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From AM Radio to Pandora: The Health Care Innovator’s Next Frontier

From AM Radio to Pandora: The Health Care Innovator’s Next Frontier. PrimeHealth September 19, 2012. Today’s Agenda. Why we have to fix the system now The tsunamis that are forcing change What we are being asked to do to create a sustainable system

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From AM Radio to Pandora: The Health Care Innovator’s Next Frontier

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  1. From AM Radio to Pandora:The Health Care Innovator’s Next Frontier PrimeHealth September 19, 2012

  2. Today’s Agenda • Why we have to fix the system now • The tsunamis that are forcing change • What we are being asked to do to create a sustainable system • How entrepreneurial innovation can be part of the solution

  3. Medicare+Medicaid is Largest Driver of Future Federal Spending

  4. Huge Increases in Costs for Both Employers & Workers Employer ContributionMore Than Doubled EmployeeContributionNearly Tripled

  5. Health Care Costs Have Wiped Out Real Income Gains $ 870 for inflation $ 945 for health care $ 95 for spending $1910 more income

  6. The Second Tsunami: Information • Moore’s law: number of transistors on a chip doubles every 18 mos. (trend true for >50 years) • Corollary: Information is increasing at an exponential rate • Conclusion: The tools and methods we used twenty years ago are obsolete, and are being replaced

  7. The Third Tsunami: Consumerism • Customer expectations are rising exponentially as well • Other industries have taught Americans to expect their experiences to be individualized and automated: mass customization • Disruptive innovation: minute clinics, other professionals, telemedicine, remote monitoring, personal health records, communities of care; geography increasingly irrelevant

  8. Old Chinese curse: “May you live in interesting times.” Federal deficit over next decade will be driven largely by growth in HC spending. Employer contributions have doubled over the last decade; employee contributions have tripled. We owe the Chinese $1.2 trillion; I think they’re on to us. Being out of money has an amazing clarifying effect on people’s thinking.

  9. Old Game Maximize billable activity Biggest network of unconnected providers Value based on credentials Patients as passive recipients Care centered on providers New Game Maximize health outcomes for least price Providers who produce best outcomes together Value based on outcomes Patients as activated partners Care centered on patients The challenge of doing the opposite of what you’ve been doing

  10. Transformation of Payment and Delivery Source: Modified version of slide from Shih et al, The Commonwealth Fund, August 2008.

  11. Big Data + Empowered, Demanding Consumers = Mongo Opportunity for Innovations That Inform and Empower

  12. Berwick: Kano Model of Innovation • Kano I: reduction in defects (Dissatisfiers) • Kano II: reduction in cost while maintaining or improving customer experience (Satisfiers) • Kano III: new service or product that costs more money (Delighters)

  13. Transformation Opportunity Less of: More of: Moving beyond Kano III to offer solutions to enhance health care experiences, contain costs, and improve the health of Coloradans.

  14. Opportunities for Innovation Coverage + Coordination + Collaboration • Clinica Family Health Services | Access • Providing high-quality treatment in small groups, plus: • Education • Screening • Answers • Support • 90-minute session with coordinated team of caregivers • Improved outcomes, better adherence + Connection? What would it take to offer a new level of interactions and support to patients using the channels they’re already using?

  15. Opportunities for Innovation Connection + Performance Improvement Interventions impact adherence Medication adherence leads to lower health care costs Adherence is a $290 Billion/year problem* * New England Healthcare Institute. Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease, 2009.

  16. Opportunities for Innovation Data on Outcomes, Cost and Quality • Society of Thoracic Surgeons and Consumer Reports: • Data to report on: • complication and survival rates • whether groups used the best surgical technique • whether patients were sent home with certain medicines • Examining whether giving patients access to this kind of information could improve heart surgery outcomes

  17. Thank you! Jay Want, MD Chief Medical Officer CIVHC | Center for Improving Value in Health Care Phone: 720-583-2095 e-mail: info@civhc.org Web site: www.civhc.org

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