ADVANCING THE POPULATION HEALTH JOURNEY
Amanda Hammel, VP IT Operations and Population Health
Memorial Hermann
Memorial Hermann System of Health
Members
Patients
Consumers
Health
Insurance
Primary Care
Specialty
Care
Ambulatory
Care
Hospital Care
Post-Acute
Members
Patients
Consumers
Memorial Hermann System of Health
Health
Insurance
Primary Care
Specialty
Care
Ambulatory
Care
Hospital Care
Post-Acute
heart
Memorial Hermann System of Health
Members
Patients
Consumers
Health
Insurance
Primary Care
Specialty
Care
Ambulatory
Care
Hospital Care
Post-Acute
Sports
Memorial Hermann System of Health
Members
Patients
Consumers
Health
Insurance
Primary Care
Specialty
Care
Ambulatory
Care
Hospital Care
Post-Acute
Neuro All
Memorial Hermann System of Health
Members
Patients
Consumers
Health
Insurance
Primary Care
Specialty
Care
Ambulatory
Care
Hospital Care
Post-Acute
Population Health
Enterprise
Gr Houston >11,000
MHMD 4,000
CI 3,300
ACO* 3,000
PCMH 410
Clinically Integrated IPA
Private, Employed &
Faculty Integration
Exclusive Contracting
DOJ/FTC Protections
Health
System
3 Distinct Practice Models
Employment
*ACO number Includes UT MDs
Private
Faculty
13 Independent Medical Staffs
Building a Population Health Organization
Population Health Organization's
primary purpose is keeping their
populations healthy by doing the
following:
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•
Redefining their consumer relationships
Transforming how care is delivered
Improving access and affordability
Accepting at risk payments for health cost
and outcomes
Traditional Model
Treat sick people
Episodic patient
Specific competencies
Alleviation of symptoms
Population Health Org.
Health
People
Care Delivery
Outcomes
Incremental improvement
Keep people healthy
Members
Integrated & scalable
Improve quality of life
Drives the business
Analytics
Fee for service
Fixed Payment (Capitation)
Payment
Evolving range of financial & clinical risk
Continuum of Provider Sponsored Risk
Full
Degree of Financial Risk
Full Risk
Capitation
Provider
Sponsored
Plan
Partial Risk
Capitation
ACOs/
Bundles
Shared
Savings
FFS +
P4P
FFS
PCP
Degree of Clinical and Administrative Integration
All Services
Year 1 & Year 2Aggregate MSSP Savings
MH ACO
Palm Beach ACO
POM ACO
Oakwood ACO
Millennium ACO
ProHEALTH ACO
Allcare Options
Qualuable Medical Professionals
ACC of Texas
Mercy Health Select
West Florida ACO
Collaborative Health ACO
RGV ACO Health Providers
Quality Independent Physicians
Delaware Valley ACO
Physicians ACO
Methodist Patient Centered ACO
Reliance ACO
Maryland Collaborative Care
Premier Patient Healthcare
Lahey Clinical Performance ACO
ACC of Southeast Wisconsin
Integral Healthcare
Genesis APN
Winchester Community ACO
Seton ACO
Medical Mall ACO
New Health Collaborative
Optimus Healthcare Partners
Accountable Care Options
Integrated ACO
The Accountable Care Organization
Nevada Primary Care Network
WellStar Health Network
Independent San Diego ACO
Rio Grande Valley Health Alliance
AnewCare Collaborative
John Muir Health ACO
Circle Health Alliance
TP-ACO
WESTMED Medical Group
Coastal Medical
Paradigm ACO
HHC ACO
Cumberland Center
ACC of Maryland Primary Care
Virginia Collaborative Care
Southern Kentucky HCA
Ingalls Care Network
BHS Accountable Care
MH ACO
$-
Tier II Risk
Generated Savings Yr 2
Generated Savings Yr 1
$20.000.000
$40.000.000
$60.000.000
$80.000.000
$100.000.000
$120.000.000
Population Identification
Care Managers
Health Assessment
Care Mgmt MD
Risk Stratification
Case Manager
Software and Big Data
Health Continuum
Low or No Risk
Moderate Risk
High Risk
Portfolio of Health Management Interventions
Preventative
Services
Lifestyle
Coaching
Transitional Care
Complex Care
Management
Palliative and
End-of-Life Care
Specialist
Physicians
Rehab / SNF
/ Hospice
Improved
Outcomes
Benefit
Design
Other Claims…
Care Mgmt MD
Care Team
Lower
Costs
Medical
