We are excited to be here… Ian Juliano Matthew Tabor CEO VP, Strategy ijuliano@trellahealth. com mtabor@trellahealth. com
• Headquartered in Atlanta, GA • 55 staff • 200 customers, 43 in GA: ⎯ 29% of GA Home Health Admits ⎯ 19% of GA Hospice Admits We are a Georgia Company • Over 24 M GA claims including: ⎯ ⎯ ⎯ ⎯ 175, 000+ dual eligible GA residents 108 home health providers 198 hospices 423 skilled nursing facilities Over 26, 000 physicians 220 inpatient facilities 1, 273 outpatient facilities © Trella Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons.
OUR MISSION Create and promote optimal care networks that yield superior performance and greater efficiencies © Trella Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons.
Trella Health is the leader in care network/care path analytics Our mission is to create and promote optimal care networks that yield superior performance and greater efficiencies. We are a Saa. S data analytics healthcare company We help customers compete in value-based care We provide quality transparency to develop more efficient care networks and care paths We support decision making to connect patients with the appropriate provider
Trella Health is uniquely positioned to drive out drive billions in waste Changing the way providers compete and care for patients Changing how systems construct patient care paths Changing how payers construct care networks While improving the lives of our most vulnerable Achieving better outcomes And reducing utilization
Enabled by our uniquely powerful proprietary database We have one of the richest claims databases in the US Complete Medicare Claims Data The Trella Health DB For every hospital, agency and MD in the US: Over 60 M Medicare Patient Data VRDC innovator ü ü ü ü Physician visit or procedure Device or Equipment purchase Diagnostic (Lab & Radiology) Facility stay (INP, OUT, SNF, LTAC & IRF) Agency encounter (HHA & HOS) Drug prescription and purchase Coming Soon: Medicaid and CHIP Trella Processing ü ü Patient population details High end performance stats Detailed operational stats Episodic costs and utilization metrics ü Total care costs during episode and beyond ü Impact on patient cost curve
Via massive data analytics and outstanding solutions Trella Health is unique in that we can navigate the entire care continuum LONGITUDINAL ANALYTICS: WHAT HAPPENED TO THE PATIENT Patient Physician Hospital Skilled Nursing Home Health Hospice CLAIM abc 123… CLAIM xyz 124… CLAIM efg 125… CLAIM uvw 126… CLAIM hij 127…
Positioning us to drive more efficient care paths and care networks Trella Health provides insights to determine the proper care setting and best providers based on cost and outcomes ü Improved quality of care ü Increased patient satisfaction ü Reduce total cost of care H LT E M HO A HE SKILLED NURSING HOSPITAL DISCHARGE HO SP IC E
And our client list … of 200 customers 6 of the Top 10 HH 5 of the Top 10 HOS 3 of the Top 10 SNFs 2 well known Systems © Trella Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons. 1 leading IDN
We address the issue of massive waste in our healthcare system Total US Healthcare Spending Over 3. 5 trillion $ is spent on healthcare in America annually $ 3. 5 T APPROXIMATELY $ 875 B WASTED … and about a quarter of it is wasted* *IOM (Institute of Medicine). 2012 Report On Healthcare Spending; 2013 Report On Variation In Health Care Spending.
Healthy and Efficient Markets Need Transparency in cost and quality Results in more efficient care paths Clear, concise and consistent quality measurement Improvements in quality and outcomes
GA Medicaid ABD A Huge Opportunity Discreet savings of $600 Million alone for GA Medicaid ABD Through attainable and modest performance improvements In “competitive” counties – multiple providers competing for patients Post Inpatient discharge only – 12 months Post Acute Care
ABD savings approach – Narrow the Gap Creating a competitive, transparent market: Analyze every competitive county in Georgia Divided performance into quartiles Project a one quartile improvement for the 3 non-leader quartiles – Preferred patient routing and performance-based compensation – Driven by performance transparency and measurement Estimated a conservative 15% savings in Inpatient and subsequent care – This only considers ABD patients with an Inpatient stay
• Coordinating care makes a difference Bending • Transparency to patients the patient & caregivers care cost curve • Rewards impact the cost trajectory • Emphasize care paths vs episodes • Increases flexibility in care planning • Enhances patient satisfaction © Trella Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons.
