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Breaking the Deadlock: New Partnership Models to Improve Chronic Care

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Information about Breaking the Deadlock: New Partnership Models to Improve Chronic Care
Health & Medicine

Published on November 6, 2008

Author: brown2020

Source: slideshare.net

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Breaking the Deadlock: New Partnership Models to Improve Chronic Care, Presentation by Steve Brown, Founder and CEO, Health Hero Network Inc., at the World Congress: Health & Human Capital Management Congress, Washington DC, January 25, 2006
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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

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