Post on 09-Jan-2017
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright
Health Catalyst WebinarMarch 23, 2016
Return On Engagement: The Fundamental Metric of Population Health Management
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright
Introductions• Dale Sanders, Executive Vice
President, Product Development
• Russ Staheli, Vice President, Product Line Manager, Population Health
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Our observations on Population Health
Details of Care & Patient Relationship Management strategy and application
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How we approach everything
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Founded 2008Employees 450+HQ Salt Lake City, UT
Patients Hospitals
65M+ 200+Clinics
2000+
Integrated Delivery Systems
Accountable Care Organizations
Community Hospitals
Children’s Hospitals
Academic Medical Centers
Health Catalyst Clients
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Population Health Management is to chronic disease what Public Health Management has been to infectious disease
”…the science and art of preventing disease, prolonging life and promoting health through organized efforts and informed choices of society, organizations, public and private, communities and individuals."
”…the health outcomes of a group of individuals, including the distribution of such outcomes within the group."
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Someday, we’ll drop the adjectiveIt won’t be a new “thing”… it will just be
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Return On Engagement
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Robert Wood Johnson & University of WisconsinPublic Health Institute
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Our current state of existence in US
healthcare
Norman, G (2003) New Strategies in Disease and Utilization Management. Society of Actuaries: San Francisco Spring. Meeting, June 24-22, 2002. Proceedings in: Record 28(2), 2003.
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Challenges to the Change
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Two Basic Types of Professional Services Contracts
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Any wonder why physicians are burned out?
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What the leaders are doing
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Courageous, visionary CEOIn 2010, she took the negotiations and data to the payers
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Cost of Care @ Point of Care
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Multiple payer contracts, one comp modelComplex allocation models have been a failure
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Her proposal for fixed-fee contracts
Inpatient procedures• Knee replacement• Hip replacement• Hip and knee replacement
revisions• Hip and knee arthroscopy
Outpatient procedures• Cataract removal• Perinatal care• Hysterectomy• Maternity
Chronic conditions• Asthma• Diabetes• End stage renal
Acute conditions• Upper respiratory
infection
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For better and worse, software has overtaken the impact of heroic leadership as the greatest agent of change in human behavior.
We have to build software that deliberately borrows lessons from the software that has changed human behavior.
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Care ManagementGetting patients involved in the numerator and denominator of ROE
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Agenda• Definition & Key Driver
• Care Management Strategy
• Product Demos
• Open Discussion
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Population Health
Care Mgmt.
Disease Mgmt.
Sometimes referred to as Care Coordination
Broader than traditional Case or Disease Management.
More narrow than full Population HealthSource: Frost & Sullivan 2015
• Under “Fee-For-Service” only the health plan was incented to optimize care across settings
• “At-Risk” value based reimbursement aligns the incentive with care providers
Care Managementour definition of care management
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1%
5%
Patients that account for
20%of your costs
Patients that account for
50%of your costs
-2012 study by NIHCM Foundation
Care Managementkey driver of care management
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Poll Questions• Which of the following depicts your perception of the “financial
value” care management will provide over the next 3-5 years?• 300 respondents
a) It will have a high financial ROI – 54%b) It will have a neutral financial ROI – 31%c) It will have a negative financial ROI, needs reformation – 15%
• Which of the following depicts your perception of the “clinical quality” care management will provide over the next 3-5 years?
• 181 respondentsa) It will have a major positive impact – 59%b) It will have a slightly positive impact – 36%c) It will have a neutral/negative impact, needs reformation – 5%
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright
Agenda• Definition & Key Driver
• Care Management Strategy
• Product Demos
• Open Discussion
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Care Management Strategy• Review Existing Frameworks and Market Need
• Define Health Catalyst’s Framework
• Demonstrate Product Flow
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Care Management Strategyreview existing frameworks and market need
1st Half 2015 - Leveraged;- Internal;
- Visioning from internal Catalyst leadership- Partners Health System iCMP initiative
- External;- 10+ 3rd party companies in this space assessed in build vs buy- 10+ requests for proposals (RFPs)- 3+ current client requests- Competitive analysis report- Market capitalization report- SI Patient Engagement Model
- Many other discussions and meetings…
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Care Management Strategyreview existing frameworks and market need
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Data Integration (EDW)
Patient Stratification &
Intake
Care Coordination
Patient Engagement
Performance Measurement
Care Management Strategydefine health catalyst’s framework
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Care Management Strategydemonstrate product flow
AB
A
BA
AB
A
BA
A
A
A
AA
AB
A Care Program A
Care Program B
Claims Clinical
EDW
Population Under at Risk
Contract
Configurable Catalyst Patient Complexity Score
& Stratification
Configurable cut point and initial;
program, PCP, and team attribution
Pre-enrollment patient list refinement (add/remove)
Final attribution to Care Program
Fina
l attr
ibut
ion
to C
are
Team
and
PC
P
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance Measurement
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright 34
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance MeasurementCare Management Strategy
demonstrate product flow
Agreement on:- Patient Centered Goals- Tasks to drive to Goals
Initial tasks are prioritized, scheduled, and dispersed
On an ongoing basis;- Goals are modified- Tasks are modified- Tasks are re-assigned- Alerts are created and sent based on
task- Extended care team members are
added (or removed) as needed- Secure SMS communication between
all playersTypes of tasks for patients include;- Education materials to be reviewed- PROM surveys to be completed- Daily activity and measurements to be
enteredTypes of tasks for care team include;- Active medications review- Follow up appointment creation- Identify local resource/support for
patient
Patient “discharged” from care program
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Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance MeasurementCare Management Strategy
demonstrate product flow
How are our patients doing?
