Management of Transformative Healthcare Trends How to ... · Estimated 2018 US Healthcare Spending...

JJacque J. Sokolov, MD

V14.2

Management of Transformative Healthcare Trends –

How to Expect the Unexpected

SEPTEMBER 6, 2018

PROPRIETARY 2MANAGEMENT OF TRANSFORMATIVE HC TRENDS | SEPTEMBER 2018

Presentation Overview

Management of Transformative Healthcare Trends – How to Expect the Unexpected

̶ The Basics: Expenditures, Populations and Products̶ Transformative Healthcare Trends

• Disruption in the “Healthcare Food Chain”• The Birth of the “Unicorn” Physician Practice Management Company • The Population Specific “Virtual Digital EPO”• Destination Medical Center Meets Super Consumer Experience• Adaptive Artificial Intelligence, Expert Systems and Blockchain Technology• VA CCN – The Next Evolution in VA Care• RNA Neo-epitopes Drive New Cancer Diagnosis and Treatment Models

Conclusions and Critical Takeaways

September 2018

Management of Transformative Healthcare Trends –How to Expect the Unexpected

3

Management of Transformative Healthcare Trends

̶ The Basics: Expenditures, Populations and Products


The Basics: Expenditures, Populations and ProductsEstimated 2018 US Healthcare Spending by Payer Source

* Sources: CMS/NHE with 4.6% year over 2015-2016 and an estimated 5.3% year over year 2016-2017

Cost of Healthcare 5.3% ̶ High-deductible HP’s̶ Hospital-owned MD Groups̶ Pharma Cost Escalation̶ Utilization trends – Aging, etc.̶ Hospital-owned ASC’s JVs, etc.

Total Healthcare

Expenditures$3.67 Trillion*

OUT OF POCKET10%

PRIVATE HEALTH INSURANCE

34%

MEDICARE20%

MEDICAID17%

OTHER INSURANCE…

OTHER THIRD PARTY…


The Basics: Expenditures, Populations and Products Providers Create Structures to Optimize Value-Based Care Participation

Value-Based Reimbursement New Payer Products

Alignment of Quality Metrics with Financial Incentives

Business Model

̶ Fee-for-Service

̶ “Hybrid FFS/Value”

̶ APR DRGs

̶ Shared Savings

̶ Bundles

̶ Episodes of Care

̶ Global Risk

Clinical Model

̶ Care Transformation

̶ Population Health Management

• Individual

• Small Group

• Mid-Size Group

• Mid-Large Group

• Private Exchange

• PCP/ Specialty Referrals

• Expansion

• FFS

• Block Grants/VB

• APR DRGs• FFS

• MSSP ACO

• Medicare Advantage

Patient Care/Experience

Changes in Reimbursement

Commercial Insurance

ERISA (ASO)

VA Expansion & TriCare

Medicaid

Medicare

Expansion of Patient Population Coverage Creates New Products and

Purchase Options

New Provider Entities

ACOSpecialty

CIN

DEFINITIONS

CIN- FTC- compliant Clinically Integrated

Network

ACO- Accountable Care Organization

Medicare Shared Savings Plan

Specialty CIN- CIN for CV, Orthopedics, Oncology,

CV, Spine and other key specialties

CIN/CMMI

KEY TAKEAWAYHospitals and affiliated physicians have an opportunity to capture incentive-based reimbursement by entering into “value-based” contracts with payers. But to do that, they need to form a Clinically Integrated Network (“CIN”) or a “Value Based” Enabled Entity to Execute on VB Products


Seeking Strategic Opportunities

Managing a Specific Condition

or Service Line

Provider Care Accountability and integration

Re

lati

ve F

inan

cial

Ris

k

FFS

SharedIncentives

Bundles and Episodes of Care

% of Premium

Global Risk

Provider Assets/ JVs

Managing Health of a

Designated Population

Achieving Specific Quality and Cost

Improvement Metrics or

PCMH Status

Participating in a Narrow Network

Narrow Network(or Tiered)

Four Examples of Payer/Provider Goals:

1) Find NEW partners in CURRENT VB partnership categories

2) Find NEW partners in NEW VB partnership categories

3) Expand EXISTING partners into NEW VB partnership categories

4) Evaluate POTENTIAL Expanded Provider Asset Acquisitions /JV Partnerships

How do Health Plan product strategies align with specific provider VBC initiatives?

