care transformation and the journey to population health ... · care transformation and the journey...

15
Richard A Bankowitz, MD MBA FACP Chief Medical Officer, Premier healthcare alliance Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

Upload: others

Post on 22-Sep-2020

5 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

Richard A Bankowitz, MD MBA FACP Chief

Medical Officer, Premier healthcare alliance

Care Transformation and the Journey

to Population Health Management

AMGA Institute for Quality

September 26, 2013

Page 2: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

2 PROPRIETARY & CONFIDENTIAL – © 2013 PREMIER INC.

Premier: the largest healthcare alliance in the U.S.

Owned by health systems

Uniting more than 2,800 hospitals –

57% of U.S. community hospitals–

and over 100,000 alternate sites of

care

$40+ Billion in group purchasing

volume – saving $5 Billion through

collaboration, integrated data, and

sharing of best practice

Database representing 1 in every 4

U.S. hospital discharge

2.5 Million real-time clinical

transactions per day

Our mission: to improve the health of communities

MAKE HEALTHCARE SUPPLY CHAIN EFFICIENT AND EFFECTIVE

DELIVER CONTINUOUS IMPROVEMENT IN COST AND QUALITY TODAY AND

ENABLE SUCCESS IN NEW HEALTHCARE DELIVERY / PAYMENT MODELS

INTEGRATE DATA AND KNOWLEDGE TO CREATE MEANINGFUL BUSINESS INTELLIGENCE THAT

DRIVES IMPROVEMENT

Page 3: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

3 PROPRIETARY & CONFIDENTIAL – © 2013 PREMIER INC.

Innovators Early

Adopters

Early

Majority

Late

Majority Laggards

• Pay for volume

• Fragmented care

• FFS

• Treating sickness

• Adversarial payors

• Little HIT

• Duplication &

waste

• Pay for value

• Accountable care

• Global payment

• Fostering wellness

• Payer partners

• Fully wired systems

• Right care, right

setting, right time

Transitioning to population health means having a foot in more than one camp

Page 4: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

4 PROPRIETARY & CONFIDENTIAL – © 2013 PREMIER INC.

1. Preparatory 2. Transformational 3. Implementation 4. Expansion

Four stages in the Journey to Population Health Management

• Education

• Assessment

• Gap analysis

• Operational

plan

• Primary care

• Patient

Centered

Medical Home

• Clinical

integration

• Care

management

• Network

development

• Health

informatics

• Defined

population

• Payor

partner

• Employee

health plan

• Commercial

arrangement

• Medicare

• Medicaid

• Employer

contracting

• Uninsured

Page 5: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

5 PROPRIETARY & CONFIDENTIAL – © 2013 PREMIER INC.

250 Medicare ACOs in

43 states

Over 480 Medicare and

Commercial ACOs

500 providers in CMS

Bundled Payment

initiative

Growing number of ACOs nationwide

Page 6: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

6 PROPRIETARY & CONFIDENTIAL – © 2013 PREMIER INC.

Key Insights from alliance members for Population Health

29 markets | 23 systems | 100+ hospitals | 5,000+ MDs,

1.5M accountable care covered lives

86 markets | 67 systems | 300+ hospitals | 12,000+ MDs

Primary Care network development

Patient Centered Medical Home

Physician-led / professionally managed

Clinically Integrated Network

Care Management programs

Population Health Analytics

Aligned Payer arrangements

PACT Implementation

PACT Readiness

Page 7: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

William B. Bunn, MD, JD, MPH

Vice President, Health, Safety, Security & Productivity (Now Advisor)

Navistar, Inc.

Professor, Northwestern University School of Medicine

AMGA – Scottsdale, Arizona – 9/26/2013

Total Cost of Care:

Exploring Payment Models

Page 8: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

8

Page 9: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

Health Care Cost - National Trends vs. Navistar Actual

-10.00%

-5.00%

0.00%

5.00%

10.00%

15.00%

1999-2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Health Care Cost Trend Per Employee/Retiree

Navistar National Average

9

Page 10: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

Combined Workers Compensation and Disability Cost -

National Trends* vs. Navistar Actual

*Assumes only 5% annual combined increase

in WC and Disability costs

**Estimated through May

10

Page 11: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

per 1000 EEs

Savings

Rate

$4M

$3M

$2M

$1M

$0

Conclusion

From 1999-2010, Navistar’s controllable absenteeism rate dropped from 5.0% to 1.8%.

Treating 1999 as benchmark, its annual savings now exceeds $2 million per 1000 EEs.

Controllable Absenteeism

Controllable Absenteeism Cost Savings: Navistar, 1990-

2010 In constant 2005 Dollars Per 1000 Employees

11

Page 12: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

Hospital Admissions per Employee

12

Page 13: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

Outpatient Visits per Employee

13

Page 14: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

Pharmaceutical Prescriptions per Employee

14

Page 15: Care Transformation and the Journey to Population Health ... · Care Transformation and the Journey to Population Health Management AMGA Institute for Quality September 26, 2013

Measures Taken

• Monthly measurement and management

of costs / quality

• Plan and payment design

• Preventive care

• Case management

• Disease management

• Special analyses

• Physician selection

• Health and Productivity

15