the new health age: the future of health care in america

The New Health Age:

The Future of Health Care in America

Jonathan FleeceCo-Author

AdvisorHealth Care Attorney

Health Insurance & Benefits Going

ForwardIT IS MUCH MORE THAN THE QUOTE

“America’s state of health, the economic models driving health care choices and costs, and America’s health care delivery systems do not adequately foster the right incentives for

American Stakeholders to (1) increase the quality of their health, (2) improve health care service to everyone, or (3) control health care costs. This reality is contributing to the rapid decline of America’s pride, financial strength, and competitive advantage in a global marketplace. It is, therefore, essential for America to acknowledge, embrace, and foster The New Health Age.”

The Current Landscape of Health Care in America

➠ American companies of all sizes

➠ Individuals of every age - young, old and in between

➠ Public and private sectors

➠ Workers and employers

➠ Unemployed and employed

➠ Patients and health care providers, including physicians, nurses, hospitals, and long term care providers

➠ Payers and their beneficiaries

➠ Teachers and students

➠ Governments and citizens

Who Are America’s Health Care Stakeholders?

➠ There are nine dynamic flows that are and will reshape health care in the New Health Age

➠ They are grouped into three categories:

The Dynamic Flows of the New Health Age

o How we THINK about health care

o How we DELIVER health care

o The ECONOMICS of health care 

Sickness Wellness

Ignorance Awareness/Understanding

Opposition Alignment

The Dynamic Flows About How We THINK About Health Care

Treatment Prevention

Reactive Proactive

Episodic Wholistic

The Dynamic Flows About How We DELIVER Health Care

Procedures Performance

Isolation Integration

Non-Efficient Efficient

The Dynamic Flows of the ECONOMICS of Health Care

1. Medical Homes

2. Integrated Delivery Systems (IDS)

3. ACOs and EACOs

4. Star Rated Medicare Advantage Plans

5. Health Insurance Exchanges

The New Structure of Health Care

“Medical homes will function at the center of health care and be the catalyst for community-based collaborative care networks, expanding access to primary care and general health care services.”

- David Houle and Jonathan Fleece “The New Health Age: The Future of Health Care in

America”

Medical Homes

➠Not physical structures

➠Physician driven

➠Patient centered

➠Coordinated care

➠Appropriate care

Medical Homes

Integrated Delivery Systems

➠ Think of top health care players coming together to collaborate in a board room

➠ Agree on sharing bundled, capitated, and performance bonus payments

➠ Contract with payers (government and private)

➠ Appropriate care

➠ Performance based

Accountable Care Organizations

➠Employer funded health care benefit plans

➠New world around health management

➠Health care network design and partnering

➠Absenteeism management

➠Workforce productivity oriented

Employer Accountable Care Organizations (EACOs)

EACOs

EACOs

Analytics

Benefit Design

Total Health

Management

Health Delivery

Alignment

Workforce Health Management

Today

Employees

Flu

Injury

Risk

Workforce Health Management

Tomorrow

HEALTH MANAGEMENT

Risk

Flu

Injury

What is the #1 Enemy Against a Workforce Health Incident?

• High Performance Provider Networks

• Agree on sharing bundled, capitated, and performance bonus payments

• 5 Star Rating System

• 85% of Medicare Funds Go To Health Care Services

Private Medicare Plans

➠Travelocity, Expedia, Orbitz for health care insurance

➠Shopping place for small business and “free riders”

➠Must address health management

Health Insurance Exchanges

➠Defining your market

➠Health management

➠Creating a competitive advantage

➠Can smaller agencies survive?

New Models for Agencies & Brokers

➠ The New Health Age version of the Race to the Moon

➠ Goal: to make America the healthiest country in the world by 2025

www.theracetoahealthyamerica.org

Welcome to The New Health Age!

jfleece@blalockwalters.com Twitter @JonathanFleece

941.920.0494