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Return On Engagement: The Fundamental Metric of Population Health Management

The fundamental question of the future for population health management is, “How much will it cost our system to achieve a unit of improvement in this patient’s outcome?” At Health Catalyst, we call that Return on Engagement (ROE), and we measure the numerator and denominator, analytically. Engaging patients in their own care is not just an altruistic gesture. It is an economic imperative for healthcare organizations who are at financial risk for achieving clinical outcomes and value based care contracts.

Join Dale Sanders and Russ Staheli as they share their observations about population health management from across the industry and how those observations are influencing the Health Catalyst product roadmap. Simply put, achieving optimal care for a population of patients begins with providing optimal care for a single patient, then repeating that over and over again for an entire community of patients. What public health is for infectious disease, population health is to chronic disease; the same concepts for engaging patients in their socio-economic context are applicable to both.

In the last half of this webinar, Russ will demonstrate Health Catalyst’s Care Management suite. The five applications in the suite are powered by the Health Catalyst Analytics Platform and were designed by synthesizing concepts from Customer Relationship Management and social networking applications— blending data collection, suggestive and predictive analytics, and decision support into a seamless software experience— and applying that to population health management, one patient at a time.

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Return On Engagement: The Fundamental Metric of Population Health Management

  1. 1. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright © 2014 Health Catalyst www.healthcatalyst.comCreative Commons Copyright Health Catalyst Webinar March 23, 2016 Return On Engagement: The Fundamental Metric of Population Health Management
  2. 2. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Introductions • Dale Sanders, Executive Vice President, Product Development • Russ Staheli, Vice President, Product Line Manager, Population Health
  3. 3. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Our observations on Population Health Details of Care & Patient Relationship Management strategy and application 3
  4. 4. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright How we approach everything 4
  5. 5. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright c 5 Founded 2008 Employees 450+ HQ Salt Lake City, UT Patients Hospitals 65M+ 200+ Clinics 2000+ Integrated Delivery Systems Accountable Care Organizations Community Hospitals Children’s Hospitals Academic Medical Centers Health Catalyst Clients
  6. 6. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Population Health Management is to chronic disease what Public Health Management has been to infectious disease 6 ”…the science and art of preventing disease, prolonging life and promoting health through organized efforts and informed choices of society, organizations, public and private, communities and individuals." ”…the health outcomes of a group of individuals, including the distribution of such outcomes within the group."
  7. 7. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright c 7
  8. 8. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Someday, we’ll drop the adjective It won’t be a new “thing”… it will just be 8
  9. 9. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright c 9 Return On Engagement
  10. 10. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright c Robert Wood Johnson & University of Wisconsin Public Health Institute
  11. 11. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright c 11 Our current state of existence in US healthcare Norman, G (2003) New Strategies in Disease and Utilization Management. Society of Actuaries: San Francisco Spring. Meeting, June 24-22, 2002. Proceedings in: Record 28(2), 2003.
  12. 12. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright c 12
  13. 13. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Challenges to the Change 13
  14. 14. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Two Basic Types of Professional Services Contracts 14
  15. 15. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Any wonder why physicians are burned out? 15
  16. 16. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright c 16 What the leaders are doing
  17. 17. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Courageous, visionary CEO In 2010, she took the negotiations and data to the payers
  18. 18. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright c 18
  19. 19. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Cost of Care @ Point of Care 19
  20. 20. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Multiple payer contracts, one comp model Complex allocation models have been a failure
  21. 21. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Her proposal for fixed-fee contracts Inpatient procedures • Knee replacement • Hip replacement • Hip and knee replacement revisions • Hip and knee arthroscopy Outpatient procedures • Cataract removal • Perinatal care • Hysterectomy • Maternity Chronic conditions • Asthma • Diabetes • End stage renal Acute conditions • Upper respiratory infection 21
  22. 22. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright c 22 For better and worse, software has overtaken the impact of heroic leadership as the greatest agent of change in human behavior. We have to build software that deliberately borrows lessons from the software that has changed human behavior.
  23. 23. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright © 2014 Health Catalyst www.healthcatalyst.comCreative Commons Copyright Care Management Getting patients involved in the numerator and denominator of ROE
  24. 24. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Agenda • Definition & Key Driver • Care Management Strategy • Product Demos • Open Discussion
  25. 25. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright 25 Population Health Care Mgmt. Disease Mgmt. Sometimes referred to as Care Coordination Broader than traditional Case or Disease Management. More narrow than full Population Health Source: Frost & Sullivan 2015 • Under “Fee-For-Service” only the health plan was incented to optimize care across settings • “At-Risk” value based reimbursement aligns the incentive with care providers Care Management our definition of care management
  26. 26. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright 1% 5% Patients that account for 20% of your costs Patients that account for 50% of your costs -2012 study by NIHCM Foundation Care Management key driver of care management
  27. 27. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Poll Questions • Which of the following depicts your perception of the “financial value” care management will provide over the next 3-5 years? • 300 respondents a) It will have a high financial ROI – 54% b) It will have a neutral financial ROI – 31% c) It will have a negative financial ROI, needs reformation – 15% • Which of the following depicts your perception of the “clinical quality” care management will provide over the next 3-5 years? • 181 respondents a) It will have a major positive impact – 59% b) It will have a slightly positive impact – 36% c) It will have a neutral/negative impact, needs reformation – 5% 27
  28. 28. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Agenda • Definition & Key Driver • Care Management Strategy • Product Demos • Open Discussion
