looking over the horizon patient centric …...source: data from company websites as of february,...
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Patient Centric ConsumerismLooking over the Horizon
Matthew Bates, MPH
Copyright © 2016 Studer Group. Please do not quote or disseminate without Studer Group authorization
Public Disclosure
Bilateral Mastectomy & Reconstruction
BRCA Genes Sequenced
Source: “My Medical Choice”, New York Times Op-Ed by Angelina Jolie; May 14, 2013
Consumer Initiated & Led
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Consumer-Centric is Disruptive!
It’s 7pm on Tuesday night and you have a productive chest
cold that you know needs treatment. Which do you choose?
Doctor Office(next morning | $$$)
Emergency / Urgent Care(now | $$$-$$$$)
Retail Clinic(now | $-$$)
Mobile Visit(now | $)
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4 out of 5 healthcare consumers (82%) are open to trying new
ways of receiving medical attention and treatment.
More mobile, more accessible, more connected
Source: HCI Consumer Survey, 2015
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What Do Healthcare Consumers Want?
ReliabilityPersonalization
Access Transparent
Pricing
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“We always overestimate
the change that will occur
in the next two years and
underestimate the change
that will occur in the next
ten. Don't let yourself be
lulled into inaction.”
-Bill Gates
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Examples: MedLion Clinics; Oscar; ChenMed;
Iora Health; Surgery Center of Oklahoma
Consumer friendly hours, transparent pricing,
reliable quality
Healthcare via your mobile phone where & when
you want. Includes remote monitoring & alerts
24x7 access to physicians who know your
history and will come to your location
Patient-Centric
Innovation
Retail Clinics
Mobile Health (mHealth)
Concierge
Medicine
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Patient-Centric Consumer Models
Doctors schedule visits to see patients in their
homes and then drive up with their equipment
Home-Based
Doctor Visits
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• Full-risk primary care providing coordinated primary care to moderate
to low-income seniors with complex chronic diseases
• Primary care physicians serve relatively small patient panels (about
350 to 450) generally through monthly visits plus same-day
appointments when needed.
• On-site pharmacies fill prescriptions within 15 minutes of ordering, so
doctors can hand patients their medication and discuss how to take it
as part of the visit.
• Key specialists see patients at the primary care clinics to promote
easy access and facilitate collaboration among providers.
• Key Outcomes:
40-50% less hospital utilization
Net Promoter Score: 90
60,000+ seniors in 6 states
Patients have 3+ major chronic conditions
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• Primary care to meet local-market needs based on risk-adjusted
capitated fees for its services; supplemented by incentives for
meeting patient experience, quality, utilization or savings targets.
• Focus on providing patients with the support they need to follow
recommended treatment and improve their health.
• Small clinics typically staffed by 2-3 primary care providers; 6-9 health
coaches; a clinical team (nurse) manager; and a social worker.
• Health coaches greet arriving patients and stay with them through the
visit acting as patient advocates and doctor’s scribe.
• Doctor panel size: 1,000 | Health Coach panel size: 200-300
• Key Outcomes: acuity-adjusted ED utilization is 50% lower and
hospital utilization is 33% less | Net Promoter Score: 93
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40,000 patients | 29 practices in 11 states
Plans to open 20 practices in 2016
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Transparent Pricing:
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*The prices for the procedures listed on this website include the facility fee, the surgeon’s fee and the
anesthesiologist’s fee. The initial surgical consultation is also included, as is uncomplicated follow-up care.
Surgery Price*
ACL Repair $6,790
C-Section including 3-day Stay $8,605
Pacemaker Placement (includes device/leads) $11,400
2nd Stage Breast Reconstruction with Implant
Placement, Bilateral$5,550
Anterior Cervical Discectomy with Fusion, 1 level
(includes hardware)$18,960
Inguinal Hernia Repair $3,060
Source: http://surgerycenterok.com/ accessed Feb, 2016
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The Expansion of Retail Clinics
Corporate Titans vs. Organized Medicine--The New England Journal of Medicine, July 23, 2015
“With … U.S. retail clinics now meeting patients' demands for
convenience, their quality withstanding peer-reviewed scrutiny,
and their number growing, some physician leaders have
begun to acknowledge that traditional medical centers must
reckon with this development.”
There are now more than 3,000 retail clinics
open across the US!
Source: data from company websites as of February, 2016
Clinics
600+Clinics
219+Clinics
160+Clinics
107+
Owner
Humana(Insurer)
Owner
Dignity Health(Hospital System)
Owner
Independently
Owned(Private)
Owner
Enhanced
Equity Funds(Private Equity)
Clinics
202+Clinics
1,000+Clinics
18+Clinics
400+
Owner
Sequia Capital &
General Atlantic(Private Equity)
Owner
CVS Health(Retailer)
Owner
Walmart(Retailer)
Owner
Walgreens(Retailer)
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$30 PHYSICALS
Requiring no appointment, $30 sports physicals from
MedExpress couldn’t be easier. Whether your child is getting
ready for sports, school or camp, a physical is the first step in
making sure they’re healthy and ready for activity.
MedExpress website accessed February, 2016
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Clinical Affiliations
• Allina Health
• Baptist Health Care
• Cleveland Clinic
• Dignity Health
• Emory Healthcare
• HCA
• OU Physicians
• Robert Wood Johnson
• Sharp Healthcare
• Sutter Health
• UCLA Health
• etc.
• 1,000+ Locations
• Open 7 days a week
• Extended hours
• Walk-ins welcome & encouraged
• Staffed by Advanced Practice
Providers (NP/PA) with physicians
available via videoconference
• Example Services:
– Common Acute DX & TX
(strep, flu, pink eye, cuts, etc.)
– Physicals
– Vaccinations
– Common Lab Tests Source: http://www.cvs.com/minuteclinic, accessed February, 2016
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US mHealth Demand
80%+ have a
smartphoneSource: comScore, 2015 data analysis
78% of US Smartphone
Users accessed a health
app in 2015. More than any
other app category!
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*Source: Accenture Survey Analysis, 2015
Less than 10%
of Providerssupport online
appointments today.*
77% of patientsthink that the ability to
book, change or cancel
appointments online is
important.*
• Make/Change/Cancel an
Appointment, 24/7
• View/Print/Share Personal
Health History
• Refill a Prescription
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Paid for by:(partial list)
Delivered by:(partial list)
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mHealth: Payers & Providers
18Atrial Fibrillation (AF) Detector | FDA Approved
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“Many of Kaiser Permanente's regional
systems are already performing greater
than 50% of visits virtually- through
mobile, or secure messaging, or video!”
--Jamie Ferguson, Kaiser Permanente vice president
of health IT strategy and policy, December 2014
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• Try it! Become a retail health consumer.
o Get care at a retail clinic
o Try a leading smartphone mHealth service (Amwell or Teledoc)
• Explore partnerships with retail clinics in your area
o Consider leveraging services for “after-hours care”. Many will agree to send patients back
for ED care and/or follow-up care needs.
• Leverage your EMR investment
o Most modern EMRs include “patient portal” capabilities for scheduling & patient questions
• Talk with your major private payers about reimbursement
o Many private payers have guidelines to pay for “mHealth” visits
• Experiment with access changes and price transparency
o The two most cited reasons why consumers seek retail & mHealth delivery
Ways to Get Started
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“Think big, start small, learn fast.”
&
“Give your team permission to make mistakes.”
-Wendy Clark, President of Sparkling Brands & Strategic Marketing,, Coca-Cola North America
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Back Up
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Go for it!
Slide 23
Thank You!
Matthew Bates, MPH
Managing Director
720-355-1053 (mobile)
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