Chronic Heartfailure

Benelux Healthcare NBD, 9 December 2014Leon van der Vorst, Floortje Jansen, Murk W.

What is Heart Failure?The diagnosis given when the heart is unable to pump enough blood to meet the needs of the body.

Pulmonary congestion Edema

Breathlessness

Congestion

Edema

Weight gain

Symptoms

2

Heart Failure

+ =Ventricular Dysfunction

Symptoms and/or Signs

2/3rds from heart attack

Multiple other causes

Origin

Diagnosis

Patient view Professional view

How to improve care? Prevention, prevention, prevention

How will Philips get paid for prevention?Focus on quality of care for patient

Quality BasedDRG-Based*“Improved Workflow”• Bundled payments for

single episodes of in-patient care

• Forces hospitals to consider reducing costs for a given procedure type

• No incentive to reduce number of care episodes

“Shared Quality”• Quality incentives, bundled

payments, value-based purchasing shift

• Encourages use of lower-cost options, incentivized reduction in preventable readmissions

• Clinical and economic evidence of quality required to support reimbursement

Managing the patientManaging the healthcare event

Confidential*DRG = Diagnosis Related Groups

1. Shifting Healthcare Payment Landscape 2. Our Right to Play*

* In-market projects to accelerate systemic change in BNL to Shared Quality

Healthcare Systems are changing rapidlyWhat does this mean for care givers?

Historical: Paid for Volume Future: Paid for Lives

Patient Acquisition

Revenue Source

Margin Driver

An economic model driven byreferral capture and fee-for-service reimbursement

An economic model driven by the population size served and total costof care to manage its health

Broad-based,comprehensivereferral network

IP admissionsand facility-basedOP encounters

Geographicallydistributed acutecare platform

Populationmanaged

Integrated primaryand continuum of care network

High-performing,distributed medicalmanagement

Practical implementationCombining care improvements and new remuneration model

Healthstatus ofPopulation1

Chronic

Acute/Exacerbated

Optimalisationpotential

Acute Costs(55%)

Day Clinic Costs(35%)

GP Costs(10%)

Insurer

Total cost = €10.000 p.a.(but savings potential = €3.500)

Total costs for society = €8.000

Shared QualityDRG-Based

Prevention Costs(30%)

Day ClinicCosts(40%)

Acute Costs(30%)

€6.500

Optimized careflow

1 Bron: Diagnose Zorginnovatie

Hospital

Risk sharing technology partner

X

X

Y

€500

Traditional careflow

€1.000

€2.000

Continuous care

HealthSuite DigitalPlatformEnabling the transformation of healthcare in two areas

Professional healthcare deliveryOrchestration, collaboration & analytics to:• Better leverage scarce resources

improving access and quality of care • Reduce overall cost of population

health management

Continuous personal healthMeasurement, monitoring & motivation• Support better health decisions• Improve accuracy of patient

information• Healthier lifestyle

Outcomes-driven Prevention-focused