OVERALL USHEALTHCARE INDUSTRY     STRUCTURE         Presented by        Philip Corsano    CEO Gnostam Consulting
How to drive costs down?—  Collect data, is there an “exchange” where the data  for price and service delivery lives?—  ...
The Problem ~ Complexity
Healthcare Exchange
The Problem—  Overuse, inappropriate use of care, fee for service;—  Payment incentivizes delivery of more service;—  O...
The US Heathcare System
Health Care Costs Concentrated in Sick Few—Sickest 10 Percent Account for 64 Percent of                 Expenses         1...
The Model—  First acquire the procedure data, best if payment  for services with an outcome:—  Is there an obvious proce...
Quality Assurance           Improvement            Threshold                             Threshold                        ...
Quality Improvement          In this case the whole process delivery system is overhauledbetter                  worse    ...
Costs of Care for Medicare Beneficiaries with           Multiple Chronic Conditions, by Hospital Referral                 ...
How “BreakthroughImprovement” manifests itself                                       B                    A     Incrementa...
Continuous feedback loop strategic model
Tools for Improving How We Do Our Work:           Improving the Process                            Process flowchart      ...
Tools for improving what we do:            Content                            Benchmarking best practice    Field force an...
Leverage performance         improvements                                                            How we think         ...
Thank youfor your attention             Philip Corsano         Gnostam Consulting LLC         5731 Kirkwood Place N       ...
One idea for the New System, Medicare for all. REJECTED
Structure of us healthcare
Structure of us healthcare
Structure of us healthcare
Structure of us healthcare
Upcoming SlideShare
Loading in...5
×

Structure of us healthcare

4,962

Published on

Structure of US Healthcare industry determines its economic performance

Published in: Business
0 Comments
3 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
4,962
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
148
Comments
0
Likes
3
Embeds 0
No embeds

No notes for slide

Structure of us healthcare

  1. 1. OVERALL USHEALTHCARE INDUSTRY STRUCTURE Presented by Philip Corsano CEO Gnostam Consulting
  2. 2. How to drive costs down?—  Collect data, is there an “exchange” where the data for price and service delivery lives?—  Understand what part of the “value chain” you occupy;—  Build an economic model;—  Optimize strategic choice by running scenarios’s;—  Quality improvements;—  Process improvements;
  3. 3. The Problem ~ Complexity
  4. 4. Healthcare Exchange
  5. 5. The Problem—  Overuse, inappropriate use of care, fee for service;—  Payment incentivizes delivery of more service;—  Old oligopolistic market structure, favors big pharma, big insurers, and suppliers who restrict efficient price discovery;—  Barriers to access in primary, preventive care, leads to over use of Hospital admissions, ER and complications of chronic acute disease.
  6. 6. The US Heathcare System
  7. 7. Health Care Costs Concentrated in Sick Few—Sickest 10 Percent Account for 64 Percent of Expenses 1% 5% $36,280 24% 49% $12,046 50% $715 Distribution of health expenditures for the U.S. population, by magnitude of expenditure, 2003
  8. 8. The Model—  First acquire the procedure data, best if payment for services with an outcome:—  Is there an obvious process for price discovery?—  Is the data in a form that allows for like with like comparisons?—  Is there a model against which to benchmark?—  Is there a process improvement component?—  Is there a quality control, reliability component?
  9. 9. Quality Assurance Improvement Threshold Threshold Improvementbetter worse worse
  10. 10. Quality Improvement In this case the whole process delivery system is overhauledbetter worse better worse
  11. 11. Costs of Care for Medicare Beneficiaries with Multiple Chronic Conditions, by Hospital Referral Regions, 2001 Ratio of percentile Average annual reimbursement groups 10th 25th 75th 90th 90th to 75th to Average percentile percentile percentile percentile 10th 25thAll 3 conditions(Diabetes + CHF $31,792 $20,960 $23,973 $37,879 $43,973 2.10 1.58+ COPD)Diabetes + CHF $18,461 $12,747 $14,355 $20,592 $27,310 2.14 1.43Diabetes + COPD $13,188 $8,872 $10,304 $15,246 $18,024 2.03 1.48CHF + COPD $22,415 $15,355 $17,312 $25,023 $32,732 2.13 1.45 CHF = Congestive heart failure; COPD = Chronic obstructive pulmonary disease. Data: G. Anderson and R. Herbert, Johns Hopkins University analysis of 2001 Medicare Standard Analytical Files (SAF) 5% Inpatient Data.
  12. 12. How “BreakthroughImprovement” manifests itself B A Incremental Breakthrough Refinements Breakthrough improvements Vision/ to vision/ Vision/ Redefine context Redefining Context Context
  13. 13. Continuous feedback loop strategic model
  14. 14. Tools for Improving How We Do Our Work: Improving the Process Process flowchart Cause and effect Category Frequency A lll Data Collection B llll ll C llll Data Analysis
  15. 15. Tools for improving what we do: Content Benchmarking best practice Field force analysis Driving Restraining Evidence based practice, run scenario’s
  16. 16. Leverage performance improvements How we think Appreciating a Systems Perspective What we do Addressing Underlying Assumptions: •Goals •Purpose •Measurement •Traction •Implementation •Teams How we do it •Improving Content •Improving Content •Improving Process •Improving Process •Improving ProcessLow leverage High Leverage
  17. 17. Thank youfor your attention Philip Corsano Gnostam Consulting LLC 5731 Kirkwood Place N Seattle, WA 98103E-mail: pcorsano@gnostamconsulting.com or pcorsano@gmail.com Tel 206 384 0069 www.gnostamconsulting.com
  18. 18. One idea for the New System, Medicare for all. REJECTED
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×