Tackling the Challenge of Effective Patient Engagement: How Health Catalyst is Learning from an Innovative Internal Program

© 2016 Health CatalystProprietary and Confidential

Tackling the Challenge of Effective Patient Engagement: How Health Catalyst is Learning from an Innovative Internal Program

June 8th, 2016

© 2016 Health CatalystProprietary and Confidential2

IntroductionJeff Selander – SVP, Chief People Officer

Chief Financial Officer…

…Chief People Officer

2011 - 2015


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


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…”


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


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


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…


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.


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


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


- 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


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.


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


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


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?


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+%


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%


What is Get Fit Stay Fit™ (GFSF)?

• Wellness Program• Outcomes Improvement• Employee Engagement• Rewards Program


Available for iOS, Android, and Windows Mobile (HTML5).

Features

GamificationQuarterly ChallengesPrizesActivitiesPersonal ChallengesLeaderboards

CustomizableSelf Select:

Favorite activitiesHealth habitsPersonal challenges

Daily StatusSynchs with:

FitBitGarmin


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


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?


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%


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%


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


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


Questions?


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


Thank you