Collaboration between Medical Homes and Urgent Care Clinics
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- Sheryl Haynes
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1 Collaboration between Medical Homes and Urgent Care Clinics
2 THE VISION Our company vision is to have a world in which: CITYMD MAKES EVERYONE BETTER. TODAY AND TOMORROW. EVERYWHERE. Patients Providers Payers Never or Immediate Access Outstanding Patient Care Goal to See Everyone Geographic Expansion Active Voice Medical Financial Population Health Long Term Cost Savings +
3 ACCESS & BRAND AWARENESS
4 OUR SCALE
5 WHAT WE RE MADE OF EMERGENCY MEDICINE Family Medicine Internal Medicine TRAINING AND EXPERIENCE
6 YOU MIGHT BE THINKING Traditional Knocks on Urgent Care Fractured Care Low Quality Premium Patients Too Accessible
7 CARE COORDINATION Turning Episodic Care Into Coordinated Care
8 AfterCare: OUR INVESTMENT Our Long Island Site and Staff Who Work Behind the Scenes
9 CARE COORDINATION SOLUTION I: AVERT A Formalized Way To Be The ER Alternative A Real Time ER Diversion Platform: Collects Patient Data Calculates Patient Risk Scores Alerts CityMD Doctors and AfterCare teams Triggers Automatic Response and Focus
10 THE CARE COORDINATION SOLUTION II: NAVIGATE Directing Patients to The Best Providers in the Right Networks True Referral and Direction For Patients and Providers: Collects Key Information: Required Doctor Type, Neighborhood, Insurance Plan, Practitioner Power Score Proactively Notifies: Partner Health Systems, Physicians, and Plans Receive Notifications of Patient Visits Discovers Invisible Patients: Offers new PCP relationships to unattached patients
11 THE CARE COORDINATION SOLUTION II: NAVIGATE The End Goal Of Channeling Patients to The Right Providers Specialist 1 Hospital 1 PCP 1 Urgent Care PCP 2 Specialist 2 Hospital 2 Specialist 3 Specialist 4 Hospital 3
12 THE CARE COORDINATION SOLUTION III: HEAL Exploring and Implementing Long-Term Solutions for the Greater Good Testing New Care Platforms to Heal the Not Yet Sick: Studies Population Health: Dedicated in house team led by the Chief Medical Officer Forms Collaborative Partnerships: Inside our organization and with outside healthcare companies Invests in the Future Of Care: Forms initiatives designed to treat the undiagnosed, newly diagnosed, and not yet sick populations
13 SAMPLE HEAL PROJECT: NOOM HEALTH Compounding Care Value Through Partnerships
14 THE CARE COORDINATION SOLUTION IV: CareCheck The Invisible Care Network Behind Our Doctors On A Mission To Elevate Outcomes: Complete Team Located on Long Island: Dedicated team of 100+ local MDs, PAs, and Scribes Clinical Follow Up Powerhouse: AfterCare makes 2.2 clinical calls per visit, to make visits more valuable A System of Tools and QA: Closing episodic care loop, ensuring compliance with directives, and coaching patients
15 AFTERCARE IS HALF OF CARE Why AfterCare Changes The Value of an Urgent Cate Visit Name: Marjorie Insurance: ID Number: A12090B7 DOB: 6/1/79 Chief Complaint Abdominal Pain Follow Up After Care CareCheck Follow-up call to ensure wellness and quality review Avert system sets UltraSound order in real time Navigate assists in scheduling routine follow-up with specialists HEAL provides Marjorie with diet and monitoring instructions Services Exam Performed by ER Doctor CBC/Chemistry Liver Function Test Outcomes Gall stones detected Marjorie is treated as an outpatient and avoids ER visit
16 DATA INTERGRATION CityMD s Data Collection Capability Need for PCP BMI Fatigue Smoking Chronic Illness High Blood Pressure Need for Specialist Asthma
17 DATA INTERGRATION Our Data Distribution Team and System Need for PCP ACOs / Systems BMI Fatigue Smoking PCPs & Specialists Chronic Illness High Blood Pressure Need for Specialist Payers Asthma CityMD QA Team
18 THE RECIPE The Above and Beyond Components of Care + + =? Outstanding Access The Best ER Doctors Forward Care Coordination
19 THE PROOF IS IN THE PERCENTAGE Evidence That Our Recipe Provides a True ER Alternative % OF CITYMD PATIENTS BY DIAGNOSIS TYPE CY % 26.61% Acute Trauma Abdominal Pain Eye & Ear Gyn/Urology Chest Pain Shortness of Breath Well Visit 1.93% 1.35% 0.49% 1.88% 4.40% 4.18%
20 OUR DON T SEND TO ER RATE Despite Higher Acuity, We Get Patients Home 98.4% SENT HOME 1.6% Send To ER
21 PARTNERING FOR QUALITY: HEDIS 82% 79% 65% What s Next?? Non Use of Imaging for Lower Back Pain Non Prescription of Antibiotic for URI YES Strep Test and Antibiotic for Positive
22 PARTNERING FOR QUALITY: PATIENT CONTROL Compounding Care by Directing Patients REFERRALS BY THE NUMBERS: SINGLE SITE TEST Q WHERE THEY GO: REFERRAL POWER SINGLE SITE TEST Q Soft Referra l Manage d Referral AVERT N/A 22% PCP 19% 15% Ortho 12% 15% ENT 14% 6% Cardiol
23 PARTNERING FOR QUALITY: PATIENT CONTROL The Two Numbers That Make All The Difference REFERRALS WITH NO KNOWN PCP OR NETWORK AFFILIATION SINGLE SITE TEST Q % OF REFERRALS FOR STAT FOLLOW-UP SINGLE SITE TEST Q1 2015
24 Thank You! Q&A
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