What approach/support leads to “win/win” provider collaborations?

Provider Asset Acquisitions/

JV Partnerships


MSSP Incentive Award Opportunity

• Part A and Part B claims for beneficiaries attributed to the ACO

• Benchmark projection based on 3 years of CMS data

• In Year 1, requirement is complete and accurate reporting on all measures

• In Years 2 and 3, a performance score is calculated for the ACO

• Total award is capped at a % of Benchmark expenditures depending upon chose track (Track 1: 10%, Track 2: 15%, Track 3: 20%)

• Calculation of award occurs 6-9 months after end of year.

AC

O B

en

chm

ark

$$

AC

O A

ctu

al $

$Savings

Preventative Health (8metrics)

Care Coordination

Patient Safety (6 metrics)

Patient/Caregiver

Experience (7 metrics)

Managing At-Risk

Populations (12 metrics)

$$$

ACO Portion of Shared Savings

H

Physicians Hospital

33 Total Performance Metrics

Expenditure Reduction

Achieved by ACO ×Track 1: 50%

Track 2: 60%

Track 3: 75%

Performance Score

Earned by ACO× =MSSP Shared Savings Award

Paid to ACO

September 2018

Management of Transformative Healthcare Trends –How to Expect the Unexpected

8

Management of Transformative Healthcare Trends

Transformative Healthcare Trends• Disruption in the “Healthcare Food Chain”• The Birth of the “Unicorn” Physician Practice Management Company • The Population Specific “Virtual Digital EPO”• Destination Medical Center Meets Super Consumer Experience• Adaptive Artificial Intelligence, Expert Systems and Blockchain Technology• VA CCN – The Next Evolution in VA Care• RNA Neo-epitopes Drive New Cancer Diagnosis and Treatment Models


Disruption in the “Healthcare Food Chain” – The Community Pool in 2017

Care Coordination and Patient OutreachProgram Advisory and Implementation Services

Data Aggregation and Intelligence Risk Management and Analytics

END-TO-END

Source: Curating the Best of Digital and Population Health, Dr. Gordon Joneshttp://www.slideshare.net/elcid84/phmslideshare2014?qid=331b8a6e-df33-4f6b-8bbf-ee7bc139c465&v=default&b=&from_search=3

http://www.slideshare.net/elcid84/phmslideshare2014?qid=331b8a6e-df33-4f6b-8bbf-ee7bc139c465&v=default&b=&from_search=3


Disruption in the “Healthcare Food Chain”– Who Will Be the Shark(s) in the Community Pool in 2018?

̶ Apple →Medical Clinics ̶ Google/Alphabet →Medicaid̶ Microsoft → Cloud̶ Amazon → Prescriptions̶ Facebook → Hospital Data̶ Uber → Ambulances̶ Others

Market Capitalization

̶ Aetna̶ Cigna̶ Humana̶ Anthem – Government $̶ United Health/Optum̶ Merck, Pfizer, J&J̶ Others

Market Capitalization $$- $ 250 Billion+ ̶ $100 Billion+

̶ CVS̶ Express Scripts̶ Walmart̶ Kaiser̶ Walgreens̶ HCA̶ MDs, Other Providers

Market Capitalization$ 250 B+ ̶ $ 50 Billion+$$$- $ 1 Trillion + ̶ $750 Billion +


Disruption in the “Healthcare Food Chain”Types of Healthcare Transactions

New Healthcare

Hybrid Entities

Health Retailers

Technology Invaders

Employer Sponsored Initiatives

Vertical & Horizontal Integrators


Disruption in the “Healthcare Food Chain”Types of Healthcare Transactions

1. Vertical & Horizontal Integrators – CVS Health and Aetna, Optum and DaVita Medical Group, and Cigna and Express Scripts. These hybrid organizations are trying to lower costs of the supply chain by owning more of it and extending those savings to consumers. The challenge? Execution risk is very high with poor history of success.

