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Session #32:How One ACO Is Using Analytics to Position Itself for Population Health Management and

Shared Savings

Pre-Session Poll Question

On a scale of 1-5, how effectively is your organization positioned for population health and accountable care?

1)Not at all effective

2)Somewhat effective

3)Moderately effective

4)Very effective

5)Extremely effective

6)Unsure or not applicable

James Dearing, DOVice President and Chief Medical Officer, CEO

Honor Health Network ACO

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About the Organization

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Non-for-profit healthcaresystem,ACO

Addressing accountable care and population health

Five acute care hospitals, extensive outpatient care

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Industry Trends

• Healthcare reform focuses on quality and slowing spending growth

• Accountable care organizations (ACOs) are emerging as a key way to tackle this challenge

• The CMS Medicare Shared Savings Program (MSSP) has been a driving force

• Today, there are a total of 744 ACOs with more than 405 of them participating in the MSSP program

• ACOs that achieve lower costs while achieving quality targets will receive shared savings payments

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The Problem

• Honor Health Network, a MSSP ACO, has a reputation for quality and physician collaboration • Including an advanced Patient-Centered Medical Home (PCMH)

• Optimizing PMPM costs requires understanding care utilization and outlier behaviors• Referral leakage, unnecessary tests, inappropriate use of

specialists

• A robust analytics platform was critical to: • Better manage the quality of patient care

• Manage utilization and costs

• Identify service gaps in the provider network

• Identify growth opportunities

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Our Approachand Results

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Solution

• Implemented a comprehensive ACO analytics platform in support of:

Data-driven cost and referral management

Granular cost analysis to facilitate physician engagement and collaboration

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The Analytic InfrastructureMetadata: EDW Atlas security and auditing

Common, linkable Vocabulary

FinancialSource Marts

AdministrativeSource Marts

DepartmentalSource Marts

PatientSource Marts

EMR Source Marts

HRSource Mart

Diabetes

Etc.

ACO Explorer

FINANCIAL SOURCES

ADMINISTRATIVE SOURCES

EMR SOURCE

DEPARTMENTAL SOURCES

PATIENT SATISFACTIONSOURCES

OPERATIONAL SOURCES

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The ACO Executive Dashboard

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Tracking Referral Leakage

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Poll Question #2

On a scale of 1-5, how effectively is your organization using healthcare analytics to support accountable care and population health?

1) Not at all effective

2) Somewhat effective

3) Moderately effective

4) Very effective

5) Extremely effective

6) Unsure or not applicable

10

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Results: EDW Platform

Implemented an EDW platform and ACO analytics to manage costs, referrals, and risks

• Integrated data from multiple disparate transactional source systems into a single source of truth

• Eliminated data timeliness and data quality concerns

• Significant reduction in lag time in attribution of patient care and costs to the responsible provider

• Improved ability to consume data in meaningful ways and to identify trends that affect quality and cost

• Improved ability to identify high-risk patients

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Results: Cultural Transformation

Drove cultural transformation through physician engagement and patient support services

• Active physician participation in data validation resulted in a sense of ownership for the data

• Physicians empowered by the transparency, robustness, and reliability of the data

• Helping leverage the data to achieve the best possible health for patients at sustainable costs

• Educational and engagement efforts are designed to ensure physicians play a meaningful role in the design and implementation of improvement programs

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Results: Physician Practices

More accurately assess physician practices

• With good data and cultural transformation, the ACO is building a value-based reimbursement environment

• Data informs physicians regarding high-cost procedures and tests which can be benchmarked against their necessity under evidence-based practices

• The data also helps physicians identify and manage high-risk patient populations

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Clinical Care Results Example

• Most recent focus has been on the management of diabetes

• Specifically on management of the “diabetic trifecta”

LDL less than 100

BP less than 140/90

HgbA1C less than 8

• Goal: Increase the percentage of patients in the diabetic population meeting all three criteria

Start: < 8% of diabetic population met all three criteria

Now: 20% of diabetic population met all three

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Next Steps

Continue to refine and improve existing analytics capabilities

Continue to advance data-driven quality improvement

Lower PMPM costs through reduction in clinical variation and adoption of best practice

Strive to reduce referral leakage (improved contracting, address patient access issues, etc.)

Better forecasting through the use of predictive analytics

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Lessons Learned

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1. No one likes prior authorization – need good data to manage it more precisely

2. Good data is required to ask the right questions and focus on what is most important

3. It is important to have a strong and highly collaborative working relationship with your analytics vendor

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Analytic Insights

AQuestions &

Answers

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Choose one thing…

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Write down one thing will you do differently after hearing this presentation

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Thank You

19

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Session Feedback Survey

1. On a scale of 1-5, how satisfied were you overall with this session?

1) Not at all satisfied

2) Somewhat satisfied

3) Moderately satisfied

4) Very satisfied

5) Extremely satisfied

2. What feedback or suggestions do you have?

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Upcoming Speakers

3:20 PM – 4:10 PM

36) Building Creative and Innovative Organizations

Ed Catmull, Co-Founder of Pixar, President of Pixar and Walt Disney Animation Studios

4:10 PM – 4:30 PM

Final Polls and Summit Winners

4:30 PM – 5:00 PM

37) Closing Remarks

Dan Burton, Chief Executive Officer, Health Catalyst

Location

Grand Ballroom

Grand Ballroom

Grand Ballroom