accountablecare service organization
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TRANSCRIPT
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Accountablecare Service Organization™
Investing in the Future of Healthcare
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Healthcare Spending Health spending will rise by
5.8% each year from 2010 to the end of 2020.
In 2020 health care will account for one-fifth of America’s economy.
The federal government will pay for a greater share than ever before.
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Recent reform in the federal Medicare program changes the way health care is organized and paid for.
What does it mean?
The rules lay out a new path for doctors, hospitals and other providers of care to form teams called "accountable care organizations," which save money by better coordinating medical services for Medicare patients.
Under the rules, teams that treat patients for less money would be rewarded financially by the government if they also meet certain measures of quality.
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Recent reform in the federal Medicare program changes the way health care is organized and paid for.
What are ACOs?
A form of managed care that differs from health maintenance organizations (HMOs)
Run by doctors or hospitals, rather than by insurance companies
To qualify as an ACO, doctors or hospitals must be able to provide primary care for at least 5,000 patients
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Who will be affected?
Accountable Care Organizations
45 million seniors will ultimately get their care this way
5 million Medicare patients will participate through 1000 ACOs that will be licensed on January 1, 2012
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How much money will be saved? Up to $960 million*
during the first three years (65% of which goes to the ACOs!)
How?
Caregivers required to share medical records
Required to administer preventive care
And required to "invest in keeping people healthy”
* Source: U.S. Department of Health and Human Services
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What are the quality standards?
1. Patients' experiences in getting care
2. The extent to which care is coordinated
3. Patients' safety
4. The degree of emphasis on preventive health
5. The effectiveness in treating patients who are sick and frail
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Accountablecare Service Organization™ (ASO™)
A national service organization for Accountable Care Organizations (ACOs)
Establishing at least 25 ACOs by January 1, 2012, and 75 more over the first half of 2012
At least a dozen of these 5000-patient ACOs in the Los Angeles metro area
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ACO–IN–A–BOX™
ASO provides 100% of the requirements needed for an ACO License.
While we will accept direct fees for these services, we also provide our services for no upfront money in exchange for a 25% equity stake in the new ACO.
We then actively coordinate with our ASO partners to offer Wellness programs that help the new ACO succeed in saving money and increasing quality.
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ASO Toolkit™
Doctors, medical groups, medical associations and hospitals can utilize our services for everything they need to create a licensed ACO.
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ASO Toolkit™
Business Services Cost-Savings Programs
Shared Marketing ServicesPartner Wellness Programs
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Business Services
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Business Services Formulates a customized
business plan
Uses state-of-the-art techniques to make sound financial projections
Analyzes the fundamentals facing each emerging ACO
Darwin “Trey” Miller is an associate economist with the RAND CORPORATION and holds a Ph.D. in Economics from Stanford University. He is currently working on a chapter in a book for the Gates Foundation. Trey’s firm will build all of the business documents and provide all the analysis needed to place emerging ACO’s in the cross-hairs of the ACO Review committee.
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Legal Services
Prepares and files all necessary documents to establish ACOs
Distills federal regulations and provides expert legal counsel
Prepares contracts between ACOs and our service partners
Russ Frandsen is a 35-year veteran attorney who heads up the ASO legal team. He was Caltech MIT Enterprise Forum Committee Chair from 1998-2000 and again from 2003-2007. He sits on the Board of Directors for the Association for Corporate Growth.
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Electronic Medical Records
Adheres to federal government requirements
Allows patient to monitor their own health care and that of their spouse
Motivates them to follow up and stay involved
Woody Anderson was a director of insurance and health programs for the 241 hospitals in the Southern California Hospital Association working with physician groups as well as ancillary medical facilities and medical organizations. He is well-suited for the task of running the ASO.
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ASO Toolkit™
Business Services Cost-Savings Programs
Shared Marketing ServicesPartner Wellness Programs
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Cost-Savings Programs
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Clinical Trials
Offer patients a chance to receive new and innovative treatments that are not yet available to the general public
Offer hope to ill patients while representing substantial savings to ACO participants
ACOs generate revenue by shifting costs to the clinical trial
Over 112,667 trials with locations in 175 countries** Source: www.clinicaltrials.gov
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Adult Stem Cell Clinical Trials Adult stem cells – and their
capacity to treat diseases – have become a driving force in the field of biotechnology.
Thanks to regenerating mechanisms found in stem cell therapies, we can better address diseases, mental ailments, aging, and thousands of other health concerns.
Included in our clinical trial program, we will screen patients to determine those with the highest projected healthcare costs and attempt to match them to clinical trials using stem cell therapy.
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Adult Stem Cell Treatment Dr. Stanley Jones, a Houston
orthopedic surgeon, has been a staunch advocate for the healing properties of adult stem cells since last year, when he says he was effectively cured of his debilitating arthritis after being injected with his own stem cells in Japan.
Presidential frontrunner Gov. Rick Perry used our program recently to treat recurring back pain by implanting stem cells during surgery.
ASO president Woody Anderson has had remarkable results with adult stem cell therapy to cure his fibromyalgia.
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Travel Medicine
Provides patients the opportunity to receive high cost procedures in 141 countries.
Focuses on ethnic patients, particularly immigrants.
For example, a Korean patient requiring a heart bypass has the opportunity to receive that procedure in Korea, where he or she may have relatives.
