Embed Size (px)
Citation preview
MGC | 04.28.09MGC | 04.28.09
Peter H. Diamandis, MDChairman/CEO, X PRIZE Foundation
Revolution Through Competition
“The best way to predict the future is
to create it yourself…”
“Nothing... nothing
is impossible…”
1927 Orteig
Prize: New York ‐
Paris“First team to fly non-stop
between NY and Paris…”• O
rteig puts up $25,000
• 9 teams spend $400,000
•
Lindbergh, 25 year old underdog wins!
•
Results:
• Top media story of the century
•
Transformed public’s view of Aviation
•
6,000 180,000 passengers in 18 months
Ansari
X PRIZE“First team to fly 3 people to
space, twice within 2 weeks”
Rules:
•
$10 Million prize purse
•
Privately funded teams
•
3 person reusable spaceship
•
100 km altitude
•
Two flights within 2 weeks
Finding Sponsorship…
1996 thru 2004…
Competing Teams
ARCA Space Transport
Pablo DeLeonStarChaser Scaled Composites
DaVinci
Project Canadian Arrow Rocketplane
Armadillo Aerospace
26 teams from 7 nations spending over
$100 million, sparking a new generation
of space entrepreneurs
Darwinian Evolution: Literally every possible approach was tried by teams.
>6 Billion
Media Impressions Worth in Excess of $120 Million
X PRIZE Vision Video
What We Do:
We identify, design and launch X PRIZEs
–
to address the
grand challenges
of our times.
Our Mission:
To bring about radical
breakthroughs for the benefit of
humanity.
Hallmarks of an X PRIZEHallmarks of an X PRIZE•
Highly leveraged: typically 10 –
40x•
Efficient: only pays the winner•
Sparks new industry development
$2.5M Start-upSt. Louis
$1B+Industry Start
$100MTeams’
Spend$10M PurseAnsari
Family
Trustee & Vision Circle MembersTrustee & Vision Circle Members
Eric Anderson
‐
CEO, Space AdventuresAnousheh
Ansari
‐
CEO, ProdeaMichael Boustridge
‐
President, BT – N. Am Sergey Brin
‐
Co‐Founder, President, GoogleArianna
Huffington
‐
CEO, Huffington
PostDean Kamen
‐
President, DEKA R&D CorpRay Kurzweil
‐
CEO, Kurzweil
AIErik Lindbergh
‐
Vice‐Chair, Lindbergh FndtnElon
Musk
‐
CEO, SpaceXLarry Page
‐
Co‐Founder, President, GoogleAdeo
Ressi
‐
CEO, The FundedEric Schmidt
‐
CEO, GoogleRatan
Tata
‐
Chairman/CEO, Tata
GroupCraig Venter
‐
Pres, J. Craig Venter InstituteWill Wright
‐
Video Game God, Maxis
FPO
Four X PRIZE GroupsFour X PRIZE Groups
Life Sciences Exploration
Energy &Environment
Education &Global Development
•
Target area that is ‘stuck’; market failure
•
Clear, objective & simple rules
•
Hard but attainable
•
Define a problem, not a solution
•
Can be won in 3 ‐
8 years
•
Significant Cash Purse: $10M >
•
Assure there is a “back end business”
•
Open to teams worldwide
•
Telegenic
X PRIZE Design AttributesX PRIZE Design Attributes
•
Attract maverick
thinkers
•
Make heroes of the teams
•
Create global media events
•
Educate and excite the public
•
Bring new capital to the problem
•
Launch an industry
•
Encourage taking intelligent risk
•
Change the paradigm
X PRIZE Design GoalsX PRIZE Design Goals
Active X PRIZESActive X PRIZES
Where Next?
Healthcare Video
Revolution Through Competition
Peter H. Diamandis, MD
Ferris M. Thompson
Peter H. Diamandis, MDChairman/CEO, X PRIZE [email protected]
The WellPoint XPRIZE: Driving Innovation in Health Care
Milken Institute Global Conference 2009 Los Angeles, CA
April 28, 2009
Sam Nussbaum, M.D.
Executive Vice President and Chief Medical Officer
Company Confidential | For Internal Use Only | Do Not Copy 23
35 Million Members Across the United States,
1 in every 9 Americans covered by WellPoint Plans
WellPoint, Inc.
Blue Cross or Blue Cross Blue Shield
UniCare >100K members
Company Confidential | For Internal Use Only | Do Not Copy 24
Source: McGlynn, E.A, et. al. “The Quality of Health Care Delivered to Adults in the United States.”
New England Journal of Medicine 348 (26): 2635-45 (2003); Mangione-Smith R, DeCristofaro
AH, Setodji
CM, Keesey
J, Klein DJ, Adams JL, Schuster MA, McGlynn
EA. The Quality of Ambulatory Care Delivered to Children in the United States The New England Journal of Medicine, Vol. 26, No. 5, Sept 2007, pp. 644-649
Why does nearly half the physician care delivered in America not
comply with established best practices?
