The best way to predict the future is to create it yourself

Transcription

1 The best way to predict the future is to create it yourself MGC Revolution Through Competition Peter H. Diamandis, MD Chairman/CEO, X PRIZE Foundation

2 Nothing... nothing is impossible

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4 1927 Orteig Prize: New York Paris First team to fly non-stop between NY and Paris Orteigputs up $25,000 9 teams spend $400,000 Lindbergh, 25 year old underdog wins! Results: Top media story of the century Transformed public s view of Aviation 6, ,000 passengers in 18 months

5 Ansari X PRIZE First team to fly 3 people to Rules: space, twice within 2 weeks $10 Million prize purse Privately funded teams 3 person reusable spaceship 100 km altitude Two flights within 2 weeks

6 Finding Sponsorship 1996 thru 2004

7 Competing Teams ARCA Space Transport 26 teams from 7 nations spending over $100 million, sparking a new generation of space entrepreneurs DaVinci Project Canadian Arrow Rocketplane Armadillo Aerospace StarChaser Pablo DeLeon Scaled Composites Darwinian Evolution: Literally every possible approach was tried by teams.

8 >6 Billion Media Impressions Worth in Excess of $120 Million

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11 X PRIZE Vision Video

12 Our Mission: To bring about radical breakthroughs for the benefit of humanity. What We Do: We identify, design and launch X PRIZEs to address the grand challenges of our times.

13 Hallmarks of an X PRIZE Highly leveraged: typically 10 40x Efficient: only pays the winner Sparks new industry development $1B+ Industry Start $2.5M Start-up St. Louis $10M Purse Ansari Family $100M Teams Spend

14 Trustee & Vision Circle Members Eric Anderson CEO, Space Adventures Anousheh Ansari CEO, Prodea Michael Boustridge President, BT N. Am Sergey Brin Co Founder, President, Google Arianna Huffington CEO, Huffington Post Dean Kamen President, DEKA R&D Corp Ray Kurzweil CEO, Kurzweil AI Erik Lindbergh Vice Chair, Lindbergh Fndtn Elon Musk CEO, SpaceX Larry Page Co Founder, President, Google Adeo Ressi CEO, The Funded Eric Schmidt CEO, Google Ratan Tata Chairman/CEO, Tata Group Craig Venter Pres, J. Craig Venter Institute Will Wright Video Game God, Maxis

15 Four X PRIZE Groups Life Sciences FPO Exploration Energy & Environment Education & Global Development

16 X PRIZE Design Attributes Target area that is stuck ; market failure Clear, objective & simple rules Hard but attainable Define a problem, not a solution Can be won in 3 8 years Significant Cash Purse: $10M > Assure there is a back end business Open to teams worldwide Telegenic

17 X PRIZE Design Goals Attract maverick thinkers Make heroes of the teams Create global media events Educate and excite the public Bring new capital to the problem Launch an industry Encourage taking intelligent risk Change the paradigm

18 Active X PRIZES

19 Where Next?

20 Healthcare Video

21 Peter H. Diamandis, MD Chairman/CEO, Peter H. Diamandis, X PRIZE Foundation MD peter@xprize.org peter@xprize.org Ferris M. Thompson ferris.thompson@xprize.org Revolution Through Competition

22 The WellPoint XPRIZE: Driving Innovation in Health Care Milken Institute Global Conference 2009 Los Angeles, CA April 28, 2009 Sam Nussbaum, M.D. Executive Vice President and Chief Medical Officer

23 WellPoint, Inc. Blue Cross or Blue Cross Blue Shield UniCare >100K members 35 Million Members Across the United States, 1 in every 9 Americans covered by WellPoint Plans Company Confidential For Internal Use Only Do Not Copy 23

24 Variation in Recommended Care Why does nearly half the physician care delivered in America not comply with established best practices? % of Recommended Care Received 64.7% Hypertension 63.9% Congestive Heart Failure 53.9% Colorectal Cancer 53.5% Asthma 45.4% Diabetes 39.0% Pneumonia 22.8% Hip Fracture 45% 55% Patients do not receive care in accordance with best practices Patients receive care in accordance with best practices % of Recommended Pediatric Care Received 67.6% Acute Medical Care 53.4% Chronic Condition Care 40.7% Preventive Care Source: McGlynn, E.A, et. al. The Quality of Health Care Delivered to Adults in the United States. New England Journal of Medicine 348 (26): (2003); Mangione-Smith R, DeCristofaro AH, Setodji CM, Keesey J, Klein DJ, Adams JL, Schuster MA, McGlynn EA. The Quality of Ambulatory Care Delivered to Children in the United States The New England Journal of Medicine, Vol. 26, No. 5, Sept 2007, pp Company Confidential For Internal Use Only Do Not Copy 24

