PRESENTED BY
Consumer and Physician Engagement During a
Major Hospital Affiliation
Lisa Neveling, VP, Program Development Nur M. Nur, Business Development Associate
Lahey Health, Business Development
Lahey Health
Overview
2
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1888 Beverly Hospital, Beverly MA Founded
1889 Addison Gilbert Hospital, Gloucester MA Founded
1912 Winchester Hospital, Winchester MA Founded
1923 Lahey Clinic, Boston MA Founded
1980 Lahey Clinic Moves to Burlington MA
1994 Lahey Clinic, Peabody MA Opens Beverly and Addison Gilbert Merge
1995 Northeast Health System Forms (Beverly/Addison Gilbert, Behavioral Health, Senior Health)
2012 Lahey Health System Forms (Lahey Clinic and Northeast Health System)
2014 Winchester Hospital Joins Lahey Health VNA Middlesex East Joins Lahey Health
History of the Lahey Health System
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Massachusetts Health Care Landscape
Rising Costs, Unique Utilization
5
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Academic Medical Center Utilization
The Massachusetts delivery system uses major teaching hospitals for far more of its inpatient care than the rest of the nation.
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State Budget Consequences
Lahey Health Model of Care
Keeping Care Local
8
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Right-Sized Inpatient Capacity
Ability to Keep Care Local
Lahey Health’s Unique Advantage
© Copyright 2016 Healthgrades Operating Company, Inc. All Rights Reserved. May not be reproduced or redistributed without the express permission of Healthgrades Operating Company, Inc.
Overall Hospital Case Mix Index Benchmarked against Median Teaching Hospital
10
1.77
1.78 1.79 1.84
1.87
1.82
1.80
1.86 1.84
1.82 1.84
1.89
1.63
1.63 1.64
1.66
1.64
1.70 1.66
1.70
1.69 1.69
1.71 1.75
1.30
1.40
1.50
1.60
1.70
1.80
1.90
2.00
2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q4 2014 Q1 2014 Q2 2014 Q3 2014 Q4
LAHEY Median Teaching Hospital 75th Percentile Teaching Hospital 25th Percentile Teaching Hospital
Source: AAMC•COTH Quarterly Survey of Hospital Operations & Financial Performance Note: recent survey n=147 Overall Hospital Case Mix Index = Overall Hospital Case Mix Index
Higher is Better
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CMI Adjusted Expense per Adjusted Discharge Benchmarked against Median Teaching Hospital
11
$7,609 $7,424
$8,351
$7,492 $7,900
$7,165 $7,529
$7,173 $7,607 $7,726 $7,764
$7,555
$9,577
$9,438 $9,660
$9,533 $9,422
$9,177 $9,593
$9,841
$9,936 $9,492 $9,480
$9,651
$5,400
$6,400
$7,400
$8,400
$9,400
$10,400
$11,400
$12,400
2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q4 2014 Q1 2014 Q2 2014 Q3 2014 Q4
LAHEY Median Teaching Hospital 75th Percentile Teaching Hospital 25th Percentile Teaching Hospital
Lower is Better
Source: AAMC•COTH Quarterly Survey of Hospital Operations & Financial Performance Note: recent survey n=147 CMI Adjusted Expense per Adjusted Discharge = (((Total Operating Exp - Total Other Operating Rev) * (Inpt Gross Rev/ Total Gross Rev) / Total D/Cs) / Overall Hospital CMI
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Lahey Hospital & Medical Center – A Top Performer Among Peers on Quality Measures COMPARED TO US NATIONAL RATE
12
Hospital Overall Nurses Doctors Responsive
ness Pain
controlled
Explanation about
medicines
Lahey Hospital & Medical Center(MA)
Massachusetts General Hospital (MA)
Brigham & Women’s Hospital (MA)
The Johns Hopkins Hospital (MD)
Cleveland Clinic Foundation (OH)
Hospital of University of Pennsylvania (PA)
Source: Hospital Compare - 7/1/2014-6/30/2015
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Economic Savings to the Payers and Commonwealth
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Lahey Health Competitive Vision
Cost, Quality, Access = Value
Lahey Health Patient Direct Connect
Experience
15
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Eastern MA: Competitive Spending
16
$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
2012 2013 2014
Lahey Health
Key Competitor
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Emerging Points of Disruption to Healthcare’s Business Model
Payer shift from volume to value
Emergence of “care anywhere”
Entrance of new, innovative, well-financed competitors Health care as a “retail good”, consumer price sensitivity
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Lahey Health and Healthgrades
• Customer Relationship Management and Call Center since 2009
• Patient Direct Connect program since 2014
• Quality Achievement online messaging
• Marketing Automation
• Expansion of CRM database with Lahey Health data in progress
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Lahey Health Patient Direct Connect (PDC) Objectives
• Capture new business for Lahey Health primary care/specialist care
• Enhance Lahey Health profile among women (45 to 64 yrs)
• Increase commercial payer mix
• Enhance physician alignment/engagement
• Engage in measurable growth activity
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Lahey Health PDC Phased Implementation
• Employed Lahey Health primary care providers and specialists launched first in September 2014 – Creation of Central Physician Database
– Quality Control of Data – Met minimum physician profile data requirements to
launch program
• Next wave captured newly-affiliated, employed Winchester Hospital PCPs and specialists in October 2015
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Sustaining PDC in Lahey Health
Educate and partner with
system program
stakeholders Continuous
evaluation of performance
Ensure high physician fill
rate Frequent update of physician
roster
Identify PDC tools to help
build on existing
successes of the program
Create program standardization by centralizing
ownership
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Lahey Health PDC Results
23
Program to Date totals from September 2014 forward
March 2016 Contract to Date Program to Date Searches 60,371 273,266 602,975 Calls 1,656 8,204 15,372 Referrals 1,612 7,895 14,650 Transfers 780 3,911 6,980 Conversion Ratios Call/Search 2.7% 3.0% 2.6% Referral Transfer Rate 48.4% 49.5% 47.7%
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Lahey Health PDC Call Volume
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43% 50% 55% 55% 53% 51% 56% 52% 57% 61% 56% 59%
0%10%20%30%40%50%60%70%
Apr2015
May2015
Jun2015
Jul2015
Aug2015
Sep2015
Oct2015
Nov2015
Dec2015
Jan2016
Feb2016
Mar2016
% New Patient callers by month
* New Patients are self-reported at the time of call
3720
2922
338
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
6,980 Transferred Callers
OTHER
EXIST
NEW
89 80 94 154
* 261 298 260
+ 458
395 462
0
100
200
300
400
500
Apr2015
May2015
Jun2015
Jul2015
Aug2015
Sep2015
Oct2015
Nov2015
Dec2015
Jan2016
Feb2016
Mar2016
Number of New Patient Callers
* Moved to HG call center + Added Winchester and increased competitive search
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Lahey Health New Patient Projected ROI
25
*ROI Estimated based on average encounters per call and historic reimbursement rates for encounters
-0.53 -0.18
0.33
0.98
1.73
2.53
3.39
4.33
-2.00
-1.00
0.00
1.00
2.00
3.00
4.00
5.00
Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16
New Patient ROI
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PDC: Reflection
• Identify active champions from across the organization
• Create seamless coordination between internal access center and Healthgrades call center
• Engage Finance/IT to ensure timely ROI measurement
• Centralize PDC program management
• Create and launch internal communication plan early on
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PDC: Future Goals
• Determine program ROI
• Expand PDC program to include private practice primary
care providers and specialists
• Enhance patient access through online appointment scheduling
• Continue to enhance and hone provider profiles
Questions?
28
Thank You