presentation to 2014 virginia health care conference june 5, 2014

Presentation to 2014 Virginia Health Care ConferenceJune 5, 2014

©2014 The Advisory Board Company • advisory.com

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Trusted Advisor to America’s Leading Health SystemsThree Decades of Experience Translating Policy into Practice

Source: The Advisory Board Company.

1) Includes urban and rural health systems; academic medical centers and community hospitals; safety net hospitals; non-profit and for-profit hospitals; and the VA.

Key Areas of Expertise

• Health care delivery system transformation targeted at higher quality and more efficient care, including development of ACOs and medical homes

• Improvements in clinical operations and health care cost reduction, such as strategies to decrease readmissions

• Development and effectiveness of health information technology and data analytics

• Health care financing and revenue management, including technologies to administer risk-based payments

• Health care workforce, leadership development, and staffing strategies

Broad Membership Yields Deep Insights

2,200 Advisory Board health care

professionals worldwide

3,600 Member institutions, including

health systems in all 50 states1

165,000Members among

the 100 largest US

health systems

10,000 Research interviews annually

with health care leaders

99 >1,000Health care leaders

participating in

memberships

Small-to-medium

community

hospital members


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Our Firm in Numbers

RESEARCH AND INSIGHTS

• Dedicated to the most pressing issues and concerns in health care

• 300+ industry experts on call

• 200+ customizable forecasting and decision-support tools

Memberships Offering Strategic Guidance and Actionable Insights

PERFORMANCE TECHNOLOGIES

National Peer Collaboratives Powered by Web-Based Analytic Platforms• Leading provider:

Over 50% of inpatient admissions in the United States flow through our technology platforms

• Over 1.5 million user sessions annually

• Key challenges addressed: physician performance, population health, revenue cycle, referral growth, surgical profitability, and supply/ service cost

CONSULTING AND MANAGEMENT

Seasoned, Hands-On Support and Practice Management Services

• 2,500+ years of “operator” experience in hospital and physician practices

• Principal terrains: hospital-physician alignment/practice management, transition to value-based care, revenue cycle optimization, hospital margin improvement

• Range of engagements from strategy/diagnostic to best practice installation to interim management to fully managed services

TALENTDEVELOPMENT

Partnering to Drive Workforce Impactand Engagement

• Impacted the achievement of 76,000+ executives, physicians, clinical leaders, and managers

• 17,000+ outcomes-driven workshops tailored to partners’ specific needs

Survey Solutions

• Customized strategies for improving employee and physician engagement

• National health care-specific benchmarking database of 480,000 respondents

165,000+ health care leaders served globally

$500+ million in realizedvalue per year

1,300+ engagementscompleted

6,200+ employee-ledimprovement projects

3,600+ 2,200+ 1,500+Hospitals and health careorganizations in our membership

Health careprofessionals employed

Hospitals using ourperformance technologies


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Scaling “Best Practices” to Accelerate and Sustain Transformation

Advisory Board Approach to Innovation

Health Care’s Original

“Big Data” Asset• Field Intelligence

• Data Science

Proprietary Methodology

• Tomorrow’s problems today

• 80/20 process leverage points

• Scalable, sustainable BDPs

• Member activation model

Our Sustainable ROI Model

Directive Technologies

Action, Not Analysis

Performance Blueprints

Roadmaps to Rapid Results

Applied Expertise

Right Expert Against Right

Lever

Network-Driven Innovation

Iteratively Attacking Hard

Problems

Clinical Integration

Referral Management

Labor and Supply Cost

Care Variation

Driving Enterprise-Level Outcomes

Patient Engagement

Predictive Care Plans

Network Optimization


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Offering Data and Analytics to Improve Cost, QualityPerformance Technologies Improving Value at Front Lines of Care

Source: The Advisory Board Company.

Advisory Board Technologies

360,000 Physician cost and quality profiles

1,500 Hospitals using Advisory Board technology

50% US admissions flowing through Advisory Board IT tools

Advisory Board Technology Suite

Improving Quality of Care• Population Risk Management• Preventive and Chronic Care• Cross-continuum Care Management• Patient Engagement and Experience• Patient Safety and Care Quality

Lowering Cost of Care• Supply and Labor Costs• Care Variation Reduction

Aligning Incentives• Value-based Contracting• ICD-10 Transition

Representative Results Achieved by ABC Members

Claims ($) Incurr...

