The Kelsey-Seybold Triple Aim

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2 The Kelsey-Seybold Triple Aim Better Experience Better Quality Better Value 2

3 About Kelsey-Seybold Clinic 68 years in the Greater Houston region 436 employed physicians in 55 specialties Trusted by 500,000 patients 1.2 million patient visits each year 30 years of experience in population health 20 multispecialty, outpatient clinic locations in the region Partnerships with all major hospital systems and affiliated physicians $250 million investment in outpatient infrastructure and an Electronic Medical Record (EMR) System 3

4 Care Delivery: The Woodlands to Clear Lake, Katy to Pasadena Main Campus TMC Area The Woodlands Clinic Pearland Clinic Downtown at The Shops 4

5 Kelsey-Seybold Outpatient Care Centers Kelsey-Seybold Convenience and Access Same-day and next-day Primary Care access. Saturday visits 9am - 2pm at 4 convenient locations. KelseyCare After-Hours Nurses, On-Call Physicians and Specialists. Secure messaging with your physician. Onsite lab, X-ray and advanced imaging services. No appointment or copay needed for lab or X-ray. Total access to 20 Care Centers and All Physicians. 24/7 appointment scheduling. MyKelseyOnline lab results, appointment scheduling. 5

6 KelseyCare Hospital Partners Texas Children s Hospital ranked nationally in 10 pediatric subspecialties, and was named to U.S. News & World Report s America s Best Children s Hospital Honor Roll. Texas Heart Institute at CHI St. Luke s Health ranked by U.S. News & World Report as one of the nation s top centers for cardiology and heart surgery. 6

7 Our Goal Is A Personal Relationship with Each Member Convenience Talk To Us 24/7 Saturday Appointments 4 locations Same-Day and Next-Day Doctor Appointments After-Hours Kelsey Nurses + Urgent Care No Referrals to see Kelsey specialists Access all doctors, any location whenever needed BUILDING RELATIONSHIPS Connecting Online App to schedule and access your doctor Outgoing Outreach for preventative Telemedicine E-Visits available 7 days a week Concierge Help with any questions Help choosing a doctor Help getting physicals & screenings scheduled Local. Accountable. Nationally Recognized for Quality. 7 18

8 Convenient Online Care from Kelsey-Seybold E-Visits Medical care for adults and children for 10 common conditions including: Allergy Back pain Cough Cold Flu Heartburn and acid reflux Pink eye Sinusitis Urinary tract infection Vaginal discharge One-hour turnaround + Rx Adult care hours: Monday Friday: 8 a.m. 9 p.m. Saturday & Sunday: 10 a.m. - 4 p.m. Pediatric care hours Monday Friday: 8 a.m. - 9 p.m. Sprained ankle or knee Insect bite Shingles Laryngitis GERD Video Visits Real-time, face-to-face medical visits 50 conditions treated Eczema Ear infection Burns Bladder infection Cold, flu or sinus infection Use your smartphone, ipad or desktop Monday Friday; 8 a.m. to 5 p.m. Schedule using your MyChart app or MyKelseyOnline Post-op Orthopedic visits available

9 Kelsey-Seybold is recognized for excellence with major NCQA recognitions, including ACO accreditation. The Nation s First NCQA-Accredited Accountable Care Organization (ACO) Houston s Only NCQA-Accredited ACO One of only two in Texas NCQA Level 3 Patient-Centered Medical Home Level 3 is NCQA s highest level of achievement NCQA National Recognition for Excellence in Diabetes Care 79 recognized physicians NCQA National Recognition for Excellence in Heart and Stroke Care 103 recognized physicians NCQA National Recognition for Excellence in Back Pain and Spine Care 5 recognized physicians 9

10 About The KelseyCare Network Plan The KelseyCare Network Plan currently delivers coordinated, accountable care to more than 70,000 enrollees in the Greater Houston area. Care delivery is provided and coordinated by Kelsey- Seybold Clinic and its 4,000+ members, affiliated doctors. Care delivery and care coordination is delivered by Kelsey-Seybold Clinic, named in 2012 as the nation s first accredited Accountable Care Organization (ACO) by the National Committee for Quality Assurance (NCQA). NCQA accreditation is a rigorous process that verifies Kelsey-Seybold s ability to deliver high-quality, coordinated, accountable care, meeting the NCQA s triple aim of higher patient satisfaction, higher quality, and lower total medical cost KelseyCare is delivered through four carrier partners: Cigna, UnitedHealthcare, Aetna, and Boon-Chapman. 10

11 Accountable Care Plan Structure Open Access, No Referral Required for Appointments 436 Kelsey-Seybold Physician Providers 50+ Specialties 20 Clinic Locations Saturday Hours Clear Lake Fort Bend Spring Tanglewood Kelsey Physicians Refer to KelseyCare Affiliated Specialists (referral required) 4,691 Affiliated Physicians and Specialists This plan is offered by Cigna, UnitedHealthcare, Aetna, and Boon-Chapman. Affiliated Hospitals Texas Medical Center and the Community Medical Center West Campus Urgent Care Centers and Emergency Care 2 Outpatient Surgical Centers Clinically Integrated Medical Management Programs Prescription Management Physician Hospitalist Program Prevention Plus Disease Management Case Management Utilization Management Online Patient Portal Electronic Medical Record Telemedicine Services After-Hours Nurse Triage 11

12 How We Achieve Results Conservative, evidencebased practice of medicine Care coordination in person, online, telephonic Outpatient first, hospital when needed Proactive, aggressive management of chronic diseases Emphasis on prevention and early identification of disease Intensive inpatient management Comprehensive pharmacy management Comprehensive, integrated Electronic Medical Record

13 KelseyCare Plan Financial Outcomes Better Clinical Management 15-30% savings on total healthcare costs 3-5% reduction of total costs through clinical prescription management 60-70% preventive care compliance rates early detection of chronic disease 40-55% Reduction of High-Cost Claimants Per Member Per Month Cost* Average Performance Results Kelsey-Seybold Hospitalist Program 20-25% Lower Inpatient Admits Per 1,000 Members* 20-30% Lower Inpatient Bed Days Per 1,000 Members* 20-25% Lower Emergency Room use* *As compared to traditional PPO, POS and HMO products. 13

14 How Do I Get a Quote? You can ask your current broker or consultant for a Kelsey-Seybold KelseyCare quote option from Aetna, Cigna, or UnitedHealthcare. Go to and complete the Get a Quote form and a licensed sales team member will reach out to you by phone. Contact the following sales team members directly for assistance: Paula Turnquist Cell Paula.Turnquist@Kelsey-Seybold.com Christine Tricoli Cell Christine.Tricoli@Kelsey-Seybold.com 14