Perennial CareCare Coordination for the Senior Life StageIn collaboration with the Mayo Clinic Center for Innovation
May 21, 2009
Designing + Leading a Business Carnegie Mellon University Professors Boni, Evenson + Weingart
Melissa Cliver Dave Passavant Christina Payne
Objective
We intend to increase the holistic value delivered by the
healthcare system by designing a disruptive business concept
that delivers new value for all stakeholders with a reduced
and sustainable cost structure.
Our Concept
Perennial Care is a long-term support service for seniors
to navigate the complexity of the health care system and
create partnerships, enabling informed health care decisions.
Why It’s Disruptive
• An affordable, convenient gatekeeper coordination
service directing seniors to customized social and medical
care networks.
• Health care delivery and coordination that is not physician
led and not based on acute episodic health management.
• Integrates both the general practitioner and the specialist
physician as expert consult.
• 77 million baby boomers are aging.
• Medicare costs 27% of total federal budget by 2030
• 70% of health care cost is for chronic care.
• 55% of medicare patients ages 65 - 74 have 3 and 4
chronic conditions simultaneously.
• Another 20% have 5 chronic conditions simultaneously.
Why Seniors?
Seniors
VALUE PROPOSITION
Time and specialty with experts
Monitor medications
GOAL
Manage complex deteriorating life
Maximize quality of life
Care GiversGOAL
Facilitate best possible quality care for aging loved one
Balance senior care with life tasks
VALUE PROPOSITION
Able to formally track observations
Time management and efficiency
Access to quality medical research
PayersGOAL
Maximize profits
Minimize overhead
Fund quality care
VALUE PROPOSITION
Reduced ER visits
Better patient Rx adherence
Lower costs, non-doctor led care
ProvidersGOAL
Deliver quality care
Minimize risk
Minimize administrative overhead
VALUE PROPOSITION
Better summary of patient history
Better patient Rx adherence
Holistic view of patient health
Relationship with GP
• Recognizing there is a shortage in US, integrate
tele-med potentially integrating global support.
• Focus on a holistic view of general care,
allopathic and osteopathic.
• Prevention and specialist referrals (acute).
Perennial Team
Midlevel medical
Basic testing
Monitoring
Drug management
Guide
Life stage planning
Social Resources
Relationships
Manager
Medical records
Insurance
Expert Awareness
Services
• Supplement the existing PCP and specialist care model.
• Organize patient’s data and needs.
• Partner for cost efficiency: labs, supplies, payment.
• Research and recommend life stage options.
• Guide patients and caregivers to external innovators
and specialists.
Technology
• EMR/EHR
• Drug interaction software
• Caregiver tracking software
• Telemedicine
• 24/7 support line
Christensen Models
Solution Shops
Provide intuitive, specialized
recommendations of
solutions to
unstructured problems.
Christensen Models
Value-Adding Process
Transforms inputs into
outputs of higher value via
a repeatable process.
Christensen Models
Facilitated Networks
Institutions that operate
systems in which customers
buy and sell, and deliver
and receive things from
other participants.
“Any program for resolving our runaway health-care
costs that does not have a credible plan for changing
the way we care for the chronically ill can’t make more
than a small dent in the total problem.”
Clayton Christensen, The Innovator’s Prescription
• Shortage of PCPs and incentives created by
the 3rd party payer system result in
7-minute visit.
• ER visits per capita are increasing. Many
due to acute occurrence of complex care
and drug mismanagement.
• Caregivers are acting as untrained
coordinators.
• Services are not aggregated for easy access.
Current Trends
Source: NYTimes
Value Proposition Recap
REDUCED ER VISITS
better drug management
alternate high availability option for acute care
better holistic care management
COST STRUCTURE
cost effective labor force
leverage technologies for efficiency
partner with specialized businesses to deliver low cost services
BUSINESS MODEL
focused on care coordination
Go to Market Strategy
INSURANCE
Charge per capita
% of cost savings
MEDICARE
Pursue reimbursement
Care coordination
SENIORS
Membership fee
Cost per visit
Pareto Economics
• 7M of 36M seniors drive
80% of costs.
• A 1% cost reduction for 50%
of the those seniors would
yield $2.8B in savings
• A 10% of savings fee model
would result in $280M
in revenue
29
7
20% of seniors drive 80% of costs
560
140
36M seniors
$700B costs
Opportunities
Perennial Care is a long-term support service for seniors
to navigate the complexity of the healthcare system, while
increasing value and lowering costs.
We recommend starting with a pilot project in the Florida or
Arizona Mayo Clinic facilities for validation with seniors.