Year 1 Year 2

$385K $354K

PMPM Claims (...

$25.38$17.61


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Gaps in awareness of all available information lead to sub-optimal outcomes

Opportunity to Personalize Care

Static

Unstandardized

Missing Data

Case Manager Assesses Risk of Readmission

Nurses Screen for Delirium Risk

Care Managers Assess Risk of Non-Compliance

ICU

M.D. Office

6th Floor Cardi

ac Care

Current Attempts to Improve Precision Fraught with Shortcomings


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Natural Language Processing to Detect Risk Factors Buried in Clinician Notes

Crimson Real-Time Clinical Analytics

Sample Findings of Text Analytics


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Algorithmic Early Warnings Enabling Proactive Risk-Reducing Interventions across Care Settings

Crimson Real-Time Clinical Analytics

Clinical Risk Surveillance

• Risk of DVT

• Core measure patient identification

• Sepsis early warning score

• Risk of mortality

Referral Flags

• Pain management consult

• Mental health consult, undetected depression

• Palliative care consult

• Social work consult

Clinical Utilization Risk

• Risk of readmission

• Risk of avoidable admission

• Risk of extended length of stay

• Risk of extended ICU LOS

Revenue Risk Management

• Ensure medical necessity is met

• Alert to present on admission

• Documentation opportunities

• Computer-Assisted Coding

Customized Surveillance Alerts


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Precise Risk Stratification, Risk Factor Identification Drives Reduction

Enabling Readmission Reduction within the Medicare Population at Baylor Health

Change in HF and PN Readmissions Rates at Baylor Health System

2012:Q3 2012:Q4 2013:Q1 2013:Q2 2013:Q314

15

16

17

18

19

2019.6

17.9

17.3916.6 16.4

Quarterly Readmission Rates:Heart Failure

N = 343

2012:Q3 2012:Q4 2013:Q1 2013:Q2 2013:Q30

4

8

12

16

20

16.67

5.56 5.88 7.045

Quarterly Readmission Rates: Pneumonia

N = 243

Rea

dm

iss

ion

s R

ate

(%

)

Quarter (Time)

Rea

dm

iss

ion

s R

ate

(%

)

Quarter (Time)

16% relative reduction 70% relative

reduction


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1 in 4 Patients with Depression Conditions at High Risk for Readmission

Identifying Population Level Risk Factors Enables Efficient Resource Allocation


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Complementary Changes Required to Create a Value-based System

Unlocking the Full Value of “Big Data”

Stages of Analytical Progression and Value Creation

Incentives Alignment

• Right rewards for clinical transformation

• Lowering costs (and perceived threats) of data sharing

Integration with Workflow

• Minimally-disruptive to native workflows

• Contextually-appropriate “answers”

IT Interoperability

• Lower the total cost of accessing data, systems

• Data unification across systems

Cultural Transformation

• Comfort with performance transparency

• Data “improvement”, not data “perfection”

Descriptive Predictive Prescriptive

How many of my diabetic patients are overdue for their a1C test?

Which of my diabetic patients is least likely to respond to my outreach to get a blood test?

Which outreach message should I send to each diabetic patient to maximize response rate?


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Policy Can Play Role in Fostering Interoperability

Lower Cost Connectivity Will Accelerate Innovation

Require standard APIs in Meaningful Use Stage 3

• Any API would need to be published, public, and open to use by any third-party

• Commonly required APIs should expand over time

Opportunities for Policymakers to Encourage Interoperability

Further specify standards for data transport

• Current standards make data transfer possible, but not financially viable

• Reducing financial barriers to data integration would spur rapid and broad innovation

Drive greater data sharing between providers and payers

• Would facilitate better population health management

• At a minimum, providers should have access to full claims data under risk-sharing arrangements

2445 M Street NW I Washington DC 20037P 202.266.5600 I F 202.266.5700

advisory.com

presentation to 2014 virginia health care conference june 5, 2014

Documents

health care leaders

health care organizations

population health

health care cost reduction

efficient care

valuebased care

largest us health systems

revenue management