2. Employer Sponsored Initiatives – JPMorgan/Berkshire Hathaway/Amazon, Blackstone, etc. Combinations such as this are setting out to limit the growth of their own healthcare costs. The challenge? Previous employer lead initiatives have had variable success and sustainability (e.g. SCE, Ford, Macy, Kaiser, etc.) and always require geographic and scope scale.

3. Technology Invaders – Google, Apple, Amazon, Lyft and Uber live in this class. These deals will command more space in the healthcare industry, and they have an advantage in their understanding of modern consumer expectations and new currently non existent healthcare relevant technologic advances. The challenge? Technology invaders need technology that is applicable and actually provides real synergy in both the clinical and business facing applications.

4. Health Retailers – Retailers including Walmart, CVS Health, Amazon and Rite Aid want to gain market share by functioning as healthcare providers directly or as referral conduits. The challenge? Scope of care, complexity of treatment, telehealth, tele monitoring, etc. complicate the patient/provider/payer relationships.

Adapted from Becker’s Hospital Review May 29, 2018


SUMMITHEALTHMANAGEMENT

MANAGEMENT SERVICE AGREEMENTS LICENSED ORGANIZEDDELIVERY SYSTEM

(assumes financial risk for the provision of healthcare services)

ARIZONA

OREGON

REAL ESTATE HOLDING COMPNAIES

SUMMIT SELECT

The Birth of the “Unicorn” Physician Practice Management Company Zoonie/Summit Health Management Example


The Birth of the “Unicorn” Physician Practice Management Company Zoonie/Summit Health Management (SHM)

• Physician owned, managed, governed – No Debt

• For profit, projected collections $ 950+MM in 2018 with over %50% of Revenue from Value Contracts

• 1,000+ providers in 70+ medical specialties

• 3 States have 100+ Locations

• High Acuity Urgent Care Centers with Multiple Population Specific Designs

• 4,000 employees

• 125,000+ patient treatments per month

• Care to 700,000+ unique patients, 280,000+ attributed patients and 150,000+ at risk lives

• Comprehensive Diagnostic Radiology & Lab/Pathology

• MD Anderson Cancer Center Partnership

• Multiple “Horizon” % of Premium Contracts

• Pioneers in Clinical IT Solutions

• Physician growth of 400 Physicians in 2014-2018

• 250,000 SF expansions/consolidations in Development

Summit Health Management Expands to NJ, OR, & AZ Markets

PROPRIETARY 15MA N A G E M E N T O F TR A N SF O R M A T IV E HC TR E N D S | SE P T E M B E R 2018

Physician Governance and Leadership

• Facilitate goal development• Create alignment of Clinical and Management

responsibilities• Effectuate culture change to successfully transitions

from FFS to FFV

Population Management

• Care management models

• Quality reporting

• Clinical intelligence

• Strategic clinical programs

Operations Management

• Consolidation & Clinical Integration

• Maximize Practice Performance

• Access, capacity, utilization, productivity, staffing

• Technology Infrastructure Management

• Roadmap for integration

• Strategic real estate development

Revenue Management

• Revenue cycle optimization

• Financial Statements & Budgeting

• Contracting

• Coding Compliance & Education

• Regulatory change management

• Payer contracting assessment

The Birth of the “Unicorn” Physician Practice Management CompanyZoonie/Summit Health Management – Key Elements for Success in Both FFS and “Hybrid FFS Value Based” Reimbursement


The Birth of the “Unicorn” Physician Practice Management Company Successful Summit Medical Group Year-Over-Year Savings for It’s Commercial ACO with Horizon While Maintaining Robust SMH Margins


Birth of the “Unicorn” Physician Practice Management Company Significant Upside Supports Premium Valuation – Generic Example *

Financial Buyers are competing head to head with Strategic Buyers for Physician Organizations, IT Platform Companies, etc.

