1. Your Patient Experience James Merlino, MD President and Chief Medical Officer Strategic Consulting

8. 8 OUR GOAL: Alleviate by responding to Inherent patient needs OUR GOAL: Prevent suffering by optimizing care delivery Sources of Suffering © 2015 Press Ganey Associates, Inc.

9. 9 © 2013 Press Ganey Associates, Inc.

11. 11 Patient Desires © 2013 Press Ganey Associates, Inc. Respect Communication between staff Happy people Empathy

12. 12 The Healthcare Ecosystem © 2013 Press Ganey Associates, Inc.

14. 14 © 2013 Press Ganey Associates, Inc. Hospitals feeling the most heat (for now) 20102011201220132014201520162017 Readmissions Reduction 3% Outpatient Quality Reporting (OQR) 2% Value-Based Purchasing (VBP) 2% Inpatient Quality Reporting (IQR, formerly RHQDAPU) 25% Inpatient Psychiatric Facility (IPF) 2% Hosp Acquired Conditions 1% Meaningful Use 75% Percent of of APU Percent of DRG payment This is NEW!

15. 15 2013 Value-Based Purchasing Measures © 2013 Press Ganey Associates, Inc.

16. 16 Value-Based Purchasing - 2014 © 2013 Press Ganey Associates, Inc. 2 nd Year of VBP Reporting: April – December 2012: Performance period Measures: - 13 Core Measures - 8 HCAHPS - 3 Mortality - 8 Hospital Acquired Conditions - 2 Composite PSI - 1 Efficiency (spend per beneficiary) $$ impact 2014 Measures FY 2014

17. 17 VBP Domain Weighting Changes 2013-2017 © 2014 Press Ganey Associates, Inc. 1% at risk 1.5% at risk 1.75% at risk Core Measures 5% HCAHPS 25% Outcomes 45% Efficiency 25% FY 2017 (Based on FY 2015 Performance) 2% at risk 2015 1.5% at risk 2014 1.25% at risk 2013 1% at risk FY 2016 50 – 100% by 2018

18. 18 Why are we here? – What’s our North © 2013 Press Ganey Associates, Inc. “Patients First….” Delo “Toby” Cosgrove, CEO Cleveland Clinic …most profound “Why” Charles Sorenson, CEO Intermountain “PEOPLE 2020” Rich Gilfillan, CEO Trinity Health “Health of Humankind” David Feinberg, Former CEO UCLA What is your purpose?

19. Satisfaction Patient Experience

20. Safe Care High Quality Care Patient Satisfaction Everything else Patient Experience….

21. In-Episode care (ED to Medicine to Surgery) data and solutions along the Continuum 21 ED Medicine Surgery Discharge

22. PerceptionPre-Care Patient Care Post Care Service Experience Process People Patients Execution

23. Recommend % Yes Definitely Response Industry Average

24. Doctor Communication % Always Response Industry Average

25. Nurse Communication % Always Response Industry Average

27. Physician Patient Comments N = 540

28. Opportunities for Improvement Doctor Communication Verbatims 72% Communication

29. 29 Be Transparent Internally © 2013 Press Ganey Associates, Inc.

30. 30 Anecdotes are powerful © 2013 Press Ganey Associates, Inc. “Never sure who my doctor was..” “Surgeon never saw me – until I was very critical” “Never saw my surgeon – only the fellow” “Doctor had attitude” “Doctor was rushed” “Too many doctors – I never new who was in charge.” “ ----- group was backing out of the door as my wife was asking questions – very rude.”

31. Nat’l %ile

32. Providers at the 99 th Percentile or above Medical Practice Survey minimum n=30 returned in calendar year National Rank – compared to Press Ganey National Database: 128,705 physicians % of total providers

33. 33 © 2013 Press Ganey Associates, Inc.

34. Patient Expectation Bad Experience Patient Experience

35. Good Experience Patient Expectation Patient Experience

36. 36 © 2015 Press Ganey Associates, Inc. This is about us! Align to the “North Star” Not about happiness Culture is critical Communication is foundational Meet expectations Final thoughts…

37. Discussion © 2014 Press Ganey Associates, Inc.