Variation in Recommended Care
Patients do not
receive care in accordance
with best practices
Patients receive care in
accordance with best practices
45% 55%64.7%
Hypertension63.9%
Congestive Heart Failure53.9%
Colorectal Cancer53.5%
Asthma45.4%
Diabetes 39.0%
Pneumonia22.8%
Hip Fracture
% of Recommended Care Received
% of Recommended Pediatric Care Received
67.6%
Acute Medical Care53.4%
Chronic Condition Care40.7%
Preventive Care
Company Confidential | For Internal Use Only | Do Not Copy 25
Variation in Inpatient Care
Why, amongst our country’s
leading
academic medical centers, is there a
three-fold variation
in
hospital days
during the last six months of life?
8.0
12.0
16.0
20.0
24.0
28.0NYU Medical Center
27.1
Mount Sinai Hospital
22.8NY Presbyterian Hospitals
21.6Cedars-Sinai Medical Center
21.3
Mass. General Hospital
16.5UCLA Medical Center
16.1Yale-New Haven Hosp.
15.3
Brigham & Women’s Hosp.
13.9UCSF Medical Center
11.5Stanford University Hospital
10.1Source: John E Wennberg, et. al.; Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United States British Medical
Journal 2004 328: 607
Company Confidential | For Internal Use Only | Do Not Copy 26
The State of U.S. Population Health
ObesityPhysicalActivity
SmokingStress
66% obese or overweight
28% inactive
23% smokers36% high stress
Key Drivers of Health Status
Aging 22% > 55 years, aging population
Driver
Population health status continues to deteriorate…
Schroeder S. N Engl J Med 2007;357:1221-1228
Proportional Contribution to Premature Death
Genetic predisposition
30%
Social circumstances
15%
Environmental exposure
5%
Health care10%
Behavioral patterns
40%
Prevalence
Company Confidential | For Internal Use Only | Do Not Copy 27
Prevalence of Chronic Illnesses
More than 130 million Americans suffer from chronic conditions; that number
will continue to rise
100
105
110
115
120
125
130
135
140
145
1995 2000 2005 201042
43
44
45
46
47
48
Chronic Conditions % of Population
Popu
latio
n in
Mill
ions
% o
f Pop
ulat
ion
Chronic Condition
Prevalence Annual Cost
Diabetes 16 million Americans
•
$105 billion in health expenses
•
11 million lost work days
Heart Disease 60 million Americans
•
$300 billion in health expenses
•
1 million deaths
Asthma 14 to 15 million Americans
•
$5.1 billion in medical expenses
•
2.1 million missed work days
Depression 17 million Americans
•
$43 billion
Company Confidential | For Internal Use Only | Do Not Copy 28
•Claims•Rx•Lab•Provider•Member•HRA
Low Risk Members
Optimize Resources in Acute Episodes of Care,
Population Care
Moderate Risk Members
DM and Education, Risk Avoidance
Well Members
Prevention and Education
High Risk, Multiple Diseases
Episodic Care Mgmt, Clinical Guidelines,
High Risk DM
Complex and Intensive Care
Total Care Integration
10%
10%
25%
30%
25% % of Health Care Costs
Identification and Stratification
Predictive Models
Predictive Models
% of WellPoint Members 50%
20%
25%
4%
1%
Evidence-Based Medicine
Evidence-Based Medicine
Variation Models
Unit/Unit $
Clinical Information Drives Evidence-Based Care and Care Management
Source: Company estimates.
Company Confidential | For Internal Use Only | Do Not Copy 29
Pay For Quality
Support from ACP, AAFP and AAPSupport from ACP, AAFP and AAPSupport from ACP, AAFP and AAP
Prospective Payment
Prospective Payment
Payment MethodologyPayment MethodologyPayment Methodology
NCQA’sPPC Recognition:
•Care Coordination•Process Redesign•HIT
Evaluate Levels of
Achievement
ClinicalProcess and Outcomes
Resource Use/Cost of Care
Satisfaction
FFSFFS
For services currently recognized through
Medicare RBRVS system; potential for additional services
Pre-Assessment of Practice ReadinessPrePre--Assessment of Practice ReadinessAssessment of Practice Readiness
New Care and Reimbursement Models:
Patient-Centered Medical Home
Company Confidential | For Internal Use Only | Do Not Copy 30
Integrated Health Records:
Delivering Health Information at the Point-of-Care
Physicians Emergency RoomsHospitals Members Employers
INTEGRATED HEALTH RECORD
Imaging Labs Pharmacy Medical RecordsClaims
Company Confidential | For Internal Use Only | Do Not Copy 31
Healthcare X PRIZE
Initial Design and Prize Guidelines Summary
for Public Comment
Join the discussion at: www.xprize.org/wellpoint
Company Confidential | For Internal Use Only | Do Not Copy 32
Healthcare X Prize Goal
Reactive Proactive
Disease Based
Consumer Centered
Sick Care
Today
Tomorrow
System Focus
System Focus
Optimal Health
“To create an optimal health paradigm that empowers and engages individuals and communities in a way that will
dramatically improve health value.”
