• President and CEO of Centura Health Integrated Physician Network
• CEO of Health Solutions LLC
• President for the VHA Mountain States Region (a network of 60-plus hospitals and aligned physician practices across the region)
This unique point of view allows Hans to see solutions among the silos. Where others are committed to competition, Hans brings insight, intelligence, and community based strategies that go beyond the typical healthcare discussions to find common ground between groups who previously believed they had competing interests.
For example, co-locating behavioral health and integrating pharmacists into the primary care setting are key parts of Hans Wiik’s vision. Also, clinical information, data analytics, validated patient registries, benchmarking, and better coordination among all providers is critical for long-term success for the triple aim of healthcare (improved cost and quality and a better patient experience).
Hans has recently embarked on a new vision and challenge as President and CEO of the Hans Wiik Health Group, LLC – a Colorado-based consulting group that will focus on assisting providers, payers, and employers on guidance and strategies around ACO development and performance, clinical integration, care coordination, co-location of behavioral health and pharmacists in the primary care setting, population health management, value based benefit design, that leads to overall performance improvement in healthcare quality, cost reduction, and better outcomes.
From 2008-2014, Hans was the President and CEO of the Centura Health Integrated Physician Network (iPN). The iPN was formed in 2004 when a group of independent practices and physicians in the North Denver metropolitan area began implementing a common/enterprise-wide EHR to improve the quality of clinical performance and care. This adoption of a common EHR made the iPN one of the first clinically integrated networks of independent practices in the nation. The iPN currently has over 260 providers represented in 25 different multi-specialty practices across 45 separate practice sites. Over 120 of these providers are primary care providers (PCPs) — all certified by the NCQA as Level 3 Patient Centered Medical Home (PCMH) providers. This is the largest group of PCPs with Level 3 NCQA- and PCMH-designation in Colorado.
The iPN is sponsored by (and partners with) Colorado’s largest not-for-profit healthcare system – Centura Health. Practices include both primary care and specialty practices, including a large, successful Federally Qualified Health Center (FQHC) – Clinica Family Health Services, which has 5 clinic locations.
Practices currently include Family Practice, Internal Medicine, Ob-Gyn, General Surgery, Neurosurgery, Orthopedics, Pulmonology, Cardiology, and Reconstructive Plastic Surgery. The practices are integrated through a series of population-based quality initiatives, which focus on quality of care, patient satisfaction, and the sharing of best practices.
- Population Health - Care Coordination and Care Transitions
Organized Primary Care networks and clinically integrated multi-specialty networks are increasingly facing financial risk from payers as to contractually required quality outcome and cost metrics. Understanding the key cost drivers and developing and initiating new community partnerships with the overall provider community will be critical for long term success and delivered value. Sharing data, reviewing performance, measuring success with key clinical leadership from each party will be required in new constructs with the overall provider community – with emphasis to care transitions. Post-acute services in Home Health Care, Skilled Nursing, Assisted Living, Physical and Occupational Therapy, Rehabilitation Hospitals, Hospice and Palliative Care are often independent and sometimes out of network for the patient. The organized PCP network will have to be selective and focused on building value based – win/win relationships for all key episodes of care, many of which are now starting the journey on bundled payments with full or shared financial risk. Building bridges in a current environment of silos of key providers will be an increasing focus for the provider community entering new risk models from the payer community.
- Employer Solutions for Affordable Healthcare
All employers are focused on solutions for their increasing health care costs and to encourage and promote a healthier workforce. There are many areas where employers, especially large self-funded employers, can be innovative in supporting and providing affordable health care insurance for their employees. The following areas are emphasized for employers to examine with their brokers, commercial insures and PBM’s and the local provider community to bring significant value forward.
•Benefit Design – Educating and Incenting employees to be part of the solution
•Employee Wellness Programs that are proven and sustainable
•Direct Provider Community Engagement for Employees with Chronic Disease
•Cost transparency solutions for High Deductible Plans/Incentive Rewards
•PBM – Pharmacy Benefit Manager Collaboration – Developing and implementing a value based Drug Formulary
•Beyond annual HRA’s – Health Risk Appraisals – What is currently working?
- Designing and Implementing Physician Led Clinical Integration
Successful Clinical Integration to support the Triple Aim in improving the patient experience, improving quality outcomes and reducing cost requires many key ingredients for market success. The following areas or critical success factors will be overviewed from personal experience in building and leading one of the first successful, clinically integrated multi-specialty physician networks in the nation.
•Physician Leadership – Interest and Knowledge in Clinical and Claims Data Analytics
•Primary Care Network Emphasis – Broad Geographic Access and Culture
•Quality Coaches at the Practice/Provider Level to ensure trusted/validated EHR data
•Team Based Care / Patient Centered Medical Home Standards and Certification
•Collaborative Payers to support the needed infrastructure and related costs
•Accountability at the Practice and Provider Level
•Population Health Initiatives – the proactive management of high risk patients
- Value Added Healthcare Reform – Focusing on Quality Improvement and Cost Reduction
Meaningful and Value Added Healthcare Reform requires new models of healthcare delivery and financing. It requires that Employers, Providers, Payers and Patients to all collaborate and interact in new innovative plans and models. Whether new benefit designs and wellness initiatives for employer sponsored health plans or in new clinically integrated primary care networks with proactive models for effectively managing chronic disease, all the stakeholders have a key role in helping to maintain an affordable health care system for the nation. Payers – Commercial Insurers, Medicare and Medicaid are all implementing new collaborative health plans partnering with selected, organized physician networks to hopefully deliver significant value, with aligned cost and quality incentives. Patients and families also need to be engaged at all levels with their employers, insurers and most importantly with their providers to be active participants in their prevention and wellness programs – especially in an aging society with increasing levels of chronic disease – diabetes, heart disease, cancer and all auto-immune diseases. This presentation overviews the key elements and functionality that needs to be in place for value based purchasing and successful health care reform.