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Proprietary & Confidential
On-Site Health & Wel lness Centers
February 19 th, 2014
1
On-Site Health & Wel lness Centers
Ben Baker Chief Operating Officer, CareHere
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Proprietary & Confidential 2
AGENDA
Background & History
Healthcare Reform & Self-Funding
Benefits of Onsite Healthcare &
Wellness
Data Analysis
Reporting & ROI
Implementation
Q&A
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Proprietary & Confidential 3
CareHere History & Ownership
• Formed in January 2004
• Headquarters: Brentwood, TN
• 163 health centers, located in 22 states
• 850+ on payroll
• Medical services provided to 95,000+
employees nationwide
• Named the 6th Fastest Growing Private
Company in Middle Tennessee
(2013 Nashville Business Journal Award)
Public59%
Private
41%
CURRENT ENTITIES • City, County & State Governments
• School & Utility Districts
• Manufacturers (Auto, Food, Equipment)
• Banking & Insurance Companies
• College/University
• Construction
• Transportation
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Proprietary & Confidential 4
Tier 1 supplier to Ford,
General Motors and Toyota
CareHere Clients
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Proprietary & Confidential
US Health Care
Reform
Insurance Reform
Delivery System
Reform
Coverage
Expansion
Individual
Mandate
Medical-Loss
Ratio
New Org
Structures
ACO
PCMH
Payment
Reform
Value-Based
Payments
Bundled
Payments
2010 U.S. Healthcare Reform
• PCMH = Patient Centered Medical Home
• ACO = Accountable Care Organization
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Proprietary & Confidential 6
Patient Centered
Healthcare
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Proprietary & Confidential 7
Benefits of a CareHere Health & Wellness Center
Reduce
Healthcare
Claims Cost
Identify/Treat
Chronic
Illness
Increase
Productivity
Improve
Employee
Morale
Save Money
With No
Co-Pay
No
Appointment
Wait Times
Access to
Wellness
Programs
Trust in
On-site Care
Providers
Employer Benefits:
Employee Benefits:
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Proprietary & Confidential 8
Benefits to the Provider
• Build Trust with the Patient
• Educate and Provide Treatment
• No Double or Triple Booking
• Not a Fee for Service Model
• No Daily Patient Quota
• Covered Medical Malpractice Insurance
• Care-Coordination with Specialist, Health Coaches, and Outside
Primary Care Providers
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Proprietary & Confidential 9
Specialist Referrals
• Referrals are made within the provider network
• Establishing a high performance network
• Outside provider access to the CareHere EMR
Specified EMR accessibility
Fax
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Proprietary & Confidential 10
Local Hospital Alliance
• Specialized Services at Contracted Rates
• Hospitalist Established
• Bypass the Emergency Room
• Avoid the cost of the Emergency Room
• 24/7 Service
• Provides a higher level of service and convenience to the
employee
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Proprietary & Confidential
Market Place VS. Onsite Health Centers
No relationship
between patient and
Provider
Co-Pays
5-7 minutes on average
with the Provider
Poor or No communication
between Providers
No Co-Pays
20 minute Appointments
Care flows through onsite
Provider
Access to integrated wellness programs
Market Place Onsite Centers
Profit Driven Patient-
Centered Approach
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Proprietary & Confidential
Personalized Cover Letter Summarized Lab Results
Color-Coded Health Summary
20-30 Core Report
Health Risk Assessments
On-Site and Off-Site Blood Draw for Employees
12
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Proprietary & Confidential 13
CareHere Coaches
Exercise Health Coach | Registered Nurse | Behavioral Health Coach
Pharmacist | Tobacco Cessation | Registered Dietitian
CareHere has 185 Case and Disease Management (CM/DM)
programs developed for 2014!
Sample CM/DM Programs:
•Weight Management
•Smoking Cessation
•Diabetes Management
•Beginning Exercise
•Basic Nutrition
•Grocery Store Tours
Provider Driven Wellness & Case Management
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Proprietary & Confidential 14
Wellness Tracking Application
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Proprietary & Confidential
Patient interaction notes are
accessible by:
• On-Site Clinic Medical Provider
• CareHere Wellness Coaches
• Telemedicine Provider
• 24/7 Nurse Line Providers
• Outside Providers
EMR Differentiators:
• Ability to share CareHere EMR notes with Outside
Providers
• Ability to separate occupational health/workers
compensation notes from primary care notes within the
EMR while maintaining HIPAA compliance.
• Transmission of eligibility and claims data in a fully
integrated 837 file.
Electronic Medical Records
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Proprietary & Confidential
“…Among employees
who are at low-
moderate risk for
Cardiovascular Disease
and adhere to an online,
interactive, web-based
Work Health Program,
significant reduction in
multiple Cardiovascular
Disease risk factors(…)
is attained within only 90
days.”
