CARILION CLINIC CONVERSION ENTERS NEW PHASE, WILL PILOT NEW PAYMENT STRUCTURE FOR PRIVATE INSURANCE AND MEDICARE

Programs move away from fee-for-service model, supporting prevention, wellness, quality and technology

ROANOKE, Va. (July 21, 2009) Carilion’s conversion from a traditional, hospital-centric health care organization to a multi-specialty, patient-centered clinic is entering a new phase. The conversion began three years ago with a commitment to improve patient care, improve service and eventually decrease health care costs.

“We’ve made remarkable progress in building the organization and infrastructure necessary to fulfill our promise, “said Carilion Clinic president and CEO Edward G. Murphy, M.D. “We’ve added more than 200 doctors, a physician leadership structure and a comprehensive electronic medical record. At the same time we’ve improved our academic profile by developing a new medical school and research institute with Virginia Tech.”

According to Murphy, Carilion is now turning its attention to problems inherent in the current medical payment system, which rewards over-treatment while providing no incentive to keep people well. Two new pilot programs aimed and improving patient care, efficiency and wellness while lowering costs will begin in 2010.

Carilion Pilots Brookings-Dartmouth Model

A new and innovative, nationally-recognized health care model that rewards providers for improving patient outcomes while lowering cost growth will soon be pilot tested in Roanoke through a cooperative effort by the Engelberg Center for Health Care Reform at Brookings, The Dartmouth Institute for Health Policy and Clinical Practice, and Carilion Clinic. The “Accountable Care Organization” (ACO) model encourages physicians, hospitals, insurance companies, and the government to work together to coordinate care, improve quality, and reduce costs.

The Engelberg Center and the Dartmouth Institute have selected Carilion Clinic to be a pilot site to implement the model through the Brookings-Dartmouth ACO Pilot Project. In an ACO, providers assume greater responsibility for the quality and cost of the care they deliver –supporting providers when they take steps to keep their patients healthy, deliver high-quality care, and avoid costly medications and procedures. It makes it financially feasible for doctors to practice preventive care and to provide enhanced disease management for patients with chronic conditions such as heart disease and diabetes.

“The Brookings-Dartmouth ACO Pilot Project and Carilion Clinic are on similar paths,” said Murphy, “We understand that rising health care costs are not sustainable and that provider leadership is essential to reforms that reduce costs, improve efficiency, and are accountable for clinical outcomes. As providers, we are best equipped to develop solutions that keep patient care and quality at the center of the discussion.”

“Carilion’s work in developing an integrated multi-specialty physician group provides a strong foundation from which to pilot the payment reforms central to ACOs,” said Elliott Fisher, director of the Center for Population Health at Dartmouth.

“Accountable Care Organizations are a model for delivery reform that can help transform our nation’s health care system from one that rewards overuse to one that delivers high-quality care at lower costs,” said Mark McClellan, director of the Engelberg Center for Health Care Reform and Leonard D. Schaeffer Chair in Health Policy Studies at the Brookings Institution. “We look forward to working with the partners in Roanoke and with other sites around the country to test this promising new model.”

Carilion Clinic will receive technical assistance in setting up, implementing and testing the ACO concept, and will develop a pilot process for payment and delivery system reform based on accountability for quality improvement and cost reduction. Brookings and Dartmouth will assist with various components of the pilot to ensure the success of the multi-year effort, with the ultimate goal of generating a structure that can be easily replicated across the country.

Several insurance payers including Anthem, CIGNA, United Healthcare and Southern Health have expressed interest in participating with Carilion Clinic in the ACO pilot and are in discussions with Carilion, Brookings, and Dartmouth.

Medicare Health Plan

Carilion Clinic has received conditional federal approval to operate a Medicare Advantage Plan. The new organization, called Carilion Clinic Medicare Health Plan, will offer a variety of plan designs with no or low member premiums, affordable co-payments, prescription drug benefits, and wellness care.

Medicare Advantage Plans are paid a flat monthly fee, which makes it possible for participating doctors to provide wellness and preventative care. Quality, outcomes and patient satisfaction measures will be monitored to ensure patients are happier and healthier as a result.

