Making Better Healthcare Happen in the San Francisco Bay Area

Making Better Healthcare Happen
in the San Francisco Bay Area
Brown & Toland’s strength lies in
the dynamic points of connection
between our network physicians,
Who We Are
our patients and our wider Bay Area
Our mission is to coordinate and
Brown & Toland Physicians is a community of
approximately 1,500 doctors and hundreds of
healthcare professionals who share a single vision:
to support our doctors in delivering the best
possible care to their patients.
enhance these points of connection
Our Roots
across our network, thereby helping
In 1992, Brown & Toland Physicians was founded on
the belief that a coordinated network of independent
physician practices could make a positive impact
on the health of the Bay Area. In 2011, Alta Bates
Medical Group became part of Brown & Toland
Physicians, making us one of the premier associations
of independent physician practices in California.
This partnership allows us to provide exceptional
healthcare to hundreds of thousands of people across
San Francisco, the East Bay, Marin and the Peninsula.
community.
our physicians to collaborate, share
clinical information, run successful
practices and deliver exceptional
patient care.
Our name—and our work—are inspired by the legacy
of two nineteenth century San Francisco healthcare
pioneers: Dr. Charlotte Amanda Blake Brown, who
founded Children’s Hospital in San Francisco, which
later became California Pacific Medical Center; and
Dr. Hugh Huger Toland, who established the Toland
Medical College in 1864, which was transferred as a
gift to the University of California in 1873.
Guided by Dr. Brown’s and Dr. Toland’s pursuit of
innovation and their commitment to the health of
our community, our story includes many of its own
history-making achievements:
• We were one of the first medical groups in the
nation to deploy integrated electronic health
records (EHRs) in a private practice setting.
• We are a Medicare Pioneer Accountable Care
Organization (ACO) and leader in the development
of ACOs across the Bay Area and nationally.
• Our patient-centered medical home—My Health
Medical Group—was the first practice in San
Francisco to earn the highest recognition
(Level 3) from the National Committee for Quality
Assurance. The California Association of Family
Physicians named My Health Medical Group the
2013 Patient-Centered Medical Home practice
of the year.
Our Timeline
Brown & Toland launches accountable care
California Pacific
PPO program launches.
Electronic health record
Close to 500 Brown & Toland physicians and
Medical Group is
More than 500
product is installed in
staff are using the clinical results reporting
Blue Shield and California Pacific Medical Center for City
As a part of Pioneer ACO program, Brown &
physicians sign on.
first physician office.
component of the electronic health record.
and County of San Francisco employees and retirees.
Toland helps Medicare save $4.5 million.
founded.
1992
2001
1997
2009
2012
2011
2014
Brown & Toland combines with Alta Bates Medical Group. The Group’s 1,500
My Health Medical Group receives level 3 NCQA
Medical Center and the University
doctors care for approximately 135,000 HMO patients and 175,000 PPO patients.
recognition as a Patient-Centered Medical Home.
Brown & Toland is selected to be one of the 32
Brown & Toland Health Services is launched, taking on
Pioneer Medicare accountable care organizations.
facility-risk via a limited Knox-Keene license.
form Brown & Toland Medical Group.
2015
2013
Physicians from California Pacific
of California San Francisco combine to
1
2005
projects for Cigna and Aetna PPO patients, and with
Brown & Toland enters into partnerships with Blue Shield and
Anthem Blue Cross to greatly expand its PPO and ACO line of business.
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Our Patients
At Brown & Toland Physicians we focus on the
whole patient. Hundreds of thousands of residents
throughout the Bay Area trust us with their care.
Here are some of the reasons why:
• We are available in leading insurance networks.
We work with the nation’s leading health insurance
companies, so you can get access to the doctors
in our networks and all the services we offer when
you enroll with one of our health plan partners.
Brown & Toland and Alta Bates Medical Group
physicians are available through many types of
HMO, PPO, ACO, Medicare Advantage and
Medi-Cal plans.
