Looking over the Horizon Patient Centric …...Source: data from company websites as of February, 2016 Clinics 600+ Clinics 219+ Clinics 160+ Clinics 107+ Owner Humana (Insurer) Owner

Copyright © 2016 Studer Group. Please do not quote or disseminate without Studer Group authorization

Patient Centric ConsumerismLooking over the Horizon

Matthew Bates, MPH


Public Disclosure

Bilateral Mastectomy & Reconstruction

BRCA Genes Sequenced

Source: “My Medical Choice”, New York Times Op-Ed by Angelina Jolie; May 14, 2013

Consumer Initiated & Led


Consumer-Centric is Disruptive!

It’s 7pm on Tuesday night and you have a productive chest

cold that you know needs treatment. Which do you choose?

Doctor Office(next morning | $$$)

Emergency / Urgent Care(now | $$$-$$$$)

Retail Clinic(now | $-$$)

Mobile Visit(now | $)

3

Copyright © 2016 Studer Group. Please do not quote or disseminate without Studer Group authorization4

4 out of 5 healthcare consumers (82%) are open to trying new

ways of receiving medical attention and treatment.

More mobile, more accessible, more connected

Source: HCI Consumer Survey, 2015


What Do Healthcare Consumers Want?

ReliabilityPersonalization

Access Transparent

Pricing


“We always overestimate

the change that will occur

in the next two years and

underestimate the change

that will occur in the next

ten. Don't let yourself be

lulled into inaction.”

-Bill Gates

6


Examples: MedLion Clinics; Oscar; ChenMed;

Iora Health; Surgery Center of Oklahoma

Consumer friendly hours, transparent pricing,

reliable quality

Healthcare via your mobile phone where & when

you want. Includes remote monitoring & alerts

24x7 access to physicians who know your

history and will come to your location

Patient-Centric

Innovation

Retail Clinics

Mobile Health (mHealth)

Concierge

Medicine

7

Patient-Centric Consumer Models

Doctors schedule visits to see patients in their

homes and then drive up with their equipment

Home-Based

Doctor Visits


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• Full-risk primary care providing coordinated primary care to moderate

to low-income seniors with complex chronic diseases

• Primary care physicians serve relatively small patient panels (about

350 to 450) generally through monthly visits plus same-day

appointments when needed.

• On-site pharmacies fill prescriptions within 15 minutes of ordering, so

doctors can hand patients their medication and discuss how to take it

as part of the visit.

• Key specialists see patients at the primary care clinics to promote

easy access and facilitate collaboration among providers.

• Key Outcomes:

40-50% less hospital utilization

Net Promoter Score: 90

60,000+ seniors in 6 states

Patients have 3+ major chronic conditions


• Primary care to meet local-market needs based on risk-adjusted

capitated fees for its services; supplemented by incentives for

meeting patient experience, quality, utilization or savings targets.

• Focus on providing patients with the support they need to follow

recommended treatment and improve their health.

• Small clinics typically staffed by 2-3 primary care providers; 6-9 health

coaches; a clinical team (nurse) manager; and a social worker.

• Health coaches greet arriving patients and stay with them through the

visit acting as patient advocates and doctor’s scribe.

• Doctor panel size: 1,000 | Health Coach panel size: 200-300

• Key Outcomes: acuity-adjusted ED utilization is 50% lower and

hospital utilization is 33% less | Net Promoter Score: 93

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40,000 patients | 29 practices in 11 states

Plans to open 20 practices in 2016


Transparent Pricing:

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*The prices for the procedures listed on this website include the facility fee, the surgeon’s fee and the

anesthesiologist’s fee. The initial surgical consultation is also included, as is uncomplicated follow-up care.

Surgery Price*

ACL Repair $6,790

C-Section including 3-day Stay $8,605

Pacemaker Placement (includes device/leads) $11,400

2nd Stage Breast Reconstruction with Implant

Placement, Bilateral$5,550

Anterior Cervical Discectomy with Fusion, 1 level

(includes hardware)$18,960

Inguinal Hernia Repair $3,060

Source: http://surgerycenterok.com/ accessed Feb, 2016

http://surgerycenterok.com/


The Expansion of Retail Clinics

Corporate Titans vs. Organized Medicine--The New England Journal of Medicine, July 23, 2015

“With … U.S. retail clinics now meeting patients' demands for

convenience, their quality withstanding peer-reviewed scrutiny,

and their number growing, some physician leaders have

begun to acknowledge that traditional medical centers must

reckon with this development.”

