The Role of Technology in Value Based Care & Patient Engagement

March 21, 2018

Agenda

Welcome and Overview • Claudia Ellison, Director Programs and Services, eHealth Initiative

Overview of Interview Results• Nekose Wills, Program & Communications Specialist

Discussion & Comments• Jeff Chester, Senior Vice President & Chief Revenue Officer, Availity• Taya Mohesier, Director of Health Policy & Product Development, HC3• Charlotte Hale, System Director Admission Services and Central Access, Cox

Health

Q&A

Speakers

Jeff Chester

Senior Vice President & Chief Revenue Officer,

Availity

Charlotte Hale

System Director Admission Services & Central Access,

Cox Health

Taya Mohesier

Director of Health Policy & Product

Development, H3C

Housekeeping Issues

• All participants are muted– To ask a question or make a comment, please submit via the Q&A feature and we will

address as many as possible after the presentations.

• Technical difficulties:– Use the chat box and we will respond as soon as possible

• Questions:– Use Q&A feature

• Today’s slides will be available for download on eHI’s Resource page www.ehidc.org/resources

Our Mission

eHealth Initiative's mission is to serve as the industry leader convening executives from multi-stakeholder groups to identify best practices to transform healthcare through use of technology and innovation. eHI conducts, research, education and advocacy activities to support the transformation of healthcare.

Multi-stakeholder Leaders in Every Sector of Healthcare

Convening Healthcare ExecutivesBest Practice Committees Identify & Disseminate SuccessStories

Value &

Reimbursement

Workflow for Providers

and Patients

Research & Identify Best Practices

Data Analytics

eHealth Resource Center AvailableWith Best Practices & Findings

Best Practice Committees contribute to the eHealth Resource

Center www.ehidc.org/resources which provides assistance,

education and information to organizations transforming

healthcare through the use of information, technology and

innovation. The Resource Center is a compilation of reports,

presentations, survey results, best practices and case studies

from the last16 years.

This webinar was made possible through the generosity and support of

The Role of Technology inValue-Based Care & Patient Engagement

Research Project – Executive Interviews

The impact of healthcare reimbursement polices on technology & revenue cycle

• How do policies, consumerism, and patient engagement strategies influence provider decisions around the acquisition and usage of technology, while also affecting revenue?

• October & November 2017

INTERVIEWEES

William Borden, MD Chief Quality & Population Health Officer, Associate Professor of Medicine & Health Policy

Chuck Christian Vice President of Technology

Gordon Edwards Chief Financial Officer

Jean Groves Chief Financial Officer

Keith Hepp Chief Financial Officer

Tom Lee, PhD Chief Executive Officer & Founder

Charles Macias, MD Chief Clinical Systems Integration Officer (Texas Children’s), Executive Director (EMSC), Associate Professor (Baylor)

Shawntea (Taya) Moheiser Director of Health Policy & Product Development

Mark Norby Vice President of Revenue Cycle

Albert Oriol Chief Information Officer

Dhruv Sikka LeHigh Valley Health Network

Michael Sims Chief Financial Officer

Interview Topics - Technology

VALUE-BASED CARE TRENDS AND THE IMPACT OF TECHNOLOGY

• Value-based care affects how data is conceptualized, collected, and analyzed in their practices

• Data & analytics are a priority when deciding how to build onto, and beyond, their existing fee-for-service platforms

• EHRs with built in population health analytic tools (close care gaps, identify populations)

• Tools that help with data for MIPS, APMs, CMMI, MACRA, and CPC+ programs

• There is no roadmap when moving from volume- to value-based care

ADOPTION OF TECHNOLOGY

• Tools to track and manage patient flow and admissions

• Tools specific to acute care

• Tools that document outcomes and free up provider time

• Tools that improve existing EHRs are important to providers

Interview Topics - Technology

TECHNOLOGY: IN-HOUSE, OUTSOURCED, CONSOLIDATED

• EHRs, the biggest factor in this decision and boiled down to preference

• Integration & Collaboration – when EPIC dominated in one region providers worked together

• Nothing must remain in house (1/3 of interviewees)

• Any solutions providing the greatest patient experience, with the lowest cost, and most amount of accuracy should be explored

CURRENT TECHNOLOGY USE

• Patient portals, doctor portals, EHRs, mobile health software, clinical data exchange portals, HL7 messages, population health tools, predictive analytics, PDMP, patient reminders

TOP TECHNOLOGIES IN THE NEXT 12-18 MONTHS

• Predictive analytics

• Document & Patient management

• Genomics

Interview Topics

IMPACT OF CONSOLIDATION

• Provider (more than half ) & Vendor consolidation

CONSUMERISM & EXAMPLES OF PATIENT ENGAGEMENT

• The move towards value-based care has prompted providers to leverage a variety of customer-centered technology- patients want engagement on their own terms

• Examples• Hospital Home / E-visits• Online scheduling, Book Now” through social media, evening & weekend appointments• Surveys and questionnaires

Consumers are shopping for health services and are interested in convenience and cost

Interview Topics

PRE-SERVICE INNOVATIONS—WHAT IS MISSING?

