mHealth Israel Conference, Rob Egan, CMO, Aetna Healthagen, October 7, 2013
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Presentation at the mHealth Israel Conference and Business Contest, October 7, 2013 by Rob Egan, Chief Marketing Officer, Aetna Healthagen
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mHealth Israel Conference, Rob Egan, CMO, Aetna Healthagen, October 7, 2013
- 1. Healthagen Population Health Management Rob Egan | CMO Healthagen October 7, 2013
- 2. Confidential and Proprietary2 Purchasers buy health care that is fundamentally more affordable, higher quality, more convenient and satisfying, based on value The local health care ecosystem is accountable for care of the population holistically, and the care of individuals is collaboratively managed across the care continuum, focusing on quality, affordability and satisfaction The population’s health needs are well understood, individuals at risk are identified and the health care system’s performance is continuously measured Providers collaborate to provide patient-centered team-based care and are compensated on performance and value, rather than volume Individuals and their caregivers are actively engaged, interacting though convenient mobile tools with social support Healthagen, a division of Aetna, vision for population health
- 3. Confidential and Proprietary3 Key value drivers for population health Population Health Technology CARE MANAGEMENT ACCOUNTABLE CARE PATIENT ENGAGEMENT OPERATIONAL INTELLIGENCE CLINICAL INTEGRATION
- 4. PATIENT ENGAGEMENT CARE MANAGEMENT CLINICAL INTEGRATION OPERATIONAL INTELLIGENCE ACCOUNTABLE CARE • Integration with unique EMRs and Health IT systems • Intuitive collaboration tools and user interfaces • Community patient records deployment • Secure message notifications • Referral management • Transitions in care • System performance monitoring • Longitudinal view into a given patient or population • Evidence-based medicine rules engine and notifications • Population risk stratification, disease registries • Gaps in care, alerts • Reporting (cost, utilization, quality, provider performance) • Medical care management • Wellness programs • Alternate site care • Medication management • Patient portal, PHR • Decision support • Access, registration and appointments • Wellness, disease management programs • Social caregiving • e-Visits • Education • Financial/bill management • Business transformation services • Value-based contracting • Financial models alignment and modernization • TPA administration • Provider-led health plan insurance products • Marketing and distribution • Consulting • Patient centered medical homes • ACO enablement POPULATION HEALTH TECHNOLOGY & SERVICES Population health management: products & services Confidential and Proprietary4
- 5. 5 Population health management: products & services HEALTH INFORMATION EXCHANGE CARE MANAGEMENT CLINICAL INTEGRATION ACCOUNTABLE CARE OPERATIONAL INTELLIGENCE CLINICAL ANALYTICS EMPLOYEE WELLNESS ACCOUNTABLE CARE PATIENT CENTERED MEDICAL HOME EMPLOYER SPONSORED CLINICS CARE MANAGEMENT & WELLNESS CARE COORDINATION NEONATAL SOLUTIONS SOCIAL CAREGIVING COST COMPARISON MOBILE HEALTH NeoCarePATIENT ENGAGEMENT A Healthagen Business A Healthagen Business A Healthagen Business A Healthagen Business A Healthagen Business A Healthagen Business A Healthagen Business A Healthagen Business A Healthagen BusinessA Healthagen BusinessA Healthagen BusinessA Healthagen Business POPULATIONHEALTHTECHNOLOGY&SERVICES Confidential and Proprietary
- 6. Confidential and Proprietary6 Healthagen population health management entities Healthagen Business Synopsis Comprehensive Population Health Technology and Analytics stack, and largest Health Information Exchange in the U.S. Leading mobile patient engagement platform, providing decision support and tools for individuals to access and navigate the health care system One of largest providers of care management, disease management, health and wellness services; driven by clinical intelligence and active analytics Decision support tools for consumers to select a provider based on transparent cost information Social caregiving platform; allows elderly and debilitated patients to remain independent longer by enabling caregiver support and collaboration Social caregiving platform for families of NICU babies that integrates care management and social support during NICU stay and post-acute phase Personalization framework to integrate wellness programs around the unique needs of the individual Accountable Care enablement and management services Patient-centered Medical Home enablement and management services Ne o Wellness 2.0
- 7. Confidential and Proprietary7 Population health clients & goals Employers Reduce growth in health care costs High-value insurance products for their members Satisfied, loyal members Government Accessible, affordable and efficient delivery system High quality care Reduce cost and burden of chronic diseases Promote healthy behaviors Providers Assume accountability and risk under accountable care and value-based financial incentives, and remain financially viable Provide high-quality and efficient clinically integrated care Attract and retain new patient populations GoalsClients