Company Confidential | For Internal Use Only | Do Not Copy 33
Exceptional Solutions
Real‐World Testing
Transparent
Process
WellPoint Commitment
Company Confidential | For Internal Use Only | Do Not Copy 34
Proposed Competition Goal
•
Health value: Improvements in “community health index”
and “total cost”•
Create mechanisms to engage, coordinate, advise, evaluate, and influence
individuals and relevant care providers in assigned test community to generate health value
•
Finalists compete in pre-selected community / employer
test community of ~10K individuals; results compared against an control group
•
Aggregate 3-year results
determine winner; 50% threshold
required to win award.
Company Confidential | For Internal Use Only | Do Not Copy 35
1.
Focus on Health Outcomes and Value at Community Level•
“Community health index”
tracks outcomes across a community; •
“Total cost”
tracks expenditure across all parties2.
Consumer Engagement •
Consumer engagement required 3.
Payment Incentives•
Teams may create incentives for consumers, providers, business partners who demonstrate desirable behaviors/ outcomes
4.
Comprehensive and Proactive Outlook•
Increased focus and investment in proactive, longer-term health improvement programs; improve health across all care settings and multi-year time horizon
5.
Local Partnerships•
Must develop relationships with local health care providers and/
or community organizations
Difference from Other Efforts:
Company Confidential | For Internal Use Only | Do Not Copy 36
Impact Potential
Successful implementation of Healthcare X PRIZE could create within 10 yrs:
1.
A new model and system of health
demonstrating >50% improvement in “health value”
2.
A measurable and globally accepted population health metric, “community health index”
(CHI) benchmark for measuring improvements in population health
3.
An individual health metric, or “individual vitality score”, to help individuals and care team understand and benchmark health status and improvement
4.
A personalized “vitality dashboard”
to understand current health status, “portfolio”
of improvement options, projected return from health improvement efforts
5.
A new “optimal health”
model
that to optimize consumer health and reward providers who create improved health value
Company Confidential | For Internal Use Only | Do Not Copy 37
What Is The Philosophy Behind The Prize Design Guidelines?
Transparent and Objective
•
Open sharing of results and implementation experiences•
Detailed public updates on team progress •
Independent judges oversee team through selection to finalists
Open contest;global idea recruitment
•
Teams may enter from anywhere; must compete in test areas•
“Cap”
on operating expenses to ensure equal playing field•
Limited use of existing, controlled facilities to maximize entrants
Demonstrable
impact w/in3 year window
•
Broad population health spectrum to maximize relevant approaches•
High target: need to generate radical change•
Large enough / long enough to demonstrate sustainable value
Company Confidential | For Internal Use Only | Do Not Copy 38
What Are The Phases Of The Competition?
Entry Concept Pilot Finalist
Requirements •
Registration document–
Concept–
People–
Resources / Assets–
$10k
•
Intervention model–
Targets–
Interventions–
Engagement–
Modeled impact•
Execution strategy / high-level plan
•
Concept sketch
•
Demonstration pilot of key assumptions (50-
100 pts network test)•
Alpha product•
Business plan, modeled financials
•
Intervention model and pilot exceed targets
•
Team in place•
Beta product / interface
Proof •
Reasonable Concept•
Mergers between complementary concepts
•
Model target impact•
Testable key assumptions
•
Pilots exceeding requirements
•
Evidence of consumer and provider engagement
•
Matching / selection into test-beds
•
Actual progress in test-
beds (live competition, reported monthly, quarterly reports)
Timing •
Fall 2009 •
Summer 2010 •
Spring 2011 •
Early 2015
Company Confidential | For Internal Use Only | Do Not Copy 39
What capabilities might teams deploy?
Financing and payment
Coordinationof care
Measurement, Tracking, Feedback
Personalized Decision Support
Outcomes / Comparative Effectiveness
BehaviorModification
CareExperience
ConvenienceAnd Access
Health Information Technology
Company Confidential | For Internal Use Only | Do Not Copy 40
Which Populations Will Be Included?D
isea
seSe
verit
y
At-risk /
lifestyle•
Behavioral / lifestyle foundational to avoiding preventable illness
Chronically
ill •
Coordination puts “care”
back in healthcare and saves lives
Acutely ill •
Coordination and best practices to prevent error and reduce “fragmentation”.
Early health
risks •
Similar goals to at-risk, but costs likely to be additive in short-term
Wellness •
All costs additive
End of life •
Ethical considerations
Company Confidential | For Internal Use Only | Do Not Copy 41
We Look Forward to Your Input and Participation
Visit our website: www.xprize.org/wellpoint•
Add comments to the proposed approach/ guidelines
•
Add yourself to the mailing list for updates
•
Follow the conversation on our blog, twitter, facebook, etc.
•
Let us know if you are interested in creating a team
