Rich Roth: SharedClarity is "ahead of the curve," leading the charge in changing health care industry, controlling costs

Transcription

1 Supplier Update Q IN THIS ISSUE Featured Story Rich Roth: SharedClarity is "ahead of the curve," leading the charge in changing health care industry, controlling costs Clinical Review and Collaborative Contracting News Member Update New Faces Get the Facts What Makes SharedClarity Different? Holiday Greeting Featured Story Rich Roth: SharedClarity is "ahead of the curve," leading the charge in changing health care industry, controlling costs GAIN EFFICIENCY. SPEED TO MARKET. MARKET SHARE. Health care executive Rich Roth says SharedClarity is "catching the right wave" at the right time. Health systems are facing more competition for patients and revenue and must manage their costs better, especially under the still-evolving Affordable Care Act. "As health care costs become increasingly complex," says Roth, vice president of strategic innovation for Dignity Health, "every provider needs to react now to improve health care and the cost of health care. Implants are an important cost and quality factor for patients. Patients should be able to trust that not only are they getting a good value for their implant, but that it won't need a replacement surgery in ten years."

2 UnitedHealthcare and Dignity Health one of the five largest health systems in the nation established SharedClarity, a unique organization focused on transforming how medical devices are evaluated, selected and sourced. The startup company conducts clinical reviews and studies on high-impact medical devices think hip and knee replacements, pacemakers, stents to determine the most-effective implants, with the goal of improving patient outcomes and reducing readmissions. "Health care is a very human industry," he says. "We all play a role in it, and need to partner together to have superior outcomes in order to succeed." SharedClarity establishes contracts with manufacturers of the top-performing medical devices on behalf of its members, currently UnitedHealthcare, Dignity Health, Advocate Health Care and Baylor Scott & White Health. The Phoenix-based company helps control costs and improves outcomes, while increasing market share and efficiency for medical device suppliers. "SharedClarity will be an important tool," says Roth, whose charge is to improve care through innovative solutions and partnerships at Dignity Health. "We need to have significant changes to develop the health care of the future." Collecting and examining data will play a key role in the next-generation of health care, Roth says. SharedClarity, through its three health care systems and industry giant UnitedHealthcare, has access to literally tens of millions of patient data, from the devices utilized to the various treatments they received regardless of location where they were rendered. "There has been a 'black box' in the past when it comes to transparency around outcomes," Roth says. "We're just coming to grips with the data and what that will mean." That data helps SharedClarity determine the most-effective medical devices for its member health care systems and UnitedHealthcare. SharedClarity is actively pursuing members who align from a cultural fit. "It's really a combination of data and participation" he says. "With more members, SharedClarity should be able to make marked changes in the industry." But with change comes uncertainty. Medical-device companies to physicians are asking questions about SharedClarity. "We're unveiling a game-changer here," Roth says. "SharedClarity is ahead of the curve." Of course, patients those who will likely benefit the most from SharedClarity are not aware of the new, behind-the-scenes model. "I think the general public just wants to go to the physician and ensure they are being treated with kindness, the highest quality of care, and given an implant that is safe and secure," he says. And that's the goal of SharedClarity. "We all have a responsibility to make sure patients' needs are met," he says. "And this is an unmet need we will be able to fill."

3 Clinical Review and Collaborative Contracting News Clinical reviews on Bare Metal, Drug-Eluting and Peripheral Stents started in Led by a member-physician, the clinical review teams (CRTs) provided insights from their case studies using these devices. Concurrently, SharedClarity released three RFPs for these cardiology categories. We are in the final stages of the clinical reviews and strategic sourcing activities. Contract award announcements are expected first quarter of Did you know? More than 1 million patients in the United States receive coronary artery stent procedures each year. Blocked by Costs Coronary heart disease costs the U.S. $108.9 billion annually, including the cost of health care services, medications and lost productivity. A recent Health Affairs study predicts the average risk of heart disease will rise to 15.1% for men by 2030 from 12.7% today, and 8.6% for women from 6.8% today. In a report issued by GBI Research, it suggests that individuals with heart problems are at highest risk of health problems or even fatality as a result of unsafe devices. From 2005 to 2010, cardiovascular therapeutic devices accounted for 16% of total device recalls. New Pathways of Treatment Cardiologists are increasingly accessing coronary arteries by way of the wrist rather than the groin to insert life-saving stents into patients with blocked arteries, according to the first broad report of the American College of Cardiology's Clinical Data Registries. The report showed stenting performed at the radial access site (the wrist) increased from 2.9% of cases in 2009 to 10.9% of cases in 2011, while stenting performed at the femoral access site (the groin) decreased from 96.5% to 88.8%, during this time period. While this approach is new and still being studied, research has shown that radial access can reduce complications, discomfort and recovery times in some patients. Member Update Baylor Health Care System has completed its merger with Scott & White Healthcare, creating the largest not-for-profit health care system in Texas. The newly formed Baylor Scott & White Health will continue as a member of SharedClarity. Baylor Health Care System was a member before the merger. The combined health care system has more than $8 billion in assets, 34,000 employees, more than 500 patient-care sites, 43 hospitals and 6,000-plus affiliated physicians.