- 8. Confidential and Proprietary8 Foundation for population health delivery: a clinically integrated care system Organized health care “ecosystem” Governance structure in place Care collaboration and management Electronic health care records with the ability to aggregate and exchange data Holistic, patient-centered focus and engagement Business and financial models that align accountability and incentives – ACOs – PCMHs – Care Bundles Clinically Integrated Delivery System
- 9. Confidential and Proprietary9 Actionable clinical intelligence: identify gaps in care & actively engage patients & providers Cost and utilization Quality and outcomes Avoidable services Preventable leakage Individuals at risk Gaps in care System operating and financial performance
- 10. Confidential and Proprietary10 Embedded team-based care management services: superior impact when delivered by providers Multi-disciplinary provider teams are embedded in the practices – MD, RN, PA, MA, Social Services, Nutritionist, Pharmacists, Behavioral Health Care management technology is integrated with local EHRs in real time Patients are engaged and activated Providers have ownership of process and accountability for outcomes Medical leadership drives results High-Value Provider-driven Care Management Activities Utilization Management Referral management ER management Extended office hours Nurse advice line Concurrent review Discharge planning Care / Case Management Care Navigator (coordinator) Complex case management / extensivist program Transition in care Home & Post-acute care Palliative Care & Hospice Care bundles Medication therapy management Disease Management Asthma / COPD CHF Diabetes IHD High-risk OB Oncology
- 11. Confidential and Proprietary11 Wellness programs: focus on healthy lifestyles, disease prevention Long-term goals are to reduce the burden of chronic diseases, avoidable injuries, depression and suicide Engagement must be personalized and use compelling approaches – Mobile apps that are easy and compelling – Social networking – Game mechanics (neural-behavioral feedback) – Incentives and rewards Health and Wellness Programs — Diet — Workplace and school education and safety — Exercise — Stress reduction — Smoking cessation — Biometric screening / monitoring — Education — Public health actions (immunizations, etc.)
- 13. Confidential and Proprietary13 Engaged patients: more active and satisfied in their care Patients increasingly demand a satisfying, retail-like experience, where quality = convenience With high-deductible insurance, they have skin in the game and are active decision makers They are well informed by the Internet, social media and crowd sourcing They expect to interact through mobile devices and digital media When engaged by their physician and “activated”, outcomes are better We need to re-think the patient experience – Access to my health care record – Transparent information and decision support – Ease of accessing my doctor and getting appointment – Getting to know your Navigator and Care Team – Communicating electronically via mobile device or email – Help staying fit and healthy, and enjoying it – Help managing my chronic condition, and being motivated – Social support from my care givers and others like me – Reducing complexity and burden of managing it all
- 14. Confidential and Proprietary14 Accountability & Risk Accountable Sponsor Accountable Provider Value created through pricing, via competition, in narrow networks. Collaboration Managing risk and accountability by aligning incentives for financially sustainable health care Value created through efficiency, reducing waste, cost restructuring and keeping patients healthier. Financial sponsor assumes accountability Episode-based payment to providers Fragmented, uncoordinated care — left to sponsor’s centralized DM, CM, UM (telephonic & mail) Payer provides traditional insurance services in adversarial relationship with providers Providers assume accountability and risk for population Payment based on value in terms of total cost, quality and satisfaction Care coordination and management longitudinally by providers Payer becomes an enabling partner
- 15. Confidential and Proprietary15 Healthagen’s population health experience > 1,100 Hospitals > 250,000 Physicians > 8 RHIOs > 22M Lives > 8M Lives > 10M downloads > 2.5M mobile users > 4M portal users > 30 ACOs > 100 PCMH/Collab. > 22M lives CARE MANAGEMENT ACCOUNTABLE CARE PATIENT ENGAGEMENT OPERATIONAL INTELLIGENCE CLINICAL INTEGRATION
Notas do Editor
- Pete: If I understand this slide correctly, it starts with image of actual iTriage App and builds to tell the broader story of iTriage’s benefits. This slide gives the audience a good sense of total iTriage package before zeroing in on physician office on the next slide. Discuss how we are a workflow company for the consumer and the provider…we are a a full platform that meets the consumer and helps them navigate their healthcare… wherever they are.