BCBS National Clinical Innovation Acceleration Driving Smarter, Better Healthcare in Every Local Community

Transcription

1 BCBS National Clinical Innovation Acceleration Driving Smarter, Better Healthcare in Every Local Community Session 37, March 6, 2018 Jody Voss Vice President, Development, Innovation and Group Purchasing Organization BlueCross BlueShield Association Sarah Ahmad Senior Vice President, Innovation & Transformation Highmark Health 1

2 Conflict of Interest Jody Voss Sarah Ahmad Have no real or apparent conflicts of interest to report. 2

3 Learning Objectives Discuss innovative health plan/provider partnerships that are benefiting the member/patient Describe opportunities to scale local innovation across multiple locations Provide examples of how member/patient health can be improved through an effective health plan/provider collaboration 3

4 I M P R O V E D C A R E I N E V E R Y C O M M U N I T Y It begins locally, and scales nationally. B E T T E R I N S I G H T S M I L L I O N M E M B E R S 1 I N 3 A M E R I C A N S H A V E B L U E C R O S S B L U E S H I E L D B E T T E R H E A LT H C A R E E V E R Y C O M M U N I T Y M + P A T I E N T I N T E R A C T I O N S Generating deeper insights through relationships with 1.3 M doctors to provide higher-quality care at lower costs. U S I N G T H E I N D U S T R Y S L A R G E S T N A T I O N A L D A T A R E S O U R C E T O I N F L U E N C E A N D I M P R O V E E V E R Y A S P E C T O F H E A L T H C A R E Powered by BlueCross BlueShield Axis 4

5 VALUE-BASED CARE: NOW AVAILABLE TO 62 MILLION MEMBERS T H E N A T I O N S B E S T A N D B R O A D E S T V A L U E - B A S E D C A R E P O R T F O L I O Reimbursement based on value, not volume. 5,500+ contracts with ACOs and provider groups rewarding better outcomes. Value-based care programs in 99/100 top MSAs more than any other payer. Local provider partnerships - coupled with National data driven-performance measures allow the BCBS System to provide the largest suite of value-based programs across the US 5

6 I N N O VAT I O N 36 P U R P O S E F U L I N N O V A T I O N ENVISIONING A BETTER FUTURE F U S I N G I N T E L L I G E N C E W I T H A G I L I T Y F O R P U R P O S E F U L I M P A C T SPEED S C A L E C O N T I N U O U S O P T I M I Z AT I O N 6

7 PARTNERING WITH TECHNOLOGY INNOVATORS T O B E T T E R M A N A G E C H R O N I C C O N D I T I O N S A N D I M P R O V E T H E H E A L T H O F A M E R I C A Blue Cross Blue Shield Plans partner with Alphabet Venture to manage diabetes Using virtual reality to treat addiction and autism. Sanofi Verily Onduo BlueCross BlueShield + Blue Cross Blue Shield Association taps Lyft for nationwide ride-sharing program 7

8 Highmark Health: At-A-Glance Highmark Allegheny Health Network A Highmark Health Company United Concordia Dental Visionworks HM Insurance Group A Highmark Company HM Health Solutions HM Home & Community Services Post-Acute Care Management Solutions Serve 50 million people 8

9 Trends In a time of dramatic health care transformation, there are many factors driving the need for change Industry Change Shift from volume to value based care Patient-centered approaches to transformation Need for Proof Stakeholders need real-world environment for clinical & economic guidance Unmet Needs Lack of appropriate evidence can delay adoption/use of new solutions and its impact on care New Technologies Health innovations & solutions are rapidly hitting the market 9 VITAL Test. Learn. Transform Care.

10 What is VITAL? Vision Identify and partner with the best health innovators to lead care transformation. Mission Become a self sustaining innovation platform that identifies best in class healthcare solutions, connects innovators to facilitate testing, generates evidence, and influences market adoption. 10

11 Partner Needs There is a need to accelerate launch and adoption of medical innovations in the industry; VITAL is the platform to do it. VITAL Tech Needs: fast-track process to test innovations in market and obtain performance data real-world evidence to spur adoption after commercial launch Clinicians Needs: access to technologies and partners to help enhance quality & lower medical costs quickly 11 Health Plan Needs: cost and quality outcomes data from technology test-and-learns to advance innovation decision-making and capabilities

12 VITAL Benefits 12

13 Benefits for Innovation Partners Integrated Clinician Network Access to Target Population Advanced Health & Cost Analytics Clinical & Economic Guidance Access to a leading provider system with ~2,800 clinicians across 8 hospitals in AHN plus independent physicians and other strategic partners Access to >5 million Highmark Inc. members with claims, longitudinal health data & usability feedback Advanced data & analytics capabilities to track and measure cost, outcomes data and determine overall health system impact Guidance on navigating the clinical, economic and reimbursement landscape 13

14 Why is VITAL Different? Vital applies scientific rigor to the test & learn process in a continuous and scalable way Care & coverage Seamless integration Actionable outcomes Best-in-class partners As an integrated delivery and financing system, we can identify care and coverage efficiencies Our process allows for seamless integration between researchers, data scientists, clinicians & patients VITAL leverages outcomes data across quality, medical cost, & experience VITAL facilitates matching and collaboration between best-inclass tech manufacturers and clinicians Provides real and relevant clinical care, cost & human experience evidence 14

15 Process 15

16 The VITAL Process Verification Accelerating real-world evidence generation to guide quicker market adoption Innovation New commercially-available solution applies to VITAL program. Testing VITAL team and clinical leaders prepare and execute the test. Analysis Measure key performance indicators and outcomes. 16 Learning Use verified learnings to accelerate care transformation in the health care industry.

17 Results & Success Stories 17

18 Results 82% clinical improvements 53% average cost savings 91% patient satisfaction Heartflow: reduced unnecessary angiograms by over 83% Freespira: patients 80% panic-attack-free Linx: cost savings 50% greater than standard invasive treatment Freespira: total medical costs reduced by 53% PMPM Heartflow: 48% reduction on average patient OOP costs Bronchial Thermoplasty: projected 62% savings over 2 years 18 Linx: patient satisfaction went from 8% to 92% Freespira: 90% patient satisfaction

19 VITAL Success Story LINX 19

20 VITAL Success Story HeartFlow 20

21 VITAL Success Story Freespira 21

22 The future of VITAL 22

23 Where is VITAL headed? A full and focused pipeline with over 40 new ideas under evaluation. High current demand with partners, such as J&J, Omron, and BCBSA, that want to utilize the VITAL innovation engine Research advantages that puts us a the center of the clinical transformation landscape for our industry Broader innovation initiative evolution that will power care and experience transformation at enterprise level Anticipated testing and validation of 10+ innovation projects per year by

24 I N N O VAT I O N 36 P U R P O S E F U L I N N O V A T I O N SCALING VITAL NATIONALLY. T H R O U G H BCBS I N N O V A T I O N A C C E L E R A T O R T O P R O V I D E Accelerated access to new clinical technology innovations Improved patient outcomes and experiences 24

25 BlueCross BlueShield Highmark Health TOGETHER, WE CAN MAKE HEALTHCARE BETTER 25

26 Questions Jody Voss Vice President, Development, Innovation and Group Purchasing Organization Sarah Ahmad Senior Vice President, Innovation & Transformation 26