Thriving in uncertainty Mike Barber GE Healthcare Association i of American Medical Colleges November 2011
by 2015 For customers: For employees: For investors: For the public: $6B to launch 100+ innovations to lower cost, increase access and improve quality by 15% Healthier employees via Health Ahead ; cost increases <inflation Organic growth of 2-3x GDP; grow healthcare value gap from $500M to significantly higher Be transparent Partner Engage thought and policy leaders Focus: 1. Health system reforms 2. Appropriate technology 3. Health delivery 4. Consumers healthymagination: Innovation for a healthier world 2
Focus investment on key outcomes Cost savings Greater efficiency Asset optimization Maximize throughput Reduce variation Managing g chronic diseases Access improvement Maternal & infant care Water & sanitation Screening for life threatening conditions Improve quality Reducing medical errors Remote medicine/ monitoring Early disease detection 15% 15% 15% 3 rd party validation 2010 20-25 validations 1st annual report 2015 100+ validations 4 th annual report 3
Healthcare industry environment Providers Productivity and market share Sweating the assets maximizing ROI Pursuing market share service line focus Investing to acquire/align physicians Payers & Regulators Patients Evidence and transparency Questioning clinical and economic value shifting to payment for outcomes New provider-payer p dynamics systems vs. silos Sunshine law reporting Care Coordination Consumerism paying more out of pocket Awareness increasing looking for integrated care 4
Future care environment Hospital Multiple departments High acuity Clinic Multiple specialists Episode prevention Home Disease mgmt Wellness Utilization Today Future High Acuity Low Current model Episodic, reactionary, high cost Patients not personally invested High acuity focus clinical settings Future model Longitudinal, preventative, lower cost Empowered patients/consumers Mobile and home/residence-based Hospitals specialized acute care centers with very sick patients Clinics caring for sicker patients, more procedures & diagnostics Home increasing i acuity of patients t living i at home 5
Integrated health policy push everywhere Germany UK France Switzerland Middle East IHO Policy Objective IHO/ICO stated policy objective IHO Pilots In Progress Broad Adoption Now 13/ 14 Global trends: Integrated care decision power shifting from acute to primary care Care integration entities driving 2012 control & value-concentration Global: 3rd party mgmt co. 2012 USA: likely provider orgs 2012 Benefit sharing business models dominant USA 12/ 13 Not a question of if only how & when 6
Employers are starting to control their destiny Lowe s signed 3-year contract with Cleveland Clinic to bundle payments for cardiac procedures nationwide Waiving cost-sharing and covering travel expenses, if patient opts for Cleveland Clinic Saved on average $62,000/patient and received best-inclass care Partnered with Henry Ford Health System to offer We ve Got Your Back program designed to eliminate widespread back pain Uses occupational therapy and relaxation to mitigate pain 55% of employees reported no pain following program completion Walgreens, formed Take Care Health Systems, offering worksite health clinics i for employer purchase Wellness, low-acuity primary care, occupational therapy, and disease management Onsite clinic i minimizes i i employee absenteeism, maximizes convenience ROI from 60 100% 7
As a self insured employer GE launched The Cincinnati i Project Extensive health systems 30+ hospitals 5,000 physicians Active collaborations Strong experience with innovative pilots National healthcare IT leader Engaged employer base (GE, P&G, Kroger, Fifth Third, etc.) 8
Community-Wide Transformation Higher Quality + More Cost-Effective Care Overall goals: Cost Growth to no more than CPI (3%) Care & Quality: diabetes; reduced ED visits and adverse events Population Health: smoking cessation; preventive screening/interventions; ti optimal care for chronic conditions Key stakeholder organizations contributing to community-wide programs: Employers for employees, retirees and families. NGOs and Gov. agencies for populations and specific conditions w/public and private funding 1 2 3 4 5 Strategy/Approach Multi-Stakeholder Community Council Health Information Technology Acceleration - Beacon Grant $13.8M - HIT will accelerate other projects Provider Payment Innovation -Compensation tied to results vs. volume; Employers leading Administrative Improvements - Hospital efficiencies & HIT Pilot Projects - Primary Care Medical Homes - Public Reporting: Adult Diabetes - Transitions of Care: CHF 9
Cincinnati coordinated care PCMH A paradigm shift in primary care delivery Progress Patient Experience Care Plan (and Team Support) Strong Physician i Relationship Proactive, Appropriate, Holistic Care Performance Measures Quality Measurements Electronic Medical Records Improved Access Regular (Non-PCMH) (2010/2009 V%) PCMH Practice (2010/2009 V%) Emergency Visits -11% -32% Hospital Admissions +1.2% -21% PCMH Practices 116 Practices 6,000 GE Covered Lives 22 1,350 Days in Hospital +5.2% -16% YE 10 YE 11 10
What the Community is Saying Mike Fisher, CEO CCHMC Frankly, I did not expect this to take off the way it has my people have been very complimentary of the work Jim Anderson, CEO CCHMC (Ret d) This sort of collaboration, does not always drive results this project is really beginning to make a big change. I want to connect it to the IHI Tom Finn, President-Global Health Care, P&G P&G is more committed to this than ever. It s making steady progress. Trying to align this many organizations is tough, but we re making progress for the City It is really exciting to see the level of community commitment... we are beginning to understand [Cincinnati s] success. Kim Young Min, US Health and Human Services
Enabling integrated care GE s solutions Knowledg ge Con nnectivity Ap pplication ns Enabling better outcomes & cost improvement: Organizational integration model End-to-end data connectivity Care pathway protocols Disease management capability Analytics/metrics/dashboards Financial/benefits sharing model Robust governance 12
Future industry landscape Winner Playbook Payer collaboration strategy Asset utilization programs Service line differentiation Physician alignment strategy t Patient safety programs Laggard Playbook Wait and see approach to payers and physician relationships Undifferentiated service line offerings Reliance on pay for procedure / volume model Operational efficiency to survive on Medicare rates Decision-making paralysis 13
Questions and Discussion 14