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Tackling the Challenge of Effective Patient Engagement: How Health Catalyst is Learning from an Innovative Internal Program
June 8th, 2016
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IntroductionJeff Selander – SVP, Chief People Officer
Chief Financial Officer…
…Chief People Officer
2011 - 2015
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How we approach Population Health
Parallels between effective team member and patient engagement
Health Catalyst case study
Insights that support both team member and patient engagement initiatives
Agenda
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Jason
“Before joining Health Catalyst, my body had been on a long slow road of neglect and degradation over the space of about 10 years…”
“...it was to the point where I could not tie my shoes without getting red in the face from held breath and strain…”
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Population Health ManagementHealth Catalyst thinking and definition – Sanders style
This definition, thinking and approach also applies very closely to the management of healthcare costs within a corporate team member population…
Slide: Dale SandersReturn on Engagement WebinarMarch 23, 2016
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How concentrated is healthcare spend within the US population? 101 respondents
a) Top 1% of spenders account for 10% of spend, top 5% account for 20% of spend. – 7%
b) Top 1% of spenders account for 15% of spend, top 5% account for 40% of spend. – 17%
c) Top 1% of spenders account for 20% of spend, top 5% account for 50% of spend. – 37%
d) Top 1% of spenders account for 40% of spend, top 5% account for 75% of spend. – 40%
Quiz Question
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Distribution of Health Care Spending, 2009
Source: NIHCM Data Brief July 2012
Top 1% of spenders account for 20% of spending…
…top 5% of spenders account for 50% of spending…
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Population Health FrameworkStratifying Patient Risk
Complex & High Risk
Latent Risk
Rising Risk
Members with current & predicted significant risk & healthcare service utilization.
Members with predicted “near” future significant risk & healthcare service utilization if no intervention occurs.
Members with latent risk, where continued preventative measures will keep risk latent.
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Care Managementhow we think about managing patient populations
How are our patients doing?
How are we performing to our plan?
Is it working? Are we getting “Return on Engagement”?
What do we do more of… what do we change?
Outcome
Process
Balance
Insights
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How concentrated is the spend within the Health Catalyst team member population? 105 respondents
Remember, Top 1% of spenders accounted for 20% of spend, while top 5% of spenders accounted for 50% of spend in the national study...
a) More highly concentrated than the national concentration. – 10%
b) Less concentrated than the national concentration. – 40%
c) Much less concentrated than the national concentration. – 30%
d) About the same. – 20%
Quiz Question
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- 6 12 18 24 30 36 42 48 54 60 66 72 78 84 90 96 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0.1% 0.6% 1.3% 2.7% 4.5%7.4%
11.7%
18.3%
31.5%
45.3%
68.3%
100.0%
Percent of Health Catalyst member population, ordered by health care spending
Cum
ulat
ive
perc
ent o
f tot
al h
ealth
care
spe
ndin
g
Distribution of Catalyst Healthcare Spending, 2015
9995
The top 1% of consumers account for almost 32% of total spending ($1.3 million).
The top 5% of consumers account for almost 55% of total spending ($2.2 million).
Total Health Catalyst 2015 Healthcare Spend - $4.1 million
$200 Thousand
$3.9 Million
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Team Member Health FrameworkStratifying Employee Risk
Complex & High Risk
Latent Risk
Rising Risk
Members with current & predicted significant risk & healthcare service utilization. May be skewed by anything in smaller populations.
Members with predicted “near” future significant risk & healthcare service utilization if no intervention occurs.
Members with latent risk, where continued preventative measures will keep risk latent.
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Care Managementas applied to team member wellness and financial return
How are we doing?• Financial Incentives• Wellness Baseline
How are we performing to our plan?• Are we achieving our self-funded aspirations?• GFSF app design and execution.
Are company and team members getting “Return on Engagement”?• Company benefits• Team Member benefits
What do we do more of… what do we change?• Benefit Plan Design• Gamification• Managed interactions
Outcome
Process
Balance
Insights
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Financial incentives misaligned between payers, businesses, and employees
Apply a firm fixed price philosophy/approach to our corporate healthcare claims:
• Self funded• Third-Party Administrated• Stop-loss insurance
Slide: Dale SandersReturn on Engagement WebinarMarch 23, 2016
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Apply a fixed fee philosophy to our corporate healthcare claims:• Self funded• Stop-loss insurance
Implement appropriate care management tools:• Get Fit Stay Fit™ (GFSF) Wellness program and app• Biometric screening• Gamification• Manage provider/team member interactions at the POC
How do we better align financial and wellness incentives within our business?
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Corporate wellness economicsto fully fund or self fund?
Fully Funded Model
Time
Cos
t
PremiumsClaims
Time
Cos
tPremiumsClaims
Fixed premium ✅Rate control ❌Return on engagement ❌
High Claims Scenario
“How it’s supposed to work.”
Fixed premium (for now) ❌Rate control (going up) ❌Return on engagement ❌*10 year Healthcare Study, KFF, 2009
“Fixed price until next renewal.”
Improving Claims Scenario
Time
Cos
t
PremiumsClaims
Fixed premium (nope, going up) ❌Rate control ❌No incentive to engage members ❌
“You’re taking my winnings!”
13.1%*
15%15%
40+%
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Corporate wellness economicsto fully fund or self fund?
Self Funded Model
Time
Cos
t
Premiums
Claims
Time
Cos
tPremiums
Claims
Fixed premium ✅Rate control ✅Return on engagement ✅
High Claims Scenario
“How it’s supposed to work.”
Fixed premium (for stop-loss) ❌Rate control (decent) ❌Return on engagement ✅*10 year Healthcare Study, KFF, 2009
“Still greater control over swings.”