25 Variation in Inpatient Care Why, amongst our country s leading academic medical centers, is there a three-fold variation in hospital days during the last six months of life? Source: John E Wennberg, et. al.; Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United States British Medical Journal : NYU Medical Center 27.1 Mount Sinai Hospital 22.8 NY Presbyterian Hospitals 21.6 Cedars-Sinai Medical Center 21.3 Mass. General Hospital 16.5 UCLA Medical Center 16.1 Yale-New Haven Hosp Brigham & Women s Hosp UCSF Medical Center 11.5 Stanford University Hospital 10.1 Company Confidential For Internal Use Only Do Not Copy 25

26 The State of U.S. Population Health Population health status continues to deteriorate Key Drivers of Health Status Proportional Contribution to Premature Death Driver Obesity Physical Activity Smoking Prevalence 66% obese or overweight 28% inactive 23% smokers Genetic predisposition 30% Social circumstances 15% Environmental exposure 5% Stress Aging 36% high stress 22% > 55 years, aging population Health care 10% Behavioral patterns 40% Schroeder S. N Engl J Med 2007;357: Company Confidential For Internal Use Only Do Not Copy 26

27 Prevalence of Chronic Illnesses Population in Millions More than 130 million Americans suffer from chronic conditions; that number will continue to rise Chronic Conditions % of Population % of Population Chronic Condition Diabetes Heart Disease Asthma Depression Prevalence 16 million Americans 60 million Americans 14 to 15 million Americans 17 million Americans Annual Cost $105 billion in health expenses 11 million lost work days $300 billion in health expenses 1 million deaths $5.1 billion in medical expenses 2.1 million missed work days $43 billion Company Confidential For Internal Use Only Do Not Copy 27

28 Clinical Information Drives Evidence-Based Care and Care Management Claims Rx Lab Provider Member HRA Variation Models Unit/Unit $ Predictive Predictive Models Models Evidence-Based Evidence-Based Medicine Medicine Identification and Stratification % of WellPoint Members 50% 20% 25% 4% 1% Well Members Low Risk Members Moderate Risk Members High Risk, Multiple Diseases Prevention and Education Optimize Resources in Acute Episodes of Care, Population Care DM and Education, Risk Avoidance Episodic Care Mgmt, Clinical Guidelines, High Risk DM 10% 10% 25% 30% 25% % of Health Care Costs Source: Company estimates. Complex and Intensive Care Total Care Integration Company Confidential For Internal Use Only Do Not Copy 28

29 New Care and Reimbursement Models: Patient-Centered Medical Home Payment Payment Methodology Methodology FFS FFS Prospective Payment Pay For Quality For services currently recognized through Medicare RBRVS system; potential for additional services NCQA s PPC Recognition: Care Coordination Process Redesign HIT Evaluate Levels of Achievement Clinical Process and Outcomes Resource Use/ Cost of Care Satisfaction Pre-Assessment Pre-Assessment of of Practice Practice Readiness Readiness Support Support from from ACP, ACP, AAFP AAFP and and AAP AAP Company Confidential For Internal Use Only Do Not Copy 29

30 Integrated Health Records: Delivering Health Information at the Point-of-Care Imaging Labs Claims Pharmacy Medical Records INTEGRATED HEALTH RECORD Physicians Hospitals Members Employers Emergency Rooms Company Confidential For Internal Use Only Do Not Copy 30

31 Healthcare X PRIZE Initial Design and Prize Guidelines Summary for Public Comment Join the discussion at: Company Confidential For Internal Use Only Do Not Copy 31

32 Healthcare X Prize Goal To create an optimal health paradigm that empowers and engages individuals and communities in a way that will dramatically improve health value. Consumer Centered Optimal Health System Focus Tomorrow Reactive Proactive System Focus Today Disease Based Sick Care Company Confidential For Internal Use Only Do Not Copy 32