4 Joel Allison, who was CEO of Baylor Health Care System, will continue as CEO of Baylor Scott & White Health. Robert Pryor, president and CEO of Scott & White Healthcare, will serve as president, chief operating officer and chief medical officer of the newly merged systems. Baylor Health is a leading provider in North Texas, while Scott & White is a major system in Central Texas. Their service areas do not overlap, creating more opportunities for ensuring quality and affordable health care in the region. New Faces SharedClarity has hired Shay Damaske as our first national sales consultant, a critical role for the new venture that is conducting independent studies on the long-term effectiveness of medical devices implanted into patients. Damaske, a 20-year clinical and health care supply chain industry expert, was most recently marketing manager for Novation in Las Colinas, Texas. She was responsible for the company's strategic initiative for price leadership and launched an interactive digital resource and tools platform. She also managed a portfolio of physicianpreference contracts and launched an innovative contracting strategy for hip and knee joint replacements with Novation. Damaske earned her Bachelors of Science in Nursing from Texas Tech University Health Sciences Center. "Shay has the industry and clinical experience that will greatly benefit SharedClarity and its members," said SharedClarity President Mark West. She is the latest to join an impressive lineup of first-rate health care industry professionals." Get the Facts A regular feature which focuses on issues impacting our health care industry and how the SharedClarity business model addresses these challenges.

5 Sources: EHR Intelligence, "Current readmissions data may be misleading," Robert Wood Johnson Foundation, "The Revolving Door: A Report on U.S. Hospital Readmissions," 2013 New accountable care guidelines institute hard penalties for hospitals that are unable to prevent readmissions for certain conditions, including joint replacement procedures. With an increasing number of seniors seeking joint replacements to maintain their active lifestyles longer, hospitals must find better ways to treat patients. Hospitals will begin to pay up to $265,000 per knee or hip replacement readmissions. Fines for joint replacements will also be assessed for patients retroactively to However, hospitals trying to cut their readmission rate to avoid penalties may not be working with the right data, says a study by the University of Michigan Health System. While health systems are aware of how many patients are readmitted to the same facility, they are lacking data on which patients may receive care at one provider and then check into a different hospital. Without the full continuum of care data, a hospital's attempts at quality improvement may not go far enough. According to Andrew Gonzalez, MD, JD, MPH, a research fellow in vascular surgery at the University of Michigan's Center for Healthcare Outcomes and Policy, says hospitals are attempting to solve the readmissions problem without having all of the puzzle pieces. At SharedClarity, our database follows the patient. By triangulating claims data from UnitedHealthcare, device and clinical data from our large member health systems and publicly available data such as registries, members have all the pieces of the puzzle. This complete picture is the infrastructure we use for all clinical reviews/comparative effectiveness studies on all sourced medical devices. Sourcing proven medical devices, allows health care facilities to use reliable devices and reduce the need for readmissions. What Makes SharedClarity Different? We're asked this question almost daily. It's a great question, one that we're always glad to answer because SharedClarity's approach is a new innovation for the health care industry. So, we wanted to take a few moments and detail just some of the things that make SharedClarity different, special unique.

6 Some people refer to our company as a GPO (group purchasing organization). But our business model is very different. It's like comparing a Toyota with a Tesla. Sure, both are cars, but they are dramatically different under the hood. Here are some ways that our business model makes a new path: SharedClarity is a corporation that will have up to as many as 10 members. Industry leaders UnitedHealthcare and Dignity Health launched SharedClarity. UnitedHealthcare offers the full spectrum of health benefits for individuals, employers and Medicare and Medical beneficiaries, and contracts directly with 780,00 physicians and care professionals and 5,900 hospitals and other care facilities nationwide. UnitedHealthcare serves more than 40 milion people in health benefits. Two other members Advocate Health Care and Baylor Health Care System (now Baylor Scott & White Health) have joined, and others are expected soon. With UnitedHealthcare and three health care systems as initial members, SharedClarity has access to tens of millions of patients' records during the past decade, ensuring a broad understanding of the effectiveness of medical devices, from knee and hip implants to heart valves and stents. UnitedHealthcare's vast database includes pharmacy, lab, socioeconomic and mortality information. In short, data is the key to opening the door to better patient outcomes. And, well, we hold the key. SharedClarity will conduct physician-led clinical reviews on 30 categories of medical devices, and full-blown comparative effectiveness studies are expected on some products. We do not identify physicians participating in the reviews and studies, greatly reducing the likelihood of a conflict of interest. The Optum Labs facility serves as the data and research partner for SharedClarity, with consultants from The Lewin Group overseeing the research. Both Optum and Lewin are highly regarded in the industry. Once the company determines the most effective medical devices, SharedClarity contracts with medical device manufacturers and ensures competitive contracts for health care systems purchasing the implants. In the end, everyone benefits from SharedClarity, from heath care systems to medical device manufacturers. But, most importantly, patients are the real winners, receiving medical devices that improve their health and reduce the likelihood of readmissions. And that should be the goal of everyone in the health care industry.

7 Holiday Greeting At the holiday season, our thoughts turn gratefully to those who have played an important part in SharedClarity's first year of operations. It is in this spirit that we say simply and sincerely - thank you for your collaboration and continued interest in SharedClarity. We wish you a warm and happy holiday season.