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ADVANCED PRIMARY CARE November 7, 2019 1 Private & - PowerPoint PPT Presentation

Jan 27, 2023 •17 likes •257 views

ADVANCED PRIMARY CARE November 7, 2019 1 Private & Confidential People with access to advanced primary care are healthier, happier and cost less money Outstanding Primary Care is Essential Private & Confidential 2

  1. ADVANCED PRIMARY CARE November 7, 2019 1 Private & Confidential

  2. People with access to advanced primary care are healthier, happier and cost less money Outstanding Primary Care is Essential Private & Confidential 2

  3. BUT….Primary Care in This Country is Broken Root cause of this dysfunction • is the fee-for-service payment model • Systemically undervalues primary care • Perverse volume incentives • No compensation for critical elements of effective primary care • Too many patients, too little time – immense patient frustration Private & Confidential 3

  4. Primary Care in This Country is Broken • This leads to: • Exit strategies and constraints of 8 to 10 minute appointments • Delaying essential chronic care management • Wasteful ER/specialist/urgent care use • Redundant/dangerous tests, procedures, and medications Private & Confidential 4

  5. And Physicians Are Burning Out 79% of primary care physicians have reported symptoms of physician burn out More than 1/3 of primary care physicians would not recommend a career in medicine to family and friends 5 Private & Confidential

  6. Physician Burnout By 2030, we will have a shortfall of between 14,800 and 49,300 primary care physicians nationally 2018 Study, Association of American Medical Colleges 6 Private & Confidential

  7. Forward-Thinking Employers Are Transforming Primary Care • Liberating primary care from perverse incentives of fee-for- service payments • Rewarding primary care doctors for superior clinical care, stewardship of overall healthcare spend and patient experience Private & Confidential 7

  8. Onsite and Near Site Clinics Private & Confidential 8

  9. Direct Contracting 9 Private & Confidential

  10. Telemedicine 10 Private & Confidential

  11. Near Home Direct Primary Care Private & Confidential 11

  12. Keys to Transformative Primary Care • Economics • Breaking down financial barriers for patients • No co-pays/deductibles • Removing Access Barriers • Fewer patients • Longer appointment times • Evening and weekend hours • Integrated, HIPAA compliant communication app • Ensuring Proper Financial Incentives for Doctors • No fee-for-service • No downstream financial allegiances Private & Confidential 12

  13. Keys to Transformative Primary Care Optimize care Train primary delivery for Harness data & care teams to different technology to think & operate patient enhance care differently segments PATIENTS WHO EXPECT MORE AND DOCTORS WHO DELIVER MORE Private & Confidential 13

  14. How Advanced Primary Care Saves Money PROACTIVE PROVIDING HIGH VALUE REDUCING UNNECESSARY ER, MANAGEMENT OF REFERRALS URGENT CARE, AND HOSPITAL CHRONIC CONDITIONS UTLIZATION Private & Confidential 14

  15. Challenges • Scale • Consistent clinical quality Private & Confidential 15

  16. Case Study: State of New Jersey The New Jersey State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP) offers employees and their covered dependents the opportunity to join an R-Health doctor’s office at no additional cost. 16 Private & Confidential

  17. State of NJ: Program Outcomes & Highlights PRIMARY CARE 93% OF URGENT RISK 61% OF MEMBERS WITH ENGAGEMENT MEMBERS REDUCED HIGH CHOLESTEROL HAVE REDUCED THEIR OVER 4X THE THEIR HEALTH RISK CHOLESTEROL NATIONAL AVERAGE QUOTIENT Private & Confidential 17

  18. State of NJ: Program Outcomes & Highlights 51% OF MEMBERS WITH 43% OF MEMBERS 83% OF MEMBERS WITH UNCONTROLLED DIAGNOSED WITH HYPERTENSION HAVE DIABETES MOVED FROM OBESITY HAVE CONTROLLED BLOOD UNCONTROLLED TO DECREASED THEIR BMI PRESSURE CONTROLLED A1C LEVELS 18 Private & Confidential

  19. State of NJ: Program Outcomes & Highlights 85,688 Spruce messages sent between the R-Health care team and members since the program inception 44% of NJ Employee members have secure Spruce accounts (compared to 0.52% national telemedicine adoption rate for large employer health plans*) *2018 Employer Health Benefits Survey, Kaiser Family Foundation 19 Private & Confidential

  20. State of NJ: Program Outcomes & Highlights Member satisfaction with R-Health is high. R-Health measures this satisfaction through the Net Promoter Score (NPS), a standard benchmark for brand loyalty. Data collected from post-appointment surveys since November 2018. Industry average for health insurance from Satmetrix 2018 Net Promoter Benchmarks. 20 Private & Confidential

  21. State of NJ: Lessons Learned • Strong collaboration with both employers and unions is critical • People are skeptical of change – communication is key • Strong data integration with TPA • Integrate into overall plan design • Create patient ambassadors at all levels of state government to support and promote the program • Multi-year investment is essential 21 Private & Confidential

  22. Choosing a Partner Robust data & technology platform • • Integrating data feeds from multiple sources • EMR • Claims • Communication • Administrative/eligibility • Generate actionable clinical information • Reporting Proactive population health workflows • Clinical collaboration & oversight • System independence • Experience integrating behavioral health • Private & Confidential 22

  23. 23 Private & Confidential

  24. THANK YOU Mason Reiner 215.600.4590 mason@r-health.md Co-Founder & CEO WWW.R-HEALTH.MD Private & Confidential

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