Improving Outcomes in a Value-Based World Through Stratified Data and Patient Nurturing. Tuesday November 3, :15 AM - 10:30 AM

Transcription

1 Improving Outcomes in a Value-Based World Through Stratified Data and Patient Nurturing Tuesday November 3, :15 AM - 10:30 AM

2 Presenter(s): Bob Dichter - Senior Director, Product Management Brian Sauers Sr. Product Manager Topic Improving Outcomes in a Value-Based World Through Stratified Data and Patient Nurturing Level 300 CME/CNE

3 Safe Harbor Provisions/Legal Disclaimer This presentation may contain forward-looking statements within the meaning of the federal securities laws, including statements concerning future prospects, events, developments, the Company s future performance, management s expectations, intentions, estimates, beliefs, projections and plans, business outlook and product availability. These forward-looking statements do not represent a commitment, promise or legal obligation to deliver any material, code or functionality. The development, release and timing of any features or functionality described for our products remains at our sole discretion. Future products developed beyond what is contemplated by existing maintenance agreements, will be priced separately. This roadmap does not constitute an offer to sell any product or technology. We believe that these forward-looking statements are reasonable and are based on reasonable assumptions and forecasts, however, undue reliance should not be placed on such statements that speak only as of the date hereof. Moreover, these forward-looking statements are subject to a number of risks and uncertainties, some of which are outlined below. As a result, actual results may vary materially from those anticipated by the forward-looking statements. Among the important factors that could cause actual results to differ materially from those indicated by such forward-looking statements are: the volume and timing of systems sales and installations; the possibility that products will not achieve or sustain market acceptance; the impact of incentive payments under The American Recovery and Reinvestment Act on sales and the ability of the Company to meet continued certification requirements; the development by competitors of new or superior technologies; the timing, cost and success or failure of new product and service introductions, development and product upgrade releases; undetected errors or bugs in software; changing economic, political or regulatory influences in the health-care industry or applicable to our business; changes in product-pricing policies; availability of third-party products and components; competitive pressures including product offerings, pricing and promotional activities; the Company's ability or inability to attract and retain qualified personnel; uncertainties concerning threatened, pending and new litigation against the Company; general economic conditions; and the risk factors detailed from time to time in the Company s periodic reports and registration statements filed with the Securities and Exchange Commission.

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5 Drivers of Health Market 2.0: Fundamental Shifts Resulting Market Dynamics A Rise of Value Based Care 1 Delivery System Restructuring B Acceleration of Consumer Powered Health 2 3 New Economic and Clinical Models New Customer and Competitive Landscape Oliver Wyman Group 3

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7 It s all connected Multiple terms for value-based care P4P (pay for performance) Risk sharing Incentivized payment Capitation arrangements Gain sharing Value-based purchasing Risk adjusted care Population health Value-based payment models are associated with improving outcomes and reducing the cost of care delivery Effective Population Health Management impacts clinical and financial outcomes, and quality reporting

8 Population Health: a collaborative care foundation Chronic disease accounts for 75% of our total healthcare spending* Identify at-risk patients starting with chronic conditions At-risk patients utilize medical services the most Highest costs associated with at-risk care Payers are transferring risk to providers * Centers for Disease Control and Prevention

9 Cost of chronic disease in U.S. $1.5 Trillion Chronic diseases are increasing healthcare costs at an alarming annual rate* Heart Disease and Stroke: $432 billion Diabetes: $174 billion Lung Disease: $154 billion Alzheimer s Disease: $148 billion * Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services

10 A diabetes care management team can consist of any or all of the following providers: Primary care provider Endocrinologist Nurse diabetes educator Dietitian Dentist Ophthalmologist Pharmacist Mental health professional Cardiologist Exercise physiologist Nephrologist Neurologist Podiatrist Leads to fragmented, uncoordinated & costly delivery of care

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12 PHM to Improve Collaborative Care Comprehensive PHM involves: 1. Identifying patients at risk & with gaps in care 2. Managing risk thru chronic care mgmt. 3. Improving clinical outcomes & patient satisfaction 4. Engage patient for proactive care 5. Reducing cost