  29. 29. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Care Management Strategy • Review Existing Frameworks and Market Need • Define Health Catalyst’s Framework • Demonstrate Product Flow 29
  30. 30. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Care Management Strategy review existing frameworks and market need 1st Half 2015 - Leveraged; - Internal; - Visioning from internal Catalyst leadership - Partners Health System iCMP initiative - External; - 10+ 3rd party companies in this space assessed in build vs buy - 10+ requests for proposals (RFPs) - 3+ current client requests - Competitive analysis report - Market capitalization report - SI Patient Engagement Model - Many other discussions and meetings… 30
  31. 31. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright 31 Care Management Strategy review existing frameworks and market need
  32. 32. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright 32 Data Integration (EDW) Patient Stratification & Intake Care Coordination Patient Engagement Performance Measurement Care Management Strategy define health catalyst’s framework
  33. 33. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Care Management Strategy demonstrate product flow 33 A B A B A A B A B A A A A A A A B A Care Program A Care Program B Claims Clinical EDW Population Under at Risk Contract Configurable Catalyst Patient Complexity Score & Stratification Configurable cut point and initial; program, PCP, and team attribution Pre-enrollment patient list refinement (add/remove) Final attribution to Care Program FinalattributiontoCare TeamandPCP Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance Measurement
  34. 34. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright 34 Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance MeasurementCare Management Strategy demonstrate product flow Agreement on: - Patient Centered Goals - Tasks to drive to Goals Initial tasks are prioritized, scheduled, and dispersed On an ongoing basis; - Goals are modified - Tasks are modified - Tasks are re-assigned - Alerts are created and sent based on task - Extended care team members are added (or removed) as needed - Secure SMS communication between all players Types of tasks for patients include; - Education materials to be reviewed - PROM surveys to be completed - Daily activity and measurements to be entered Types of tasks for care team include; - Active medications review - Follow up appointment creation - Identify local resource/support for patient Patient “discharged” from care program
  35. 35. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright 35 Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance MeasurementCare Management Strategy demonstrate product flow How are our patients doing? How are we performing to our plan? Is it working? Are we getting “Return on Engagement” What do we do more of… what do we change? Outcome Process Balance Insights
  36. 36. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Poll Question • Those of you who are a part of a health system, which of the following best describes your current state in care management? • 141 respondents a) We do not have a program and don’t plan on adding one – 9% b) We do not have a program and are evaluating starting – 25% c) We have a program, that isn’t working well – 19% d) We have a program that is successful but can get better – 47% 36
  37. 37. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Agenda • Care Management Strategy • Product Demos • Open Discussion
  38. 38. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright - Patient Stratification - Patient Intake - Care Coordination - Care Companion - Care Team Insights Care Management Products
  39. 39. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Care Management Products Patient Stratification 39 Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance Measurement A B A B A A B A B A A A A A A A B A Care Program A Care Program B Claims Clinical EDW Population Under at Risk Contract Configurable Catalyst Patient Complexity Score & Stratification Pre-enrollment patient list refinement (add/remove) Final attribution to Care Program FinalattributiontoCare TeamandPCP Configurable cut point and initial; program, PCP, and team attribution
  40. 40. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Care Management Products Patient Stratification Demo 40 Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance Measurement
  41. 41. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright 41 Care Program A Care Program B Claims Clinical EDW Population Under at Risk Contract Configurable Catalyst Patient Complexity Score & Stratification FinalattributiontoCare TeamandPCP Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance Measurement Configurable cut point and initial; program, PCP, and team attribution A B A B A A B A B A A A A A A A B A Final attribution to Care Program Pre-enrollment patient list refinement (add/remove) Care Management Products Patient Intake
  42. 42. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance MeasurementCare Management Products Patient Intake Demo
  43. 43. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright 43 Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance MeasurementCare Management Strategy Care Coordination Agreement on: - Patient Centered Goals - Tasks to drive to Goals Initial tasks are prioritized, scheduled, and dispersed On an ongoing basis; - Goals are modified - Tasks are modified - Tasks are re-assigned - Alerts are created and sent based on task - Extended care team members are added (or removed) as needed - Secure SMS communication between all players Types of tasks for patients include; - Education materials to be reviewed - PROM surveys to be completed - Daily activity and measurements to be entered Types of tasks for care team include; - Active medications review - Follow up appointment creation - Identify local resource/support for patient Patient “discharged” from care program
  44. 44. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Care Management Products Care Coordination 44 Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance Measurement Demo
  45. 45. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright 45 Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance MeasurementCare Management Strategy Care Companion Agreement on: - Patient Centered Goals - Tasks to drive to Goals Initial tasks are prioritized, scheduled, and dispersed On an ongoing basis; - Goals are modified - Tasks are modified - Tasks are re-assigned - Alerts are created and sent based on task - Extended care team members are added (or removed) as needed - Secure SMS communication between all players Types of tasks for patients include; - Education materials to be reviewed - PROM surveys to be completed - Daily activity and measurements to be entered Types of tasks for care team include; - Active medications review - Follow up appointment creation - Identify local resource/support for patient Patient “discharged” from care program
  46. 46. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Care Management Products Care Companion 46 Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance Measurement Demo
  47. 47. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Care Management Products Care Team Insights 47 Data Integration Patient Stratification & Intake Care Coordination Patient Engagement Performance Measurement Demo
  48. 48. © 2014 Health Catalyst www.healthcatalyst.com Creative Commons Copyright Agenda • Care Management Strategy • Product Demos • Open Discussion

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