Population Health Management Presentation
18
Central Ohio Primary Care July 2014 www.hcgc.org Population Health Management …sharing learning from a national perspective
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Transcript of Population Health Management Presentation
Central Ohio Primary Care July 2014
www.hcgc.org
Population Health Management
…sharing learning from a national perspective
WHY: The need to transform healthcare in the U.S.
www.hcgc.org
WHY: The need to transform healthcare in the U.S.
www.hcgc.org
Variations in QUALITY: Readmissions within 30 days medical discharge
Central Ohio region is one of
57 regions ranked with highest
variation
WHY: The need to transform healthcare in the U.S.
www.hcgc.org
Variations in COST: Recent study for Lower Back MRI
Columbus Ohio Average: $1,711
Price Range: $1,335 - $2,749
Nashville TN Average: $1,066
Price Range: $531 - $1,975
Source: Centers for Disease Control and Prevention, University of California at San Francisco, Institute for the Future
Access to Care
Environment
Genetics
Lifestyle & Behavior
Access to Care
Other
Health Behaviors
What influences our health status
Where our nation spends its health care dollars (~$3+ Trillion)
10%
20%
20%
50%
88%
8%
4%
WHY: Spending not aligned with what influences our health status?
www.hcgc.org
Patient–driven care • “Others have struggled to find a proper definition of
patient-centeredness. Three useful maxims that I have encountered are these:” – “The needs of the patient come first.” – “Nothing about me without me.” – “Every patient is the only patient.” Donald M. Berwick, What 'Patient-Centered' Should Mean: Confessions Of An Extremist Health Affairs, 28, no.4 (2009):w555-w565
New definition: Patients largely determine their own outcomes.
WHY: Patients largely determine their own outcomes!
www.hcgc.org
Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
2010-2016: Wave 1 - Patient -Centered Care 2014-2020: Wave 2 – Consumer Engagement
2018-2025: Wave 3 – The Science of Prevention
WHAT: Transformation from Volume to Value-based Healthcare
www.hcgc.org
Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
• Healthcare providers focus their care model on patient needs.
• Physicians break the cycle of transactional patient visits that generate a diagnosis and a standardized, non-personal treatment plan.
• Physicians shift from a one-size-fits-all approach to a population-health approach, aligning care-team resources to meet the needs of different patient segments.
• Patients with different needs are treated by care teams designed to meet the unique needs of the patient—this is the essence of population-health management.
2010-2016: Wave 1 - Patient -Centered Care
www.hcgc.org
Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
$1.2 trillion
2010-2016: Wave 1 - Patient -Centered Care
www.hcgc.org
Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
$910 billion
2010-2016: Wave 1 - Patient -Centered Care
www.hcgc.org
Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
• New patient centered businesses competing on price, value, and outcomes, mobile apps that support consumer health decision making.
• Consumers will use healthcare dollars to actively vote for better care.
• Wave 1 population-health managers will invite extra-industry players into the market to improve their value proposition to the consumer and to increase points of engagement.
• Some extra-industry players will barge in with disruptive (and much more valuable) models.
• With the convergence of electronic health records, health kiosks, personal genomics, mobile apps, and home-based monitoring, consumers will expect and demand personalized real-time access to health services.
• Wave 2 will be driven by pent-up consumer demand from aging baby boomers and tech-savvy Millennials.
2014-2020: Wave 2 – Consumer Engagement
www.hcgc.org
Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
2014-2020: Wave 2 – Consumer Engagement
www.hcgc.org
Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
• Imagine holding a mobile device up to your child’s ear and transmitting the relevant biometric information to the retail health cloud for an immediate diagnosis and treatment plan.
• Imagine a $100 saliva-based genomic-sequencing test at a walk-up kiosk—available in 50,000 retail health stores—along with a personalized health plan and a mobile app or avatar to help navigate your personal health profile.
• Wave 2 will help Wave 1’s great population managers become even more effective and will devastate provider-centric players who have lagged the market.
• Wave 3 will make the most highly evolved and adaptive population health managers more powerful and will significantly constrict the Wave 1 players who don’t continue to accelerate innovation.
2018-2025: Wave 3 – The Science of Prevention
www.hcgc.org
Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
2018-2025: Wave 3 – The Science of Prevention
www.hcgc.org
HOW: Disrupting a culture of distrust and blame
www.hcgc.org
LESS OF THIS…
www.hcgc.org
LESS OF THIS…
MORE OF THIS…
SHARED RESPONSIBILITY for patients/parents/caregivers
and healthcare teams having important conversations
necessary to receive high-quality healthcare at a lower cost
HOW: Disrupting a culture of distrust and blame
Medicine is in for a radical change as we shift to
performance-driven teams
All members of performance-driven teams will need to function at
“the top of their license”
Measure value: achieving good outcomes as efficiently as possible
Integrating care to be patient-centered
www.hcgc.org
HOW: Accepting disruptive change as the norm in healthcare
Central Ohio Primary Care July 2014
www.hcgc.org
Thank you for your time!
