the ‘triple aim’ · 2017-03-09 · • cough • cold • flu medical care for adults and...
TRANSCRIPT
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The Kelsey-Seybold ‘Triple Aim’
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BetterExperience
BetterQuality
Better
Value
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• 68 years in the Greater Houston region
• 436 employed physicians in 55 specialties
• Trusted by 500,000 patients
• 1.2 million patient visits each year
• 30 years of experience in population health
• 20 multispecialty, outpatient clinic locations in the region
• Partnerships with all major hospital systems and affiliated
physicians
• $250 million investment in outpatient infrastructure and
an Electronic Medical Record (EMR) System
About Kelsey-Seybold Clinic
Care Delivery: The Woodlands to Clear Lake, Katy to Pasadena
Main Campus – TMC Area
Pearland Clinic
The Woodlands Clinic
Downtown at The Shops4
Kelsey-Seybold Convenience and Access
• Same-day and next-day Primary Care access.
• Saturday visits 9am - 2pm at 4 convenient locations.
• KelseyCare After-Hours Nurses, On-Call Physicians and Specialists.
• Secure email messaging with your physician.
• Onsite lab, X-ray and advanced imaging services.
• No appointment or copay needed for lab or X-ray.
• Total access to 20 Care Centers and All Physicians.
• 24/7 appointment scheduling.
• MyKelseyOnline lab results, appointment scheduling.
Kelsey-Seybold Outpatient Care Centers
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Texas Children’s Hospital ranked nationally in 10 pediatric subspecialties, and was named to U.S. News & World Report’s America’s “Best Children’s Hospital” Honor Roll.
Texas Heart® Institute at CHI St. Luke’s Health ranked by U.S. News & World Report as one of the nation’s top centers for cardiology and heart surgery.
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KelseyCare Hospital Partners
Our Goal Is A Personal Relationship with Each
Member
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Connecting
• Online App to schedule and access your doctor
• Outgoing Outreach for
preventative
• Telemedicine E-Visits available 7 days a week
Convenience
• Talk To Us 24/7
• Saturday Appointments —4 locations
• Same-Day and Next-Day Doctor Appointments
• After-Hours Kelsey Nurses + Urgent Care
• No Referrals to see Kelsey specialists
• Access all doctors, any locationwhenever needed
Concierge
• Help with any questions
• Help choosing a doctor
• Help getting physicals & screenings scheduled
Local. Accountable. Nationally Recognized for Quality.
BUILDING RELATIONSHIPS
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Convenient Online Care from Kelsey-Seybold
• Sprained ankle or knee
• Insect bite
• Shingles
• Laryngitis
• GERD
• Eczema
• Ear infection
• Burns
• Bladder infection
• Cold, flu or sinus
infection
E-Visits Video Visits
• One-hour turnaround + Rx
• Adult care hours:
• Monday – Friday: 8 a.m. – 9 p.m.
• Saturday & Sunday: 10 a.m. - 4 p.m.
• Pediatric care hours
• Monday – Friday: 8 a.m. - 9 p.m.
• Real-time, face-to-face medical visits
• 50 conditions treated
• Use your smartphone, iPad or desktop
• Monday – Friday; 8 a.m. to 5 p.m.
• Schedule using your MyChart app or
MyKelseyOnline
• Post-op Orthopedic visits available
• Allergy
• Back pain
• Cough
• Cold
• Flu
Medical care for adults and children
for 10 common conditions including:
• Heartburn and acid reflux
• Pink eye
• Sinusitis
• Urinary tract infection
• Vaginal discharge
Kelsey-Seybold is recognized for excellence with major NCQA recognitions,
including ACO accreditation.
NCQA Level 3 Patient-Centered Medical Home • Level 3 is NCQA’s highest level of achievement
The Nation’s First NCQA-Accredited Accountable Care Organization (ACO)• Houston’s Only NCQA-Accredited ACO
• One of only two in Texas
NCQA National Recognition for Excellence in Diabetes Care• 79 recognized physicians
NCQA National Recognition for Excellence in Heart and Stroke Care • 103 recognized physicians
NCQA National Recognition for Excellence in Back Pain and Spine Care• 5 recognized physicians
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• The KelseyCare Network Plan currently delivers coordinated,
accountable care to more than 70,000 enrollees in the Greater
Houston area. Care delivery is provided and coordinated by Kelsey-
Seybold Clinic and its 4,000+ members, “affiliated doctors.”
• Care delivery and care coordination is delivered by Kelsey-Seybold
Clinic, named in 2012 as the nation’s first accredited Accountable
Care Organization (ACO) by the National Committee for Quality
Assurance (NCQA). NCQA accreditation is a rigorous process that
verifies Kelsey-Seybold’s ability to deliver high-quality,
coordinated, accountable care, meeting the NCQA’s “triple aim” of
higher patient satisfaction, higher quality, and lower total medical
cost
• KelseyCare is delivered through four carrier partners: Cigna,
UnitedHealthcare, Aetna, and Boon-Chapman.
About The KelseyCare Network Plan
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Open Access,
No ReferralRequired
for Appointments
Kelsey Physicians Refer to KelseyCare Affiliated
Specialists(referral required)
436Kelsey-Seybold
Physician Providers
50+Specialties
20Clinic Locations
Saturday HoursClear LakeFort Bend
SpringTanglewood
4,691Affiliated Physicians
and Specialists
Affiliated HospitalsTexas Medical Centerand the Community
Clinically Integrated Medical Management
Programs
Prescription Management
Physician Hospitalist Program
Prevention Plus
Disease Management
Case Management
Utilization Management
Online Patient Portal
Electronic Medical Record
Telemedicine Services
After-Hours Nurse Triage
Medical Center West Campus
2 Outpatient Surgical Centers
Urgent Care Centers and Emergency Care
This plan is offered by Cigna, UnitedHealthcare, Aetna, and Boon-Chapman.
Accountable Care Plan Structure
How We Achieve Results
Conservative, evidence-
based practice of medicine
Care coordination— in
person, online, telephonic
Outpatient first, hospital
when needed
Proactive, aggressive
management of chronic
diseases
Emphasis on prevention
and early identification of
disease
Intensive inpatient
management
Comprehensive pharmacy
management
Comprehensive, integrated
Electronic Medical Record
KelseyCare Plan Financial Outcomes
• 15-30% savings on total healthcare costs
• 3-5% reduction of total costs through clinical prescription management
• 60-70% preventive care compliance rates early detection of chronic
disease
• 40-55% Reduction of High-Cost Claimants Per Member Per Month Cost*
Better Clinical Management
Average Performance Results – Kelsey-Seybold Hospitalist Program
• 20-25% Lower Inpatient Admits Per 1,000 Members*
• 20-30% Lower Inpatient Bed Days Per 1,000 Members*
• 20-25% Lower Emergency Room use*
*As compared to traditional PPO, POS and HMO products.13
How Do I Get a Quote?
• You can ask your current broker or consultant for a Kelsey-Seybold KelseyCare quote option from Aetna, Cigna, or UnitedHealthcare.
• Go to www.kelseycare.com/getaquote and complete the Get a Quote form and a licensed sales team member will reach out to you by phone.
• Contact the following sales team members directly for assistance:
Paula Turnquist
832-326-7565 – Cell
Christine Tricoli
713-408-1466 – Cell
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