33 WellPoint Commitment Exceptional Solutions Transparent Process Real World Testing Company Confidential For Internal Use Only Do Not Copy 33

34 Proposed Competition Goal Health value: Improvements in community health index and total cost Create mechanisms to engage, coordinate, advise, evaluate, and influence individuals and relevant care providers in assigned test community to generate health value Finalists compete in pre-selected community / employer test community of ~10K individuals; results compared against an control group Aggregate 3-year results determine winner; 50% threshold required to win award. Company Confidential For Internal Use Only Do Not Copy 34

35 Difference from Other Efforts: 1. Focus on Health Outcomes and Value at Community Level Community health index tracks outcomes across a community; Total cost tracks expenditure across all parties 2. Consumer Engagement Consumer engagement required 3. Payment Incentives Teams may create incentives for consumers, providers, business partners who demonstrate desirable behaviors/ outcomes 4. Comprehensive and Proactive Outlook Increased focus and investment in proactive, longer-term health improvement programs; improve health across all care settings and multi-year time horizon 5. Local Partnerships Must develop relationships with local health care providers and/ or community organizations Company Confidential For Internal Use Only Do Not Copy 35

36 Impact Potential Successful implementation of Healthcare X PRIZE could create within 10 yrs: 1. A new model and system of health demonstrating >50% improvement in health value 2. A measurable and globally accepted population health metric, community health index (CHI) benchmark for measuring improvements in population health 3. An individual health metric, or individual vitality score, to help individuals and care team understand and benchmark health status and improvement 4. A personalized vitality dashboard to understand current health status, portfolio of improvement options, projected return from health improvement efforts 5. A new optimal health model that to optimize consumer health and reward providers who create improved health value Company Confidential For Internal Use Only Do Not Copy 36

37 What Is The Philosophy Behind The Prize Design Guidelines? Transparent and Objective Open sharing of results and implementation experiences Detailed public updates on team progress Independent judges oversee team through selection to finalists Open contest; global idea recruitment Teams may enter from anywhere; must compete in test areas Cap on operating expenses to ensure equal playing field Limited use of existing, controlled facilities to maximize entrants Demonstrable impact w/in 3 year window Broad population health spectrum to maximize relevant approaches High target: need to generate radical change Large enough / long enough to demonstrate sustainable value Company Confidential For Internal Use Only Do Not Copy 37

38 What Are The Phases Of The Competition? Entry Concept Pilot Finalist Requirements Registration document Concept People Resources / Assets $10k Intervention model Targets Interventions Engagement Modeled impact Execution strategy / high-level plan Concept sketch Demonstration pilot of key assumptions ( pts network test) Alpha product Business plan, modeled financials Intervention model and pilot exceed targets Team in place Beta product / interface Proof Reasonable Concept Mergers between complementary concepts Model target impact Testable key assumptions Pilots exceeding requirements Evidence of consumer and provider engagement Matching / selection into test-beds Actual progress in testbeds (live competition, reported monthly, quarterly reports) Timing Fall 2009 Summer 2010 Spring 2011 Early 2015 Company Confidential For Internal Use Only Do Not Copy 38

39 What capabilities might teams deploy? Financing and payment Coordination of care Health Information Technology Measurement, Tracking, Feedback Behavior Modification Convenience And Access Personalized Decision Support Care Experience Outcomes / Comparative Effectiveness Company Confidential For Internal Use Only Do Not Copy 39

40 Which Populations Will Be Included? End of life Acutely ill Ethical considerations Coordination and best practices to prevent error and reduce fragmentation. Disease Severity Chronically ill At-risk / lifestyle Early health risks Coordination puts care back in healthcare and saves lives Behavioral / lifestyle foundational to avoiding preventable illness Similar goals to at-risk, but costs likely to be additive in short-term Wellness All costs additive Company Confidential For Internal Use Only Do Not Copy 40

41 We Look Forward to Your Input and Participation Visit our website: Add comments to the proposed approach/ guidelines Add yourself to the mailing list for updates Follow the conversation on our blog, twitter, facebook, etc. Let us know if you are interested in creating a team Company Confidential For Internal Use Only Do Not Copy 41

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