VS19 / HIGHLIGHTS FROM THE 2019 VALUE SUMMIT

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To achieve optimal healthcare performance, Dr. Teisberg encouraged transformation initiatives to center around outcomes that matter most to patients, underscoring that these outcomes usually fall into three buckets:

• CAPABILITY – Can the patient do what allows them to be themselves?

• COMFORT – Has the patient experienced relief from suffering (i.e., pain, depression)?

• CALM – Has the care been delivered without creating chaos and mayhem in the patient’s life?

Value-based care depends on identifying and intervening where the current medical management is ineffective, disparate, inappropriate, missing, or chaotic. While the popular vernacular speaks of ‘volume-to-value’, Dr. Teisberg proposes that the discussion may be reversed; many places provide value in care, but we need to take this to scale and do it for everyone.

HIGHLIGHTS FROM THE 2019 VALUE SUMMIT

Health Network

NEW ORLEANS • DECEMBER 1 - 2, 2017

The 2019 Value Summit – an annual forum where healthcare leaders from care-delivery organizations, payer groups, government agencies, and life science and technology companies discuss today’s most relevant healthcare reform topics – took place September 19-20th in New Orleans, LA.

Presented by Ochsner® Health Network and The Kinetix Group, with support from the American Medical Group Association, the conference gave panelists and audience members an opportunity to share insights and advance dialogues on the transition to value-based care.

This year’s keynote speaker was Elizabeth Teisberg, who, along with Harvard Business School Professor Michael Porter, co-wrote Redefining Health Care: Creating Value-Based Competition on Results, the book that pioneered many of the terms and concepts now popular in the movement toward healthcare reform.

NEW ORLEANS • SEPTEMBER 19-20, 2019

2019

“Results matter. A low-cost ticket to the wrong place is not a bargain.”

“Value is created one person, one family at a time. Creating value is about helping people, about getting better health.”Elizabeth Teisberg, PhD

The topics presented at this unique collaborative event were:

Pioneering care models to disrupt – and

advance – the status quo in health care

Examining value in health care

from a consumer’s perspective

Advancing innovative

payment models

Designing equitable value-based

partnerships with employers

Exploring the role of pharmaceutical and

device manufacturers in value

VS19 / HIGHLIGHTS FROM THE 2019 VALUE SUMMIT

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Disruptive Care Models • New players are shaping innovations to disrupt traditional healthcare delivery where complication

and high cost have become the status quo; “breakthrough” innovation and disruption can redefine provider roles, shift responsibility, and help bring care from the hospital to the community

• New care models couple technological advances with appropriately matched business models to create simpler, more convenient, and more affordable options. They enable the participation of a new set of customers who were previously ignored by the market or shut out completely

• Healthcare partners are enthusiastic about the capacity of new models to: (1) identify nonmedical conditions impeding adherence via in-home patient visits; (2) support behavior change by providing access to technology-enabled daily communication; (3) target vulnerable groups, such as recently-discharged patients, with continuous and proactive care to prevent hospital readmissions

• To balance innovation and patient safety, the government and the regulatory and legal systems will have to think broadly about which regulations to lighten in a new health-tech driven world

Health Care Value From a Consumer’s Perspective • As Americans are asked to pay more out of pocket for their medical care, they will begin to approach

these purchases with more of a shopper’s eye

– Patients are not comparing their online customer service experiences with another hospital or health system; they are comparing them with those of a retail company in another field. For today’s connected consumer, their best experience becomes their expectation everywhere

– Many patients indicate a willingness to pay more for such foundational healthcare points as a courteous staff, a doctor who knows them, and time with their doctor

• Every patient values access, coordination, and convenience, but a patient’s health status changes how they prioritize of those 3 factors. For generally healthy patients, convenience is king; for the very sick, access is king; and for the chronically ill, coordination is king

• Retail clinics, like the CVS MinuteClinic, appeal most to high-income consumers willing to pay for convenience, or to uninsured consumers who have no cheaper alternative and whose work schedules can’t accommodate long emergency room waits

Progress in Innovative Payment Models • The move to risk is increasing. In 2019, 77% of organizations say they will be ready for downside

risk in 2 years, in comparison to 42% in 2015

• Fee-for-service will not be going away in the foreseeable future. Nevertheless, CMS is pushing risk, and this is a powerful influencer for other organization to follow suit

• Primary care doctors are taking more risk and are reaping financial rewards for doing so

• Stats show that providers are spending $20B on measures and administrative complexity. Alignment on critical measures between payors and providers via open dialogue and collaboration can help reduce this waste

• Choice drives innovation. The idea of expanding coverage and continuing to allow Medicare beneficiaries to have choice is at the core of our ability to innovate

HIGHLIGHTS FROM THE 2019 VALUE SUMMIT

Health Network

NEW ORLEANS • DECEMBER 1 - 2, 2017

“We no longer have to think of medication escalation as the answer for type 2 diabetes.”

Derek Newell, MBA, MPH Senior Vice President of Commercial, Virta Health

“There are patients who, for whatever reason, choose not to have a PCP and want access to our CVS MinuteClinics. We provide them with what they want.”