Enrollment in the Carilion Clinic Medicare Advantage Plan for 2010 is expected to begin on November 15, 2009.

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Virginia Tech Carilion School of Medicine Appoints Founding Chair of Family Medicine

"Any sustainable health care reform will include strong primary care as a foundation..." Mark Greenawald, M.D.


ROANOKE, Va. (July 15, 2009) – The Virginia Tech Carilion School of Medicine and Research Institute (VTC) is pleased to announce the appointment of Mark Greenawald, M.D., associate professor, as the founding chair of the Department of Family Medicine for the Virginia Tech Carilion School of Medicine. This new academic department within VTC is being developed under Carilion Clinic’s Department of Primary Care and Regional Medicine. As part of his new role, Greenawald will also serve as associate chair for undergraduate medical education within the Department of Primary Care and Regional Medicine.

“Mark is a physician thought leader of the caliber we expect to graduate from VTC. His mentorship through the AAFP Chief Resident Leadership Development Program to residency directors at the front-line in teaching the next generation of physicians is critical to keeping the practice of family medicine vital,” states Cynda Ann Johnson, M.D., M.B.A., president and dean, VTC.

Greenawald is a graduate of Bucknell University and the University of Virginia School of Medicine. After five years as a naval medical officer, he joined Carilion in 1995, and since then has made a substantial impact on the family medicine community locally, regionally and nationally. Locally, he is the education director for the Carilion Clinic Family Medicine Residency and is current president of the Blue Ridge Academy of Family Physicians. This year he was named the family medicine residency inpatient attending of the year.

Regionally, Greenawald is on the board of directors for the Virginia Academy of Family Physicians and has been a pioneer in the development of a group self-assessment process, which has helped hundreds of family physicians with the new maintenance of certification process. He is a regular speaker at state academy meetings, particularly in the area of men’s health care. Greenawald has been very active in the Patient-Centered Medical Home (PCMH) initiative for primary care and serves on the executive committee for the tri-state PCMH residency collaborative. He has also held creative and leadership roles in the TO GOAL and IMPACT quality improvement programs sponsored by the Medical Society of Virginia Foundation for primary care practices.

Nationally, Greenawald is on the faculty for the American Academy of Family Physicians (AAFP) Chief Resident Leadership Development Program where he has been involved in the leadership development of over 2,000 emerging leaders in family medicine and is the author of two monthly e-newsletters, Leaders Digest and Coaches Corner. He has also been part of a small group of faculty who have developed and implemented leadership development workshops for the Society of Teachers of Family Medicine. Through this leadership development work, Greenawald has become known for his innovation in teaching the skills of feedback, negotiation, conflict management and leadership coaching. Greenawald is also a regular presenter at the AAFP national meeting on the topic of rejuvenation in medical practice.

"Any sustainable health care reform will include strong primary care as a foundation, and family medicine will be an important building block of this foundation. We anticipate that the thought leaders who graduate from VTC will help lead the way to an even better American health care system,” states Greenawald.

About Virginia Tech Carilion School of Medicine and Research Institute
Virginia Tech Carilion School of Medicine and Research Institute is a public-private partnership that leverages Virginia Tech’s world-class strength in basic sciences, bioinformatics and engineering with Carilion Clinic’s highly experienced medical staff and rich history in medical education. Virginia Tech Carilion will improve human health and quality of life by providing leadership in medical education and biomedical and clinical research. More information at vtc.vt.edu

Carilion's Roanoke Hospitals and Rehab Center Awarded Electroencephalograph Laboratory (EEG) Accreditation

Accreditation granted to less than 50 hospitals nationwide

ROANOKE, Va. – The Laboratory Accreditation Board of the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET) has recently granted the Electroencephalographic (EEG) laboratory at Carilion Roanoke Memorial and Community Hospitals and Rehabilitation Center a five year accreditation. Having received this approval, Carilion Clinic’s Roanoke campus joins an elite group of only four hospitals in the state of Virginia to receive this accreditation.

ABRET’s lab accreditation process evaluates technical standards, the quality of the laboratory’s performance and management. Accredited labs demonstrate the ability to produce high quality EEG recordings that conform to current American Clinical Neurophysiology Society (ACNS) guidelines.

