Introducing HealthSpan

1
Introducing HealthSpan

• Founded in 1991
• Partner organization to Catholic Health Partners
  (CHP)
• HealthSpan Partners
• HealthSpan Integrated Care
• HealthSpan Physicians
• HealthSpan, Inc.
• 30 interest in Summa Health System

Toledo
Cleveland
Youngstown
Lima
Springfield
Cincinnati
2
The Changing Healthcare Landscape
Presented by Dr. Nick Dreher, Medical Director
3
Payment Reform

• Average US Salary vs. Health Insurance Premium
• From 1999 2009, salaries have increased 38
  while premiums have increased 131
• If other prices grew as quickly as healthcare
  costs since 1945
• Dozen eggs would cost 55
• Gallon of milk would cost 48
• Dozen oranges would cost 134

Institute of Medicine, 2011
4
Affordable Care Act and Healthcare Reform

• Current Fee For Service
• New Model Reward Quality Outcomes
• and Stewardship of Resources

5
Extreme Makeover Home Edition

• Team-based approach
• Open access
• Patient engagement and empowerment
• Data-directed quality improvement
• Engaged leadership

• Uncoordinated care
• Over-loaded schedule
• Physician and practice-centric
• Arbitrary quality improvement projects
• Lack of clear leadership and support

6
What is Population Health Management?
7
What Is the Solution?
TRANSFORMATION

• beyond transaction
• through technology
• to manage shared risk
• by connecting
• for our patients

VALUE DRIVEN CARE
8
How Do We Improve Care and Manage Costs?
Patient-Centered Medical Home (PCMH) is one way
9
Care Coordination What Is It?

• The goals of coordinated care
• Ensure that patients, especially the chronically
  ill, get the right care at the right time
• While avoiding unnecessary duplication of
  services AND preventing medical errors

VALUE for the Patient QUALITY/COST
10
Care Coordination

• AIM
• Effectively identify, manage and track results of
  PCMHs high risk patient population through care
  coordination, patient coaching and education,
  application of Evidence Based Medicine, and
  population data analysis and reporting
• Interventions
• Embed Care Coordination Teams in Primary Care
  offices, identify high-risk patients and provide
  high touch to these patients

11
What Is the Goal of the ACO?
12
What Are the Cornerstones of the ACO?
13
What Are the Components of the ACO?
14
Tying It All Together

• Integrated elements of a successful ACO
• Improved clinical outcomes and patient
  satisfaction linked to
• Care Coordination embedded in
• Patient Centered Medical Homes practicing
• Improvement Science Methodologies that support
• Population Health Management using
• Data Analytics across a Clinically Integrated
  Organization

15
Where Does Wellness Fit In?(To Date, Wellness
has not Proven Sustainable Outcome Improvements
for Large Populations.)

• Interlinking Electronic Medical Record with
  Wellness Platform.
• Physician participation in Wellness goals and
  monitoring.
• Physician based treatment protocol for behaviors
  related to morbidity, (addiction, obesity, etc)

16
Comments and Questions