American Heart Journal Mayo Clinic Study
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Proprietary & Confidential 17
Incentives/Disincentives
•Mandatory HRAs
•Biometric Benchmarks
•Wellness Program Participation
•Premium Differentials
•Reward Programs
•Contests
Clinic and Wellness Marketing, Tools
and Education
• Employee Presentations
• Free HRA Events
• Open House
• Wellness Groups
• Health Events
• Mailers and Emails
• Health Educator Presentations
• On-Site Flu Vaccinations
• Paycheck Stub Announcements
• Targeted Notifications/Reminders
Creating Employee Engagement
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Proprietary & Confidential
Creating Employee Engagement
• Promoting the Health Center
• Educating the employees
• Incentives and Rewards
• Customized to the employer
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Proprietary & Confidential 19
0%
10%
20%
30%
40%
50%
60%
70%
80%
Client 1 Client 2 Client 3 Client 4 Client 5 Client 6 Client 7 Client 8 Client 9
Negative Negative Positive Positive Positive Pos./Neg. None None None
71%
62%
70% 68%
54%
47%
37%
13%
4%
53%
63%
19% 26%
19% 21%
2% 2% 0%
Count of Unique Patients/Engaged in Wellness Count of Unique Patients Assigned Programs/Completed Programs
Employer Incentive Impact
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Proprietary & Confidential 20
On-Site Provider Dispensing
• Zero-revenue venture for CareHere
• 30/60/90 Day Supply
• 150 to 200 Generic Drugs Stocked On-Site
• Pharmaceutical Mail Order Plan
Top 5 Comparison (Brand vs. Generic)
Name Brand Marketplace
Price
Generic or
Equivalent
CareHere
Price
Nexium $5.71 Esomeprazole
(therapeutic sub to
Pantoprazole)
$0.08
Prilosec $1.02 Omeprazole $0.15
Protonix $1.17 Pantoprazole $0.08
Lipitor $5.00 Atorvastatin $0.24
Claritin $1.00 Loratadine $0.07
CareHere Differentiators:
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Proprietary & Confidential
“What should
this cost?”
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Proprietary & Confidential
With data analytics, you can:
• Control health costs
• Measure performance
• Assess risks
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Proprietary & Confidential 23
• Cholesterol Management
• Weight Management
• Pre/Diabetes Management
• Tobacco Cessation (COPD)
• Hypertension Management
High Risk
Moderate Risk
Low Risk
John’s Hopkins ACGs
Data analytics enables you to evaluate
the total disease experience of a patient
and predict cardio respiratory
failure/shock, among other conditions.
Disease Management Protocols:
Quality Care Delivery
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Proprietary & Confidential
Member Analysis
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Proprietary & Confidential
Preventable Conditions
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Proprietary & Confidential
Data Analytics: Regression
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Proprietary & Confidential
Regression: BMI/All patients - $9
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Proprietary & Confidential
Regression: BMI > 30 - $14
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Proprietary & Confidential
Regression: BMI $22 + HbA1C $133
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Proprietary & Confidential
Claims Trend and Savings Analysis
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Proprietary & Confidential
OVER $15 MILLION SAVED
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Proprietary & Confidential
Health Risk Assessment Condition Savings
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Proprietary & Confidential 33
Services
Medical & Health Services
• Primary Care
• Acute Care
• Episodic Care
• Patient Medication Adherence
• Pharmaceutical Dispensary
• Mail Order Medication
• Immunizations
• Sports Physicals
• Plan of Care Compliance
Wellness
• Case Management
• Weight Management
• Hypertension Management
• Addiction Intervention
• Pre-Diabetes Management
• Lipid Management
• Stress Management
• Nutritional Counseling
• CareHere Staffing
• Wellness Coaches
• Accounting
• Training
• Pharmacist
• Director of Client/Clinic Operation
• Care Coordinator/Case Manager
• Medical Staff Management
• Medical Provider Management
• Medical Provider Recruitment
• Medical Staff Recruitment
• Medical Malpractice Insurance
Technology
• Electronic Medical Record
• CareHere Connect
• Information Technology
• Online Appointment Scheduler
• Smartphone Application
• EMR Access & Integration with
Outside Specialist/PCP/ER
Support Services
• 24/7 Call-Center
• 1-800 Customer Support
• Education Tools
• Marketing
• Information Technology Support
• HRA Employee Events
Clinical Outcome
Services
• Reporting
• Purchasing Coordination
• Clinic Inventory Management
• Patient Survey Feedback
• Clinic Best Practices Sharing
• Integration of Services
• ROI Analysis
• Budget Adherence
Staffing
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Proprietary & Confidential 34
Workers’ Compensation • Medical Management of Work Related
Injuries/Illnesses
• Ergonomic Job Analysis
• Coordination of Care/ Collaborative
Model
• Maintain Productivity
Restriction of Work Vs. Disability
• Integrated Disability Case
Management: Systems Approach
Understand Workplace Culture
Negotiate & Manage Referrals
Disability Management
• Understanding Clients Environment
• Control Costs
• Preserve Patient Satisfaction
Occupational Health Services • DOT Physicals
• Random Drug Testing Program
• Assist with Job Placement
• Hearing Testing
• Hearing Protection Training
• Hearing Conservation Program
Management
• Annual Fit for Duty (FFD) Exams
• Respiratory Fit Testing
• Spirometry Testing (Pulmonary Function
Testing)
• EKG Testing
• HazMat Physicals
• Lift Testing
• Breath Alcohol Testing (BAT)
Worker’s Compensation and Occupational Health
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Proprietary & Confidential 35
Implementation
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Proprietary & Confidential
Waiting Room
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Proprietary & Confidential
Nurse Triage
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Proprietary & Confidential
Exam Room
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Proprietary & Confidential
Exam Room
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Proprietary & Confidential 40
The appearance, design, content and graphics of this presentation are the property of
CareHere and are protected by applicable copyright laws and may not be copied,
used, reproduced, altered, distributed, or transmitted in whole or in part without the
express written consent of CareHere which reserves all rights.
Re-use of any of the content or graphics in any medium, electronic or otherwise, for
any purpose is strictly prohibited.
Any unauthorized use of the text, images, audio and video may violate copyright,
trademark, privacy and publicity laws and other civil and criminal statutes of the United
States and other countries.
INTELLECTUAL PROPERTY DISCLAIMER