“We are extremely proud to be accredited as this is not a common accomplishment. Less than 50 hospitals in the U.S. have approved EEG laboratories and it is an honor to be named among those institutions,” says Dr. Tom Wilson, medical director at Carilion Clinic. “Our motivated staff has worked very hard to achieve this prominent certificate, and it is our hope that patients and families will feel even more confident with our level of service, training and care.”

Carilion Clinic’s Roanoke campus has met strict standards and is to be recognized as a place where patients and physicians can have confidence they are receiving quality diagnostics. For more information, please visit http://abret.org/.

Mill Demolition Enters New Phase as Large Silos Come Down

Over the weekend demolition began on the large silos on the former Roanoke City Mill property, across the street from Carilion's Riverside Center and the future Virginia Tech Carilion School of Medicine.
Jefferson Street was closed over the weekend as workers built a temporary protective screen in the middle of the road to protect the buildings from possible flying debris.

The panorama of the mill site below was taken today (7/13).
Hat-tip to the folks at S.B. Cox for their professional, well-organized and remarkably fast work!

(Reminds me of a cell phone commercial)

Carilion Clinic Named One of Nation's "Most Wired" Hospital Systems

Third Information Technology Achievement Recognition in Three Months


ROANOKE, Va. (July 7, 2009) – Carilion Clinic has been selected as a 2009 “100 Most Wired” hospital system according to the Most Wired Survey and Benchmarking Study. This is the third time in three months Carilion Clinic has received national recognition for IT achievement.

"I think recognition as 100 Most Wired is a testament both to Carilion Clinic's commitment to technology as a key tool for patient care, and to the skill of our Technology Services Group,” says Daniel Barchi, chief information officer at Carilion Clinic. “Our talented Technology Services Group has been able to deliver an integrated electronic medical record (EMR) and other technology to seven hospitals and 110 physician practices that truly is as wired as a patient could expect anywhere."

Hospitals are named to the list based on a detailed scoring process. The survey asks hospitals to report on how they use information technology in regard to safety and quality, customer service, business processes, workforce, and public health and safety.

As more health care organizations implement IT projects, the bar is continually raised for achieving the “100 Most Wired” list. Hospitals & Health Networks, the journal of the American Hospital Association, has published this list annually since 1998. Previously, Carilion Clinic has been named on the “100 Most Wired” list six times. Carilion’s strong commitment to investing in technology that improves care, quality and efficiency keeps the organization at the forefront of health care IT. In 2008, Carilion began rolling out a fully integrated electronic medical record (EMR), and is currently on the leading edge of hospital systems moving toward paperless patient records.

Earlier this year, Carilion Clinic was included in CIO magazine’s “CIO 100” list, recognized among the top organizations in the country using IT to enable growth. Health Information Management Systems Society (HIMSS) Analytics recognized Carilion as one of only 42 hospitals nation-wide to achieve “Stage 6” implementation of its electronic medical record.

For more information about Hospitals & Health Networks “100 Most Wired”, please visit www.hhnmostwired.com.

President Obama Advocates Clinic Model as Key Part of Health Reform

Carilion Clinic began conversion to clinic model of care in 2006

In a meeting with health reporters and a Town Hall Q&A session in suburban Washington, President Obama praised the clinic model of care for coordination, quality and cost efficiency, stating "that coordinated care drives down costs tremendously, that's the kind of common sense approach we're going to have to take".

The President is calling for health care providers to coordinate care in a way that the Roanoke Times says is "similar to what Carilion Clinic is attempting".

Click below for an excerpt of the President' s town hall meeting, in which he talks about coordinated care, and the need to provide incentives to reduce unnecessary care.

FDA Considers Changing Rules for Acetaminophen (Tylenol, Excedrin, Vocodin, Percocet) to Prevent Accidental Overdose

Carilion Clinic's Pharmacy has already made changes to protect patients.

400 people die every year and thousands are hospitalized according to the Washington Post. People are often unaware of the amount of acetaminophen they're taking when they combine medications.

Click below to watch a WSLS report on the issue, including an interview with Carilion Roanoke Memorial Hospital Pharmacy Director Karen Lowdon.