Multiple Levers for Continued Value Creation

• Transition of out patient reimbursement to In patient reimbursement methodologies

• Economies of scale• Margin expansion• Accretive acquisitions• Organic growth• New product development and

innovation• Expansion of addressable market• Growing recurring revenue streams• Multiple expansion based n greater

scale, market position

Source of Additional Value Creation

~3x Return

$ 50 MM

Revenue2018E

$ 125 MM

35%Margin

$ 45 MM

Revenue EBITDA2022E

$275 million - $375 million

5.5 – 7.5x 2018E Revenue

$800 million - $1+ Billion

6.5 – 8.5x Revenue

19x – 24x EBITDA

~25% EBITDARevenue Margin

CAGR Expansion

*Generic Example Adapted from KeyBank/Cain Brothers/SSB materials


The Population Specific “Virtual Digital EPO”Medicare Highest Spend Areas are Leading the Transition from Fee-for-Service to Medicare Advantage Plans

Source: Dartmouth Atlas


The Population Specific “Virtual Digital EPO”High-Cost Seniors – Governmental and Commercial Focused Programs

Source: Fischbeck, Paul. "US-Europe Comparisons of Health Risk forSpecific Gender-Age Groups.” Carnegie Mellon University: September 2009

An

nu

al p

er

cap

ita

he

alth

care

co

sts

Age0 10 20 30 40 50 60 70 80 90

$45,000

$40,000

$35,000

$30,000

$25,000

$20,000

$15,000

$10,000

$5,000

$-

UK

Germany

Sweden

US

Spain

U.S. is spending much more for older ages

Key Takeaway: The CIN must also have clinical models for the management of specialty care, including chronic care management and the management of episodic care.

Governmental Programs Have Focused on High Cost Medicare Beneficiaries – CV, Spine, Ortho, Oncology, End of Life Expenses Lead to the Expansion of Medicare Advantage Plans and Medicare Shared Savings Programs


The Population Specific “Virtual Digital EPO” Digital Medicare Advantage Narrow Network/EPO Technology –Care Coordination Platform Improved MLR, Stars, & Performance Incentives

Eligibility /

Authorization

PaymentsMessaging

MarketPlace

ClinicalData

Exchange

e-Screening

Referral

Management

Access Center/

Gap CloserWaitlist

MarketPlace

Self-Service

Solution Capability

Increase Scheduling Access2

2

Enhance Scheduling1

1

Scheduling

Unify the Scheduling Experience3

3

Platform


9+Online patients per provider per month

25%Increase in referral

capture

9 dayReduction in lead time

19%Show rate

improvement

The Populations Specific “Virtual Digital EPO”Quantitative Metrics/Outcomes from the Digital EPO

400%Efficiency gains

5XCall center conversion

improvement


The Population Specific “Virtual Digital EPO”Revenue Implications – FFS Medicare vs. Medicare Advantage

Assume 5,000 enrollees at $1,200 PMPM (HCC= 1.23) without additional “star” reimbursement

$72MM in Total Premium MA Revenue vs. $60MM in total FFS Premium Revenue

MLR = 85% (industry incentives) to providers/Humana Model*

MA Health Plan $MM

Administration 7.2

Profit 3.6

Totals (15% MLR) 10.8

Providers

Hospital (Inpatient) 20.2

Physician Services 14.4

Pharmacy/OP/Other 14.4


Incentive Allocation

Hospitals (50%) 7.14

Physicians (50%) 7.14


Financial Impact on Key StakeholdersMedicare FFS vs. Medicare Advantage ($MM)

*Humana = 81% MLR: Aetna FL 83% MLRWithout 5 Star incentive allocation (4%+)

1.8

$25.05

$16.80$17.40

7.2

$20.20

$14.4 $14.4

TPI/MA Hlth Pln Hospitals Physicians Parmacy/OP Other

Medicare FFS Medicare Advantage

$21.5 Total+28%

+400%

-17%

$27.3 Total+9%

-14%

-19%


Clinical, Geographic and Cultural Models Synergize Each Other

Source: SSB adapted changes from EYGM Limited 2017 and CMS Sources

Destination Medical Center Meets Destination Super Consumer Experience Engaging the Super Consumer with Transformative Health