How are we performing to our plan?
Is it working? Are we getting “Return on Engagement”
What do we do more of… what do we change?
Outcome
Process
Balance
Insights
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Poll Question
• Those of you who are a part of a health system, which of the following best describes your current state in care management?
• 141 respondentsa) We do not have a program and don’t plan on adding one – 9%b) We do not have a program and are evaluating starting – 25%c) We have a program, that isn’t working well – 19%d) We have a program that is successful but can get better – 47%
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright
Agenda• Care Management Strategy
• Product Demos
• Open Discussion
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- Patient Stratification
- Patient Intake
- Care Coordination
- Care Companion
- Care Team Insights
Care Management Products
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Care Management ProductsPatient Stratification
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance Measurement
AB
A
BA
AB
A
BA
A
A
A
AA
AB
A Care Program A
Care Program B
Claims Clinical
EDW
Population Under at Risk
Contract
Configurable Catalyst Patient Complexity Score
& Stratification
Pre-enrollment patient list refinement (add/remove)
Final attribution to Care Program
Fina
l attr
ibut
ion
to C
are
Team
and
PC
P
Configurable cut point and initial;
program, PCP, and team attribution
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright 40
Care Management ProductsPatient Stratification
Demo
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance Measurement
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright 41
Care Program A
Care Program B
Claims Clinical
EDW
Population Under at Risk
Contract
Configurable Catalyst Patient Complexity Score
& Stratification
Fina
l attr
ibut
ion
to C
are
Team
and
PC
P
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance Measurement
Configurable cut point and initial;
program, PCP, and team attribution
AB
A
BA
AB
A
BA
A
A
A
AA
AB
A
Final attribution to Care Program
Pre-enrollment patient list refinement (add/remove)
Care Management ProductsPatient Intake
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance MeasurementCare Management Products
Patient Intake
Demo
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright 43
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance MeasurementCare Management Strategy
Care Coordination
Agreement on:- Patient Centered Goals- Tasks to drive to Goals
Initial tasks are prioritized, scheduled, and dispersed
On an ongoing basis;- Goals are modified- Tasks are modified- Tasks are re-assigned- Alerts are created and sent based on
task- Extended care team members are
added (or removed) as needed- Secure SMS communication between
all playersTypes of tasks for patients include;- Education materials to be reviewed- PROM surveys to be completed- Daily activity and measurements to be
enteredTypes of tasks for care team include;- Active medications review- Follow up appointment creation- Identify local resource/support for
patient
Patient “discharged” from care program
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright 44
Care Management ProductsCare Coordination
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance Measurement
Demo
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright 45
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance MeasurementCare Management Strategy
Care Companion
Agreement on:- Patient Centered Goals- Tasks to drive to Goals
Initial tasks are prioritized, scheduled, and dispersed
On an ongoing basis;- Goals are modified- Tasks are modified- Tasks are re-assigned- Alerts are created and sent based on
task- Extended care team members are
added (or removed) as needed- Secure SMS communication between
all playersTypes of tasks for patients include;- Education materials to be reviewed- PROM surveys to be completed- Daily activity and measurements to be
enteredTypes of tasks for care team include;- Active medications review- Follow up appointment creation- Identify local resource/support for
patient
Patient “discharged” from care program
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright 46
Care Management ProductsCare Companion
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance Measurement
Demo
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright 47
Care Management ProductsCare Team Insights
Data Integration
Patient Stratification
& Intake
Care Coordination
Patient Engagement
Performance Measurement
Demo
© 2014 Health Catalystwww.healthcatalyst.comCreative Commons Copyright
Agenda• Care Management Strategy
• Product Demos
• Open Discussion