Restoring

Humanity

to Healthcare

Iora Health

Ali Khan, MD, MPP

November, 2014

Restoring humanity to healthcare

PEOPLE AT

THE CENTER

TOOLS THATENABLE CARE

PAYMENTSFOCUSED ON

OUTCOMES

Restoring humanity...starting from scratch

Restoring humanity to healthcare:

Change anything

PEOPLE AT

THE CENTER

TOOLS THATENABLE CARE

PAYMENTSFOCUSED ON

OUTCOMES

PEOPLE AT

THE CENTER

Endorse people’s natural ability to care for themselves

Restore Humanity:

A different kind of care team.

Restore Humanity:

PEOPLE AT

THE CENTER

Restore Humanity:

“I don’t feel rushed, patronized or unimportant. I’m still getting used to not having to fight for an appointment or to feel visible. I’m a respected customer with choice and dignity. That makes me feel like my health is important and encourages me to take the best care I can of myself.”

Patient, Brooklyn practice

PEOPLE AT

THE CENTER

PEOPLE AT

THE CENTER

PAYMENTS

FOCUSED ON

OUTCOMES

Restore Humanity:

Start with trust, then align payment with outcomes• Capitation, not fee for service• Increase investment in primary care• Incentivize humanity, pay for outcomes

TOOLS THAT

ENABLE

CARE

Restore Humanity:

• Tools to work together as a team: Huddle, cuddle, triad visits, tasks

• Tools to work together with patients: groups, movement, headline, shared care plans, online scheduling, email and phone 24/7

• Tools to record stories and thoughts, not bills and codes

• Tools to manage the health of a community

Iora Worry Score• A clinically meaningful stratification tool for targeting patient recruitment

and population health management

• Consistent use across populations, practices, and processes

• Multiple, independent data sources (e.g. subjective; clinical, claims,

patient-reported data) to lead to consistent scores

• Transparent, straightforward algorithm - Not a black box

PEOPLE AT

THE CENTER

TOOLS THATENABLE CARE

PAYMENTSFOCUSED ON

OUTCOMES

Restoring humanity to healthcare

It Works

TOOLS THATENABLE CARE

14

It works: Patients are rapidly signing up

Patient enrollment since Feb 2012Now over 8,000 patients in 6 practices

Hanover, NH

Brooklyn & Manhattan, NY

Boston, MA

Las Vegas, NV

Hanover, NH

Las Vegas, NV

Patient enrollment since Feb 2012Now over 8,000 patients in 6 practices

15

It works: Access and outcomes improve

93

0

20

40

60

80

100

Amazon.com

76%

Kaiser

Permanente

33%

Net Promoter Score = % Promoters – % Detractors

Question: “How likely is it that you would recommend

Iora practice to a friend or coworker?”

Patients love the practice

94

0

20

40

60

80

100

Patients are engaged

%

% patients with >1 visit

Average 4.5 visits

per year at Iora practice

Typical payer

care mgmt program

9%

“Before I didn’t go to the doctor much. Now I feel like I am going to see my friends. I am not joking.”

-50 y/o patient who has lost 32 lbs in 6 months

%

23%4%

32%

6%

25%

19%

20%

72%

0%

20%

40%

60%

80%

100%

Intake FU

Primary care provider was informed

about visits to specialists they referred?

Intake n = 689; n/a = 347;

blank = 152. FU n = 275;

n/a = 167; blank = 98. 8% 3%

25%

4%

40%

14%

27%

79%

0%

20%

40%

60%

80%

100%

Intake FU

Got an urgent appointment with

primary care provider?

Intake n = 696; n/a =

286; blank = 146. FU n

= 271; blank = 96.

Always

Usually

Sometimes

Never

Key

6681

0

20

40

60

80

100

Initial BP Most recent BP

Hypertension ControlInitial vs. Most Recent Blood Pressure

<140/90(at practice enrollment)

National average= 47%1

<140/90>= 3 mo enrolledN = 659

%

Patient Experience results: Based on CAHPS survey at one Iora practice

Hypertension benchmark: CDC. Vital signs: prevalence, treatment, and control of hypertension. MMWR. 2011;60(4):103-8

%

15

It works: Downstream utilization & costs decrease

16

At SCC, total spend fell a net of 12.3% Driven by large decreases in hospital admissions,

ER visits, outpatient procedures

Data from Special Care Center Practice, Atlantic City

Population was high risk/cost

Total spending, -

12%

Hospital admits, -41%

Rx fills, 40%

Outpatient procedures, -

23%

ER Visits, -41%

Office Visits, -4%

-60% -40% -20% 0% 20% 40% 60%

Restoring humanity to healthcare

PEOPLE AT

THE CENTER

TOOLS THATENABLE CARE

PAYMENTSFOCUSED ON

OUTCOMES