in place from the beginning helps to build mutual expectations and consensus on the foundational elements of the project. Taking these steps is critical to engagement and can go a long way in eliminating the challenges of the unavoidable “forming, storming, performing and norming” committee dynamics.
Premier® is working with BPCI Advanced participants on implementation plans for their care teams now. If you want to learn more about how to accelerate performance in bundled payments or are considering reapplying in the spring of 2019, contact us.