Leveraging Primary Care Population Health Management to Create

Leveraging Primary Care & Population Health Management to Create Value: Lessons from Kaiser Permanente Donna Lynne, Executive Vice President Kaiser Foundation Health Plans March 5,

Agenda Kaiser Permanente Primary Care Best Practices Discussion Fourth Agenda Fifth Agenda 2

Kaiser Permanente: Today § 9. 6 million members § $55 billion revenue § 174, 500 employees § 17, 500 physicians § 48, 300 nurses § 648 hospitals, medical offices & other facilities 3

What Makes Kaiser Permanente Unique § Partnership between health plan & medical groups § Health plan & delivery system § Physicians are paid a salary § Focus on wellness, preventive care & prevention § Patient-centered medical home § Early adopter of electronic medical records § Recognized for high quality 4

KP in relation to US health plans § 5 th largest health plan in US § Only one in top 5 that is NOT in all 50 states § Only top 5 plan with “integrated delivery system. ” 5

Integrated Care = Care at its best 6

Health happens where you live, work, play and pray Society Neighborhood/ Community Home/School/Work Individual/ Family 7

Drivers of Health Care Personal Behaviors 40% Environment al & Social Factors 20% 8 Family History/ Genetics 30%

Primary Care Best Practices § Collaborative Cardiac Care Service § Care Management Team Program § Behavioral Health “i. COT” § Life Choices 9

Collaborative Cardiac Service (CCCS) Look 10

Primary Care Best Practices § Collaborative Cardiac Care Service § Care Management Team Program § Behavioral Health “i. COT” § Life Choices 11

Care Management Team Program Patient Primary Care CMT (Care Management Team): RN, CPS, CDE PMT (Prevention Management Team): MAs 12

Primary Care Best Practices § Collaborative Cardiac Care Service § Care Management Team Program § Behavioral Health “i. COT” § Life Choices 13

Improved Care Outcome Tool - i. COT § Behavioral Health Questionnaire – Completed by adult patients – Completed at each individual therapy visit in mental health, chemical dependency and psychiatry § Provides “picture” of progress § Help guide with treatment decisions § Utilizes patient motivation for behavior change 14

Primary Care Best Practices § Collaborative Cardiac Care Service § Care Management Team Program § Behavioral Health “i. COT” § Life Choices 15 27 November 2020| © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Life Choices What is Life Care Planning? § Life Care Planning is a systematic member centered approach to advance care planning. § An organized process of communication to help individuals understand, reflect upon and discuss goals for future health care decisions in the context of their values and beliefs. § When the process is done well, it has the power to produce a written plan that accurately represents the individuals’preferences and thoroughly prepares others to make health care decisions consistent with these preferences. 16

Meeting Patients Where They Are At Emails with Dr. 1 million patient emails 17 27 November 2020| Phone Visits Video Visits Completed 200, 000 “scheduled” telephone visits. Video visits for follow up care © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Discussion/Questions