Mary Brainerd, President & CEO of HealthPartners @ Minnesota High Tech Association (MHTA) CEO...
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Transcript of Mary Brainerd, President & CEO of HealthPartners @ Minnesota High Tech Association (MHTA) CEO...
Minnesota High Tech AssociationMinnesota High Tech Association
June 23, 2010June 23, 2010June 23, 2010June 23, 2010
HealthPartners MissionHealthPartners Mission
To improve the health of our members, patients and
2
our members, patients and the community.
HealthPartnersHealthPartners
• Consumer-governed, not-for-profit
• Health plans, medical group, hospitals
• Health and dental plans– 1.25 million members
The Health of a defined population
To simultaneously optimize…
HealthPartners ApproachThe Triple Aim
44
The Experience of the individual Per capita Cost for the population
How are we organized? How are we organized? Members / Patients / Community
Medical
Dental
Health Plan
Medical & Dental ClinicsPharmacies
Hospitals- Regions- Westfields
Care Delivery
Research Foundation
FoundationsContracted Networks
- Medical- Specialty- Hospital- Pharmacy- DentalDental
Pharmacy
Health Promotion
- Westfields- Hudson
Home Care & HospiceRiverway ClinicsNorth Suburban ClinicsN. St. Paul Transitional CareCentral MinnesotaPNBC
Institute for Medical Education
(IME)
Philanthropy
Administrative support such as: Legal, IS&T, Communications, HR & Finance
- Dental
Strategic Partnerships
- ICSI- MNHIE- MNCM- Other WI partnerships
Health Care Reform
• Coverage for 35-40 million more Americans• Insurance practices/requirement for coverage• Health care changes• $1 trillion price• $1 trillion price• Tax increases (50%)• Medicare cuts (50%)
Real Health Care Reform
• Support healthy life choices• Coordinated care/focus on that triple aim!• Payment reform to support value• Use health information technology to improve
resultsresults• Measure and publicly report quality and cost• Partner with consumers in making choices –
health, care, cost, quality• Adopt innovate approaches that add value • Reduce administrative burden
Support Healthy Lifestyles
• Healthy living = longer life and better quality of life.
Also, lower health care costs.
• Four lifestyle behaviors could impact 25% of health care costs:– Healthy diet (5 servings fruits/vegetables/day)– Regular exercise– Not smoking– Moderate alcohol use/avoiding risky use
Obesity Trends* Among U.S. AdultsBRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1986
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1989
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
No Data 10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2002
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System
Obesity Trends* Among U.S. AdultsBRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System
Adherence to Healthy Lifestyle Behaviors and New Disease
High Blood
Pressure Cholesterol Cancer Back Pain
Heart
Disease Diabetes
Difference in 2-year incidence of new disease between peoplewho adhere to 0 or 1 and 3 or 4 healthy behaviors (%)
33
-15 -17
-24
-43 -45
-66
Source:HealthPartners Health Assessment database, 2007
Change health care itselfCoordinated care/triple aim
focusfocus
• Proactive• Prevention focused• Chronic illness care coordinated• Templates, tools and teams• Templates, tools and teams
35
38%
0.946
0.966
0.986
1.006
Tot
al C
ost
Inde
x
25%
33%98%
97%
90%
95%
100%
TRIPLE AIM: HealthTRIPLE AIM: Health--ExperienceExperience--AffordabilityAffordability
HealthPartners ClinicsHealthPartners Clinics
0.91050.906
0.926
0.946
4Q04 1Q05 2Q05 3Q05 4Q05 1Q06 2Q06 3Q06 4Q06 1Q07 2Q07 3Q07 4Q07 1Q08 2Q08 3Q08 4Q08 1Q09 2Q09 3Q09 4Q099%
17%
85%
90%
% patients with Optimal Diabetes Control *
* controlled blood sugar (per ICSI guideline A1C changed from < 7 to < 8 in 1st quarter 2009), BP & cholesterol, AND
daily aspirin use, AND non-tobacco user
% patients “Would Recommend” HealthPartners
Clinics
Total Cost Index
(compared to statewide average)< 1 is better than network average
1.00
0.9400
0.9500
0.9600
0.9700
0.9800
0.9900
1.0000
1.0100
Total Cost Index
AffordabilityAffordability: (Statewide): (Statewide)HealthPartners ClinicsHealthPartners Clinics
0.91
0.9000
0.9100
0.9200
0.9300
0.9400
4Q04
1Q05
2Q05
3Q05
4Q05
1Q06
2Q06
3Q06
4Q06
1Q07
2Q07
3Q07
4Q07
1Q08
2Q08
3Q08
4Q08
1Q09
2Q09
Total Cost Index
Total Cost Index (compared to statewide average)< 1 is better than network average
Total Cost of Care
• A method to measure the overall performance of a medical group relative to other groups.
