Population Health 2.0: Bending the Cost Curve by Moving Beyond the Pyramid

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1 Population Health 2.0: Bending the Cost Curve by Moving Beyond the Pyramid

2 Advocate Health Care $5 Billion Annual Revenue AA Rated 12 Acute Care Hospitals 1 Children s Hospital 5 Level 1 Trauma Centers 4 Major Teaching Hospitals 6 Magnet Designations 1 Clinically Integrated Hospital Over 250 Sites of Care Advocate Medical Group Dreyer Medical Clinic Occupational Health Imaging Centers Immediate Care Centers Surgery Centers Home Health/Hospice Advocate Physician Partners Clinically Integrated Network Physician Membership 4,500 physicians 25% PCPs and 75% specialists Total membership includes 1,300 Advocate-employed physicians and 3,200 aligned physicians 9 Physician Hospital Organizations (PHO s) 2 Medical Groups 609,000 Attributable Lives Commercial Medicare Medicaid

3 Advocate s Information Evolution Can we quantify Health Outcomes Performance? Why is that our performance? Can we understand care provided across the continuum? What is our KRA performance across the continuum? Can we quantify performance for other key areas (e.g., Pat Sat)? Can we predict our performance? 3

4 Emerging Capabilities People Data analyst statistician data scientist Technology Reporting data warehousing big data platform Data Claims clinical claims + clinical

5 Advocate Cerner Collaborative (ACC) Mission Leverage Advocate s experience in clinical integration and Cerner s experience in health care automation to improve population health management capabilities Together the collaborative team will innovate to: Identify /risk stratify patients at risk Facilitate appropriate and early interventions Guide care across the continuum

6 ACC Timeline Year 1, 2, 3 Acute Care Near-term Population Health Long-term Year 1 goal: Focus on near-term population health opportunities while establishing the foundation for comprehensive long-term innovation. Readmission model Falls risk and prevention Build the population health data platform Year 2 goal: Focus on creating predictive models to improve care in the ambulatory settings and begin connecting the community to broader population health tools. Year 3 goal: Drive health and care of the population with predictive analytical models across care settings.

7 ACC Core Competencies: The People 2 Associates Model Deployment Analytic Models 5 Associates 3 Associates Data Platform

8 Billing data ACO PBM ACO Claims Healthe Intent Raw Data Big Data Information Model Longitudinal Record Optimized Programs Evidence Learned Knowledge Data Transformation Analytics AMG (Allscripts) APP (ecw) Dreyer (Epic) Indexed Algorithms 8 Hospitals (Millennium) BroMenn (Meditech) Sherman (Millennium) De-identified Metathesaurus Identify Attribute Predict Intervene Measure Analyze Big Data Analytics Workflow Enhancement ACO Support Home Health and Other Post Acute data (Allscripts) Advocate empi ACC Clinicians Physicians/Care Management/APP

9 Data Platform Uses Solution Development Registries Business Intelligence for ACO Health Information Exchange Outpatient Care Management Business Needs Clinical Integration, physician alignment, research Patient centered operational improvement across the continuum Real-time patient information Improved information to support appropriate patient interventions

10 Readmission Outcomes Leading the industry ~ 20% better than industry (Yale, LACE, etc.) Solution purchased by 170 non-advocate Cerner clients Gaining efficiency ~ 3.5 FTE productivity savings across system Automated continuous calculation of risk score in EMR Reducing readmissions 20% reduction in readmission rates (for high risk patients that received interventions) Statistically significant reductions observed for sub-populations (e.g., COPD and HF)

11 Where is the Most Appropriate Location for Our Patients? Hospital Rehab Assisted Living? Skilled Nursing Home Care Behavioral Health Retail Pharmacy

12 Transition of Care Model Results The overall proportion of concordance vs. discordance is 71% vs. 29% ~ $200M total cost of care savings Discharge Locations Actual (Historic) Recommendations Home 67.1% 66.4% Home Health 13.2% 15.5% SNF 14.7% 14.1% Rehab 2.4% 1.6% LTAC 2.6% 2.3%

13 Moving to Population Health: 201 Issues with the Pyramid Case Management Complex 12.0% Disease Management Common Multi-Chronic 15.8% Supported Self-Care Single Chronic 14.6% Prevention and Wellness Promotion Healthy No Claims 35% 22.5%

14 Population Health Spectrum Opportunity Value

15 From Pyramid to Spectrum Population Health Business Intelligence Tool Targeted interventions based on impactability Global measurement of clinical effectiveness

16 Health Definition (Germanic): Being whole

17 Tina Esposito Advocate Health Care