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Integrated Care

Gwen Sandefur, MHSA

September 21, 2017

Megatrends Shaping the Health Care Landscape

Transition to

Value-Based Payment

Emerging Data & Technology Platforms

Acceleration of

Industry ConsolidationExpanding Ecosystem &Entry of

Non-Traditional Competitors

Consumer is getting

in the driver’s seat

Ancillary/Wellness Market on the Rise

Price Transparency & Competitive Pricing

Uncertainty in Health Care Reform &

Value-Based Payment Models

Cost of Care and Impact on Utilization

Deflationary Reimbursement

Environment

Transparency

Results Online

Transparency

Transparency

Access

Specialty Care

Direct To Consumer

Improve Health

Affordability

18th

Percentile

Among the lowest

per capita health

care costs nationallyHealthier Communities Physician

Comp Model

Primary Health

Advanced Medical Home

Changing health care

industry

needs of the

consumer and

patient

competitive

landscape for

Primary Care

Why?

Not enough time!Bodenheimer et al. Annals of Fam Med 2012; 10;396

Not enough doctors!From Bodenheimer, Share the Care: Why high-performing

teams are a necessity in Primary Care, 2012 presentation

Why?

Provider and Staff Satisfaction low!SHMG 2014 AMGA Provider Satisfaction Survey

Health care costs too much!World Economic Forum, The Global Economic

Burdon of Non-Communicable Diseases, Sept 2011

Primary Health is…

PLATFORMConduit Foundation

Critical ComplexFront Door

Primary Health

Truths of Primary Health

Capacity for patients needs to be

improved. Interdisciplinary model of care is

critical.

Portfolio of services is predominantly in

traditional primary care; diversification is

needed.

Primary health is generally data rich and

knowledge poor.

Today it is focused on episodic illness

care; providers should add wellness care

over a patient/consumer’s lifetime.

An aging population will require different

and more effective approaches to chronic

disease.

Consumerism will have a significant

impact on the future of primary health

For a panel of 2500 patients, a physician would need to spend

a. 4.6

b. 6.4

c. 7.4

d. 8.8

hours per day doing recommended preventive care.

Take a guess!

Yarnall et al. Am J Public Health 2003;93:635

For a panel of 2500 patients, a physician would need to spend

a. 6.4

b. 7.8

c. 8.9

d. 10.6

hours per day doing recommended chronic care.

Guess again!

Ostbye et al. Annals of Fam Med 2005;3:209

One more time!

For a panel of 2500 patients, a physician would need to spend

a. 16.4

b. 18.0

c. 21.7

d. 23.8

hours per day to meet all acute, chronic and preventive needs.

Bodenheimer et al. Annals of Fam Med 2012; 10;396

Vision

Team-based, relationship-driven

model of care using innovative

staffing and tools to manage a

risk-stratified population to the

lowest cost per capita and the

best health in the nation, while

optimizing patient experience

and maintaining high patient,

staff and provider satisfaction.

The Model of Care

Paving the way

Started with

10 Practices(90,000 people)

Moving to

27 practices

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A place designed to make it easy to be healthy and well.

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ACCESS DESIGNED AROUND YOU• Primary Care Services – home or as a complement

• Same or next day access, weekdays 7 a.m. - 7 p.m.

• Schedule appointments online

• 24/7/365 virtual visits through MedNow, evisits through MyHealth

• Convenient downtown location—validated parking

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1:1 PROVIDER RELATIONSHIP• Every visit is tailored to meet your needs – health coach

• Appointment begins and ends with provider

• Selected providers, holistic philosophy

• Extended appointment

• Email your provider anytime

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RESPECT YOUR TIME & EXPENSE• Care you need when you need it – now

• Same/next day appointments: avoid expensive ER/Urgent Care AND sick days or time away from office

• On-time scheduling means no long wait times

• Walk-in lab and immunizations

• Personalized approach for low annual fee

Primary care, 24/7 virtual and telemedicine and other services covered by member’s health insurance plans are not included in the membership

fee

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THE SCIENCE

OF WELLNESSPREVENTION VS. INTERVENTION

• Focus on lifestyle, environment

and optimizing your health –

personalized plan

• Share the latest in wellness

content and apps

• Discounted genetic testing

informs wellness plan

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BE WELL SERIESClasses, demos, screenings and more presented by local experts

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COUNT ON COMMUNITY

PARTNERS FOR EXPERTISE• Tailor your wellness plan with our community partners (Fitness, performance training,

biking, running tours, apparel and more)

• Access to partner benefits

• See full list at strive4u.org

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MEET YOU WHERE YOU ARE• Providers and wellness partners help you set goals and reach them

• One stop shop for health and wellness needs

• STR!VE team personally helps members navigate next steps if needed within the

Spectrum Health system.

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ONLINE PATIENT PORTALMyHealth

All health records in one place make it easy

to communicate and share health

information.

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A PLACE TO RELAX OR MEET• Space to meet, collaborate or unwind

• Plug in, connect to free Wi-Fi

• Spa water, healthy snacks, good coffee

• Validated parking – easy in and out

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AN EXPERIENCE

WORTH REPEATING

STR!VE is set up as an innovation site for Spectrum Health.

The membership experience will continue to evolve with new and

exciting offerings – the latest and greatest support to help you

achieve your health goals!

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STR!VE—Membership Model

What we do isn’t the whole story

Social determinants of health

Nexus

What is Nexus?

Nex·us

A relationship or connection between

people or things

plural nexuses

1. Connection, link

2. A connected group or series

3. Center, focus

The Next Us

One Patient Story

Evidence-Based Practice

Consistent Exceptional

Experience

Respect for People

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Our Journey

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391 Order sets

built

120Prepared

credentialed

and provider

trainers

115Change

compass

stories

452,000Build hours

25 Sprints

Base Camp: 6 days,

1,000+ attendees

Aug 14 to Oct 20

Training for 16,000165 training tracks, 6 a.m. to 1 a.m.

for 10 weeks

167 Standard

work

documents

Our Journey

1,200 Superusers

in training

(July/Aug)

300+ Leaders using

the Readiness

Checklists

Ranger Talks: 19

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Already launched:

Nexus in Action

Ambulatory upgrade (June 2017)

Open Notes (Ambulatory)Online scheduling (existing patients)

My Desktop (badge access for workstation sign-in)

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