13 Goal: Improving Long-term Patient Health The goal is to improve the health of your patients and the community The onus for managing, improving, and reporting your patients health status/outcomes is shifting to providers, particularly primary care physicians Reporting outcomes will impact how much you get paid, whether or not your patients comply with treatment

14 All these things increased demands, requirements and pressure on you

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16 Introducing NextGen Care

17 NextGen Care Everything you need in one place

18 Your gateway to collaborative, coordinated care Providers need a solution that enables collaborative care Onslaught of changes Regulatory mandates Ever-increasing level of quality reporting Increasing Practice/Staff Efficiencies NextGen Care - integrated across our entire ambulatory care suite Provides holistic patient data to the entire care team Makes it easier to access vital information and coordinate care Helps improve care quality and medical outcomes

19 What makes us different? Interoperable Facilitate multisource data flow with expertise of Mirth products Integrated NextGen Care is within the NextGen Healthcare enterprise. No third-party interfaces, bolted solutions Configurable Configurable automation options Scalable Hosted and server options that grow with you as you grow A one-stop shop to manage your patient population

20 NextGen Care Management Suite NextGen EHR Profiler/ Outreach Engine Population Management Hub Patient Portal* NextGen Share* Risk Milliman* * Optional Modules

21 All you need to collaborate in one integrated platform Six essential functions for collaborative care

22 One screen, few clicks, multiple functions View care gaps and risk score for a specific patient Produce a list of patients using EHR reports Take multiple actions for multiple patients (or individual patients) with very few clicks Goal = to identify the most at-risk patients, make the best clinical decisions, and take appropriate actions to enable collaborative care

23 One screen, few clicks, multiple functions View care gaps and risk score for a specific patient Produce a list of patients using EHR reports Take multiple actions for multiple patients (or individual patients) with very few clicks Goal = to identify the most at-risk patients, make the best clinical decisions, and take appropriate actions to enable collaborative care

24 Population Management Hub

25 Population Management Hub Chart - EPM/EHR/Dashboard Recall Create an EPM recall Message Send message to Patient Portal or Population Health Task Create an EPM or EHR Task Referral Create Referral (NextGen Share) Document Product an EHR Document Export Export Excel, PDF, HTML, XML, CVS or My List

26 Target Patients: Follow-up / Preventive Care Example: Hypertensive patients for blood pressure control Diabetic patients with A1C levels greater than seven Women age 55, who require pap smears and mammograms in May Men age 60, who require prostate exams in September

27 Predict, prioritize, prevent Do you really know who your patients are? Before a practice can deliver appropriate care to the patients who need it most, it must first identify those individuals. Today s diabetes patient may have been pre-diabetic last year. Not only is the patient sicker today, but he or she probably generates higher costs than a year ago.

28 Risk Stratification NextGen Healthcare has partnered with Milliman for risk analysis and predictive modeling for population health and collaborative care Group patients by chronic conditions, severity of illness, and demographics; and identify risk Take the appropriate action based on patients risk levels to address gaps in care

29 Risk Scores Data Flow User uploads CCLF, Member, Provider & Location files to Milliman Milliman processes the files Client pulls down file containing risk scores Risks are imported into NextGen

30 Risk Score Available to Care Managers

31 EHR Reporting Tool

32 Population Out Reach

33 No collaboration if you re not connected Track your outreach efforts, results, and outcomes to meet stringent reporting requirements. Provide that data to external stakeholders. Export and send information to payers and ACO leadership to show you are providing better, proactive care. NextGen Care incorporates the NextGen Share platform, enabling other connected providers to compose and exchange data.

