THE FUTURE OF HEALTHCARE DISCUSSION

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1 THE FUTURE OF HEALTHCARE DISCUSSION Jeff Pepperworth President, Healthcare Network/Inmar Lari Harding Director, Product/Inmar

2 Have you ever: Followed a sports team? Used a bank? Voted in an election?

3 Source: A Framework for Applying Analytics in Healthcare 3

4 In 2013 more than 20 percent of American adults were struggling to pay their medical bills, and three in five bankruptcies were due to medical bills. Source: Nerdwallet Health 4

5 Healthcare in its current form is unsustainable 5

6 In the transformation, we are here Broad understanding of the need for a value-driven system the triple aim 6

7 Aligning goals Improving the health of populations The Triple Aim Improving the experience of care Reducing per capita healthcare costs 7

8 The Retailization of Healthcare --Larry Merlo, CEO of CVS 8

9 Not too far away from now in the next six to seven years 75 million Americans will be retail buyers of healthcare. And, they ll come to the marketplace with their own money and either a subsidy from their employer or a subsidy from their government. And, it doesn t much matter they ll be spending their money. --Mark Bertolini CEO, Aetna 9

10 HHS has set a goal of tying 30 percent of traditional, or fee-for-service Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of HHS Secretary Sylvia M. Burwell 10

11 Disruptive examples, $40- $60 doctor visits Creating a new price position for retail health services that aims to give patients greater access to quality, affordable healthcare that will improve their lives Ownership model by retail Primary Care Provider in retail Longer hours offered Lower-cost solutions Ubiquity with thousands of convenient locations Competitive to the small-practice physician Opportunity to create horizontally integrated systems 11

12 $ The point of care and coordination Intelligent Medicines The Patient Technology 12

13 Transparency will be critical to $ success Make pricing public Prices on order forms / doctors office Doctors don t know the charges Cost control (what works and provides good value, economic incentives to do these things, management tools on clinician side to implement and manage populations) Unified value metrics Pharmacy pricing is already public 13

14 Care and coordination Preferred networks may become performance networks Coordinated care will be a requirement for success Choice 14

15 Intelligent medicines That communicate information That differ by patient based on genetics and metabolism Implantable medicines Regenerative medicines 15

16 The patient Social influence Educated consumer Food selections Becoming much more engaged and using technology to do it Responsible for financial decisions Demanding choices and data sharing Interested in convenience 16

17 Discussion Re-aggregation in data Discharge to checkout Supply chain, pharma implications, price pressures and more of a requirement to demonstrate value Manufacturers targeting patients directly Transparency Employer plans self funded How to get our of that model, the middlemen Providers perspective gets talked about, but the patients perspective is completely different Self diagnosis Predictions how does Hipaa effect this expect enabling information connections Genomics The use of data to prevent shifts in patient demographics, 80% of HC dollars spent by 20% of the population the 20% will be the focus of changing behaviors Virtual doctor model what angle cost is lower, state lisc. Issues, not sure about quality More seeing patients in their home face to face in their location and making a difference in their homes 17

18 Jeff Pepperworth Lari Harding

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