Breaking the Deadlock:
New Partnership Models to
Improve Chronic Care
Steve Brown, Founder and CEO, Health Hero Network Inc.
Health & Human Capital Management Congress, January 25, 2006

Health Hero Network
We develop and market the
Health Buddy® System: A
patient-centered technology
and service platform that
empowers individuals to
manage chronic conditions
at home – with professional
monitoring and support.

Deadlock: Human, Social Costs
“Insurers, for example, will often refuse
to pay $150 for a diabetic to see a
podiatrist, who can help prevent foot
ailments associated with the disease.
Nearly all of them, though, cover
amputations, which typically cost
more than $30,000.”
- New York Times, January 11, 2006

The Price of Deadlock
$69,900,000,000,000
-Federal Reserve Governor Edward Gramlich, April 21, 2005

Something’s Got to Give
• Institution-centered care based on crisis response,
inadequate attention to care management or prevention
• “Global Aging” combined with “Global Gaining” forcing
payers to deal with largest cost driver, chronic illness
• To address these needs, healthcare is going electronic,
focusing on the home, reorienting around the patient
• Deadlock persists because of misaligned incentives

A New Hope
• Creative public policy can unlock resources for
programs that improve chronic care and save money
• Creative business solutions can enable private sector
to take risk and guarantee results
• Information technology can enable systems of care that
ensure best practices and measure performance

VA Chronic Care Model
Daily education, monitoring
and feedback at home
Personalized care
management and support

VA Chronic Care Results
Veterans Administration Community Care
Coordination Service, Florida
• 63% reduction in hospital admissions
• 60% reduction in hospital bed days of care
Published in: Disease Management, Volume 5, Number 2, 2002
Veterans Administration Heart Failure Study
• 81% reduction in inpatient bed days
Published in: Telemedicine and e-Health Volume 11, Number 1, 2005

Model at Work Outside VA
New England Medical Center SPAN-CHF II
• 72% reduction in HF hospitalizations
• 63% reduction in cardiac hospitalizations
Presented at Heart Failure Society of America, 2005
Henry Ford Health System Obesity Study
• >10 lbs weight loss in treatment group
• <.01 lbs weight loss in control group
To be Published 2006

ACCENT / Health Buddy Program
• Consortium of Physician Groups
• Bend Memorial Clinic, Oregon
• Wenatchee Valley Medical Center,
Washington
• AMGA oversees clinical protocols,
quality management
• Care management process based
on Health Buddy® system
• Begins Feb. 1, serving 1,600 high-
cost patients with CHF, diabetes,
COPD, and co-morbidities

ACCENT Incentive Model
• CMS pays consortium flat monthly fee
based on program enrollment
• Consortium assumes risk for fees against
delivering 5 percent net savings
• Consortium receives bonus if savings
exceed target

The Model Revisited
• Organize physicians to take risk, guarantee
performance in chronic care
• Technology enables patient self-management /
monitoring, ensures accountability
• Model could work for any payer segment
• Opportunity for disease management
organizations to work through physicians