Perspectives From An ACO CEO - Global Health Care · Perspectives From An ACO CEO Katherine A....
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Perspectives From An ACO CEO Katherine A. Schneider MD, Mphil, FAAFP 1 DVACO Proprietary, 2016
Transcript of Perspectives From An ACO CEO - Global Health Care · Perspectives From An ACO CEO Katherine A....
Perspectives From An ACO CEOKatherine A. Schneider MD, Mphil, FAAFP
1DVACO Proprietary, 2016
2Proprietary and Confidential 2016
The Most Important Point
Proprietary and Confidential 2016 3
DVACO is NOT in
Delaware!
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DHP PCPs IWA PCPs
MLHC + Selected Independent PCPs
Selected JeffCare
PCPs (Including JUP)
DVACO as a “Super‐CIN”
or “Super‐ACO”
*** Standardization is Critical! ***
No sand here!
Proprietary and Confidential 2016 5
Part 1: A is for Accountable
Proprietary and Confidential 2016 6
Total Cost of
Care
Health
Outcomes
Care
Experience
Quality
Satisfaction Unit Cost of
Care
Population
Well‐Being
Societal
Investment
Infrastructure
A is for Accountable
Proprietary and Confidential 2016 7
Total Cost of
Care
Health
Outcomes
Care
Experience
Quality
Satisfaction Unit Cost of
Care
Population
Well‐Being
Societal
Investment
Infrastructure
DVACO is here
Metrics
Provider-centric• Care gaps• Readmissions• Visits/Episodes/Bundles
Population-centric• Morbidity• Avoidable
Hospitalizations (PQI)• “The Big Bundle”
Proprietary and Confidential 2016 8
Overutilization and waste reduction – reframe as safety
and patient centeredness
Proprietary and Confidential 2016 9
10Proprietary and Confidential 2016
DVACO is
here
Risk comes in many forms
11Proprietary and Confidential 2016
o Operational Risko Investment Risko Business Risk (market forces)
o “Pricing” risk – our network vs. everything else
o “Insurance” risk – including “my patients are sicker”
o “Performance” risk
How I think about risk
12Proprietary and Confidential
2015
Part 2: C is for Careo It’s about the C!o Incentives alone are insufficient to drive
changeo Incrementalism versus transformation
versus disruptiono Provider-centric variation versus patient-
centric variation
Proprietary and Confidential 2016 13
Where does technology fit in?
Proprietary and Confidential 2016 14
Data Marts
Data Marts
Spoke A
Data Marts
Data Marts
Spoke B
POC Health Gap
Quality Measures
Data Marts
Data Marts
ACO-wide Data
WarehousePopulation
Management
Patient Stratification / Gaps in Care
Referral Analysis
Physician Performance
Claims/ Readmit
Data
---
Spoke C (per member)
ACO-wide Data
Repository
Predictive Analytics
Concurrent Analytics
ManagementContract
ACO-wide Directories
Members’
fragmented IT environments complicate the FFV IT architecture
Proprietary & Confidential
o DVACO lives in a complex rapidly evolving IT ecosystem
o Not the quick fix for interoperability messo Underlying systems/workflows must be configured
to support fee for value (from fee for service)o Take “speed to value” approacho Small data (boring) >> big data (cool)o Analytics (risk stratification, risk adjusted cost,
care gaps) and care coordination workflowo Patient Engagement is not an App
Population Health IT
16Proprietary and Confidential 2015
ADT Data Flow to the DVACO
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* As of January 5, 2016
Engagement – what is it?
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2015
A Patient Centric View of Health Engagement
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2015
Insurer/TPA
Wellness Vendor
Employer
Family PhysicianHealth System
Public Health
Family
Community
Other
There’s an app for that…
20Proprietary and Confidential
2015
Insurer/TPA
FamilyCommunity
Other
Wellness Vendor
Public Health
Health Systems
Family
Physician
Disengagement!
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2015
Me and my husband when we received
our “care gap reminder”
snail mail from
prior insurer
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Part 3: O is for Organization
o It’s about the C!o ACO as a side project will not succeedo The who/where is less important than the
how/what/whyo Sustainable change in population health
will be difficult to do within any single siloo Health Delivery + Public Health (again!)o Business model to support mission
Proprietary and Confidential 2016 23
24Proprietary and Confidential
2015
Thank you for improving
the health of the
communities you serve
@DV_ACO
