What You Can Learn From VA- DOEs COVID -19 Mortality Risk Model and - PowerPoint PPT Presentation

What You Can Learn From VA- DOE’s COVID -19 Mortality Risk Model and the Emerging Trends Like Telehealth Property of CareJourney Confidential and Proprietary Property of CareJourney Confidential and Proprietary Property of CareJourney Confidential and Proprietary

Our Speakers Today! Dr. Amy C. Justice John Pilotte Raj Shrestha Medicine and Public Health, Director of Performance- COO, Community-Based Yale University Based Payment Policy Care and President & CEO, Staff Physician, VA Connecticut Group, CMS Castell (Intermountain Healthcare System Healthcare) Special Guest! David Klebonis Mike Kerouac Aneesh Chopra COO, Palm Beach CEO and Founder, President Accountable Care CareJourney Precise Telehealth Organization (PBACO) Expert Panelists Moderator Property of CareJourney Confidential and Proprietary | 2 Property of CareJourney Confidential and Proprietary | 2 Confidential and Proprietary 2020 | 2

Focus of Today’s Webinar We will take a look at the early findings derived from mapping linked claims and encounter data of over 130+ Million beneficiaries to the VA- DOE 30-Day COVID Mortality Model to answer important questions that will impact care delivery and ACO operations, now and into the future. We will also share ACO-level insights around the surge of telehealth utilization in 2020, exploring trends in terms of the providers and populations who have leveraged telehealth in response to the public health crisis. Attendees will learn: Which patient population segments What regions in the country are flash Has the sharp increase in are at a higher risk of mortality and points for COVID-19 resurgence and are telehealth utilization in 2020 are they getting the preventive Providers in these region equipped to helped in the response to the services they need? hand a surge? public health crisis? Property of CareJourney Confidential and Proprietary | 3 Property of CareJourney Confidential and Proprietary | 3 Confidential and Proprietary 2020 | 3

CMS perspective with: John Pilotte Director of Performance- Based Payment Policy Group, CMS

Health Affairs: 2019 Shared Savings Program ACO Performance Property of CareJourney Confidential and Proprietary | 5 Property of CareJourney Confidential and Proprietary | 5 Confidential and Proprietary 2020 | 5

Conversation with: Dr. Amy C. Justice CNH Long Professor of Medicine and of Public Health, Yale University Staff Physician, VA Connecticut Healthcare System

Predicted 30-Day COVID Mortality Model Developed by a VA-DOE Collaboration Story in Brief Using Veterans in Care data, the COVID-19 Project Team (VA-DOE Collaboration) developed a 30-Day COVID Mortality Risk Model based on both administrative claims data and EHR data leveraging a number of key variables. The administrative claims predictive model leveraged 4 key variables highlighted below and resulted in an AUC = 0.79. The predictive model was codified and run by CareJourney on the 100% FFS dataset. Experts Charlson Comorbidity Index Gender Leverages CCI weights for patients Males have a higher risk for that have diabetes, liver disease, mortality than females and/or cancer documented within 2 years prior to a positive test JT King, Jr Age MI or PVD Addition of documented myocardial Increase in age leads to an increased infarction or peripheral vascular risk of mortality including a flag for disease leads to an increase risk patients >= 85 years old of mortality AC Justice Property of CareJourney Confidential and Proprietary | 7 Property of CareJourney Confidential and Proprietary | 7 Confidential and Proprietary 2020 | 7

CareJourney Analysis Early Findings: Top Counties* by Mortality Risk Score Trends in Number and Distribution of COVID-19 Hotspot Counties March 8 – July 15, 2020 KINGS, NY COUNT RATE COOK, IL > 30% RISK > 30% RISK 4,079 2.26% COUNT RATE > 30% RISK > 30% RISK 7,671 1.07% PALM BEACH, FL LOS ANGELES, LA COUNT RATE > 30% RISK > 30% RISK COUNT RATE 2,990 0.93% > 30% RISK > 30% RISK 10,736 1.28% Map Source: www.cdc.gov/mmwr/volumes/69/wr/mm6933e2.htm *Top Counties defined as Counties with 25,000 or more attributed patients Property of CareJourney Confidential and Proprietary | 8 Property of CareJourney Confidential and Proprietary | 8 Confidential and Proprietary 2020 | 8

CareJourney Analysis Isolating Patient Cohorts Based on Risk, Prevalence • CMS Releases Paid Claims Through July 2020 to Understand COVID • High Disease Prevalence Among pre-existing condition Mortality Risk, <85 years old Beneficiary Distribution COVID+ per 1K, by Cohort % COVID+ Death Rate, by Cohort (By Risk Cohort) 2,169 2500 30.6% 30.6% 2000 1,665 30%, < 85 Years 1500 431K 1000 627 14% 30%, > 85 Years 500 4.3M 0 >85 years <85 years >85 years < 30%, < 85 Years old, >30% old, >30% old, <30% Risk Risk Risk Property of CareJourney Confidential and Proprietary | 9 Property of CareJourney Confidential and Proprietary | 9 Confidential and Proprietary 2020 | 9

