June 19, New Roles, New Routes For Managing Risk and Populations. Dial In: Code:

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1 1 June 19, 2014 New Roles, New Routes For Managing Risk and Populations Dial In: Code:

2 2 Having Audio Issues? If you experience any disruptions or other issues with audio during today s WIHI, we ask that you: Notify WIHIAdmin through the WebEx chat If the problem persists, notify IHI Customer Service at or info@ihi.org Download resources and slides when you log off or next day on IHI.org/WIHI Dial In: Code:

3 Madge Kaplan Director of Communications Institute for Healthcare Improvement 3 Madge Kaplan, IHI s Director of Communications, is responsible for developing new and innovative means for IHI to communicate the stories, leading examples of change, and policy implications emerging from the world of quality improvement both in the U.S. and internationally. Prior to joining IHI in July 2004, Ms. Kaplan spent 20 years as a broadcast journalist for public radio most recently working as a health correspondent for National Public Radio. Ms. Kaplan was the creator and Senior Editor of Marketplace Radio's Health Desk at WGBH in Boston, and was a 1989/99 Kaiser Media Fellow in Health. She has produced numerous documentaries, and her reporting has been recognized by American Women in Radio and Television, Pew Charitable Trusts, American Academy of Nursing and Massachusetts Broadcasters Association. For resources & slides, visit IHI.org/WIHI Dial In: Code:

4 Trissa Torres Institute for Healthcare Improvement 4 Trissa Torres, MD, MSPH, FACPM, is a Senior Vice President at the Institute for Healthcare Improvement. Her responsibilities encompass work in several strategic areas, including the pursuit of the IHI Triple Aim, the transformation of primary care, the creation of systems to ensure reliable care transitions, and engaging community partners to improve the health of populations and communities. Dr. Torres is a Preventive Medicine physician by training. Prior to joining IHI, Dr. Torres served for 18 years as Medical Director of Genesys HealthWorks at Genesys Health System in Michigan. There she led population health initiatives to transform care delivery to improve the health of the community. During her tenure at Genesys, Dr. Torres designed, implemented, evaluated, and evolved a novel care model anchored by Health Navigators, individuals who serve as extensions of primary care practice teams to engage patients in healthy behaviors and their own self-management, leveraging community resources to overcome barriers to better health. She has been actively involved with IHI s Triple Aim since its initial prototyping phase, serving initially as champion for her participating organization and more recently as Triple Aim faculty. For resources & slides, visit IHI.org/WIHI Dial In: Code:

5 Jennie Chin Hansen American Geriatrics Society 5 Jennie Chin Hansen is Chief Executive Officer of the American Geriatrics Society (AGS), the nation s leading membership organization of geriatrics healthcare professionals. Prior to AGS, she was CEO for On Lok, Inc., a nonprofit family of organizations providing integrated and comprehensive care community-based services in San Francisco. The On Lok prototype became the 1997 federal Program of All Inclusive Care to the Elderly (PACE), which now has 74 programs in 30 states. Ms. Hansen served as the President of AARP from 2008 to 2010, in addition to serving on AARP s Board of Directors for six years, and she has served as federal commissioner of the Medicare Payment Advisory Commission (MedPAC). Ms. Hansen is currently a member of IHI s Board of Directors. For resources & slides, visit IHI.org/WIHI Dial In: Code:

6 L. Gordon Moore Treo Solutions 6 L. Gordon Moore, MD, is a national leader in improving health care in primary care and medical office practices. He is the chief medical officer for Treo Solutions where he helps governments, insurers, and health care delivery systems structure environments and programs in pursuit of the Triple Aim: population health outcomes, patient experience of care, and their impact on total cost of care. Dr. Moore has been a faculty member with the Institute for Healthcare Improvement, working on office practice redesign, and is a Clinical Assistant Professor with the University of Washington Departments of Family Medicine. He is past president of Ideal Medical Practices ( a non-profit supporting adoption of ideal practices in health care settings across America. Dr. Moore s work is based on understanding health care as a system built upon a solid foundation of effective primary care, and is informed by his prototyping groundbreaking primary care models as well as extensive teaching and interaction with health care systems large and small from across the United States. He has participated in guideline and protocol initiatives, process redesign workshops, working with office practices from solo independent practices to large hospital-based specialty clinics, from community health centers to private and academic practices. For resources & slides, visit IHI.org/WIHI Dial In: Code:

7 What are the Opportunities? Sample Commercial Population Preventable Events by ACRG3 Two chronic conditions Total Cost: $712 PMPM Preventable Cost: $39 PMPM One chronic condition Total Cost: $289 PMPM Preventable Cost: $14 PMPM Healthy Total Cost: $49 PMPM Preventable Cost: $3 PMPM Proprietary and Confidential Treo Solutions 2014 Page 7

8 Illness burden segments by % of population and % of total cost ( Allowed ) 100% Peripheral Vascular Disease Chronic Pain 90% Osteoporosis Epilepsy 80% Pregnancy w/o Delivery Osteoarthritis 70% 60% Chronic Thyroid Disease Chronic Gastrointestinal Obesity Hyperlipidemia Cerebrovascular Disease 50% Normal Newborn Disc Disease and Chronic Back 40% 30% Chronic Renal Failure Coronary Artery Disease COPD Congestive Heart Failure Asthma 20% Chronic Joint and Musculoskeletal Delivery 10% Hypertension Diabetes 0% Proprietary and Confidential Treo Solutions 2014 % population % Allowed Other Page 8

9 Rates of hospital admission per 1000 people with diabetes Bernstein, Richard H. New Arrows in the Quiver for Targeting Care Management: High-Risk versus High-Opportunity Case Identification. The Journal of Ambulatory Care Management 30, no. 1 (March 2007): Proprietary and Confidential Treo Solutions 2014 Page 9

10 Clay Ackerly Partners Healthcare 10 D. Clay Ackerly II, MD, MSc, is a primary care physician with a special interest in the needs of older adults. In addition to his clinical work, Dr. Ackerly is the Associate Medical Director for Population Health and Continuing Care at Partners Healthcare, and Assistant Chief Medical Officer for Non-Acute Services at the Massachusetts General Hospital. Dr. Ackerly recently served as an Innovation Advisor to the Centers for Medicare and Medicaid Services (CMS) and was named a Practice Change Leader by the John A, Hartford Foundation and the Atlantic Philanthropies. Prior to pursuing his medical training, Dr. Ackerly served in the Federal Government, including at CMS and the White House, to advance multiple healthcare quality improvement efforts. While an undergraduate at Harvard University, he was founder and Editor-inchief of the Harvard Health Policy Review, and has since published articles in journals such as the Lancet, Health Affairs, and Academic Medicine.. For resources & slides, visit IHI.org/WIHI Dial In: Code:

11 Continue the Discussion over at IHI s Facebook Page 11 Pop over to IHI s Facebook page and share your thoughts from today s program!

12 Looking for next steps? Are you transforming care and need help with: How to execute on risk contracts and deliver care differently? Ways to design clinical processes to provide the best care for your patients? How to structure (or restructure) your practices to successfully manage whole populations? Methods to accelerate the transition from fee-forservice to value-based contracting? Designing systems to effectively bring together and manage multiple change efforts? Ways to reduce costs while improving health for your patient populations?

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14 Thanks to everyone who makes WIHI possible!

15 Next up on WIHI: July 24, 2014 Pre-Hospital to In-Hospital: The Continuum for Time-Sensitive Care August 21, 2014 Preventing Financial Harm to Patients: The Costs of Care Initiative For more information & episodes, visit IHI.org/WIHI