34 Referral Management Access NextGen Share from the Pop Management Hub home screen. This is our integrated HISP that automates electronic referrals both inside and outside the NextGen network. The Hub makes it easy to create a referral and Find an external provider Attach documents Transmit referral package

35 Generate referrals with NextGen Share Find a Provider Compose Referral Send Referral MU2 Search and discover external providers Connect to multiple networks and federated HISPs Built into the KBM referral template Supports multiple attachments Uses Direct Supports MU2 core measure #15 Automates MU2 Calculations

36 NextGen Care What is it? The NextGen Care solution proactively reaches out to those patients with gaps in care based on selected protocols and evidence-based clinical quality measures Patients are alerted using automated communication methods to take action NextGen provides outreach tools that are highly configurable allowing each practice to determine the best solutions for their patient populations.

37 Patient Outreach Types of Alerts / Communications: Patient Portal Secure Message Text Messaging Interactive Voice Response (IVR) Worklog Recall Plan Communication limits can be determined per practice for each message type

38 Patient Engagement / Outreach Process is fully automated and integrated with NextGen Ambulatory EHR, Practice Management, Patient Portal and Dashboard (no third-party interfaces required) Pulls your data directly from the EHR/PM/HQM systems No additional FTEs, time, or resources needed Patient Portal EHR EPM Dashboard

39 Analytics Critical role in population health management Select, filter, and save different groupings of patients You ve identified high-risk patients, now what? - Slice and dice information based on what you want to know - With true analytics, identify problem areas and utilize proven clinical decision support tools - Monitor your out reach campaigns - Ultimately, drive down the cost of care!

40 Population Health Administration Reports Outreach Reports - Example Outreach Report

41 Outreach Reports Outreach Queue & History By Measure Outreach Queue by Measure Task Queue by PCP/Rendering IVR Outreach Communication by Patient Outreach Communication by Patient/PCP/Rendering Outreach Exception by Contact Method/Patient/PCP/Rendering Patient Not Contacted Patient Skipped (DNC) Outreach Performance by Contact Method/Patient/PCP/Rendering

42 Population Health Administration Reports Return on Investment Reports (ROI) - Selecting the ROI folder displays various reports.

43 Return on Investment Reports (ROI) Expected Revenue by Appointment Type Booked Appointment by Measure Measure Return Analysis Outreach Analysis Patient Response Time Details Monthly Comparison of Procedure Counts Procedure Charges by Measure Revenue by Practice

44 Recap: Integrated Care Management Workflow Embedded in NextGen Ambulatory EHR Non-disruptive workflow for providers / care managers Automated outreach ( /text/ivr/portal ) Generate, save, and track patient list to review gaps in care Take actions from single screen, minimum clicks Access Patient Chart Access Patient Dashboard Add to Recall Plan Send message using Patient Portal & Population Health Create tasks Refer patient Generate documents

45 The future: 5.8 UD3 & KBM Spring 2016

46 NextGen Care Phase 2 Provide the ability to add Alerts to selected patients for the Hub Ability to add a patient to a my list while charting on them Ability to import lists into a my list Ability to send patient education material to a patient Ability to print Care Opportunities Single Patient All Patients Ability to see what Cohort list created the Outreach

47 Alerts

48 Alerts

49 Add to My List

50 Patient Education

51 Patient Education

52 Patient Education

53 Print Care Opportunities

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55 Additional Information

56 Additional Information Visit with one our application specialist located at the - Sales Booth Check out our web site: Client Success Stories White Papers ACO ebook

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58 Knowledge Exchange Installation Guide for NextGen Population Health, Version 1.4 UD1 Overview for NextGen Population Health, Version 1.4 UD1 Administrator Guide for NextGen Population Health, Version 1.4 UD1 Operation Staff Training Guide for NextGen Population Health, Version 1.4 UD1 Profiler User Guide for NextGen Population Health, Version 1.4 UD1 Population Management Hub User Guide for NextGen Ambulatory Products, Version 5.8 UD2

59 Questions?

60 Session Survey Please take a moment to complete a brief survey regarding this session. 1. Open your ONE UGM Mobile App (please note: you must have already logged in and accepted the Terms of Use to access this feature) 2. Click the Navigation Button at the top left of the screen 3. Select Sessions 4. Search for and select this session 5. From the sessions details screen, select Survey at the bottom right of the screen 6. Remember to hit Save at the bottom of the survey once you have answered the questions

61 Thank You!

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