Transportation

ConsumerGoods

Technology

FinancialServices

Entertainment

Telecom

Caregivers

Life Sciences

Product or Service

Developer

Government and Regulators

Investors

Non-Governmental Organization

Payer

Health Providers

SUPERCONSUMER

Policies that create a transparent market to stimulate investment

Investing in businesses and technologies that have growth potential

Affording speed to adoption of new technologies

Providing the most cost-effective health solutions to my members

Obtaining right, affordable treatment and support to be healthy

Delivering the most cost-effective care toachieve health improvement

Using affordable tools to help manage loved ones’ care

Identification of innovative ways to gain new revenue opportunities

Payment appropriate for providing novel products


Destination Medical Center meets Destination Super Consumer Experience Hospital System CV Destination Center of Excellence

Infrastructure-Staff, Technology and Partnerships

High-Performing Community-Based Independent Physicians

Dedicated Faculty Practice Physicians

CARDIOVASCULAR DESTINATION CENTER OF EXCELLENCE

Co

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Car

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logy

Co

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lex

Vas

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rvic

es

Co

mp

lex

Arr

hyt

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ia

Man

age

me

nt

Co

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lex

CT

Surg

ery

HEART AND VASCULAR INSTITUTE

DR. “D”DR. “B”

DR. “C”DR. “A”

Clinical Programmatic

Innovation

Industry Relationships

Teaching and Training

Inte

rven

tio

nal

No

n-I

nte

rven

tio

nal

Car

dia

c &

Th

ora

cic

Dia

gno

stic

Ther

apeu

tic

Ad

van

ced

Dev

ices

End

ova

scu

lar

Surg

ical

CVDCOE Steering Committee (Clinical Integration)

Research and Conferences


Inpatient Market Share Market Share Ranking1st: Aggregate Market Share 1st: Burns1st: Cardiology 1st: ENT1st: General Medicine 1st: GeneralSurgery1st: Neurology1st: Neurosurgery1st: Ophthalmology 1st: Orthopedics1st: Rehab1st: Thoracic Surgery 1st: Urology1st: Vascular2nd: Gynecology 2nd:Obstetrics2nd: Neonatology 2nd: Spine2nd: Oncology

211 Locations

$5B+ Total Assets$4B+ Net Operating Revenue 22,000

Employees; 5,000 Medical Staff

Greater Houston MSA 6.36 million population, projected to 6.9 million by 2018

Destination Medical Center meets Destination Super Consumer Experience“Population Specific” Consumer Facing Regional Programs of Excellence


Destination Medical Center meets Destination Super Consumer Experience Equality Health – “Culturally Focused” Programs of Excellence

Equality Health is the nation's first integrated

healthcare delivery system focused solely on

improving care delivery for the underserved through

the lens of their own culture

We help managed care organizations improve health

outcomes transition to value-based care and better

engage their most vulnerable members through

culturally-relevant care

We are initially focused on the HispanicLatino

community in Arizona. with plans for southwest

expansion


Destination Medical Center meets Destination Super Consumer Experience Community Integration – “Meet the Customer/Patient Where They Are"

Equality Health Initiatives exists to improve the health of

individuals, families, and communities by addressing

the social, economic and environmental determinants of

health

Excellent medical care alone is not sufficient to create

healthy communities. To bring about demonstrable

improvements in health. We partner with others to build

health-promoting physical. behavioral. social and

economic environments


Destination Medical Center meets Destination Super Consumer Experience Rochester, MN Area Foundation (RAF)/Mayo Clinic – “Medical Footprint”Destination Medical Center (DMC) – “Non Medical Footprint” Trend

• Working in association with Mayo Clinic on the DMC will be the Rochester Area Foundation, Mortenson Co. as constructor, and HCDG/SSB in leading Mayo’s expressed focus in accessing New Markets Tax Credit financing. Because of the long-term, expansive nature in developing the DMC and attentive projects in the Discovery Square area, HCDG/SSB envisions this effort as running for many years with the opportunities for better than a decade’s worth NMTC, state tax credit, and related transactions. The following graphic is a rendition of the overall project area.