• Includes all costs associated with treating a patient’s condition:–Professional, facility inpatient and
outpatient, pharmacy, lab, radiology, any other ancillary services
38%
20%
25%
30%
35%
40%
Optimal Care Percent
Health: (Optimal Diabetes ControlHealth: (Optimal Diabetes Control-- Total)Total)HealthPartners ClinicsHealthPartners Clinics
9%5%
10%
15%
4Q04
1Q05
2Q05
3Q05
4Q05
1Q06
2Q06
3Q06
4Q06
1Q07
2Q07
3Q07
4Q07
1Q08
2Q08
3Q08
4Q08
1Q09
2Q09
3Q09
4Q09
Optimal Care Percent
% Patients with Optimal Diabetes Control * *controlled blood sugar, BP & cholesterol (per ICSI guidelines A1C changed from < 7 to < 8 in 1st quarter 2009)daily aspirin use AND non-tobacco user
Saves 364 Hearts, 68 Legs & 625 Pairs of Eyes Each Year
97%
98%
80%
90%
100%
Percent
Experience: (Would You Recommend)Experience: (Would You Recommend)HealthPartners ClinicsHealthPartners Clinics
50%
60%
70%
2Q06
3Q06
4Q06
1Q07
2Q07
3Q07
4Q07
1Q08
2Q08
3Q08
4Q08
1Q09
2Q09
3Q09
4Q09
Percent
Measure: % of HPMG patients surveyed who answered “Yes, definitely” and “Yes, probably” to "Would you recommend this office to your family and friends?"
38%
0.946
0.966
0.986
1.006
Tot
al C
ost
Inde
x
25%
33%98%97%
90%
95%
100%
TRIPLE AIM: HealthTRIPLE AIM: Health--ExperienceExperience--AffordabilityAffordability
HealthPartners ClinicsHealthPartners Clinics
0.91050.906
0.926
0.946
4Q04 1Q05 2Q05 3Q05 4Q05 1Q06 2Q06 3Q06 4Q06 1Q07 2Q07 3Q07 4Q07 1Q08 2Q08 3Q08 4Q08 1Q09 2Q09 3Q09 4Q099%
17%
85%
90%
% patients with Optimal Diabetes Control *
* controlled blood sugar (per ICSI guideline A1C changed from < 7 to < 8 in 1st quarter 2009), BP & cholesterol, AND
daily aspirin use, AND non-tobacco user
% patients “Would Recommend” HealthPartners
Clinics
Total Cost Index
(compared to statewide average)< 1 is better than network average
Payment Reform to Support Value
• Take the emphasis off fee-for-service• Pay for value (triple aim)• Move to Total Cost of Care approaches• Re-evaluate fee-for-service weights and
43
• Re-evaluate fee-for-service weights and payment levels
Leveraging Technology
• Use the electronic medical record to improve care
� Disparities Initiative� H1N1 Outreach
44
� H1N1 Outreach• Online patient services: 221,000 patients
(10.5 millions test results)• m.HealthPartners.com (already 10,000 per
month)
Partner with Consumers
• Decision support – better information about care choices
• Measure and publicly report quality and costcost– Minnesota Community Measurement– www.HealthPartners.com: Cost
Comparison Tools• Support healthy choices
Reduce Administrative Costs
• Reduce administrative burdens– Paperless Plan – No paper Explanation of
Benefits necessary– Electronic Enrollment– Electronic Enrollment– Online billing, payment and record
maintenance– Electronic provider payment
�Electronic claims submission – 90%�Auto adjudication – 85%
HealthPartners Advantage
• Consumer-governed, not-for-profit status
• Low administrative costs 5.4%++
• Responsible margin 2.3%___________
Better value for customers
Real Health Care Reform
We’ll advocate for it.We’ll be an example of it