• We connect the Bay Area to leading doctors.
When you have a Brown & Toland or Alta Bates
Medical Group doctor, you have a doctor plus a
whole team of healthcare experts here to help.
In fact, we have more than 500 primary care
physicians in our networks and approximately
1,000 physician specialists in San Francisco and
the East Bay—all collaborating to provide you
with the best care possible.
• We help patients get the right care at the right
time. Our Care Management team is a group of
experts working behind the scenes with your
doctors to make sure you get the tests, services
and care you need. Coordinating care across our
entire network for you—always in the setting that
is best for your health—is the way we make care
management work.
• We offer prevention programs to help you be your
healthiest. Our resources include programs that
help patients stay well, such as prenatal education,
senior fitness and nutrition, as well as others.
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• We support people who are living with a chronic
condition. Our disease management programs
for asthma, diabetes, HIV and patients with heart
conditions focus on education, treatment and
ongoing management—all to provide coordinated
care and make a complex health situation more
manageable.
• We have answers. Our friendly customer service
reps—located right here in the Bay Area—are
resources to answer questions about our doctors
and care services. We are your connection to
finding a Brown & Toland or Alta Bates Medical
Group physician and making the most of your
healthcare.
The company champions six core values: respect
and teamwork; innovation; integrity; optimism;
health; and being physician- and patient-focused.
To live these core values, the company sponsors
several employee committees such as:
Investing in Our Employees
In an environment of innovation, collaboration and
mutual respect, Brown & Toland employees have the
opportunity to learn new skills, build competencies
and grow their careers. As a leader in accountable
care programs and an early adopter of technology in
the healthcare industry, Brown & Toland trains our
employees to use leading-edge technologies to help
our doctors provide their patients with great care.
Brown & Toland is proud to have been recognized
multiple times as a “Best Place to Work”
in the San Francisco Bay Area.
• The Values Committee, which promotes,
celebrates and maintains Brown & Toland’s six
core values through innovative tools, activities
and practices. This committee identifies and
organizes employee volunteer opportunities
that make an impact on the community.
• The Live Well/Work Well Committee, which
cultivates and promotes a health-focused work
environment where employees have tools to
sustain a healthy lifestyle.
• The Employee Recognition Committee, which
hosts programs and supports a recognition
culture by encouraging employees to recognize
one another for their contributions.
Patient and Caregiver Testimonials
“I am a high-risk patient, and my nurse care manager worked with me as a solid partner
to get me on the road to recovery.”
– Larry S., patient
“Brown & Toland really listened—they did what was best for the patient, which was also
cost-effective because it kept him out of the hospital.”
– Christopher V., senior care advocate
“My wife has been seriously ill for the last eight months, and she’s alive because of her
Brown & Toland doctors.”
– Tony N., patient’s spouse
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Accountable Care
In today’s healthcare environment, the key challenge
for most healthcare organizations is how to reduce the
cost of healthcare services for a population of patients
while maintaining or even improving the quality of
care those patients receive. “Accountable care” has
emerged as a way to manage the total cost of care by
compensating healthcare providers based on quality—
rather than quantity—metrics. Under an accountable
care model, a healthcare provider is evaluated
and compensated not on the number of tests and
procedures that are performed, but rather on his or
her ability to help the patient get better.
Brown & Toland has always been a champion of the
accountable care model—even before “accountability”
was a buzzword in the healthcare industry.
Patients with more complex and active medical
problems merit higher levels of care coordination.
Our programs are designed to assist patients who
may have multiple chronic conditions.
Proactive care management leads to improvement
in patient health and allows the team to identify gaps
in care. Our approach includes clinical integration
through real-time connectivity. We apply predictive
analytics, care coordination and a comprehensive set
of care management programs to each population
we manage.
