Feorene Presentation V2.0

30628 Detroit Road #148 Westlake, OH 44145-5844www.colonnadehealthcare.com I e. [email protected]

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colonnadehealthcare.comwww.colonnadehealthcare.com

Physician Leadership Forum

National Association for Home Care & Hospice

Annual Meeting & Exposition

Monday, October 22, 2012


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ACO

Bundling

Integrated Care Models

Patient Centered Medical Home

Independence at Home

MCO Innovation

Dual Eligibles

2

PPACA Offers Opportunities for Home Care


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Reforms creates market forces that will present challenges

Continued downward pressure on fees and margins

Potential to be viewed as a

“vendor” and not a “solutions

provider”

Accountability for quality and outcomes throughout episode

Revenue

Care Continuum Value Position

Provider

Provider Concerns


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Redefining The Value StatementOffering An Integrated Solution to Post-discharge Care Management

Medical care delivery in the patient’s residence

Alternative for follow-up visit to busy PCP office with access and scope limitations

Integrated, collaborative care in a SNF using physicians and Advanced Practice Providers

Offering ED physicians clincally appropriate options to an I/P

admission

Acute Care

MedicalHouse Calls

ED Diversion

DischargeClinic

SPaRC

Home Care

TechnologyCare Transitions

Psycho-social Support


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ChallengesOpportunities

Opportunities Bring Challenges

5

Increased demand for home care workforce

“Just” a tool for value based contracts

Infrastructure for a accountable provider

Integration of medical capability

Increased Volumes

Maintain and Enhance Margins

Move up the Value Chain


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A foundation for providing value present challenges

Build, buy or JV to create necessary infrastructure

Able to “lay hands” on patients

at the right time with the right

clinician

Programs and technology to enable superior DM capabilities

Care Coordination Infrastructure

DiseaseManagement

Care Delivery

Comprehensive Care Manager

Home-based Care


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Transitional CareMedical House Calls

Hospital At Home

Home-Based Chronic Care

Care Coordination Solutions

Technology Links & Integrates


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Dual Strategy:Volume and Solutions Provider

Volume Driven Provider

Solutions Provider

Both• Growth for the sake of

scale

• Streamlined and

efficient culture

• Consistent evaluation

of winning and losing

business lines

• Packaged solution

with niche value

proposition

• Build versus buy to fill

needed capacity

• Focused with building

care coordination

infrastructure

• Dedicated leadership

vendor and solutions

strategy

• Clear vision for each

strategy

• Alignment of

resources


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Solutions Provider

Focus operational strategies on building care coordination infrastructure

Have or willing to build/buy capability to manage at-risk or high-cost patients

Ability to communicate their value proposition as a solutions provider

Capable or moving towards an ability to manage risk

Solutions Provider Characteristics

9


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Case Study: Home Care

• A $30M+ regional powerhouse founded in 1996

• Serves the central and southwest Ohio triangle of Columbus, Dayton and Cincinnati

• Services– Skilled nursing and therapy

– Private duty services

– Hospice (2013)

• Growth – Organic - focus on quality

– Keen eye for strategic acquisitions of both skilled and private duty agencies.

• Strategy– Add a medical house call program to move up the value

chain

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Case Study: Home Care

• Results

– Closed acquisition of NP-lead HCP on

October 1, 2012

– Integrating HCP fourth quarter ‘12

– In discussion with two Dual Eligible MCOs

– Founding partner in post-acute care network

for contracting with Medicare Advantage and

ACOs

11


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Notable Innovators

NaviHealth

Manages the post acute care benefit for MCO and hospital systems.

Leveraged health system’s brand name to provide MSO and affiliate relationships outside of hospitals footprint.

Home Care Division Regional Health System

Univita Health

Manages and coordinates post acute care benefit for MCO and hospital systems.

Mid-sized home care agency manages care coordination for 13 PCMH and 2 IAH programs.

Home Care/PCMH/IAH

Innovations in Post Acute Care

12


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Care Coordination Strategy

Clinical Command Center

Care Delivery

Risk Management

Technology

Patient Recruitment

Craft a Comprehensive Care Coordination Strategy Guide and Integrate


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• Operational

• Talent

• Competitors

• Payers

• Vendors

• Access to investment capital

Assessment

Evaluate your ability to add value

Documents

Feorene Presentation V2.0