1. Ascension Health NCCCP Pilot Sites Overview

2. Ascension Health’s Mission, Vision and Values
Read
Our Mission . . .
Directs us to serve all persons, particularly those poor and vulnerable, toward improving the health of individuals and communities.
Our Vision . . .
Propels us to contribute to the building of a strong, vibrant Catholic health ministry in the U.S.
Our Values . . .
We are called to: Service of the Poor, Reverence, Integrity, Wisdom, Creativity and Dedication.
A clear starting point and touchstone for our process was the Mission, Vision and Values. These are included in your notebook.
Review Mission and Vision
Our Mission and Vision provided the context for our deliberations. We revisited them many times .
If I fail to link the Mission, Vision & Values appropriately throughout my comments, please accept that they are the foundation for all that we do.

3. Fiscal Year 2006 Systemwide Statistics
Discharges 660,341
Inpatient Malignant Neoplasm Cases ,805
Available beds ,788
Number of births ,942
Total surgical visits ,938
Emergency visits 2,073,619
Physician office visits 3,530,176
Total outpatient visits ,884,007
Employees ,000

4. NCCCP Pilot Sites Columbia St. Mary’s Milwaukee, Wis.
Lourdes Health Network
Pasco, WA
St.Vincent Indianapolis Hospital
Indianapolis, Ind.
(Lead Clinical)
Carondolet Health Network
Tucson, AZ
Brackenridge Hospital
Austin, Texas
(Lead Access)

5. NCCCP Pilot Sites Early Stage Comprehensive Cancer Care
Later Stage Comprehensive Cancer Care
Later Stage Access Model
Early Stage Access Model
Brackenridge
Hospital
Austin, TX
Columbia
St. Mary’s
Milwaukee, WI
St.Vincent
Hospital
Indianapolis, IN

6. Importance of NCCCP Project
The best care available to all
Making sure that our understanding of the value of new treatments is determined from their evaluation in all

7. Importance of NCCCP Project
“Consistent with our Mission, this initiative will allow Ascension Health to open the doors to thousands of cancer patients – including many who are poor and vulnerable – who otherwise would not have access to the excellent clinical care and cancer trials they need and deserve. This work supports our Strategic Direction in which we promise Healthcare That Works, Healthcare That Is Safe, and Healthcare That Leaves No One Behind, for Life.”
Anthony R. Tersigni, EdD, FACHE
President and Chief Executive Officer
Ascension Health

8. Challenges and Opportunities
Clinical
Offers the highest quality cancer care – including clinical trials and end-of-life care – to those who need it
Clinical trials must include all patients
Disparities
Breaks down barriers to care for thousands of cancer patients – including many who are poor and vulnerable – who otherwise would not have access to the care they need and deserve

9. Ascension Health’s Call to Action
Healthcare That Works
Consistent, exceptional Ascension Health Experience and strive to achieve absolute satisfaction by 2020
Healthcare That Is Safe
Zero preventable injuries and deaths by 2008
“A clinically obligated group”
Healthcare That Leaves No One Behind
100% Access in every community by 2020

10. Spreading Clinical Practices Across Ascension Health
The Strategy –
8 priorities for action directly address outcomes
5 challenges in how we work together change the environment to make rapid and sustained change possible
369 days from July 08

11. 2,027 Ascension Health System Mortalities Avoided from Baseline

12. Systemwide Spread -- Perinatal Safety

13. Ascension Health Birth Trauma Rate

14. National Rate is 6.5 birth traumas per 1000 live births.
System Average is 1.7 birth traumas per 1000 live births.
Comparison to National Rate: We are 74% lower than the national rate (favorable).

15. Neonatal Mortality is a death during the first 28 days prior to discharge in a live born inborn infant ≥ 24 weeks of gestational age without lethal malformation or abnormality.
National Rate is 4.7 neonatal mortalities per 1000 live births.
Goal is 0 (zero) neonatal mortalities per 1000 live births.
System Average is 1.53 neonatal mortalities per 1000 live births.
Comparison to National Rate: We are 67% lower than the national rate (favorable).
Interpreting the Graph: Data points (dots or ministry lines) that are below the System average line indicate a neonatal mortality rate that is lower than the System average.
National Average
4.7

16. National Rate is 18.1 to 21.2 facility acquired pressure ulcers per 1000 inpatient days.
System Average is 1.4 facility acquired pressure ulcers per 1000 inpatient days.
Comparison to National Rate: We are 92% lower than the national rate (favorable).
average.

17. Ascension Health System Performance 2006

18. 2020 Goal of Healthcare That Leaves No One Behind = 100% Access
What, and For Whom, is 100 Percent Access?
100% access means that all persons, particularly those persons who are uninsured or underinsured, receive healthcare services that:
Create, and support the best journey to improved health outcomes for each individual, and
2. Are funded in an adequate and sustainable fashion.

