HOW TO SURVIVE THE

HEALTHCARE TSUNAMI

May 2016

Industry Dynamics:

Payment and Delivery becoming more

interdependent

Health care becoming more retail

New clinical care models transforming

care delivery

Industry Dynamics:

Technology changes creating business

models to change

Government is playing a larger role

Local competitive dynamics shifting

Why is Change so Difficult:

Fee for service engrained in existing

architecture/reimbursement

leadership is required to change

Uncertainty of what future state looks like

Value based models and measures are still developing in some specialties and settings

Why is Change so Difficult:

Transformation requires funds for support

and infrastructure

Health IT infrastructure needed to share

health information to new models to be

successful

Difficult to communicate with patients,

doctors, employers, payers and others

How Do Companies Reduce Health

Care Cost:

Through benefit design

Pass through costs

Incentive fees

Company subsidy of copayments

How Do Providers Reduce Cost:

Cost reduction does not work!

Need to keep up with new costly technology

Expert Labor costs are unsustainable

New generation drugs always in demand

Providers need to change the way care is delivered!

Things that you do not want to see!

You do not want to see how Democracy works

You do not want to see how sausage is made

You do not want to see how healthcare is developed

What is the Problem in Healthcare

Moneys worth vs. Cost

Care vs. Value

Reimbursement vs. Outcome

Compassionate care vs. Technology

As you can see, it is very difficult to define the overall objective of Healthcare

Current Trends

OutPatient Services

Pharmacy

Inpatient Services

Current Trends

Ambulatory & retail site

Post Acute care

Alternative care

Government set the stage for providers to deliver care!

Opportunities

Maximize HACHPS value based scores

COURTESY OF PERSON CLEANING ROOM RESULTS

0

25

50

75

100

1st Qtr 2nd Qtr

3rd Qtr Goal 4th Qtr

34

84 81

90 92

COURTESY OF PERSON SERVING FOOD RESULTS

NURSING RESULTS

0

22.5

45

67.5

90

2N 3N 4N ED

22

48

27

9

48 54

40

20

81

54 54

28

Nurses Treat w/ Courtesy and Respect HCAHPS - Overall MMC

HACHPS April 2015

HCAHPS May 2015

HCAHPS June 2015

HCAHPS July 2015

HCAHPS August 2015

Opportunities

Maximize HACHPS value based scores

Maximize quality incentives and Gain Share programs

Develop Community Care Networks

Expand services in growth areas

Look for opportunities to allocate overhead in other service lines

Develop Rural Health Centers in appropriate areas