Published on November 6, 2008
Breaking the Deadlock: New Partnership Models to Improve Chronic Care Steve Brown, Founder and CEO, Health Hero Network Inc. Health & Human Capital Management Congress, January 25, 2006
Health Hero Network We develop and market the Health Buddy® System: A patient-centered technology and service platform that empowers individuals to manage chronic conditions at home – with professional monitoring and support.
Deadlock: Human, Social Costs “Insurers, for example, will often refuse to pay $150 for a diabetic to see a podiatrist, who can help prevent foot ailments associated with the disease. Nearly all of them, though, cover amputations, which typically cost more than $30,000.” - New York Times, January 11, 2006
The Price of Deadlock $69,900,000,000,000 -Federal Reserve Governor Edward Gramlich, April 21, 2005
Something’s Got to Give • Institution-centered care based on crisis response, inadequate attention to care management or prevention • “Global Aging” combined with “Global Gaining” forcing payers to deal with largest cost driver, chronic illness • To address these needs, healthcare is going electronic, focusing on the home, reorienting around the patient • Deadlock persists because of misaligned incentives
A New Hope • Creative public policy can unlock resources for programs that improve chronic care and save money • Creative business solutions can enable private sector to take risk and guarantee results • Information technology can enable systems of care that ensure best practices and measure performance
VA Chronic Care Model Daily education, monitoring and feedback at home Personalized care management and support
VA Chronic Care Results Veterans Administration Community Care Coordination Service, Florida • 63% reduction in hospital admissions • 60% reduction in hospital bed days of care Published in: Disease Management, Volume 5, Number 2, 2002 Veterans Administration Heart Failure Study • 81% reduction in inpatient bed days Published in: Telemedicine and e-Health Volume 11, Number 1, 2005
Model at Work Outside VA New England Medical Center SPAN-CHF II • 72% reduction in HF hospitalizations • 63% reduction in cardiac hospitalizations Presented at Heart Failure Society of America, 2005 Henry Ford Health System Obesity Study • >10 lbs weight loss in treatment group • <.01 lbs weight loss in control group To be Published 2006
ACCENT / Health Buddy Program • Consortium of Physician Groups • Bend Memorial Clinic, Oregon • Wenatchee Valley Medical Center, Washington • AMGA oversees clinical protocols, quality management • Care management process based on Health Buddy® system • Begins Feb. 1, serving 1,600 high- cost patients with CHF, diabetes, COPD, and co-morbidities
ACCENT Incentive Model • CMS pays consortium flat monthly fee based on program enrollment • Consortium assumes risk for fees against delivering 5 percent net savings • Consortium receives bonus if savings exceed target
The Model Revisited • Organize physicians to take risk, guarantee performance in chronic care • Technology enables patient self-management / monitoring, ensures accountability • Model could work for any payer segment • Opportunity for disease management organizations to work through physicians
Calcification Inhibitors in CKD and Dialysis Patients
Strategic Partnerships ... Changes to Improve Chronic Care ... The changes listed below for each area of the Chronic Care Model can be applied ...
[VIEW LARGER IMAGE] What is a chronic ... Evidence on the effectiveness of the Chronic Care Model was ... high-functioning teams and markedly improve care.
Helping patients with chronic conditions ... The chronic care model (CCM) is a framework to improve care for chronic conditions ... in Health Care. New ...
The Chronic Care Model and Diabetes ... uses a systematic approach to restructuring medical care to create partnerships ... new cases of blindness, and ...
Community health services in Victoria use integrated chronic ... with chronic disease. Primary Care Partnerships ... Chronic Care (Wagner) Model ...
Chronic Care Model ; CLABSI ... New review evaluates treatment options for ... Quality improvement collaborative improves outcomes in children with ...
Self-Management Support :: Improving Chronic Illness Care. ... The Chronic Care Model Care ... a new health partnership between health care providers ...
Five Communication Strategies to Promote Self ... A new model; Practice makes ... As part of our residency program's efforts to improve chronic illness ...
Innovation Center Home > Innovation Models ... new payment and service delivery models in ... improve the health care system ...