advancing the population health journey
TRANSCRIPT
ADVANCING THE POPULATION HEALTH JOURNEY Amanda Hammel, VP IT Operations and Population Health
Memorial Hermann
Hospital Care
Ambulatory
Care
Health
Insurance
Specialty
Care
Primary Care
Members
Patients
Consumers
Post-Acute
Memorial Hermann System of Health
Hospital Care
Post-Acute Ambulatory
Care
Health
Insurance
Specialty
Care
Primary Care
Members
Patients
Consumers
heart
Memorial Hermann System of Health Members
Patients
Consumers
Hospital Care
Post-Acute Ambulatory
Care
Health
Insurance
Specialty
Care
Primary Care
Sports
Memorial Hermann System of Health Members
Patients
Consumers
Post-Acute Hospital Care
Ambulatory
Care
Health
Insurance
Specialty
Care
Primary Care
Neuro
All
Memorial Hermann System of Health Members
Patients
Consumers
Hospital Care
Post-Acute Ambulatory
Care
Health
Insurance
Specialty
Care
Primary Care
Enterprise
Population Health
Memorial Hermann System of Health Members
Patients
Consumers
Clinically Integrated IPA
Private, Employed &
Faculty Integration
Exclusive Contracting
DOJ/FTC Protections PCMH 410
CI 3,300
ACO* 3,000
MHMD 4,000
Gr Houston >11,000
Private Employment Faculty
3 Distinct Practice Models
13 Independent Medical Staffs
Health System
*ACO number Includes UT MDs
Building a Population Health Organization
Traditional Model
Treat sick people
Episodic patient
Specific competencies
Alleviation of symptoms
Incremental improvement
Fee for service
Population Health Org.
Keep people healthy
Members
Integrated & scalable
Improve quality of life
Drives the business
Fixed Payment (Capitation)
Population Health Organization's primary purpose is keeping their populations healthy by doing the following:
• Redefining their consumer relationships • Transforming how care is delivered • Improving access and affordability • Accepting at risk payments for health cost
and outcomes
Health
People
Care Delivery
Outcomes
Analytics
Payment
Evolving range of financial & clinical risk
FFS All Services
Full
Deg
ree
of
Fin
anci
al R
isk
Degree of Clinical and Administrative Integration
Full Risk
Capitation
ACOs/
Bundles
FFS +
P4P
Partial Risk
Capitation
PCP
Shared
Savings
Provider
Sponsored
Plan
Continuum of Provider Sponsored Risk
Year 1 & Year 2Aggregate MSSP Savings
$- $20.000.000 $40.000.000 $60.000.000 $80.000.000 $100.000.000 $120.000.000
BHS Accountable CareIngalls Care Network
Southern Kentucky HCAVirginia Collaborative Care
ACC of Maryland Primary CareCumberland Center
HHC ACOParadigm ACO
Coastal MedicalWESTMED Medical Group
TP-ACOCircle Health Alliance
John Muir Health ACOAnewCare Collaborative
Rio Grande Valley Health AllianceIndependent San Diego ACO
WellStar Health NetworkNevada Primary Care Network
The Accountable Care OrganizationIntegrated ACO
Accountable Care OptionsOptimus Healthcare Partners
New Health CollaborativeMedical Mall ACO
Seton ACOWinchester Community ACO
Genesis APNIntegral Healthcare
ACC of Southeast WisconsinLahey Clinical Performance ACO
Premier Patient HealthcareMaryland Collaborative Care
Reliance ACOMethodist Patient Centered ACO
Physicians ACODelaware Valley ACO
Quality Independent PhysiciansRGV ACO Health Providers
Collaborative Health ACOWest Florida ACO
Mercy Health SelectACC of Texas
Qualuable Medical ProfessionalsAllcare Options
ProHEALTH ACOMillennium ACOOakwood ACO
POM ACOPalm Beach ACO
MH ACO
Generated Savings Yr 2
Generated Savings Yr 1
MH ACO
Tier II Risk
Population Identification
Health Assessment
Risk Stratification
Low or No Risk Moderate Risk High Risk
Health Continuum
Preventative Services
Lifestyle Coaching
Transitional Care Complex Care Management
Palliative and End-of-Life Care
Portfolio of Health Management Interventions
Care Mgmt MD
Care Managers
Case Manager
Software and Big Data
Improved
Outcomes
Lower
Costs
Improved
Satisfaction
Rehab / SNF
/ Hospice
Medical
Home PCPs
Care Team