• Mayo Clinic is embarking upon a $5.6 billion Destination Medical Center (DMC) project within the research and technology center of Discovery Square in Rochester, construction expected to commence next year. The DMC is slated to be a 10-20 year build-out project aimed at turning Rochester into America’s healthcare capital. The DMC environs will cover six-blocks to include transportation, hospitality, livable city and learning environments, as well as research and technology, toward making it a global destination for health and wellness.


Old World

New World

Where Shift Happens

Adaptive Artificial Intelligence, Expert Systems and Blockchain TechnologyWhat Is Really Possible?

Time

World

Blockchain

Health Information Exchange

Internet

Industrial Assembly

Computer/EHR

Adapted from Multiple Sources including Universal Health Coin


Advanced Artificial Intelligence, Expert Systems and Block Chain Technology the Constellation of AI Technology and Business Applications8

8Adapted from multiple sources

Intelligentagent

Extended reality

Text, speech, image

and video

analytics

Intelligentproducts

Recommendation systems

Collaborativerobotics

Speechto text

Expert systems

(inference)

Knowledgerepresentation

Predictive systems

Natural language

understanding

Computer Vision

Audio signal

processing

Speech and optimization

DeepLearning

Shallowlearning

Personalization

Intelligentautomation

Biometrics, facial and gesture

recognition


Adaptive Artificial Intelligence , Expert System and Blockchain TechnologyState of Electronic Medical Records in the US1

The Starting Point for Data Ingestion ?

1 Blockchains and electronic health records; Ben Yuan, Wendy Lin and Colin McDonnell


Artificial Adaptive Intelligence, Expert Systems and Blockchain Technology

EHR Interoperability through a Health Information Exchange Example2

2 Adapting Blockchain Technology for Electronic Health Record Interoperability – Submitted by cognizant Technology SolutionsAuthors: Nitesh Gupta, Anand Jha and Purna Roy


Adaptive Artificial Intelligence, Expert Systems and Blockchain TechnologyEHR Interoperability with Blockchain and Health One Cloud Example3

Hospital B

Assumption: Even if Health-One-Cloud becomes available, the legacy EHRs of various health networks will not be retired in the near future.

1. Hospital A creates the EHR for John’s visit and puts it on its health network as well as on Health-One-Cloud.

2. Hospital A has John digitally sign a related record with the visit metadata, an EHR hash, and a URL for Health-One-Cloud on the Health-Metadata-Blockchain

3. Hospital B searches for John’s recent visits on the Health-Metadata-Blockchain and finds the record.

4. Granted permission with John’s public key, Hospital B decrypts the record to find the EHR hash and the Health-One-Cloud URL and accesses it to get the visit information EHR created b Hospital A.

Hospital A

EHR PortalURLEHR HashPatient IDProvider IDVisit IDDate

EHR Interoperabilityvia Blockchain

Health-One-Cloud

Health-Metadata-Blockchain

EHR Cloud for Hospital A and its Health Network

EHR of John’s visit at Hospital A

EHR of John’s visit at Hospital A

1

1

2

4

3

Hash

2 Adapting Blockchain Technology for Electronic Health Record Interoperability – Submitted by cognizant Technology SolutionsAuthors: Nitesh Gupta, Anand Jha and Purna Roy


Adaptive Artificial Intelligence, Expert Systems and Blockchain Technology

AAI Examples – CTI, Babylon, Leidos, etc.

• AAI: Adaptive Artificial Intelligence ( Terminology is often Incorrect )

– Evolving self-learning expertise

∙ Access to relevant context data

∙ Pattern identification – UK Use for Imaging Purposes

∙ Deconstructionist

∙ Appropriate logic

∙ Internal assessment and adjustment

– Risk management

– Minimal human involvement

– Most Common/Important Use is in NSA Applications Today

Adapted from CTI



• Expert Systems created by Human Protocols

• Database Systems

– Fixed pattern relations

– Relations provided by human experts

• Rules Based Logic

– Provided by human experts

• Human Interface Query Systems

– Human operator final decision

– Risk management human

• Fixed Systems

– Large human involvement

Adapted from CTI

Expert Systems Examples – IBM Watson, Multiple Analytic, etc.



