Global

Dr. Cynthia Ambres, KPMG in the US 

Through strategic leadership and effective change management, Cynthia has brought lasting improvements to both major healthcare providers and health plans.

Transcript:

Hi, I’m Dr. Cynthia Ambres. I’m a physician in the Global Center of Excellence with a focus on business transformation. There’s been a great deal to both share and to learn since joining KPMG, and I think that one of the things that comes to mind a lot for me is how do we now take the conversation that is really happening not only nationally in the U.S. but globally around physician transformation and clinical transformation, and make that really happen.


Obviously when we’re looking at cost, I start to think, what if we looked at every specialty? What if we looked within orthopedics and pediatrics and neuro-surgery and said, “If we take one of those very major pieces that is a large cost to us; if we looked at the real value of it relative to its clinical evidence and said, ‘If we take that cost out of the system, what could be the savings and how could that savings be reallocated?’” We all know, of course, that there is a shrinking pie in healthcare. The cost structure needs to be brought down, and we want to do that while not affecting adversely, quality.


If we had what one CFO has told me, which is the intestinal fortitude to actually attack the situation and really look at the specifics of what’s happening within our clinical environments, a lot of the low hanging fruit—integration, where people take out finance and people take out – you know, bring linen services together, and IT together, when they bring organizations together—that is helpful. But at the end of the day, real cost in the system are at the clinical level. So we need to address that in a big way.


I think one of the things that’s become very evident to me is the importance of becoming rather specific as to how we can actually reduce costs from the healthcare system. We look at something very specific, like cardiac catheterization, and in that system, we have looked in The Courage Trials, which are international trials, to find that potentially 30 percent of the cardiac catheterizations that are being done are in excess of what need to be done if we followed really strict clinically evidence-based criteria. If you look at that in the U.S. alone, it’s been estimated that there could be a savings of eight billion dollars. Imagine that reallocated to the appropriate things, where we really need cost containment and appropriate savings in healthcare. This, of course, is not just a U.S. issue. This is an international issue. So I always imagine what would that look like if we began to monetize this type of change—in other words, following evidence-based medicine across criteria, across all specialties, even if we started with just one that was maybe one of the most used types of services, and looked at the cost of that; and if we followed evidence-based medicine, what that would look like in terms of savings.—And really push for that from an international perspective. What a difference we might be able to make.

Striving for higher quality while lowering costs


Cynthia has extensive experience guiding large healthcare organizations through significant change, improving productivity and patient satisfaction while boosting the bottom line. Known as a strategic thinker, she has recently focused on payment reform and accountable care.


As President and founder of Ambres Healthcare Consulting, Cynthia facilitated merger discussions between two multibillion-dollar health plans and the restructuring of large provider systems. As Senior Vice President and Chief Medical Officer of a large Blue Cross/Blue Shield (BCBS) plan in New York, she led a cardiac surgical care evaluation program that challenged the physicians to think differently about the care process, driving major improvements in the quality of these services for more than two million people.


Cynthia’s turnaround skills were in evidence when, as Executive Vice President and Chief Medical Officer for Kaleida Health, she helped eliminate operating losses and achieve profitability in just 24 months, recognizing medical costs and utilization savings of more than US$60 million annually while improving care quality and coordination. She also introduced one of the first virtual ICUs in the country allowing senior clinicians to oversee care provided across the system.


Under Cynthia’s leadership, Lifetime Health Medical Group made the leap to an incentive-based compensation model. Coordination of care and patient satisfaction greatly increased with the introduction of innovations such as group visits, in-clinic pharmacist education, an EHR, acupuncture and other complementary medicine modalities.


A regular speaker and panelist, she recently presented at the Harvard Business School Health Industry Alumni Annual Meeting. Cynthia has a MD from Mount Sinai School of Medicine, an MS from NYU Wagner School of Public Health and is a fellow of the New York Academy of Medicine. She served as Chairman of the department of emergency services at Beth Israel Medical Center in New York City.

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