Henry Ford Medical Group

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Henry Ford Medical Group Radical Convenience: A New Wave of Patient Care Presented by: Diane George, DO HFMG Associate Chief Medical Officer Thomas S. Nantais HFMG Chief Operating Officer

The Henry Ford Medical Group 40-specialty academic Medical Group practicing in 30 HFMG Medical Centers 1300 Employed Senior Staff Physicians & Researchers; 3100 non-physician providers & support staff $750M in net revenue (33% of total HFHS provider revenue) 70% FFS, 30% risk capitated (120,000 HMO commercial & Medicare Advantage) 2.1 M clinic visits annually

Henry Ford Health System Monday-Friday 8 a.m. to 8 p.m. Weekends & Holidays 10 a.m. to 2 p.m..6 HFMG Medical Center HFMG MC & UC MC & 24 Hour ER Hospital & ER Same Day Clinic Macomb UC 3 Wyandotte MC & ED

HFMG s Competitive Environment Six major health systems competing for a patient population base of 3.8M people Little to no growth in that population Difficult for the populace to differentiate one health system from another ENTER Henry Ford s Radical Convenience Model

Call, Click or Come In Henry Ford Medical Group June 11, 2014

6 Radically convenient access to Primary Care Call, Click or Come-In Call (telephone) HFMG Nurse-On-Call program to address primary care medical concerns (Internal Medicine, Family Medicine, Pediatrics & Women s Care) Click (computer) Increase the number of active MyChart users Directly schedule appointments online with Primary Care, Behavioral Services, and Women s Health physicians on line (96% patient satisfaction) Real time test results Timely communication with your physician E-visits

7 Radically convenient access to Primary Care Call, Click or Come-In Come-In (office visits) Provide evenly distributed, broad access by reconfiguring sites in Primary Care, Medical Center or Super Center models Formal MinuteClinic relationship Expanded collaboration with CVS Health Develop our own QuickCare product Pursue offering some level of concierge service Grow Same Day Clinic (walk-in) have five 7-day sites open in 2015 Pilot Clockwise MD

Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Same Day Clinic Growth 6,000 5,000 4,000 3,000 2,000 1,000 Open Fairlane Open Sterling Heights Open Detroit Northwest 0

Henry Ford Medical Group TELEMEDICINE

Henry Ford Health System Telehealth Healthcare Transformed: - Primary Care telemedicine visits facilitated by Teladoc - Remote Consulting - Convenience Clinics

Triple Aim Opportunity Henry Ford Medical Group is working in partnership with Teladoc to offer a co-branded telemedicine product delivered by primary care physicians Telemedicine provides what patients, employers & Insurance companies are looking for their Triple Aim HFMG is the first System in the Detroit Market to offer true telemedicine to its patients via this modality Timely Access Lower Cost Offered directly to patients, but also the employees Very popular with the 53 HFMG primary care physicians who have agreed to participate Timely Access + Lower Cost + Quality Care = Our Objectives Quality Care Growth

The Teladoc Approach is Working

How Teladoc Works Access Teladoc service through HFHS Website or Teladoc webpage 13

Phone Access Modalities Mobile Video Kiosk

Teladoc Clients Customers are using Teladoc across multiple market segments, including Commercial and Government-Sponsored Plans, Providers and Employer Groups Health Plans Managed Medicaid Employers Providers 15

Marketing Focus HFMG is looking to target a new employerbased market and insurance companies This will include our owned health plan Health Alliance Plan Quote from patient: I have used Teladoc 15 times this year for my family and me".home Depot employee/hfmg patient

HFHS Access HFHS patients & newly acquired employers will have dedicated access points by telephone and the HFHS webpage Payments to HFHS % of the per encounter per member (PEPM) for newly acquired employer contracts Payment from employer is $40 split between Teladoc & HFMG Physician (covered by employer) Fixed $ per encounter for non-employer aligned patients Payments to HFHS physicians Physicians are paid independently regardless of the source of the patient Physicians may also service non-hfhs patients

Telemedicine Reduces Cost Telehealth is redirecting ER and UC utilization to an affordable alternative.

Not a replacement of the PCP relationship Member communications reinforce importance of PCP relationship Evidenced-based medicine Every patient is asked before every consult if they would like a copy of their consultation sent to their PCP Referrals to the HFHS network Patient does not select their physician or develop an on-going relationship Overutilization of Teladoc services is closely monitored Credentialing, rigorous QA, maintenance of evidence-based protocols, adherence to 125+ proprietary telehealth guidelines Teladoc supports the Patient / Physician Medical Home Teladoc refers patients to their PCP for any follow up care

HFMG Implementation Progress Progress to date: Initiated in January 2015 Marketing to patients and employers Monitoring physician and patient satisfaction levels HFMG Dr. Passerman quote: 6 encounters in one evening.a lot of fun!

The industry isn t standing still HFMG, in partnership with Teladoc, is committed to transforming healthcare, pursuing better. Timely Access Member Engagement Lower Cost Employer Engagement Quality Care Provider Engagement Together, We Can

Henry Ford Medical Group TELE-CONSULTING

Tele-Consulting Remote access to HFMG specialists Works extremely well for rural facilities Box cloud technology transmits video link & images to HFMG Virtually meet consulting physician Convenient follow up on postprocedural issues remotely

Tele-Consulting (continued) Long distance Structural Heart and Neurosciences Consults Local Dermatology Consults (less costly technology) Community Health Fairs specialty on-call physician consults on patient

Convenience Clinics

Chrysler World Headquarters Clinic PA run clinic operating within Chrysler for 7 years Physician presence 1 day per week Online scheduling for employees Point of care testing for common viruses/infections Pharmacy on site High satisfaction from Chrysler & employees Significant impact on lost workdays

Chrysler World Headquarters Clinic Pros: Used as an incubator for our future convenience clinics Supported on work time by employer (not at lunch or break) Excellent payer mix (insurance or employer reimbursed) Tech saavy employees (love the scheduling technology) Confidentiality (sequestered waiting room) Lessons Learned Improvements: Not much downstream business to secondary care HFMG clinics Generated a slight loss (but is covered by employer) Demand was variable; significant volume decrease when employee based dropped from 12,000 to 9,000 during recession

Downtown Detroit Quick Care Clinic Clinics staffed by mid-level providers with tele-health consulting capabilities to any HFMG physician Quick and Easy way to meet healthcare needs Expanding urban professional market in central core of city Use learning from Chrysler experience to plan & design

Downtown Detroit Quick Care Clinic (continued) Service offerings include: Remote travel clinic services Immunizations and vaccinations Point of care testing for viruses and infections Remote access to a HFMG specialist A healthy Juice Bar Pharmacy on site Clinics will use preestablished treatment protocols Delivery of DME supplies and equipment on a real-time basis Opening April 2015

Radical Convenience : Future State Same Day Specialty Appointments Complete Video visits with PCPs HealthSpot -On the spot self serve health care kiosks

Questions and Discussion