There are now more than 3,000 retail clinics

open across the US!

Source: data from company websites as of February, 2016

Clinics

600+Clinics

219+Clinics

160+Clinics

107+

Owner

Humana(Insurer)

Owner

Dignity Health(Hospital System)

Owner

Independently

Owned(Private)

Owner

Enhanced

Equity Funds(Private Equity)

Clinics

202+Clinics

1,000+Clinics

18+Clinics

400+

Owner

Sequia Capital &

General Atlantic(Private Equity)

Owner

CVS Health(Retailer)

Owner

Walmart(Retailer)

Owner

Walgreens(Retailer)


$30 PHYSICALS

Requiring no appointment, $30 sports physicals from

MedExpress couldn’t be easier. Whether your child is getting

ready for sports, school or camp, a physical is the first step in

making sure they’re healthy and ready for activity.

MedExpress website accessed February, 2016

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Clinical Affiliations

• Allina Health

• Baptist Health Care

• Cleveland Clinic

• Dignity Health

• Emory Healthcare

• HCA

• OU Physicians

• Robert Wood Johnson

• Sharp Healthcare

• Sutter Health

• UCLA Health

• etc.

• 1,000+ Locations

• Open 7 days a week

• Extended hours

• Walk-ins welcome & encouraged

• Staffed by Advanced Practice

Providers (NP/PA) with physicians

available via videoconference

• Example Services:

– Common Acute DX & TX

(strep, flu, pink eye, cuts, etc.)

– Physicals

– Vaccinations

– Common Lab Tests Source: http://www.cvs.com/minuteclinic, accessed February, 2016

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US mHealth Demand

80%+ have a

smartphoneSource: comScore, 2015 data analysis

78% of US Smartphone

Users accessed a health

app in 2015. More than any

other app category!

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*Source: Accenture Survey Analysis, 2015

Less than 10%

of Providerssupport online

appointments today.*

77% of patientsthink that the ability to

book, change or cancel

appointments online is

important.*

• Make/Change/Cancel an

Appointment, 24/7

• View/Print/Share Personal

Health History

• Refill a Prescription


Paid for by:(partial list)

Delivered by:(partial list)

17

mHealth: Payers & Providers

18Atrial Fibrillation (AF) Detector | FDA Approved


“Many of Kaiser Permanente's regional

systems are already performing greater

than 50% of visits virtually- through

mobile, or secure messaging, or video!”

--Jamie Ferguson, Kaiser Permanente vice president

of health IT strategy and policy, December 2014


• Try it! Become a retail health consumer.

o Get care at a retail clinic

o Try a leading smartphone mHealth service (Amwell or Teledoc)

• Explore partnerships with retail clinics in your area

o Consider leveraging services for “after-hours care”. Many will agree to send patients back

for ED care and/or follow-up care needs.

• Leverage your EMR investment

o Most modern EMRs include “patient portal” capabilities for scheduling & patient questions

• Talk with your major private payers about reimbursement

o Many private payers have guidelines to pay for “mHealth” visits

• Experiment with access changes and price transparency

o The two most cited reasons why consumers seek retail & mHealth delivery

Ways to Get Started

20


“Think big, start small, learn fast.”

&

“Give your team permission to make mistakes.”

-Wendy Clark, President of Sparkling Brands & Strategic Marketing,, Coca-Cola North America


Back Up

22

Go for it!

Slide 23

Thank You!

Matthew Bates, MPH

Managing Director

[email protected]

720-355-1053 (mobile)

Insert Your

Photo Here

mailto:[email protected]

Documents

Looking over the Horizon Patient Centric …...Source: data from company websites as of February, 2016 Clinics 600+ Clinics 219+ Clinics 160+ Clinics 107+ Owner Humana (Insurer) Owner