EXAMPLE 1: A tale of two Atlanta Skilled Nursing Facilities • Two SNF’s nearby – 5 minutes from Capitol - <1 mile apart (30312) • Both receive patients from Grady • They have markedly different results Total Cost of Care Per Patient Per Year, High Acuity FFS Patients Total Cost of Care (risk adjusted) Savings (adjusted, PPPY) SNF A SNF B 52 56 $38, 692 $64, 440 $25, 748 There are scores of similar examples across GA q SNF A patients receive more care from • Home Health • Skilled Nursing q SNF B patients have significantly more • Inpatient claims • ER visits • Professional claims Closing the performance gap could result in $1. 4 m in savings for High Acuity patients alone
Collaborating to create a competitive and innovative market • Patient transparency mechanisms: – Discharge planning tool – Provider quality portal for GA residents – Informed decision-making • Provider benchmarking: – An affordable subscription product for all providers – Benchmark and share quality metrics – Assess cost variation (actual and risk adjusted) • Innovative reimbursement mechanisms: – Incentives and rewards for the top performers – Pay for achievement of performance milestones – Valuable credential / approval Inpatient Home Health Skilled Nursing No PAC
There are other benefits to improving outcomes Improved care networks = healthier Georgia • Less illness and adverse events • Leading increased productivity GA can take the national lead in healthcare • Attracting corporate investment • Setting the bar / standard for other states • Increasing engagement at municipal / county / local levels Illness-related lost productivity costs the US $530 billion per year 1 At 3% of US economy, this costs GA employers over $15 billion annually • In absenteeism • Reduced productivity 1. The Integrated Benefits Institute, 2018 • As caregivers
Georgia – leading the country through quality transparency. Data is an affordable and easy means to transform Georgia healthcare into an efficient, competitive market.
Georgia – leading the country through quality transparency. Data is an affordable and easy way to transform Georgia healthcare into an efficient, competitive market. © Trella Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons.
FORMERLY EXCEL HEALTH Thank you
EXAMPLE 2: Skilled Nursing in Northeast Even though SNF 2 has a more complex patient mix… Sending high acuity patients to SNF 2 versus its competitor, SNF 1 may save a PA health plan an average of ~$24, 000 per patient over 12 months Provider # of Patients 12 mo. TCCMortality Rate (%)INP Claims SNF Claims HHA Claims HOS Claims 87, 323 35. 9% 2. 4 3. 4 2. 1 0. 2 63, 935 43. 0% 1. 3 3. 5 0. 8 0. 2 85, 103 30. 3% 2. 3 3. 2 2. 3 0. 0 SNF 1 263 $ SNF 2 45 $ SNF 3 76 $ Reroute 50 high acuity patients to SNF 2 Result: $24 k/patient savings Savings of at least $1. 2 M per year
EXAMPLE 3: Home Health in Southeast ALL PATIENTS 90 DAY HOSPITALIZATION HHA 1 1794 22. 6% HHA 2 1665 28. 1% On the surface HHA 1 is better HIGH ACUITY BY SPECIALIZATION (DX) All Patients 90 Day Hospitalization Rates HHA 1 HHA 2 Avoided Hospital Visits Injury 1794 87 38. 1% 31. 9% 15 On further inspection, HH 2 outperforms Circulatory 118 164 55. 7% 44. 1% 14 Reroute high acuity patients to HH 2 Nervous System 38 35 48. 8% 34. 0% 6 Musculoskeletal 36 49 45. 6% 30. 2% 5 Result: ~40 fewer high cost hospitalizations/year At a savings of at least $1 M/year 1000’s of opportunities like this across US to reduce costs and improve outcomes
EXAMPLE 4: These differences add up: 3 Mid-Atlantic Hospitals In NJ, Hospital 2 has the lowest overall cost of care for respiratory patients – Despite having perhaps the highest patient acuity and complexity – Using more HHA than its peers Provider # of Patients 12 mo. TCCMortality Rate (%)INP Claims SNF Claims HHA Claims HOS Claims Hospital 1 145 $ 82, 998 28. 2% 3. 4 2. 0 0. 5 0. 0 Hospital 2 304 $ 50, 688 34. 5% 2. 5 1. 3 0. 9 0. 0 Hospital 3 438 $ 55, 328 30. 9% 2. 2 1. 0 0. 8 0. 3 Could Hospital 1 optimize its post-acute network to reduce cost and improve outcomes?
Identified “Competitive” Counties 25 Fulton Richmond Dekalb Cobb Chatham Bibb Gwinnett Floyd Clarke Muscogee Hall Houston Coweta Carroll Clayton Lowndes Dougherty Colquitt Thomas Ware Laurens Rockdale Glynn Appling Henry Meriwether Whitfield Walton Emanuel Macon Lumpkin Barrow Dodge Towns Berrien © Trella Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons.
© Trella Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons.