Healthcare Marketing and Physician Strategies Summit Harnessing the Power of Healthcare Transparency April 14, 2015
Our Speakers Laura Hennum Chief Strategy Officer Dignity Health, Nevada Region Jason Lee Darin Libby Senior Manager ECG Principal ECG 1
Dignity Nevada Region Rose de Lima Campus (119 beds) San Martin Campus (147 beds) Siena Campus (230 beds) WomensCare Centers of Excellence (three sites) St. Rose/Stanford Clinics Dignity Health Medical Group Nevada Quality/awards: Siena Campus: The Joint Commission 2013 Top Performer (three sites) Imaging centers (two sites) Surgery centers (two sites) Rose De Lima Campus: The LeapFrog Group A grades in safety Siena Campus: 2014 2015 Consumer Choice Award for Southern Nevada 2
Objectives Industry trends regarding sourcing, managing, and reporting data Rationale and considerations for Data Transparency Efforts across the industry to place information in the hands of consumers 3
A Brief History of Healthcare Data Transparency Thank you doctor, for coming over to see me, care for some tea Phase 1 Back in the Day I don t know what it costs but don t worry your insurance will cover it I wish we knew ahead of time how much these bills were going to be Phase 2 Recent Past Phase 3 Present I saw your quality scores and price online and it was really easy to sign up for an appointment 4 Phase 4 Future
A New Era in Healthcare In the health care industry, the growing abundance of data and pressure to transform into a value based system have accelerated transparency. 5
Multiple Factors Driving Transparency Consumer Demand Demand for Better Data Huge cost pressure in the context of reform, economic climate, payment innovation First movers showing impact; risk of being beaten to the punch Supply Supply of relevant data at scale Clinical data will become more accessible thanks to EMRs and HIEs Non-healthcare consumer data are increasingly aggregated and accessible Technology Technical capability Significant advances in the ability to combine claims and clinical data and protect patient privacy Analytical tools now prevalent in front line across all functions Government Government catalyzing market change Continued commitment to making data publicly available Government is enabling private sector participants to create interoperable standards Source: The big data revolution in healthcare, January 2013, McKinsey & Company 6
The Current State of Data Currently, the value of data is balanced by the availability of data. The Data Transparency movement resides at the intersection of the two. Visualize Trends Identify Care and Utilization Patterns Data Transparency Timeliness of Data Value of Availability of Data Data Demonstrate Value and Lower Costs Detect Issues Early Claims and EMR Data Public Sources (e.g., CMS, County Public Health) Personal Devices The challenge is not the availability of data, but rather how we use data to engage stakeholders in the necessary change. 7
Recent Views on Data Leveraging Data & Analytics to Improve Outcomes, published in Modern Healthcare in September, outlined several key views on analytics in healthcare that reflect the importance of having a clear plan and processes for data management. No data is better than bad data, because with bad data you think you re making intelligent decisions, but really you aren t. Steve Kastin, M.D., Chief IT Strategist, Dept. of Veterans Affairs Don t automate a Data and bad process. analytics must Otherwise, cause behavior to you re moving change. garbage at the Otherwise, it is a speed of light. completely worthless Gary Kaplan, investment. M.D., CEO, Virginia Mason Medical Center Ralph Pascualy, M.D., CEO, SMG; SVP, Physician Services, SHS 8
Data Management Considerations Providing the public with greater access to information requires better management of data by your organization. Management of the data takes a comprehensive view. HIPPA User Access Patient Access Administrative Data Security Linking Data From Multiple Sources Extracting Data Merging Payor and Provider Data Access Reporting and Visualization Data Format 9 Interoperability Connectivity Standardization of Source Outputs Patient Matching Criteria Data Warehouse Management
Preparing for a Data Future Moving toward a data-driven culture and developing robust information systems will position your organization to respond to market demands for transparency. Transforming Into a Data-Based Culture Consistently use data in planning and operational discussions. Sourcing Data From the Entire System Collect information from all possible sources to enhance the richness of the data source. Organizing Your Data Establish a plan and hierarchy for the data. Developing a Data Governance Plan Establish an organizational policy for ownership and control of data. Creating Policies for Sharing and Linking Data Set standards. Creating Reporting Capabilities Develop dashboards for key metrics and monitor them regularly. 10
Data Transparency After spending time cultivating information, what do we share with our customers (i.e., patients, providers, payors) and how do we share it? Inform Stakeholders Data transparency has historically been defined as patient access to provider information for the purposes of decision making. DRAFT 0100.006\318443(pptx) This definition has been expanding in the era of health reform to include sharing with more stakeholders as the industry works to improve overall value. 11
Retail Services Provide Lessons for the Future Learning from other retail industries, health systems able to assimilate data and share meaningful information will realize a market advantage. 12
Patient Engagement Kaiser Permanente Kaiser Permanente is setting an industry standard by enabling real-time communication with members. Offering patients data access through My Health Manager (i.e. personal health record) KP is delivery high quality care in more efficient and innovative ways. 13
Patient Engagement Dignity Health Nevada Region Dignity is using an online/mobile tool to allow appointment access and gaining valuable insight into its patient base. Executive Summary Report for Dignity Health Dignity Nevada Region (YTD) 85% of your surveyed respondents indicated they would recommend InQuicker to their family and friends 59% of registered patients indicated being NEW to your facility 35% of registered patients indicated they do not currently have a primary care physician 67% of your facility s InQuicker users registered for their visit using a mobile device We captured registrations by the patient s zip code. The five most prevalent zips represented 41% of all registrations. 62% of registered patients were female and the average age of all your InQuicker patients year-to-date is 39 14
Transparency Drives Value Information Transparency Price Performance Quality Patient Experience Patient Selection Provider Change Search for Value Cost Effectiveness 15
Rationale For Transparency Patients Providers Payors Other Stakeholders DRAFT 0100.006\318443(pptx) Informs care decisions Allows for value and price comparisons Create and monitor quality initiatives Supports data-driven population health efforts Inform risk-based contracting decisions Supports utilization management and population health efforts Informs contracting decisions Employers can use information to assess risk Government can use to inform reimbursement and care policy decisions 16
Impact of Transparency Data transparency impacts several key areas: choice, engagement, accountability, productivity, and quality. Choice Purchasing decisions are increasing being driven by publicly reported data. Engagement Connecting patients with data to encourage individuals to make healthy lifestyle choices. Accountability Reporting data is driving provider accountability to improve performance. Productivity Sharing performance data among peers is an effective tactic to drive improvements in productivity. Quality Reporting and monitoring key process data and outcomes metrics enhances clinical quality and patient service. 17
Current State Efforts at Developing All Payor Claims Databases WA NH MT ME VT ND MN OR ID WI SD WY IL UT CA CO AZ OH IN NJ WV KS OK NM MO KY VA MD DE NC TN AR SC MS TX RI CT PA IA NE NV MA NY MI AL Existing GA In Implementation LA Strong Interest FL Existing Voluntary Effort No Current Activity 2009 2012 APCD Council, NAHOO, UNH. All Rights Reserved As of February 2012; Source: APCD Council, a collaboration between the University of New Hampshire and the National Association of Health Data Organizations DRAFT 0100.010\330841(pptx)
Growing Transparency of Pricing Information A survey of employees in companies that offer Castlight found that more than half of respondents use Castlight s data to make healthcare decisions. 1785\13\216064(pptx)-E1 19
Patient Reference Pricing Employer reference pricing is recent example of transparency changing patient behavior. Example Model Drive Costs Down Employee Gets $1,000 for endoscopy Provider A $750 Median Quality 40 miles away Patient Saves on deductible Available Information Price Quality Location Provider C $1,500 High Quality 10 miles away Patient pays $500 Cost Certainty for Payor Provider B $1,000 Low Quality 5 miles away Financially neutral DRAFT 0100.006\318443(pptx) Includes Patient in Decision 20
Third-Party Consumer Assistance Several resources are aiming to put more information in the hands of consumers, here are three examples. Payor Driven Contract Bundles National independent, Offers patients the nonprofit organization. Claims repository provides access to charge information. Started due to 2009 law suit in NY with health plans. convenience of one bundled payment for services. Patients can make appoints too. http://fairhealthconsumer.org/ DRAFT 0100.006\318443(pptx) Revised: 12/18/14 https://www.mdsave.com/ 21 Public Driven Journalists focused on bringing transparency to healthcare costs. Partnered with local public radio stations. For the selected core procedures, consumers enter the costs they experienced. http://clearhealthcosts.com/
Dignity Health Nevada Initiatives Dignity Health Nevada monitors, measures, optimizes and maintains 22 digital platforms. Some of the highlights include: Analytics Google Sprinklr Websites strosehospitals.org (hospitals) dhmgnv.org (physicians) SEO and SEM Brightedge Google Adwords Access CRM InQuicker ER InQuicker Primary Care Healthgrades Navigant 22
Challenges to Transparency Information not linked across the continuum Unequal access to information Lack of understanding the information and inexperience in how to identify value No incentives to share information Patient privacy questions Information overload DRAFT 0100.006\318443(pptx) 23
Additional Data Transparency Issues Data Detail Level Gradations of metrics (e.g., binary, versus, scale) Availability of data to make decisions across the entire market place Measuring the Value Projecting cost savings from consumer choice Evaluating the costeffectiveness (e.g., quality of life, years of life) Impact of value measurements on policy decisions (e.g., covered/not-covered) Using Data Need to provide DRAFT 0100.006\318443(pptx) 24 consumer and provider incentives Studies have shown that practitioners commonly do not provide care consistent with evidencebased practice. (McGlynn et al., 2003) General bias against transparency due to limited success of prior experiments
Data Transparency Concerns Patient Adoption - Patients are likely to be slow in embracing the full value of data transparency. Location Anchors - Transparency is unlikely to have a significant impact on patient and provider choice as it relates to facility-based or inpatient services due to convenience or location considerations and provider direction. Uncertain Effectiveness - Uncertainty about the impact and effectiveness of transparency to drive improved efficiency. Limited Market Traction - Small subset of the market has demonstrated anything resembling transparency. Limited Incentives - Purchasers have not yet rewarded high value providers in a significant way. 25
Key Takeaways for Organizational Improvement Health reform is making data transparency an ongoing part of our industry s reality and is fueling the need for data and analytics. Culture Establish a data-driven culture at your organization. Consistency Build processes around standardization. There is a huge need for consistent reporting and approaches. Control and Governance Identify the department of the organization that owns information (e.g., IT, finance, strategy) and establish clear policies for access and sharing. Data Dissemination Educate the next generation of care teams, as well as patients, on how to view data. 26
Key Takeaways for Data Transparency Having an ability to apply patientspecific best practices There are a myriad of benefits to growing a data-transparent culture at your organization. Informing consumer financial decisions Educating patients regarding service options Driving operational efficiency improvement Emphasizing quality Monitoring outcomes to encourage change 27 Take small steps to improve your organization one patient at a time.
Questions Discussion Darin Libby ECG dlibby@ecgmc.com 858-436-3220 Laura Hennum Dignity Health laura.hennum@dignityhealth.org 702-616-5725 28 Jason Lee ECG jlee@ecgmc.com 415-692-6060