Improving Claims Scenario
Time
Cos
t
Fixed premium (nope, going up) ✅Rate control ✅Plenty of incentive for engagement ✅
“Rewards for engagement”
40+%
Fixed Costs Fixed CostsPremiums
ClaimsFixed Costs
10%
40+%
30%
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What is Get Fit Stay Fit™ (GFSF)?
• Wellness Program• Outcomes Improvement• Employee Engagement• Rewards Program
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Available for iOS, Android, and Windows Mobile (HTML5).
Features
GamificationQuarterly ChallengesPrizesActivitiesPersonal ChallengesLeaderboards
CustomizableSelf Select:
Favorite activitiesHealth habitsPersonal challenges
Daily StatusSynchs with:
FitBitGarmin
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Outcomehow are team members doing?
Q1 2016 GFSF activity resultsExerciseActivity Result Metric
Walking/Running 119,750 Miles
Mountain Biking 1,809 Miles
Road Biking 9,413 MilesSkiing Cross Country 214 Miles
Snow Shoeing 65 Miles
Swimming 169 Miles
Skiing 2,761 Runs
Snowboarding 924 Runs
Strength Training 113,688 Minutes
Very Active Minutes 589,742 Minutes
Active Team Sports 45,441 Minutes
Stairs 417,866 Floors
GamificationActivity Result Metric
Challenge Win 3,130 At Risk Points
Challenge Loss (3,130) At Risk Points
Healthy HabitsActivity Result Metric
Eat Right 24,105 Points
Education 18,355 Points
Mindfulness 39,918 Points
Slept Right 28,530 Points
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Jan-15 Mar-15 May-15 Jul-15 Sep-15 Nov-15 Jan-16 Mar-160
50
100
150
200
250
300
350
Claims Performance
Outcomehow are team members doing?
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Q1'15 Q2'15 Q3'15 Q4'15 Q1'16300
400
500
600
700
800
900
0%
10%
20%
30%
40%
50%
60%
70%GFSF Participation
Processare we performing to our plan?
57%
22%
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Jan-15 Mar-15 May-15 Jul-15 Sep-15 Nov-15 Jan-16 Mar-16
Financial Performance
Balanceis the company getting a return on engagement?
ROE: 10%
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Balance are our team members getting a return on engagement?
“Before joining Health Catalyst, my body had been on a long slow road of neglect and degradation over the space of about 10 years…”
“...it was to the point where I could not tie my shoes without getting red in the face from held breath and strain…”
“Health Catalyst's Get Fit Stay Fit challenges have added some much-needed fun and accountability to the mix… at the start of the Q4’15 Get Fit Stay Fit challenge until today, it has been over a year since I made that commitment…”
“My quality of life, or at least my enjoyment of life, has been increased exponentially just by doing ONE active thing per day, every single day and by making it fun…”
Jason
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Insightswhat do we do more of…what do we change?
Team Membersself funded/wellness program with our team members
• Benefit Plan Design
• Gamification
• Managed Interactions at POC
• Return on Engagement
PatientsManaging patient populations with our customers
• Benefit Plan Design
• Social Determinants
• Care team interactions
• Care Companion
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Questions?
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Healthcare Analytics Summit 16
Here’s a sneak preview …
David F. Torchiana, M.D.President and CEOPartners HealthCareFormer Chairman and CEO of the Mass, General Physicians Organization
Summit highlightsJam-Packed Agenda, all focused on outcomes67 Sessions and stories 8 keynotes, 27 breakouts, 32 Analytics WalkaboutsIndustry Leading Keynote SpeakersWe’ll hear from well-known healthcare industry champions. And by popular demand, we've invited back two of our top-rated speakers.CME Accreditation for CliniciansLast year’s HAS 15 summit was awarded 24.0 AMA PRA Category 1 Credits ™ and we expect a similar number this year.
Improved "How-to" Case Study SessionsWe’ve increased the breakout session times to give more time for detailed “how to” learning while also extending the Q&A time.
The Analytics WalkaboutBack by popular demand, we will feature 32 new projects highlighting a variety of additional clinical, financial, operational, and workflow analytics outcomes improvement successes.
Analytics-Driven, Hands-on Engagement for TeamsAnalytics will continue to flow through the three-day summit touching every aspect of the agenda.
Networking and FunWe will have longer breaks, frequent fun-run/walk opportunities, a night on the town, and some fun and games, including your favorite retro arcade games.
Pre-Summit Classes and TrainingAn early half-day of pre-session classes and training options specifically for Health Catalyst clients.
Liz WisemanPresident, theWiseman GroupBestselling Author, Speaker & Executive Advisor“Rookie Smarts: Why Learning Beats Knowing in the New Game of Work”
Anne MilgramFormer NJ Attorney GeneralSenior Fellow at NYU School of Law, VP of Criminal Justice, Laura and John Arnold Foundation ““Criminal Justice Analytics”
Eric Siegel, Ph.D.President, Prediction Impact, Inc.Best Selling Author and Founder of Predictive Analytics World“The Power to Predict Who Will Click, Buy, Lie, or Die”
Taylor DavisVP, Analysis & Strategy, KLASAssociate Professor of Statistics of Utah David Eccles School of BusinessHealthcare Analytics Mkt Overview
Don Berwick, M.D.Former Administrator, CMSFounding CEO, Institute for Healthcare Improvement
Jay Bishoff, MDDirector, Intermountain Urological InstituteIntermountain HealthcareTop Rated HAS 15 speaker
Toby Freier, FACHEPresident, New Ulm Medical CenterHearts Beat Back ™Heart of the New Ulm ProjectHAS 16 Documentary
Salt Lake CitySept 6-8 2016
The Grand America Hotel
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Thank you