lifeview care ati solution presented by sprint
DESCRIPTION
TRANSCRIPT
The Home Intensivist Practice
Linking Patient Needs to Care Expertise
• The Opportunity
• LifeView Care and Advanced Care Management (ACM™) Program
• Traditional Care v. ACM Model
• The Solution
• Discussion
You’ve got to fish where the You’ve got to fish where the fishes is?fishes is?
Where The Fishes IsWhere The Fishes IsHHIGH NEED PATIENTS REPRESENT THE GREATEST IGH NEED PATIENTS REPRESENT THE GREATEST
OPPORTUNITY TO SAVEOPPORTUNITY TO SAVE
Based on Commercial Lives @ Blue Cross Blue Shield/ WellPoint Based on Commercial Lives @ Blue Cross Blue Shield/ WellPoint
LOW RISK MEMBERS
OPTIMIZE RESOURCES IN
ACUTE EPISODES OF CARE,
POPULATION CARE
LOW RISK MEMBERS
OPTIMIZE RESOURCES IN
ACUTE EPISODES OF CARE,
POPULATION CARE
MODERATE RISK MEMBERS
DM AND EDUCATION, RISK
AVOIDANCE
MODERATE RISK MEMBERS
DM AND EDUCATION, RISK
AVOIDANCE
WELL MEMBERS
PREVENTION AND EDUCATION
WELL MEMBERS
PREVENTION AND EDUCATION
HIGH RISK, MULTIPLE DISEASES
EPISODIC CARE MGMT, CLINICAL
GUIDELINES, HIGH RISK DM
HIGH RISK, MULTIPLE DISEASES
EPISODIC CARE MGMT, CLINICAL
GUIDELINES, HIGH RISK DM
COMPLEX & INTENSIVE
CARE
TOTAL CARE INTEGRATION
COMPLEX & INTENSIVE
CARE
TOTAL CARE INTEGRATION
Population 50% 20% 25% 4%
1%
Population 50% 20% 25% 4%
1%
MEDICAL COSTSMEDICAL COSTS
10%10% 10%10% 25%25% 30%30% 25%25%
High need patients with avoidable institutional services pre-65 =.3% to .8%, post-65 = 3 to 5%
The OpportunityThe OpportunityHigh Cost Members Current Status
Top 5% users:
50% of care services
65% of services are institutional (Hospital and ER)
High Cost Members w/ LifeView Care Clinic The New Reality
Home Intensivist Practice
Chronic Care SpecialistPatient Needs MetSuperior Financial
Impact
60% drop in institutional costs
Greater access Superior Satisfaction50% Net ROI Year
One
The OutcomeThe Outcome
People We Help?People We Help?Multiple Intersecting DiseasesMultiple Intersecting Diseases
Target ProfileMultiple chronic diseases & conditionsPsycho-Social issuesMental & Behavioral issuesPoly-PharmacyKnowledge DeficitHeavy users of ER and Hospital
Co-Morbid ConditionsHeart FailureBrittle DiabetesChronic Obstructive Pulmonary DiseaseObesityHypertensionChronic Kidney DiseaseBehavioral illness
We’ve been working with the medical We’ve been working with the medical community for 15+ years to refine and our community for 15+ years to refine and our solution … solution …
US Department of Veterans Affairs
• 100 patients produced savings of $1.8M in 18 months• ROI of 94%
• Before ATI: 310 patients averaged 5 admits/yr for 2 years (1,500 admits)
• After ATI: 3 admits for entire patient group
• Net yield 1% readmission
• 150 patients/3+ years: Inpatient costs down 95%
• ER costs cut by 100%, net 73% cost reduction
• Readmit rate at 5% for all telehealth monitored patients.