Ambulatory
Services
OPID, SMR,
Lab, Surgery
Hospitals
Specialist
Physicians
Home
Health
Aligned Provider & Hospital Incentives Reduce Out
Migration
Care Mgmt MD
Care Managers
Case Manager
Population Management Tools
Population Analytics Tools
Benefit Design
Other Claims…
Other EMRs…
Smar
tDat
a (H
ealt
heI
nte
nt)
SmartRecord (Longitudinal Record)
SmartRegistry (HealtheRegistry)
SmartAnalytics (HealtheEDW)
SmartCare (HealtheCare)
Reports Dashboards
ClinicCare4 Web Report
Consumer Biometrics
Other Claims…
Other EMRs…
COPD Diabetes Heart Failure
Hypertension Ischemic Vascular Disease Coronary
Artery Disease Asthma
Adult Wellness Senior Wellness Pediatric
Back Pain Rheumatoid
Arthritis Ambulatory Urgent Care
Post-Acute In/Out Network - Dashboard ACO Lives Jan-Sep 2015
$14M of non-MH spend
22% in network
SmartA
nalytics P
rod
uctio
n Po
st-Acu
te Dash
bo
ard
Hospital Care
Post-Acute Ambulatory
Care
Health
Insurance
Specialty
Care
Primary Care
Enterprise
Co
nsu
me
r Fo
cuse
d
Pri
mar
y C
are
Memorial Hermann System of Health Members
Patients
Consumers
Increased Role of the Consumer
Information & Connectivity
Retail
Primary Care
Preference Driven Care
Fitness & Health
Coaching
Alternative Health
Probiotics & Nutrition
Personalized Diagnostics
Payment Services
Individual Insurance
Consumer Solutions – Mixed Messages
• Insurance Companies
• Urgent Care Facilities
• Media
• 3rd Party Stakeholders (i.e. Angie’s List)
• Employers
Advanced Primary
Care Physicians
Locations
Dig
ita
l E
ng
age
me
nt
Tele
Care
Hospitals
Post Acute
Specialist
Services
Ambulatory
Services OPID,
SMR, Lab, Surgery
Loca
tio
ns
Dig
ital
En
gage
men
t Te
leC
are
Broad Portfolio of Locations and Options
a) Existing Clinic Capacity Fill (campus and community)
b) New Clinic Sites
• Acquisition and De Novo
c) Inside Convenient Care Centers
d) Urgent Care Centers
e) RediClinic (HEB) locations
f) On-site at Employers work locations
g) Health and wellness engagement services - at work, at home, virtually via self service
Consumer Solutions - Locations
Med
ical
Ho
me
R
etai
l
Focu
sed
C
on
sum
er
Focu
sed
Locations
Consumer Solutions - “Clicks” Digital
Source: Accenture
Consumer Expectation Digital
Current Future
With no single user experience or identity, we offer: • Too many logins • Desktop-only • Up to 7 steps to access some features
Through Digital Engagement we’ll provide: • One login, one customer identity • A single, consistent user experience • Mobile-first design that is device
agnostic • Customer-managed preferences
Digital Engagement 2.0 Digital
Powered by Cerner’s HealtheLife consumer engagement platform
In order to achieve our objective for creating digital capabilities, we strive to design a transformative platform
to provide customers with a seamless, personalized, and user-centric healthcare experience.
DELIGHT OUR CUSTOMERS
FLEX OUR PLATFORM
RE-ORIENT OUR BUSINESS
Power our business & customer
experiences by optimizing the
technology and operations needed to put
our customers at the center
Robust, Scalable, Deployed Fast
Transform our business towards
consumer-centricity to advance
health & increase our patient
acquisition, engagement, and in-
network retention
Effective, Agile, Delivers ROI
Design a seamless consumer experience
across all stages of the journey
that aligns with a deeper understanding
of what our customers want
Relevant, Seamless, Simple
• Integrated marketing analytics
• “All my information in one place”
• Virtual care
• “Blue dot” wayfinding
• Second opinions
• Member price transparency
• And more…
TeleHealth Primary Care TeleCare
Hospital Care
Post-Acute Ambulatory
Care
Health
Insurance
Specialty
Care
Primary Care
Enterprise
Population Health
Memorial Hermann System of Health Members
Patients
Consumers
THANK YOU! Amanda Hammel
VP IT Operations and Population Health, Memorial Hermann
@ Insert Twitter Handle Here