Home PCPs
Hospitals
Care Managers
Population Analytics
Tools
Ambulatory
Other
ServicesEMRs…
OPID, SMR,
Lab, Surgery
Case Manager
Population Management Tools
Improved
Satisfaction
Home
Health
Aligned Provider & Hospital
Incentives
Reduce Out
Migration
SmartRecord
Other Claims…
Biometrics
SmartData
Other EMRs…
(HealtheIntent)
(Longitudinal Record)
SmartRegistry
(HealtheRegistry)
ClinicCare4
Web
Report
SmartAnalytics
(HealtheEDW)
Reports
SmartCare
(HealtheCare)
Consumer
Dashboards
COPD
Diabetes
Heart Failure
Hypertension
Ischemic Vascular
Disease Coronary
Artery Disease
Asthma
Adult Wellness
Senior Wellness
Pediatric
Back Pain
Rheumatoid
Arthritis
Ambulatory
Urgent Care
Post-Acute In/Out Network - Dashboard ACO Lives Jan-Sep 2015
22% in network
SmartAnalytics Production Post-Acute Dashboard
$14M of non-MH spend
Memorial Hermann System of Health
Health
Insurance
Primary Care
Specialty
Care
Ambulatory
Care
Hospital Care
Post-Acute
Consumer Focused
Primary Care
Members
Patients
Consumers
Enterprise
Increased Role of the Consumer
Retail
Primary Care
Individual
Insurance
Payment
Services
Preference
Driven Care
Information &
Connectivity
Fitness &
Health
Coaching
Alternative
Health
Personalized
Diagnostics
Probiotics &
Nutrition
Consumer Solutions – Mixed Messages
• Insurance Companies
• Urgent Care Facilities
• Media
• 3rd Party Stakeholders (i.e. Angie’s List)
• Employers
Locations
Locations
Engagement
DigitalEngagement
Digital
Ambulatory
Services OPID,
SMR, Lab, Surgery
Specialist
Services
Advanced Primary
Care Physicians
TeleCare
TeleCare
Hospitals
Post Acute
Consumer Solutions - Locations
Locations
Retail
Focused
Medical Home
Broad Portfolio of Locations and Options
a) Existing Clinic Capacity Fill (campus and community)
b) New Clinic Sites
• Acquisition and De Novo
c) Inside Convenient Care Centers
d) Urgent Care Centers
e) RediClinic (HEB) locations
Consumer
Focused
f) On-site at Employers work locations
g) Health and wellness engagement services
- at work, at home, virtually via self service
Consumer Solutions - “Clicks”
Digital
Consumer Expectation
Source: Accenture
Digital
Digital Engagement 2.0
Current
With no single user experience or identity,
we offer:
• Too many logins
• Desktop-only
• Up to 7 steps to access some features
Digital
Future
Through Digital Engagement we’ll provide:
• One login, one customer identity
• A single, consistent user experience
• Mobile-first design that is device
agnostic
• Customer-managed preferences
Powered by Cerner’s HealtheLife consumer engagement platform
In order to achieve our objective for creating digital capabilities, we strive to design a transformative platform
to provide customers with a seamless, personalized, and user-centric healthcare experience.
DE L I G H T
OUR C US TOME RS
Design a seamless consumer experience
across all stages of the journey
that aligns with a deeper understanding
of what our customers want
Relevant, Seamless, Simple
RE - ORI E N T
OUR B US I N E S S
Transform our business towards
consumer-centricity to advance
health & increase our patient
acquisition, engagement, and innetwork retention
Effective, Agile, Delivers ROI
FL E X OUR
P L AT FORM
Power our business & customer
experiences by optimizing the
technology and operations needed to put
our customers at the center
Robust, Scalable, Deployed Fast
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Integrated marketing analytics
“All my information in one place”
Virtual care
“Blue dot” wayfinding
Second opinions
Member price transparency
And more…
TeleHealth Primary Care
TeleCare
Memorial Hermann System of Health
Members
Patients
Consumers
Health
Insurance
Primary Care
Specialty
Care
Ambulatory
Care
Hospital Care
Post-Acute
Population Health
Enterprise
THANK YOU!
Amanda Hammel
VP IT Operations and Population Health, Memorial Hermann
[email protected]
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