This document describes a shared savings model between Marillac Clinic and St. Mary's Hospital in Grand Junction, Colorado. It outlines their similar missions and independent governance structures. It also details how Marillac Clinic serves as a medical home for uninsured residents, providing comprehensive primary care services. St. Mary's Hospital financially supports Marillac and they work to coordinate care for uninsured patients through clinical, operational, and financial alignment. This collaboration has led to reductions in emergency room and inpatient utilization and costs for their shared patient population.

1. A SHARED SAVINGS MODEL: Marillac Clinic and St. Mary’s Hospital March 2, 2010 Steve Hurd - [email_address] David West - [email_address]

6. LOCATION, LOCATION, LOCATION Marillac Clinic St. Mary’s ER

8. Marillac Revenue Sources

11. The Medical Home Motto: “ The right care, at the right place, at the right time.”

13. Guiding Principle Meeting several patient needs in one visit results in greater efficiency for both patients and providers .

15. Inter-agency Referral Agreements for the Uninsured Marillac Clinic Human Service Agencies Lab and Radiology Hospital Based Care Specialty Care

22. Aligning Incentives Produces Savings Marillac Clinic Human Service Agencies Lab and Radiology Hospital Based Care Specialty Care Our Shared Patients

24. Clinical What care is called for? Is it high quality? Operational What will it take to accomplish care? Is it well executed? Financial How will care best use resources? Is it a good value? C.J. Peek (2008) . Planning Care in the Clinical, Operational and Financial Worlds. Chapter in Collaborative Medicine Case Studies: Evidence in Practice . R. Kessler & D. Stafford (eds.) Springer

28. OUTCOMES

29. Utilization of ER and Inpatient Services by Marillac’s Integrated Care Patients 2000 - 2004

30. Financial Outcomes Inpatient Charges for Uninsured Patients Marillac Average 28% Lower Marillac Average 11% Lower $30,596/stay $24,493/stay N - 1029 N - 940 Non-Marillac $27,596/stay $19,078/stay N - 220 N - 209 Marillac 2009 2008