Brown & Toland’s proprietary care management
strategies are central to our success, especially
in caring for Medicare Advantage members. Our
innovative approach includes:
• Using technology to identify patient needs and
provide enhanced care and support
By joining with health plan and hospital partners,
government organizations and employers to
coordinate care and improve quality, Brown & Toland
is helping to deliver more aligned, connected and
cost-effective care. In turn, our doctors are able to
deliver the right care in the right setting and improve
clinical patient outcomes.
• Processes to identify gaps in care and to improve
preventive screenings
How We Manage Care
• Post-discharge calls for better transition of care
and medication reconciliation that improves
adherence and reduces readmissions
Brown & Toland is leading the way forward with a
proprietary set of care management strategies that
can help enhance the patient experience, improve
health outcomes and manage the total cost of care.
Using population health management analytics, we
identify and conduct outreach to specific populations
of patients—for instance, diabetics or patients with
other types of chronic illness—and match these
individuals to different care management programs.
Working with the patient’s physicians, our team
provides high-touch care and support where needed.
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• Access to After Hours Care, the Nurse Advice
Line and home visits as alternatives to the
emergency room
• Identification of patients admitted to hospitals and
daily care management rounds with hospitalists
• Complex care management and chronic disease
management, including outreach, individual care
plans, caregiver support and high-touch care
Good for Our Patients
Good for Our Doctors
Care management at Brown & Toland is unique in that
we serve as a true extension of care, always working in
close collaboration with our physicians, hospitals and
other partners to connect patients to the right care
at the right time. In doing so, we are achieving higher
patient participation in preventive screenings and
reducing hospital stays and readmissions, with the
ultimate goal of improving health outcomes.
The benefits of care management, and our ability
to manage the total cost of care, are good for our
doctors. When we manage the total cost of care, we
are able to keep insurance products affordable to
both employers and patients, which in turn keeps
more patients in the Brown & Toland network.
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My Health Medical Group
Our Innovative Programs
Brown & Toland has always embraced a spirit of innovation when it comes to the new programs we develop and support
to meet the needs of both our patients and network physicians. To that end, Brown & Toland participates in numerous
accountable care projects designed to improve patient care and reduce costs, and created My Health Medical Group—a
patient-centered medical home—to make better healthcare happen in the Bay Area.
BAY AREA MEDICARE AND MEDI-CAL POPULATION
29%
Medicare
and
Medi-Cal
SAN
FRANCISCO COUNTY 2013
71%
Commercial/
ASO/Uninsured
29%
Medicare
and
Medi-Cal
71%
Commercial/
ASO/Uninsured
ALAMEDA
COUNTY 2013
©2013 DR/Decision Resources, LLC. All rights reserved.
Reproduction, distribution, transmission or publication is
prohibited. Reprinted with permission.
Graph 1
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Medicare Advantage
Every day for the next 18 years, roughly 8,000
American baby boomers will turn 65. For Brown &
Toland, this huge demographic shift—along with the
increase in Medicare Advantage (MA) products it
is spurring—represents a tremendous opportunity.
Through several initiatives, we are positioning the
organization and our physicians proactively to reach
this growing population, which is approaching close
to one-third of the markets we serve (see Graph 1).
Brown & Toland’s contracted MA plans provide
significant value to physicians and their patients
who are eligible for Medicare. Many MA plans
lower patients’ out-of-pocket costs and include
additional benefits not covered by Medicare, such
as prescription drug coverage, vision and dental.
Brown & Toland provides additional resources, such
as care management, to help physicians care for
their patients who are covered by these plans.
Brown & Toland also provides care management
resources that include follow up on all in-patient
admissions and complex case management.
In 2013, Brown & Toland launched Brown & Toland
Health Services (BTHS), and successfully enrolled
almost 10,000 MA patients in the program by the
start of 2015. Under its Knox-Keene license, BTHS
assumes the “risk” not just for the care our
physicians deliver to their patients, but for the total
cost of care for that patient population. Our Care
Management team provides the needed outreach
and care management programs for these MA
patients to ensure better health outcomes.