The ACO can pay for the service out-of-pocket at a savings of 50-60% and come out ahead under the Medicare Shared Savings Program.
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Generic Prescription Program
The average Medicare patient spends $3,741 per year on prescription drugs.
The ACO could save up to 60% or more per patient from switching these brand name prescriptions to generic alternatives.*
* Source: Haas, et. Al. 2005
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Mail-Order Prescription Drugs
40% of the prescribed drugs are not taken as physician directs, therefore the condition may worsen.
Our mail-order drug system minimizes prescription drug costs for ACO patients as well as enhances patient care.
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ASO Toolkit™
Business Services Cost-Savings Programs
Shared Marketing ServicesPartner Wellness Programs
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Partner Wellness Programs
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Medical Foods
Optimizes medication dose level for patients
Improves clinical outcomes
Reducing the side effects associated with high dose pharmaceuticals
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Practitioners and patients use this system to monitor all-important health indicators.
By using a Wellness Index score, providers and patients alike can track health and prevent the onset of many chronic diseases.
This wellness technology is cost effective, simple to implement, and proven effective.
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The ACO will offer a monthly pre-paid METRO PASS to each participant.
The Metro Wellness Program will increase health and quality of life while reducing cost to the ACO.
Program will motivate seniors to stay interested in the world around them.
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Partnered with the Stanford School of Medicine, AgeLoc is the result of 27 years of nutraceutical research.
AgeLoc technology identifies, targets, and resets youth gene clusters, literally reversing the signs of aging.
AgeLoc improves the three dimensions of vitality – physical vigor, mental acuity, and sexual health.
AGELOC Senior Scientist Jia-Shi (Josh) Zhu, Ph.D., is also an adjunct professor in the Department of Applied Biology and Chemical Technology at Hong Kong Polytechnic University.
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Pre-paid YMCA Memberships
A national leader in physical fitness and community programs with over 2,600 facilities across the country offering physical, recreational, nutritional, and educational activities.
Patients who visit their YMCA 12 times per month will have their gym membership paid for by the ACO.
These communities become social gathering places for seniors, greatly enhancing both health and wellness.
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ASO Toolkit™
Business Services Cost-Savings Programs
Shared Marketing ServicesPartner Wellness Programs
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Shared Marketing Services
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The marketing platform will target ethnic communities in their native languages through media outlets such as Univision.
We will also target our ACOs through local churches and other various community groups.
We will use hyper local ad campaigns on websites such as the local editions of Catholic Online.
Targeted Marketing Approach
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Each ACO starts with 5000 patients.
ASO provides each ACO with proven marketing programs to double their patient base to 10,000 within three years.
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The ACO model will incentivize doctors to reduce healthcare costs by cutting unnecessary services and by considering the costs of the services they provide.
The only way to fill beds under such a scenario is to compete for patients.
Therefore a well-designed marketing and PR campaign must be an integral component of any ACO.
ASO partner organizations BannerCaswell Productions and Ethnic Media Marketing Inc. have a combined 35-year track record in health media. EMMI has implemented successful marketing campaigns for ethnic communities since the 80’s while the Banner brand has been in television since the 50’s, producing classic TV series such as Candid Camera and The Carol Burnett Show. In the 2000’s, BCP produced all the media for the eHealth Network.
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ASO Founders
Woody Anderson – President & CEORuss Frandsen – General Legal CounselTrey Miller – EVP, Business & Policy StrategyEdmund Carlson – EVP, Non-profit & Gov’t RelationsDavid Gustafson – EVP, Hospital RelationsBen Caswell – EVP, Marketing & Bus. DevelopmentChuck Banner – EVP, Media and ProductionJessica Beavers – Manager of Operations
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Board of DirectorsEdmund Carlson – Chairman
Woody AndersonRuss Frandsen
Trey MillerDavid Gustafson
Ben CaswellChuck Banner
Jessica BeaversWilliam SchifferliThomas C. Blake
Al LieferKai Nigard
_______________________________________
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Advisory Boards
PHYSICIANWilliam E. Shell, MD – Chairman
Walter Jayasinghe, MD, MPHChris Wilmouthe, MDLou Acosta, MDErlinda Dy Grey, MDFouad I. Ghaly, MDJorge Carreon, MDDr. MalinaKeith Mootoo, MDSteve Cohen, MDKen Kroll, MDJames P. Watson, MD, FACSJacob N. Flores, MDMarcel S. Filart, MDAndre Berger, MD
BUSINESSAl Pirnia – Chairman
Thomas R. Bradford, Esq.Lance MillerSteven PowersLloyd E. StollPaul S. HorvitzWilliam V. AlkhasianKing M. HuangFrank Wheaton, Esq.Chris DurkeeMaria TownsendKrystyna H. SlezakJenny YoonMartin Roy MervelRev. E. Dale Click
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ASO History (2006 – 2011)
In 2006, Woody Anderson began developing an HMO strategy that incorporated a wellness program that focused on travel medicine and clinical trials – as a way to reduce the cost of American healthcare and increase the quality to the patient.
In 2008, he expanded into the emerging field of Adult Stem Cell Therapy with RNL BIO.
In September 2009, Congress passed the H.R.3590 Patient Protection and Affordable Care Act, and Woody’s strategy shifted from HMO to ACO development in California.
In June, 2011, the strategy expanded nationally to cover existing ACOs under development as well as to establish new ACOs… and the ASO was formed.