• Standardization

• Solutions that meet the needs of providers and payers

• Prior authorization & Referral Management

• Tools to help patients share clinical data

• Price transparency

• WHAT DO BOARDS, PATIENTS, & INTERVIEWEES WANT?

Board of

Directors and

CEOs want

organizational

progress with

fiscal security

and their

strategic plans.

“America has

the most

expensive

health system

in the world

because there

are so many

layers of

overhead that

require

constant

tweaking.”

--Interviewee

Jeff Chester

Senior Vice President & Chief Revenue Officer, Availity

HCSC becomes

third owner

Provider and Health

Plan Portfolios

Intelligent Gateway

Provider Engagement

Network

Anthem becomes

fourth owner

BCBS Minnesota

becomes fifth owner

Acquisition of

RevPoint

Acquisition of

Health-e-Web

Launch of Provider

Data Management

Launch of Revenue

Program Management

Availity becomes Optum’s

exclusive clearinghouse

partner, implements Advanced

Claims Editor

Anthem’s central

region portal

migrated

Deployment of

Availity clinical

services

Acquisition of

RealMed

Availity reaches

500M annual

transactions

Availity

founded

by Florida

Blue and

Humana

Availity

becomes

gateway for

Florida Blue

and Humana

Acquisition of

FORE Support

Services

Completion of

Anthem/Amerigroup

Migration

Availity HistoryFrancisco Partners joins

Availity as a minority investor

Anthem signs exclusive

gateway agreement with

Availity

Siz

e o

f Ne

two

rk

© 2018 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.17

Taya Mohesier

Director of Health Policy & Product Development, HC3

What we do: Supporting VB Care Delivery

Supporting VBC

Varying Service Support

Advisory Services

Industry Education

Adaptive Processes

Licensed Clinical Staff

Experienced SMEs

Service Delivery Options:Full Support & StaffA-la-Carte ServicesTemporary to In-House

Including: VB Program Compliance, In-house setup, Performance Projections, etc.

All of our staff (RNs, LPNs, CNAs, etc) are licensed in the state where the patient resides

Our experienced SMEs have worked with global and national organizations, including CMS, MGMA, HIMSS, VA, Microsoft, GMAC, Bank of America and provide guidance, strategy, and compliance throughout our organization

By EHR. By Clinic. By Provider.

Chronic Care Management

(CCM)

Annual Wellness Visit (AWV) Support

Transitional Care Management (TCM)

Care Gap Closure Support Services

General Patient Engagement

Management Advisory Services

How we do it: Integration of Data Services

Clinical

Other

Claims

EHR, HIE, Ancillary

CMS, Commercial, TPA

Demographics, Social, Biometric, etc.

ETL

EDW

Risk Stratification

Cohort Builder

Quality Measures

Workflow Automation

Patient Attribution

Care Management

Patient Engagement

Analytics

• Automated outreach• Text, E-mail, and/or IVR• On-demand outreach via CM• Psychographic profiling• Engagement analytics

Licensed, dedicated clinical staff (RNs, LPNs,

CNAs)

Additional Tools:The Johns Hopkins ACG ModelSchmitt-Thompson Triage ProtocolsMedline Plus Patient EducationHCC Coding & RAF Scoring

Charlotte Hale

System Director Admission Services and Central Access, Cox Health

1906 – from humble beginnings to an industry leading healthcare system

• MISSION

• “To improve the health of the communities we serve through quality healthcare, education and research.”

• VISION

• To be the best for those who need us.

• VALUES

• Safety, Compassion, Respect, Integrity

23

CoxHealth Facts• A community-based, not-for-profit health system, CoxHealth is headquartered

in Springfield, Mo. It has been recognized with 28 number one ratings from CareChex, a division of Comparion Medical Analytics, and is nationally accredited by DNV GL - Healthcare.

• Established in 1906, the organization serves more than 900,000 people in a 24-county service area in southwest Missouri and northwest Arkansas, offering a comprehensive array of primary and specialty care including five hospitals and more than 80 clinics in 25 communities.

• The health system includes Cox Medical Center South, Cox Medical Center Branson, Cox North Hospital, Meyer Orthopedic and Rehabilitation Hospital, Cox Monett Hospital, Oxford HealthCare, Home Parenteral Services (home infusion therapy), CoxHealth Foundation, Cox College, Cox HealthPlans, Barton County Hospital and more.

•

Cox Health Facts

Staff

• 10,789 employees with 600+ staff physicians

Volunteers

• 1,672 volunteers are members of Cox Auxiliaries with 235,359 volunteer hours

Beds

987 licensed beds

Services

• 958,736 clinic visits

• 200,558 days of care

• 237,755 emergency, urgent care and trauma visits

• 34,499 surgeries

• 4,373 babies born

• 36,248 ambulance services

Q&A

Jeff Chester

Senior Vice President & Chief Revenue Officer,

Availity

Charlotte Hale

System Director Admission Services & Central Access,

Cox Health

Taya Mohesier

Director of Health Policy & Product

Development, H3C

This webinar was made possible through the generosity and support of