Employer Incentivized Doctor/Patient Evidence-Based-Medicine Protocol

Adherence ProgramHR Specialty Products & Services Catalogue Executive Summary

A No Frills Distillation of Vendor’s Marketing Collateral

Thomas A Ference

President & CEO

Human Resources Mining & Distribution Co

Locating, Validating and Accelerating HR  Innovation

 

Office: 219-662-0201

Cell: 630-240-2583

Fax: 219-661-0236

e-mail: tference@hrmdco.com

Website: www.hrmdco.com

Employer Incentivized Doctor/Patient Evidence-Based-Medicine Protocol Adherence Program

• Payers have developed tactics to make employees accountable (e.g. Value-Based Design, Wellness) and providers accountable (e.g. Episode of Care Payments, Pay-for-Performance) to the benefit plan but not the employee/patient and the doctor mutually accountable to one another

• Example: Doctors spend 49 seconds during visit telling the patient what they need to know about taking a new medication

• Up to 50% of patients leave their doctor’s office not understanding what they are told to do

• This 10+ years-in-the-making, SaaS-based patented system manages incentives and processes for both the physician and the patient to be guided by evidence-based-medicine protocols

Employer Incentivized Doctor/Patient Evidence-Based-Medicine Protocol

Adherence Program• Works where patients receive an “Information therapy (Ix)” and are

compensated from the benefit plan for both demonstrating medical literacy and declaring to their doctor compliance with the health recommendations made by their doctor

• Also, doctors are equally compensated from the benefit plan for declaring adherence to the evidence based guideline and treating the patient’s medical illiteracy by prescribing “Information (Ix)”

• The system manages 117 guidelines that cover between 50% and 55% of the total employer spend

• 100% of office visits/diagnoses are covered by Ix, whether the doctor participates or not

• Average patient participation rate of 65%• Creates win-win-win for employer-patient-physician• ROI = Range of 3:1 to 17:1 in independent studies

Employers/Insurers

Physicians

Current Status of Cost Containment & Accountability Solutions

Have Not Produced Consistent , Measurable ROI

Consumers/Patients

Yes Yes

No

Completion of the Accountability Cycle

All 3

Stakeholders

Aligned

Patient

PhysicianEmployer/ Insurer

Patient Accountability with Employer/Insurer

• Wellness and prevention• High-deductible consumer-

driven health care• Disease/care management• NEW Assured adherence

to EBM guidelines

Provider Accountability With Employer/Insurer• Capitated HMO• P4P• Accountable Care Org.• Episodic care payments• Medical home• NEW Assured adherence

to EBM guidelines (or reason for variance)

NEW Patient Accountability with Physician

• Information Ix• Mutual declaration of adherence

to EBM guidelines• Patient & physician dollar

incentives paid from benefit plan for adherence

• Vendor measured ROI

EBM = Evidenced Based Medicine

Six Year Savingsvs. Projection

$2,073,905

Total Investment $333.367

Six Year Results: Rewarding Better Care, Patient Education and

Compliance Lowers Cost

Six year program investment vs. “all-in” claims cost = 6.2:1

Next Steps• This product/service is contained in the HR Specialty

Products & Services Catalogue™ • Operational level details about this particular service

provider can be obtained in conference with the vendor• The HR Mining &Distribution Co. is an independent and

contracted representative of the vendor• Upon your request, we will arrange for an introduction

that can range from a simple, quick conference call to a services overview / system demo

• Tom Ference 219-662-0201 (Chicagoland area) or tference@hrmdco.com

• Thank you for your potential interest in this fresh thinking