Changing delivery models

Transcription

1 Changing delivery models Data Analytics 1 1

2 Changing delivery models: employers Direct contracting 2 2

3 Changing delivery models: patients Direct contracting Navigation/Navigators 3 3

4 Changing delivery models: payors Navigation/Navigators Direct contracting Shared care planning 4 4

5 Changing delivery models: suppliers Navigation/Navigators Direct contracting Prevention Shared care planning 5 5

6 Changing delivery models: providers Direct contracting Navigation/Navigators Medical Home/Tele-monitoring Scanadu developing a real-life medical tricorder The future technology depicted in the various Star Trek TV series and films certainly holds a lot of appeal for many of us - who wouldn't want to teleport to Hawaii, live out their fantasies on a holodeck, or enjoy some instant gourmet chow straight out of a replicator? It looks like the Star Trek item that we're the closest to seeing become a reality, however, is the medical tricorder. This May, the Prevention X-PRIZE Foundation proposed a US$10 million Tricorder X-PRIZE, with the intention of encouraging the production of consumer devices that can assess a person's state of health. The first potential contestant, which already has a tricorder in the works, is a tech start-up by the name of Scanadu. Shared care planning 6 6

7 Changing reimbursement Data Analytics 7 7

8 Changing reimbursement: employers Defined contribution health plans 8 8

9 Changing reimbursement: patients Defined contribution health plans High deductibles 9 9

10 Changing reimbursement: payors Defined contribution health plans High deductibles Medicare reimbursement as a base 10 10

11 Changing reimbursement: suppliers If these manufacturers think they can continue to have these kinds of high margins as healthcare is being Defined contribution health plans ratcheted down High on deductibles reimbursement they are in for a rude awakening. They have to work with us. from ModernHealthcare.com Shrinking preferred supply list Medicare reimbursement as a base 11 11

12 Changing reimbursement: providers Defined contribution health plans High deductibles Bundled payments/acquire or create an insurer Shrinking preferred supply list Medicare conventions as a base 12 12

13 Changing roles Data Analytics 13 13

14 Changing roles: employers Exit health benefit design business 14 14

15 Changing roles: patients Exit health benefit design business Personal financial planner 15 15

16 Changing roles: payors Exit health benefit design business Personal financial planner Data analytics provider 16 16

17 Changing roles: suppliers Exit health benefit design business Personal financial planner Diffuser of chronic conditions Data analytics provider 17 17

18 Changing roles: providers Exit health benefit design business Personal financial planner Patient wellness coordinator Diffuser of chronic conditions Data analytics provider 18 18

19 Changing measurements Data Analytics 19 19

20 Changing measurements: employers Predictability 20 20

21 Changing measurements: patients Predictability Level of compliance 21 21

22 Changing measurements: payors Predictability Level of compliance Community wellness dashboard 22 22

23 Changing measurements: suppliers Predictability Level of compliance Useful life Community wellness dashboard 23 23

24 Changing measurements: providers Predictability Cost Reduction Strategies Emphasis on what Level is of Controllable compliance Top Quartile Performance Profitability on Outpatient Products Total cost and inflation Transform strategically through Information Technology Useful life Burning Platform Alignment around Immediacy and Total Cost of Care Community wellness dashboard 24 24

25 Changing measurements: providers Success and measurement for providers will be in large part defined as: Has the rate of increase in the cost per capita for my population been at or below the rate of increase for general inflation? and Can we state with clarity that we are the healthiest population in the United States? 25 25

26 Summary: health care in 2012 Receive Care 26 26

27 Summary: health care in 2020 /Analytic Firms Direct $ / Receive Care Health System Members 27 27

28 Q&A Thank you Anthony V. Colarossi, FHFMA Plante Moran Healthcare Consulting Partner To view a complete calendar of upcoming Plante Moran webinars, visit webinars.plantemoran.com 28