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Chronic Heartfailure
Benelux Healthcare NBD, 9 December 2014Leon van der Vorst, Floortje Jansen, Murk W.
What is Heart Failure?The diagnosis given when the heart is unable to pump enough blood to meet the needs of the body.
Pulmonary congestion Edema
Breathlessness
Congestion
Edema
Weight gain
Symptoms
2
Heart Failure
+ =Ventricular Dysfunction
Symptoms and/or Signs
2/3rds from heart attack
Multiple other causes
Origin
Diagnosis
Patient view Professional view
How to improve care? Prevention, prevention, prevention
How will Philips get paid for prevention?Focus on quality of care for patient
Quality BasedDRG-Based*“Improved Workflow”• Bundled payments for
single episodes of in-patient care
• Forces hospitals to consider reducing costs for a given procedure type
• No incentive to reduce number of care episodes
“Shared Quality”• Quality incentives, bundled
payments, value-based purchasing shift
• Encourages use of lower-cost options, incentivized reduction in preventable readmissions
• Clinical and economic evidence of quality required to support reimbursement
Managing the patientManaging the healthcare event
Confidential*DRG = Diagnosis Related Groups
1. Shifting Healthcare Payment Landscape 2. Our Right to Play*
* In-market projects to accelerate systemic change in BNL to Shared Quality
Healthcare Systems are changing rapidlyWhat does this mean for care givers?
Historical: Paid for Volume Future: Paid for Lives
Patient Acquisition
Revenue Source
Margin Driver
An economic model driven byreferral capture and fee-for-service reimbursement
An economic model driven by the population size served and total costof care to manage its health
Broad-based,comprehensivereferral network
IP admissionsand facility-basedOP encounters
Geographicallydistributed acutecare platform
Populationmanaged
Integrated primaryand continuum of care network
High-performing,distributed medicalmanagement
Practical implementationCombining care improvements and new remuneration model
Healthstatus ofPopulation1
Chronic
Acute/Exacerbated
Optimalisationpotential
Acute Costs(55%)
Day Clinic Costs(35%)
GP Costs(10%)
Insurer
Total cost = €10.000 p.a.(but savings potential = €3.500)
Total costs for society = €8.000
Shared QualityDRG-Based
Prevention Costs(30%)
Day ClinicCosts(40%)
Acute Costs(30%)
€6.500
Optimized careflow
1 Bron: Diagnose Zorginnovatie
Hospital
Risk sharing technology partner
X
X
Y
€500
Traditional careflow
€1.000
€2.000
Continuous care
HealthSuite DigitalPlatformEnabling the transformation of healthcare in two areas
Professional healthcare deliveryOrchestration, collaboration & analytics to:• Better leverage scarce resources
improving access and quality of care • Reduce overall cost of population
health management
Continuous personal healthMeasurement, monitoring & motivation• Support better health decisions• Improve accuracy of patient
information• Healthier lifestyle
Outcomes-driven Prevention-focused