Robert Brooks, MBA Senior Vice President, Health Systems Alliances, CVS Health

“When more of the revenue in Medicare exists in MA, and that revenue is earned through value-based reimbursement models, the clinical transformation required to succeed will accelerate.”

William Shrank, MD, MSHS Senior Vice President & Chief Medical Officer, Humana

With support from Presented by

HIGHLIGHTS FROM THE 2019 VALUE SUMMIT

Health Network

NEW ORLEANS • DECEMBER 1 - 2, 2017

VS19 / HIGHLIGHTS FROM THE 2019 VALUE SUMMIT

Designing Equitable Value-Based Partnerships With Employers • Pricing pressure is considered the top strategic challenge facing the industry, by a wide margin

across sub sectors - including employers - and geographies

• Employer healthcare initiatives include:

– 51% implement more virtual solutions

– 39% focus strategy on high-cost claims

– 26% expand centers of excellence to include additional conditions

– 26% implement an engagement platform that aggregates point solutions and pushes personalized communications to employees

• There is a huge administrative cost with respect to dealing with the complexity of widely diverse plans with widely diverse payment requirements; the market is pushing employers to bypass health plans and go straight to direct contracting where they can negotiate with innovators

• Coordinating the resources and communication needed to have market leverage presents a challenge to many employers

• A small percentage of employees generate the majority of costs for employers. Predictive modeling can identify high-risk patients, and a nurse can target and try to engage those patients

The Role of Pharmaceutical and Device Manufacturers in Value• Value should be evaluated through real-world, economic-benefit, humanistic, and social perspectives

• Although many parties want to jump to value-based contracting solutions, a relationship of trust should be built first by sharing data and solving some population health-oriented problems

• There should be a science-based and transparent framework determining drug prices, and diverse parties must play by the same pricing rules

• The current system of rebates complicates fair and appropriate pricing as rebates drive an incentive to raise prices to get more rebates

• The 340B Drug Discount Program can have an important impact on a community’s ability to deliver care in underserved areas, but the program must be used appropriately

“Employers are banding together to demand quality and lower costs.”

Leah Binder, MA, MGA President & Chief Executive Officer, The Leapfrog Group

“If you’re increasing the price [of a drug], it should be correlated to a demonstration of increased value.”

Daniel Sullivan, MBA Executive Director, Value Based Partnerships, Amgen

OCHSNER® HEALTH NETWORK WOULD LIKE TO THANK GENEROUS SPONSORSHIP FROM

KEYNOTE SILVERPLATINUM CONTRIBUTOR

With support from Presented by

HIGHLIGHTS FROM THE 2019 VALUE SUMMIT

Health Network

NEW ORLEANS • DECEMBER 1 - 2, 2017

Josh Berlin, JD Principal & Healthcare Co-Practice Leader, Citrin Cooperman

Leah Binder, MA, MGA President & Chief Executive Officer, The Leapfrog Group

Jennifer F. Bollinger Senior Vice President, Consumer Strategy, Ochsner Health System

Robert Brooks, MBA Senior Vice President, Health Systems Alliances, CVS Health

David Buchanan, MD, MS Chief Clinical Officer, Oak Street Health

Dan Burke, SPHR, SHRM-SCP Director, Corporate Benefits, Turner Industries Group

David Carmouche, MD President, Ochsner Health Network; Senior Vice President, Community Care, OHS; Executive Director, Ochsner Accountable Care Network

Justin Dangel Chief Executive Officer & Founder, Ready Responders

Chrissy Daniels, MS Partner, Press Ganey

John J. Doyle, PHD, MPH Vice President, Global Healthcare Innovation Lead, Pfizer

Manny Germano Vice President, Network, Financial Performance, and Value-Based Strategy, Aetna

William Jessee, MD, FACMPE Managing Director & Senior Medical Advisor, Integrated Healthcare Strategies, Gallagher HRCC

John W. Kennedy, MD President, AMGA Foundation; Chief Medical Officer, AMGA

Derek Newell, MBA, MPH Senior Vice President of Commercial, Virta Health

Jerry Penso, MD, MBA President & Chief Executive Officer, AMGA

William Shrank, MD, MSHS Chief Medical & Corporate Affairs Officer, Humana

Daniel Sullivan, MBA Executive Director, Value-Based Partnerships, Amgen

Elizabeth Teisberg, PHD Executive Director & Professor, Value Institute for Health and Care, Dell Medical School; Senior Associate, The Institute for Strategy and Competitiveness, Harvard Business SchoolSponsored by Citrin Cooperman

Warner L. Thomas, MBA, CPA President & Chief Executive Officer, Ochsner Health System

Heather Wall, MBA Chief Commercial Officer, Civica

Harriet Wallsh, RN Director, Cigna Collaborative Care, Clinical Enablement, Cigna

Eliza Wilson Director of Product Management, Buoy Health

Many thanks to the following industry leaders whose insights and reflections contributed to the success of the panel discussions:

VS19 / HIGHLIGHTS FROM THE 2019 VALUE SUMMIT