• 781 patients produced $26M in 1st year savings
• 9:1 ROI
Practice of Medicine vs. Disease Practice of Medicine vs. Disease ManagementManagement
Why DM produces small impactWhy DM produces small impact
Disease Management
Scope of PracticePractice of
Medicine Scope of Practice
The Difference with a Home The Difference with a Home Intensivist PracticeIntensivist Practice
MEDICINE PRACTICED EVERYDAY: LIFEVIEW MEDICINE PRACTICED EVERYDAY: LIFEVIEW CARECARE
Day 1
Day 2
Every
Day
Medical Practice : individual care plans adjusted daily
&&
Hom
e In
ten
siv
ist P
ractic
e
Life
Vie
w C
are
Team
DM Nurse
Primary Care
Hospital/Facility Services
Physicians
Homecare
Basic
N
etw
ork
Telecare Clinician
Pharmacist
Chronic Care Specialist
Specialists
Nutritionist
FAMILY
PARTICIPANT
Connects Expert Care Where and When Needed
• Expert physician-led interdisciplinary team• Expert applied-knowledge networks• Mass customization of physician level care
algorithms with integrated medical devices • Real time patient assessment & intervention as
needed
•Clinical work flow redesign•Continuous access to proactive care•Daily self care/patient empowerment•Bidirectional data/knowledge exchange•Ordinary telephone line or broadband
Stitches
RX and OTC Confirmation
Injections
Tools to Keep Patients Stable at Home
Clinician Dashboard
What Changes?What Changes?Clinical
◦Proactive replaces reactive◦Continuous 24/365 connected
care replaces fragmented◦Empowerment ◦Activation◦Practice at top of license◦100-300% increases in
efficiency, effectiveness and impact
Operational/financial◦Aligned incentives◦Expert operations support◦Leverage of national and
regional infrastructure◦Rapid CQI & R&D◦Product expansion
Dramatic Improvement
Much lower utilization
Lost a lot of weight
Controlled diabetes
Off insulinOff Lasix
Cholesterol lower by 110
12 fewer prescriptions
Active and engaged
After ACM
0 Admits 1 ER165 lbs. HBA1C4.2 Insulin 0 unitsdiscontinued
Lasix discontinuedTotal Cholesterol 134 Medications 35Notes: Shopping by herself; Used debit card first time, Daily exercise at gym
Female, 57 yrs. Disabled Nurse
PCP & system expert in complex chronic care (Mayo Clinic)
Repeating cycle of ER and Hospital use…deterioration
Patient X
ACM Improves Lives
Participant Feedback “The monitor has given us peace of mind.”
“The monitor was very helpful in understanding my condition and made me more aware of what I must
do to help myself.”
“I found out so many ideas to help me cope with my health issues.”
“I liked it. Didn’t want to return it. It helped me a lot.”
“I wish I could have it always. Makes me feel more secure.”
Connect Expert Care Where & When Needed
Provider Station
LifeView™ Video Patient Station
ROI = 20% + Better Patient Outcomes ROI = 20% + Better Patient Outcomes with no Change in Existing with no Change in Existing
Benefits/ProviderBenefits/Provider
TargetedEnrollees
ACM Program Overview
Expect .5% of plan enrollees◦ 5 participants:1000 enrollees
Highest health care users ◦ more than $15,000 institutional costs
IDENTIFICATION - Complex cases (higher acuity & at higher risk for utilization)◦ More than 9 medications◦ Many health problems with one or
more uncontrolled◦ Often accompanying psycho-social
issues
Proactive physician led clinical team skilled in the “Telecare” of complex patients
ACM Program Expense◦ $1000 /patient/month◦ $500 / install & training◦ $250 / recovery
Targeted ROI : 20% QTR Progress Reporting
Insurance Cos, ACOs, & Employers
Lower , predictable health care costs; more control over financial exposure
Cost reductions drop to bottom line No disruption to current benefit
structure or network providers Reduced calls to Benefits
administrators from chronically ill employees
People, Members, Employees, &Dependents
Improved health and quality of life while breaking the cycle of deterioration
Health is stabilized and patient is more confident about self care
Care addresses holistic view of patient, not merely medical
The End Result: Everybody The End Result: Everybody BenefitsBenefits