CareJourney Analysis Early Analysis Suggests Greater Mortality Risk By Star Rating Higher Rated Hospitals Show Lower Mortality but Not Treating Less Risky Patients Distribution of COVID+ Patients, % COVID Mortality by <85 > 30% Risk Cohort 30.33% 30% 23.60% 25% 22.11% 20.66 % 20.36 % 20% 15% 10% 6.43% 6.29% 6.59% 6.22% 6.18% 5% 0% 1 Star 2 Star 3 Star 4 Star 5 Star Bala Hota, MD, MPH Tom Webb Ken Locey Property of CareJourney Confidential and Proprietary | 10 Property of CareJourney Confidential and Proprietary | 10 Confidential and Proprietary 2020 | 10

Understanding ACO Performance

CareJourney Analysis ACOs Continue to Deliver Needed Services Although mortality rates are similar, ACOs have fewer COVID+ patients in high-risk cohorts COVID+ DEATH RATE % COVID+ Rate, by Cohort 50.00 3.00 45.00 2.50 40.00 35.00 2.00 30.00 25.00 1.50 20.00 1.00 15.00 10.00 0.50 5.00 0.00 0.00 30% or Greater, 30% or Greater, 30% or Greater, 30% or Greater, Under 85 85 & Over Under 85 85 & Over Non-ACO ACO Non-ACO ACO % TELEHEALTH UTILIZATION – NON ACO % TELEHEALTH UTILIZATION – ACO 29.61% 30% or Greater, 18.33% 30% or Greater, 33.53% 30% or Greater, 24.76% 30% or Greater, Under 85 Under 85 85 & Over 85 & Over Property of CareJourney Confidential and Proprietary | 12 Property of CareJourney Confidential and Proprietary | 12 Confidential and Proprietary 2020 | 12

CareJourney Analysis Telehealth Utilization Growing Across High Need, High Cost Segments Telehealth Spend by Month, 2020 % of Beneficiaries Utilizing Telehealth by Segment, 2020 Healthy Simple CC Minor Complex CC Major Complex CC Under 65 Disabled ESRD Frail Elderly 0% 5% 10% 15% 20% 25% 30% 35% 68% 49% $198 490K 26 33.2% Average # Providers Average Average % of Average % of ACO Attributed Telehealth Spend Rendering Telehealth Patients Part B Spend Total Spend Benes with per Patient Telehealth per Provider on Telehealth on Telehealth Telehealth Property of CareJourney Confidential and Proprietary | 13 Property of CareJourney Confidential and Proprietary | 13 Confidential and Proprietary 2020 | 13

CareJourney Analysis Telehealth Utilization, by ACOs, by High Risk COVID Cohort ACO Name Count > 30% Risk, <85 % COVID+ % Telehealth Palm Beach Accountable Care 1,415 1.84% 54.63% Organization LLC Advocate Physician Partners 2,263 2.87% 43.75% Accountable Care Inc. Delaware Valley ACO 1,417 4.59% 43.12% Millennium Accountable Care 1,470 NA (<11) 36.46% Organization LLC Health Connect Partners LLC 1,675 0.90% 35.76% Baylor Scott & White Quality Alliance 1,697 0.88% 35.12% Cleveland Clinic Medicare ACO LLC 1,480 NA (<11) 29.80% Caravan Health ACO 17 LLC 2,967 1.08% 26.46% Mercy Health ACO LLC 2,298 0.70% 25.37% Keystone ACO 1,401 1.43% 19.27% Property of CareJourney Confidential and Proprietary | 14 Property of CareJourney Confidential and Proprietary | 14 Confidential and Proprietary 2020 | 14

Conversation with: David Klebonis COO, Palm Beach Accountable Care Organization

”All - in” On Driving Telehealth Adoption Across PBACO Provider Network Property of CareJourney Confidential and Proprietary | 16 Property of CareJourney Confidential and Proprietary | 16 Confidential and Proprietary 2020 | 16

CareJourney Analysis How PBACO Scaled Telehealth Patient Education Dedicated Participant Officers Mobile Phone Integration into EHR COHORT TOTAL PATIENTS % COVID+ % COVID DEATHS % TELEHEALTH UTIL PBACO | 30% or Greater | 85 & Over 12,738 1.63% 22.12% 45.59% PBACO | 30% or Greater | Under 85 1,415 1.84% NA (<11) 54.63% Telehealth Utilization: 44.7% Palm Beach CBSA Property of CareJourney Confidential and Proprietary | 17 Property of CareJourney Confidential and Proprietary | 17 Confidential and Proprietary 2020 | 17

Conversation with: Raj Shrestha COO, Community-Based Care & President & CEO, Castell (Intermountain Healthcare)

Building the Infrastructure for New Clinical Care Models Property of CareJourney Confidential and Proprietary | 19 Property of CareJourney Confidential and Proprietary | 19 Confidential and Proprietary 2020 | 19