Session 32 How One ACO Is Using Analytics

Session #32: How One ACO Is Using Analytics to Position Itself for Population Health Management and Shared Savings Pre-Session Poll Question On a scale of 1 -5, how effectively is your organization positioned for population health and accountable care? James Dearing, DO Vice President and Chief Medical Officer, CEO Honor Health Network ACO #HASummit 14 1) Not at all effective 2) Somewhat effective 3) Moderately effective 4) Very effective 5) Extremely effective 6) Unsure or not applicable

About the Organization Non-for-profit healthcare system, ACO #HASummit 14 Five acute care hospitals, extensive outpatient care Addressing accountable care and population health 2

Industry Trends • Healthcare reform focuses on quality and slowing spending growth • Accountable care organizations (ACOs) are emerging as a key way to tackle this challenge • The CMS Medicare Shared Savings Program (MSSP) has been a driving force • • Today, there a total of 744 ACOs with more than 405 of them participating in the MSSP program ACOs that achieve lower costs while achieving quality targets will receive shared savings payments #HASummit 14 3

The Problem • Honor Health Network, a MSSP ACO, has a reputation for quality and physician collaboration • Including an advanced Patient-Centered Medical Home (PCMH) • Optimizing PMPM costs requires understanding care utilization and outlier behaviors • Referral leakage, unnecessary tests, inappropriate use of specialists • A robust analytics platform was critical to: • • #HASummit 14 Better manage the quality of patient care Manage utilization and costs Identify service gaps in the provider network Identify growth opportunities 4

Our Approach and Results #HASummit 14 5

Solution • Implemented a comprehensive ACO analytics platform in support of: § Data-driven cost and referral management § Granular cost analysis to facilitate physician engagement and collaboration #HASummit 14 6

The Analytic Infrastructure Metadata: EDW Atlas security and auditing Common, linkable Vocabulary FINANCIAL SOURCES Financial Source Marts DEPARTMENTAL SOURCES Departmental Source Marts ACO Explorer Administrative Source Marts Diabetes Patient Source Marts ADMINISTRATIVE SOURCES PATIENT SATISFACTION SOURCES Etc. EMR Source Marts EMR SOURCE #HASummit 14 HR Source Mart OPERATIONAL SOURCES 7

The ACO Executive Dashboard #HASummit 14 8

Tracking Referral Leakage #HASummit 14 9

Poll Question #2 On a scale of 1 -5, how effectively is your organization using healthcare analytics to support accountable care and population health? 1) 2) 3) 4) 5) 6) Not at all effective Somewhat effective Moderately effective Very effective Extremely effective Unsure or not applicable #HASummit 14 10

Results: EDW Platform Implemented an EDW platform and ACO analytics to manage costs, referrals, and risks • Integrated data from multiple disparate transactional source systems into a single source of truth • Eliminated data timeliness and data quality concerns • Significant reduction in lag time in attribution of patient care and costs to the responsible provider • Improved ability to consume data in meaningful ways and to identify trends that affect quality and cost • Improved ability to identify high-risk patients #HASummit 14 11

Results: Cultural Transformation Drove cultural transformation through physician engagement and patient support services • Active physician participation in data validation resulted in a sense of ownership for the data • Physicians empowered by the transparency, robustness, and reliability of the data • • Helping leverage the data to achieve the best possible health for patients at sustainable costs Educational and engagement efforts are designed to ensure physicians play a meaningful role in the design and implementation of improvement programs #HASummit 14 12

Results: Physician Practices More accurately assess physician practices • With good data and cultural transformation, the ACO is building a value-based reimbursement environment • Data informs physicians regarding highcost procedures and tests which can be benchmarked against their necessity under evidence-based practices • The data also helps physicians identify and manage high-risk patient populations #HASummit 14 13

Clinical Care Results Example • Most recent focus has been on the management of diabetes • Specifically on management of the “diabetic trifecta” • § LDL less than 100 § BP less than 140/90 § Hgb. A 1 C less than 8 Goal: Increase the percentage of patients in the diabetic population meeting all three criteria § Start: < 8% of diabetic population met all three criteria § Now: 20% of diabetic population met all three #HASummit 14 14

Next Steps Continue to refine and improve existing analytics capabilities Continue to advance datadriven quality improvement Lower PMPM costs through reduction in clinical variation and adoption of best practice Better forecasting through the use of predictive analytics Strive to reduce referral leakage (improved contracting, address patient access issues, etc. ) #HASummit 14 15

Lessons Learned 1. No one likes prior authorization – need good data to manage it more precisely 2. Good data is required to ask the right questions and focus on what is most important 3. It is important to have a strong and highly collaborative working relationship with your analytics vendor #HASummit 14 16

Analytic Insights Questions & Answers A #HASummit 14 17

Choose one thing… Write down one thing will you do differently after hearing this presentation #HASummit 14 18

Thank You #HASummit 14 19

Session Feedback Survey 1. On a scale of 1 -5, how satisfied were you overall with this session? 1) Not at all satisfied 2) Somewhat satisfied 3) Moderately satisfied 4) Very satisfied 5) Extremely satisfied 2. What feedback or suggestions do you have? #HASummit 14 20

Upcoming Speakers 3: 20 PM – 4: 10 PM Location 36) Building Creative and Innovative Organizations Grand Ballroom Ed Catmull, Co-Founder of Pixar, President of Pixar and Walt Disney Animation Studios 4: 10 PM – 4: 30 PM Final Polls and Summit Winners Grand Ballroom 4: 30 PM – 5: 00 PM 37) Closing Remarks Grand Ballroom Dan Burton, Chief Executive Officer, Health Catalyst #HASummit 14 21