Inspired by our patients to provide the best care
possible, Brown & Toland established My Health
Medical Group (MHMG) in San Francisco in 2012.
Initially bringing together several physicians into a
single shared practice, the doctors changed their
practice styles to become a patient-centered medical
home (PCMH)—which, in recent years, has become a
widely accepted model for organizing and delivering
primary care. The value of the medical home is
particularly noteworthy for its focus on personalized
care, a team-based approach to care, and patients
who need extra care and support. By analyzing data
on all patients in the practice, MHMG focuses on
quality, and on closing any quality gaps whether the
patient is in an HMO, PPO or Medicare plan.
The PCMH model provides the patient better access
to care through an assigned care team of healthcare
professionals who work together to coordinate their
care. By improving access to primary care services,
a personalized care approach and utilization of
population health management tactics, MHMG has
improved care coordination and achieved better
patient outcomes.
A Patient-centric Team Approach
The PCMH model provides the patient an assigned
care team of healthcare professionals who work
together to coordinate their care—including a
physician, a nurse practitioner, social workers,
medical assistants, data analysts and other office
staff. MHMG patients also have access to on-site
laboratory services, same-day appointments,
extended hours and the ability to communicate
securely with their physicians using an online
patient portal. This collaborative approach to
primary care has improved care coordination and
achieved better patient outcomes.
result of fewer visits to the emergency room, and less
overall cost for medical care. In fact, patient costs
have dropped 15% compared to other primary care
physicians treating the same senior population.
Industry Recognition
My Health Medical Group has earned recognition from
the National Committee for Quality Assurance (NCQA)
as a Level 3 patient-centered medical home, and is the
first practice in San Francisco to receive this honor.
It is the highest recognition possible from NCQA, a
nonprofit healthcare accreditation entity that validates
practices as patient-centered medical homes using a
rigorous set of national industry standards.
In addition, MHMG was named a leading PatientCentered Medical Home by the California Association
of Family Physicians.
Furthermore, by providing high-touch care to patients
with complex health situations, we have achieved a
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A Commitment to Community
Giving Back
Community is the heart of who we are and what we
do at Brown & Toland. We are passionate about giving
back and donating our time.
Our community efforts focus on raising awareness
about important health issues and on marshaling
resources to help those in need. In this spirit, we have
worked with both local and national organizations
such as the San Francisco AIDS Foundation,
San Francisco Hep B Free, HandsOn Bay Area
and Meals on Wheels.
Brown & Toland has had a decade-long corporate
sponsorship with the American Heart Association
(AHA) to promote awareness of the causes and signs
of heart disease through the AHA’s Go Red For Women
campaign and annual Heart Walk. We sponsor the
AHA’s Lifestyle Change Award, which is presented to
a person who has dramatically changed the quality of
their life through diet and exercise.
In addition, Brown & Toland also sponsors multiple
community-based AHA events such as the “Golf and
Fitness Training for Stroke Survivors” in Pleasanton,
and the “Power Cooking and Health Education” event
at the Beebe Memorial Church in Oakland, during
which celebrity chefs demonstrate cooking healthy
meals, while Brown & Toland nurses perform blood
pressure testing, BMI screening and CPR training on
how to recognize and respond to signs of a stroke.
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Brown & Toland Physicians
P.O. Box 640469
San Francisco, CA
941614-0469
415.972.6000
800.225.5637
brownandtoland.com
About Brown & Toland Physicians
Founded in 1992, Brown & Toland Physicians is a leading network of independent doctors focused on delivering personalized, high quality, and affordable
healthcare to the San Francisco Bay Area. Brown & Toland’s 1,500 physicians, who care for more than 300,000 HMO and PPO patients, are dedicated to
improving care through a number of patient-centered programs and use electronic tools to coordinate and deliver care.
Version 1.0 Copyright © 2015 Brown & Toland Physicians