Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Mission Statement
"We promote the health of our patients and our community and advance the frontiers of clinical medicine"
Further stabilization of Stanford Hospital's operating margin, ie first positive operating margin since merger Improvement in practice's clinical revenues ($91m to $108m) and profits ($16.8m) Assessment, with SHC, of capital needs of SHC and of our practice
plans for raising $250m in bond market to achieve it
Consensus-building in funds flow methodologies regarding payments from Hospital to School for services rendered
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Context
Clinical Practice Revenue
Millions
$160 $140 $120 $100 $80 $60 $40 $20 $FY99 FY00 FY01 FY02
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Physician Net Revenue Special Labs & Service Payments Total Payments
Context
Direct Research Expenditures
Thousands
Context
Clinical Departments Revenues
Thousands
$160,000 $140,000 $120,000 $100,000 $80,000 $60,000 $40,000 $20,000 $FY99 FY00 FY01 FY02
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Ambulatory Growth
Ambulatory services are growing and becoming an increasing fraction of SHC's revenue streams, now accounting for 40% of SHC charges and 55% of faculty charges 57% of faculty collections were derived from outpatient svcs in FY'02 The increasing importance of ambulatory services revenue means that both the faculty and SHC are increasingly dependent on its growth for economic viability, as well as for a secure referral base Neither can afford to concede wholly the profit derived from outpatient services to the other entity
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Exclusion of LSS (Pediatric based) data for FY2000 and FY2001 Exclusion of Capitation reimbursement for all fiscal years.
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Newer treatment options for common chronic diseases (immune modulators, etc) tend to be outpatient modalities With the recruitment of a new VP for Ambulatory Services, along with service and operational issues, funds flow issues must be addressed
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Patient Base
A Strategic Imperative: Defining and controlling our access to the patient base around us
Kaiser controls ~ 40% of the patient base around us and is seeking to do its own tertiary/quaternary care Sutter/PAMF accounts for 23% of SHC discharges now and is seeking to consolidate the large majority of the remaining non-Kaiser patients into their system Stanford needs access to patients who will benefit from our care and help us advance medical knowledge
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Patient Base
Potential Strategies for Maintaining Patient Access Create a full service health system Partner with full service systems* Be the quality and value leader**
superior skill sets, knowledge bases, but also excellent service cost basis that is attractive to full service systems and their constituencies
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Current reality is that partnering with Sutter remains uncertain, and we need to have an independent strategy
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Patient satisfaction scores in ambulatory services have recently been below historical norms
Third party payers are now introducing "tiering", a designation made by insurers to establish different payments to centers, based on "quality and cost"
Aetna and Blue Cross propose us as first tier designees, but Healthnet seeks to place us in second tier
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Applied Research
Current models
Potential models
Stanford Cancer BMTx Unit Institute Oncology Clinic Stanford Stroke Service Neurosciences Institute Device Development Center Stanford Cardiovascular Imaging Services Medicine Institute
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Institutes Scope
Research
Patient Care
Future Institute
Future Institute
Future Institute
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Institute Organization
ACCESS/SPTRC
Institute-Based Associates
Head & Neck Cancer Center Leukemia Center ????? Cancer Center
Department-Based Affiliates
Translational Research Core Facilities
Practice Organization
Dean and CEO agreed in 8/02 upon structure that recognized a confederation of depts as the fundamental organizational model Council of Clinical Chairs provides forum for input and deliberation about issues surrounding professional practice
Dean, CEO, Clinical Chairs, COO, CFO and Sr Deans for Clinical Affairs and Finance and Administration Meets biweekly, chaired by Sr Dean for Clinical Affairs and COO
Smaller Joint Clinical Planning Committee creates proposals, organizes initiatives and supervises strategic planning
Dean, CEO, COO, CFO, Sr Deans for Clinical Affairs and Finance and Administration Meets at least weekly or more frequently when needed
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CEO
Professional Contracts
Adult/Children's Services Carve-out Splits
QA / Compliance
Ambulatory Services
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Refine and enlarge the initiative for institute and center development, as platform for clinical growth and translation Develop further the practice's organizational structure and funds flow to align finances and mission-based goals
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Key Challenges
Availability of timely, accurate data relating to financial performance across the hospital and the faculty practice
Volume, expense and profitability of clinical units P&L, expenses and performance should be transparent
Development of a faculty culture that seeks to enlarge the enterprise's resources, rather than seeking advantage in re-negotiating different splits of it
Centers and institutes will require re-shuffling of some authorities, accountabilities and funds flows
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Key Challenges
Advocacy for and recognition of the value of providers of clinical care and education
enable us to recruit and retain physicians in the "physician-educator line"
Better communication between UTL and MCL lines for translational initiatives
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