19. Principles We are committed to access for all.
Healthcare is a right required for human dignity.
We reject a “two-tiered” health system that separates those who can pay for services from those who cannot pay for services.
A comprehensive solution to finance the care of the uninsured and underinsured is the shared responsibility of public and private partners at the local, state and national levels.
Healthcare systems must redesign care to achieve safe, accessible care for the uninsured.
To achieve access to healthcare for all, a new model of access leadership involving inclusive, “ego-less” collaboration is required.
Discussion Draft from Ascension Health Board of Trustees – March 14, 2007

20. Access Models: From Strategy to Operations
Where We Have Been
Where We Are Today
Where We Want to Be
Setting/Defining a Broad 2020 Goal of 100% Access:
Defined as Linking Improved Health Outcomes and Achieving Sustainable Funding
Showcasing Health Ministry Leadership by Initiating Pilot Access Models:
Sites Catalyzed by the Federal Grant Funding from the Healthier Communities Access Program (HCAP)
Learning Together by Crafting the 5-Step Access Model:
Synthesis of Learnings from Pilot Access Model Sites
Measuring Success Through Outcome Measures:
Tracking Results of Access Models
Rewarding Health Ministries for Access Work:
One Year System Incentive Rating Leadership Participation in Access Models’ Collaborative Work
Initiating Implementation Planning Through the Access Leadership Program:
Translating the 5-Step Access Model to 18-Month Health Ministry Access Plans
Broadening the Impact of Health Ministry Leadership Through Influencing Community-Wide Systems’ Change Versus Episodic Hospital- Based Programs
Expanding Funding Sources: Seeking National Collaborative Partners and Local Partners to Match System Endowment Grants
Investing Local Resources to Access Work: Access Leadership Plans Integrated into ISFPs* and Health Ministry Organizational Structures
Engaging All Health Ministries in Access Work:
Setting an At-Risk Compensation Plan for 28 Health Ministries to Complete Access Leadership Plans
Effective Systems / Models of Care for the Uninsured/Underinsured:
Redesigning the Care Journey to Improved Health Outcomes
Outcome Measures:
Measuring Improved Health Outcomes as Success
Sustainable Funding:
Achieving Solutions for 100% Access
Incentives:
Tied to Improving Health Outcomes for Uninsured/Underinsured and Achieving Sustainable Funding
New Model of Leadership Achieved:
Integrating 100% Access Work into Health Ministry Operations
*Integrated Strategic and Financial Plans
Revised 10/25/06

21. Access Model Collaboratives
2007
Access Model Collaboratives
* Access Leadership
Planning Program Participant
Genesys Health System
Flint, MI
*Columbia St. Mary’s
Milwaukee, WI
Borgess Health
Kalamazoo, MI
Saint Mary’s
of Michigan
Saginaw, MI
*St. Joseph
Health System
Tawas City, MI
*St. John Health Detroit, MI
*Seton Health
Troy, NY
Lourdes Health Network
Pasco, WA
Good Samaritan Reg. Med. Ctr.
Pottsville, PA
*Lourdes Health Network
Pasco, WA
*Our Lady of Lourdes
Memorial Hospital
Binghamton, NY
*Carondelet Health
Kansas City, MO
*Carondelet Health Network
Tucson, AZ
Carondolet Health Network
Tucson, AZ
*St. Vincent’s Health Svcs.
Bridgeport, CT
*Daughters of Charity
Services of Arkansas
Dumas, AR
*St. Vincent Health
Indianapolis, IN
Saint Thomas Health Services
Nashville, TN
*St. Vincent’s HealthCare
Jacksonville, FL
*Seton Family of Hospitals
Austin, TX
Daughters of Charity Services
New Orleans, LA
*Daughters of Charity Services
San Antonio, TX
*Sacred Heart Health System
Pensacola, FL

22. Michael’s 3-month Healthcare Journey ---Without Insurance
2/20/04
Acute Upper Respiratory Infection
Brackenridge Hospital ER (Ascension Health)
Bronchitis
St. David ER
3/9/04
Backache
3/11/04
Lumbago, Hypertension
Skin Disturbance
4/1/04
Lumbago
Seton McCarthy (Ascension Health)
4/13/04
Neuritis
Austin Travis County FQHC
5/12/04
Joint Pain
Austin Travis County FQHC
5/13/04
Brackenridge Hospital Outpatient (Ascension)

23. SYSTEMIC CHANGE = 100% ACCESS
Ascension Health’s
5-Step Model to 100% Access
SYSTEMIC CHANGE = 100% ACCESS 5.
Sustainable Funding is Achieved for Care (State/local government; business; community partnerships) 4.
Private Physicians Volunteer as Medical Homes/Specialists for the Uninsured and Underinsured 3.
Care Models Achieve Improved Health Outcomes 2.
Community Service Gaps Filled
(Dental/Pharmaceutical/Mental Health) 1.
Develop Community-wide Formal Infrastructure
Leadership Coalitions
Shared Information Systems
Catalyst Funding
© Ascension Health

24. National Access Outcome Measures Initiative (NAOMI)*
* Work is underway to complete health outcome measures related to asthma and hypertension.
*Approved by Board Executive Compensation Committee December 8, 2006

25. Cumulative Number of Adult Medicaid Enrollees, April 2005 – December 2006
Through December 2006, ,011 (33%) obtained coverage.