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Performance Personified

November 28, 2010
by Mark Hagland
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Why Does Hill Physicians Medical Group Keep Winning Quality Awards?



Top executives at Hill Physicians Medical Group, one of the largest independent practice associations in California, discuss the organization's clinical, quality, and business successes and their vision for the future.

When California's Integrated Healthcare Association (IHA), a statewide provider association, announced in September that it was giving the San Ramon-based Hill Physician's Medical Group, one of the largest independent practice associations (IPAs) in that state, four different quality awards, it came as no surprise to those who have followed Hill Physicians' history over the years.

Indeed, the 3,500-physician organization, founded in 1984, and whose service area encompasses broad swaths of Northern California, has for years been a pioneer in care quality, pay for performance participation, clinician efficiency, patient service, and IT adoption for many years, under the leadership of CEO Steve McDermott. McDermott has been helping to lead his colleagues forward towards a vision of integrated, accountable, transparent healthcare for more than two decades now, and is one of the best-known physician group executives in California.

In September, Hill Physicians' Bay Region received dual awards from the Oakland-based IHA as a “top performer” and as the “most improved” medical group in the region. Hill Physicians' Solano region achieved “top performer” status, while its Sacramento region was recognized as the “most improved” from the Sacramento area. What's more, Hill Physicians was the only IPA in California to receive IHA recognition in multiple categories and regions this year. The organization and its divisions were among more than 220 medical groups, IPAs, and integrated systems that IHA evaluated this year with regard to their clinical quality, patient experience, IT systems, coordinated care for diabetes, and overall efficiency. Data for the evaluation was aggregated from health plan claims records, patient satisfaction surveys, and physician group records to ultimately produce a single overall score. The organizations that scored in the top 20 percent statewide received “top performer” designations, while seven medical groups received recognition as “most improved” based on year-to-year score comparisons in their regions. The IHA recognition comes a few months after Hill Physicians received “elite” status designation from the California Association of Physician Groups for the third year in a row.

So what keeps Hill Physicians winning awards? And, more importantly, what are the underlying factors involved in that organization's clinical, quality, and business success in the brutally competitive Northern California healthcare market? HCI Editor-in-Chief spoke recently with three leaders at Hill Physicians-McDermott; Vice President and CIO Craig Lanway; and Vice President and Chief Medical Services Officer Rosaleen Derington, to find out the secret of their organization's success, and the links between the intelligent, strategic leveraging of IT and patient care quality, and business success. Below are excerpts from those interviews.

Healthcare Informatics: What goes into highest-level performance, in the context?

Steve McDermott: I helped start the IHA, and when I was chair of IHA, I helped spearhead this particular pay for performance program. And I still chair the executive committee of the pay for performance steering committee, which oversees the program. And, in creating the program, we designed it so that you cannot ‘work to the test’; the metrics are designed to be broadly based so that you have to have a high-functioning organizational structure that performs well across the board. That means you have to have your physicians engaged, to have the data measurement sets in place within your organization, and the information systems, you have to have programs in place that respond to the things you're measuring. I was particularly thrilled that we got ‘most improved.’ It's not like we were laggards, right? And the fact that we are performing at this high level is really great, because it means that the programs we're putting in place at this stage of maturity-we're still very energized as an organization. It's really amazing that we still are at this thing in a way that it's not gotten old.

Craig Lanway
Craig Lanway

HCI: And IT is definitely an important element in performance?

McDermott: Absolutely. You cannot win those awards if you're not using IT.