Leading TransformationThe Commonwealth Fund

March 14, 2013

Steven Blumberg

Senior Vice President and Executive Director

AltantiCare Health Solutions

Who We Are• Southeastern New Jersey’s largest health system and largest non-

casino employer• Dedicated to building healthy communities• 5,000+ team members in over 70 locations

Vision:AtlantiCare builds healthy communities

Mission:We deliver health and healing to all peopleThough trusting relationships

Values:Safety, teamwork, integrity, respect and service are our values

Atlantic City

Primary Service area: 252,000 pop.Regional Service area: 440,000 pop.60 miles from Philadelphia market

75% local market share 16% outmigration in PSA

AtlantiCare Service Area

Building Partnerships & Establishing Relationships

• Current Partners– AtlantiCare Engaged Benefit – Medicare Advantage– MSSP effective Jan 1st 2013

• Prospects– Local large employers – Casinos– Commercial payors – Unions– Municipalities

Special Care CenterChronic care management focused on high-cost, high-utilization patients. Our objective is to improve quality of life, return patients to productivity, and reduce overall cost of care.

Operational for six years with 2,700 patients enrolled during that period. Most local large employers participate on a PMPM basis for primary care services.

The SCC Model

Patient-Centered Medical Home for high-risk populations with multiple chronic conditions

The Special Care Center (SCC) model includes multiple features to help reduce outcome disparities: •Culturally and linguistically matched physicians and health coaches •In-depth and culturally appropriate educational materials •Improved access •Team training on cultural competency

SCC Downstream Costs

• Medications: switching to lower cost alternatives • Testing: reducing unnecessary tests and using lower

cost settings when needed • Specialists: finding and steering patients to high-quality,

efficient alternatives (or creating them if they don’t exist) • Emergency Room: getting patients to call and getting

notified if they do get to ER • Hospital: better management to keep people out,

aggressively managing LOS, consults, and testing

SCC Barrier Reduction

• Personal health coach for each patient• Waive visit co-pays and prescription co-pays• Open Access scheduling• Same day/next day hospital discharge

appointments • Access to the care team 24 hours a day, 7 days

a week• EMR utilization with visit planning

Utilization Measures

Office ED Admissions Length Average Visits Visits of Stay Cost/Day

+43%

-15%-8%-23%-22%

Source: Milstein Fund Report, 2010 and Internal analysis

Exporting Success

• Hardwiring lessons learned from the Special Care Center

• Primary Care Network Development – Primary Care Plus (employed & affiliated)

• Development of high-value specialist network• Incentive value-based contracting with providers

and suppliers• Physician leadership development

Current Priorities

• Continuum-wide models of care • Integrated care and case management• Transitions of care programs• Integrated enterprise-wide technology platform• Medical home deployment• Analytics development

Thank You!