Adapted from Multiple Sources including Universal Health Coin

How would a Healthcare Blockchain System Work?

̶ Every Healthcare Event (HCE) identified from whatever “Data Ingestion Source” (e.g., EHR, Lab, Claims, Pharma, etc.) would lead initially to a financial transaction with greatly enhanced speed, accuracy and work flow.

̶ The challenge is that current Blockchain structure allows for only 8 bytes of data to populate a singular block so that financial transactions would be doable but transferring clinical data with from HIE or another data structure would be difficult without modification and/or development of a new Blockchain structure (Health-Metadata-Blockchain solution ?).

̶ A system of smart contracts at pre negotiated rates would direct revenue flow into the financial healthcare Blockchain entity will cut down transaction costs and proportionally the middlemanburden.

̶ Anonymity on behalf of the member

Healthcare Blockchain Transactional System

̶ Universal Health Coin, etc.


CURRENT STATE

Fragmented Community Care Resources

National Dialysis

Contracts

Retail Pharmacy ContractsEmergency CarePatient-Centered Community

Care (PC3)

National Dialysis Contracts

Retail Pharmacy Contracts

Federally-Affiliated Facilities

Emergency Care

Project ARCHVeteran’sChoice

Community Care Network

• VHA Vision is to build a “System of Systems” to administer CCN

- High-Performing Network Systems

- Integrated Customer Service Systems

- Integrated Coordination of Care Systems

- Integrated Administrative Systems

- Integrated Operations Systems

VA Community Care Network (VA CCN) – Next Evolution in VA CareCCN Organizes Current Offerings into Single Integrated Entity

• Fragmented and inefficient programs

• Typically focused on a specific population

• Overlapping or inconsistent eligibility criteria

• Employ multiple processes for the same activity (e.g., claims processing)

• Care often inconsistent with best practices

• Veteran experience is generally suboptimal

FUTURE STATE

Resources Integrated into Single Program


VA CCN – Next Evolution in VA CareVA Community Care Regions and Estimated Eligible Veterans


VA CCN – Next Evolution of VA CareVA Care Enabled by Advanced Platform Technology5

5 GlobalMed


VA CCN – Next Evolution in VA CareKey Takeaways Regarding VHA Transformation

✓ $80 Billion+ In VA to private sector transfer in the four VA regions over the next eight years

✓ Major re-alignment/optimization of VAMC and private network utilization

✓ Major implications for private sector hospitals/physicians willing to accept additional VA referrals

✓ VA Bidder decisions anticipated for most regions by October 2018

1) What level of referrals do you currently receive from local and regional VA facilities today?

2) If located in a market with a meaningful number of Veterans, have you specifically analyzed strategic engagement options for your relationship with the local or regional VAMC health system?

3) What can you do to differentiate your services with the local VHA to ensure you are a preferred referral resource?

QUESTIONS FOR PROVIDERS


RNA Neo-epitopes Drive New Cancer Diagnosis and Treatment Models

Focused Diagnostic Capabilities and New Vaccine Therapies6

• Focused RNA Neo-epitopes Drive New Diagnostic Models

– Advanced Diagnostic RNA Neo Antigens present before legacy diagnostic testing

– Less Expensive Diagnostic Modality

• Focused RNA Neo-epitope Vaccines Drive New Therapeutic Models

– Vaccines for Particular Cancer Types Can Be Developed-Especially hard to detect “Cold Cancers” including Glioblastoma, Pancreatic Cancer, etc.

– Not Personal, But High NeoAntigen Coverage

– Pre-made and Pre-Approved

6 Adapted from multiple Stephen A. Johnston, PhD presentations


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Management of Transformative Healthcare Trends How to ... · Estimated 2018 US Healthcare Spending...

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Transcript of Management of Transformative Healthcare Trends How to ... · Estimated 2018 US Healthcare Spending...