Reaction to Healthcare Reform & Future: a Physician Organization s Perspective. May 15, Renaissance Health Network
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1 Reaction to Healthcare Reform & Future: a Physician Organization s Perspective May 15, 2013
2 Reaction to Healthcare Reform & Future: a Physician Organization s Perspective presented by Po Chou Chief Operating Officer
3 Agenda Health Care Reform Accountable Care Organization RHN s Reaction to It RHN s View of the Future Q&A
4 Physician Organization 255 Independent PCPs Clinically Integrated 5-county area around Philadelphia Pioneer ACO Contract Apr. 32k Medicare Beneficiaries (Apr. $320 mil expenditure) Past Experience in similar model with Commercial Payor with 120k lives ($450 mil expenditure)
5 Locations
6 Agenda Health Care Reform Accountable Care Organization RHN s Reaction to It RHN s View of the Future Q&A
7
8 2010 Healthcare Reform 3/21 - House passed the Senate-passed reform bill 3/21 House passed budget reconciliation bill that modifies Senate bill $938 B price tag The Patient Protection and Affordable Care Act (PPACA) of /23 President Obama signed Senate bill into law 3/25 Senate passed budget reconciliation portion with technical correction, requiring second vote by the House 3/25 House passed budget reconciliation bill with technical correction 3/30 - President signed final budget reconciliation bill 8
9
10 THE MEDICARE CRISIS!
11 Growing Medicare Population
12
13
14 Agenda Health Care Reform Accountable Care Organization RHN s Reaction to It RHN s View of the Future Take Home Messages
15 Accountable Care Organizations
16 What is an Accountable Care Organization (ACO)? Defined as a group of healthcare providers who accept accountability to manage the care of a patient population, the ACO has the primary focus of improving the overall health of its patients while managing the total cost of care received by them. The Patient Protection and Affordable Care Act (PPACA) of 2010
17 Genesis from HillaryCare in 1993 Managed Competition History of Accountable Care as Approach Quality Payment for Services: CMS 2003 Process: Evidence Based Medicine Guidelines Outcomes: Improvement in Quality Measures Treatment of Chronic Diseases Shared Savings for Cost Containment Emerging Payer/CMS Pilots in Episodes of Care 17
18 Medicare Shared Savings Program 3-Part Aim
19 PPACA 3-Part Aim 1. Better Health: Improve the individual experience and quality of care 2. Better Healthcare: Improve the health outcomes and health status of the population (Clinical Outcomes & Quality); and 3. Lower Cost: Reduce per capita costs of care of populations
20 Accountable Care Organization and Healthcare Reform Different Paths to Accountability: Provider Experience with the Pioneer ACO Model, the Shared Savings Program & Other Payment Models
21 Key Contractual Terms Length of Agreement: 3 years MSSP Model: Track #1 One Sided (Upside Only) Track #2 Two Sided (Upside/Downside) MSR: Varies Quality Requirement: Reporting in Year #1 and Performance Based for remaining years. Upside Potential: Varies depending on the track
22
23 MSSP Example Performance Calculation Years 1-3, Track #1
24 Calculating savings based on spending targets Projected Spending Target Spending Shared Savings Actual Spending
25
26 Our Pioneer ACO model
27
28
29 Challenges Capitalization
30 Capitalization
31 38
32
33 Challenges Capitalization Infrastructure
34 Interventions Pioneer ACO
35 Programmatic Interventions
36 Capitalization Infrastructure Data/Reporting Delays Targeting Actionable Managing Risk Challenges
37 Minimizing Risk
38 Capitalization Infrastructure Data/Reporting Delays Targeting Actionable Managing Risk Confusion by Patients Healthcare Reform ACO Challenges 45
39 Confusion
40
41
42
43 MODEL 50
44 Migration
45 Impact of Healthcare Exchanges?
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47 Agenda Health Care Reform Accountable Care Organization RHN s Reaction to It RHN s View of the Future Q&A
48 55
49 Page 56
50 Po Chou
51 About the Speaker Po Chou Chief Operating Officer Po has over 25 years of executive leadership experience in the health care industry. He has served faculty and several C-level operations and financial roles in various for-profit, not-for-profit, and academic medical centers inclusive of Tenet Healthcare, The University of Texas Medical School, The George Washington University School of Medicine, and the Department of Health and Human Services in Washington, DC. Po is known for his expertise in strategic management, operations, finance, and health services research. He has led numerous start-ups, turn-arounds, and vertical/horizontal integrations. Po also serves as the Chief Operating Officer for (a Pioneer ACO) and provides management and consultation for Navvis Healthways Medicare Shared Savings Program ACO Clients. A graduate of George Washington University, Po holds both a M.P.H. and a M.S. from The University of Texas, and completed Dr.Ph. and Ph.D. doctoral qualifications at The University of Texas. 58
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