Hospital-At-HomeExtending the Continuum....

Vince Kuraitis JD, MBA

Better Health Technologies, LLCwww.bhtinfo.com (208) 395-1197

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A huge potential disruption....

...that hardly anyone in the U.S. is talking about...yet...is...

Hospital-At-Home (HAH)

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Hospital at home is defined as a service that provides active treatment by health care

professionals, in the patient's home, of a condition that otherwise would require acute hospital in-

patient care, always for a limited period.

$34 B Market for Healthcare Unbound Technologies

$0

$10

$20

$30

$40

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

ADL/elder Chronic Acute

Total

Acute

Chronic

ADL/elder $0.35

$US(billions)

$0.37 $0.47 $0.59 $0.73 $0.98 $1.2 $1.6 $2.0 $2.4 $3.0 $3.7

$0.10 $0.13 $0.22 $0.38 $0.65 $1.2 $3.8 $12.1 $23.1 $26.3 $25.7 $26.7

$0.00 $0.00 $0.00 $0.00 $0.01 $0.02 $0.65 $2.0 $3.6 $3.5 $3.0 $3.2

$0.45 $0.50 $0.69 $0.97 $1.4 $2.1 $5.7 $15.7 $28.7 $32.3 $31.7 $33.6

(Numbers have been rounded)

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While there is some overlap....

Disease/condition management is mostly about avoiding hospital care (and other

high-cost care)

HAH is mostly about substituting for hospital care

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Hospital-at-Home -- Background

• Concept emerged in the 1960s• Significant research/literature base

– Almost all outside of U.S.– Cochrane review– Johns Hopkins as only U.S. project

• HAH definition varies• NOT based on leveraging technology• But, HAH can be turbocharged with technology• Early example of a company with a HAH

business/care model – Care Level Management

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Elaborate Proof of a Hypothesis.....

The Willie Sutton Theory of Hospital-At-Home

Projected 2014 U.S. Annual Hospital Costs = $1 Trillion

Projected 2015 Healthcare Unbound market of $34 B = 3.4%

Outside the U.S. ....

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HAH Driving/Restraining Forces

Cost reduction opportunity

Hospital safety/error issues

Concerns over hospital acquired infections

Patient preference for home

Benefit structures & incentives

Advancing tech allows for safe care in home

Potential burden on caregivers

Risk of HAH being viewed as a reincarnation of managed care

Physician concerns and inconvenience?

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Long-term....A (Not So) Rhetorical Question

If we can spend $1 Trillion a year in the U.S. to care for people in buildings where– There is a high risk of infection– 98,000 people die annually due to medical errors– The cost of care is higher than anywhere else– People don’t want to be

Why would we spend only 3.4% as much ($34 B) to care for people in their

homes and communities?

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Call to Action

The U.S. needs to join & advance the world dialogue

about hospital-at-home

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APPENDIX

• Creating value for patients and shareholders• Strategy, business models, partnerships• Disease/care management and e-health • Consulting/Business Development

• E-Care Management News– Complimentary e-newsletter– 3,000+ subscribers in 27 countries worldwide– Subscribe at www.bhtinfo.com/pastissues.htm

Better Health Technologies, LLC

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BHT Clients

Pre-IPO CompaniesHealthPost

Cardiobeat

HomMed

EZWeb

Sensitron

Life Navigator

Medical Peace

Stress Less

DiabetesManager.com

CogniMed

Caresoft

Benchmark Oncology

SOS Wireless

Click4Care

eCare Technologies

The Healan Group

FitSense Technology

Established organizationsSamsung Electronics, Seoul

Intel Digital Health Group

Medtronic

Philips Corporate Strategy Group, Amsterdam

Siemens Medical Solutions

Joslin Diabetes Center

Sears Methodist Retirement System

National Rural Electric Cooperative Association

Disease Management Association of America

Blue Cross Blue Shield of Massachusetts

PCS Health Systems

Varian Medical Systems

VRI

Washoe Health System

S2 Systems

CorpHealth

Physician IPA

Centocor

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END