LDI Health Policy Seminar 4_6_12: Care Management at Geisinger: Approach, Results, and Plans

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  • Source: Total revenue per approved budget. Most statistics are also based on BY12 budget. Impact of SACH acquisition has been included in revenue and statistics. Licensed beds based on budgeted beds which were equal to 6/30/11 beds, plus SACH beds as of 1/1/12 and CMC beds as of 2/1/12.
  • 9/22/11 Geisinger Health System
  • Bothe In 13 months, closed over 50,000 care gaps. 9/22/11 Geisinger Health System
  • Transfer to Michael
  • Believing that an engaged, activated patient would have both a better acute outcome and be more likely to comply with lifestyle modifications…we developed a “Patient Compact” that reflected a bilateral commitment to do what was needed to optimize the patient’s result. All relevant educational materials throughout the system was combined, revised and re-issued.
  • N=132 is CY 2005 N=321 is Feb 2006-Jan 31, 2009
  • Variable cost FY2006 $17,672 & FY2010 $21,480. Cost grew by 21.5% over the 4 years. Contribution margin grew by 23.2% and net revenue grew by 22.4%
  • LDI Health Policy Seminar 4_6_12: Care Management at Geisinger: Approach, Results, and Plans

    1. 1. Care Management at Geisinger: Approach, Results, and Plans Earl Steinberg, MD, MPP Exec. VP, Innovation & Dissemination Presentation at Leonard Davis Institute April 6, 2012 1Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    2. 2. Outline • Overview of Geisinger • Key Attributes • Notable Programs and Results • Plans - New Center for Health Care Transformation - Efforts to Disseminate Geisinger Know-How 2Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    3. 3. Geisinger Health System An Integrated Health Service Organization Provider Managed Care Facilities Physician Companies Practice Group• Geisinger Medical Center • • ~298,000 members Hospital for Advanced Medicine, Janet Weis Children’s Hospital, Women’s Health Pavilion, • Multispecialty group (including ~63,000 Medicare Level I Trauma Center • ~1000 physician FTEs Advantage members) • • Geisinger Shamokin Community Hospital • ~520 advanced practitioner FTEs Diversified products• Geisinger Northeast (3 campuses) • • Geisinger Wyoming Valley Medical Center • 65 primary & specialty ~30,000 contracted providers/facilities clinic sites (37 community with Heart Hospital, Henry Cancer Center, • 43 PA counties Level II Trauma Center practice sites) • South Wilkes-Barre Adult & Pediatric Urgent Care, • 3 Ambulatory/outpatient surgery 3 inpatient rehab, pain mgmt, sleep center centers Heal • Teach • Discover • Serve Not for reuse or distribution without permission • Geisinger Community Medical Center • Geisinger Health System outpatient and Proprietary million System - Confidential >2.1Geisinger Health clinicProprietary Copyright Geisinger System 2012 System 2011 Copyright Geisinger Health Health Not for reuse or distribution without permission
    4. 4. Geisinger Health System Geisinger ProvenHealth Navigator Sites Geisinger Inpatient Facilities Careworks Convenient Contracted ProvenHealth Navigator Sites Ambulatory Care Facility Healthcare Geisinger Medical Groups Geisinger Health System Hub and Spoke Market Area Non-Geisinger Physicians LifeFlight Base 4 Geisinger Specialty Clinics Geisinger Health Plan Service Area With EHRHeal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    5. 5. Key Characteristics of Geisinger Health System• Strong physician leadership • Incentives aligned with aims paired with admin. partner • Team and system of care• Organizational culture that orientation prioritizes quality, efficiency • Infrastructure (IT, IM, EMR, and innovation Data Analytics)• Work force that embraces the • Skunk works and culture transformation units• A clinical enterprise and a • Focus on work flow and health plan reliability• Clear, shared aims • Performance measurement and feedback
    6. 6. Our Sweet Spot for Innovation Geisinger Clinical Enterprise Geisinger Health Plan 6 Aligned objectives for the greatest impactHeal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    7. 7. Evolution of GHS Value Re-Engineering 2011 Transitions Program 2010 Keystone Beacon 2010 NCCCP Cancer Grant 2009 Inpatient EHR Integration 2007 Automated Proactive Outreach ® 2006 ProvenHealth Navigator 2005 Physician Group Practice Demonstration 2005 Physician Directed, Team Delivered Care ® 2004 ProvenCare Chronic (Diabetes Bundle) 2002 Primary Care Redesign, Hub and Spoke model 2001 Networked Personal Health Record 1995 Outpatient EHR 7Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    8. 8. Major Geisinger Re-Engineering Initiatives• Enterprise Data Warehouse• Primary Care Re-Design• Make the EMR a Member of the Team• ProvenCare (Acute and Chronic)• Advanced Medical Home• Transitions of Care• GAPP 8 Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    9. 9. Clinical Decision Intelligence System (CDIS) Other Inputs Decision EBM Guidelines Support Patient Preferences Formulary/Economics … rm s Real-time Clinical Status o lN i ca ds Effectors ir en p Tr Em o n ati Alerts ul EHR CDIS P o p Prompts/Reminders Order Sets … Automated care plans Clinical, Patient messages Schedule … Information Rx … Claims Finance Ops … 9 Normalization, Transformation, Analytic 9Heal • Teach • Discover • Serve Application reuse or distribution without permission Not for Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    10. 10. Time Required for Primary Care • Acute Care 4.6 hours/day • Preventive Care 7.4 hours/day • Chronic Care 10.6 hours/day 22.6 Hours/day 10 10Heal • Teach • Discover • Serve 10 Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    11. 11. Key Process Redesign Strategies• Focus on quality and efficiency of care.• Agree on standardized production functions.• Eliminate steps that are found to be unnecessary.• Automate any work that can be automated.• Delegate work to appropriately trained non-physician staff when possible. (All personnel to “operate at the top of their license”.)• Support agreed upon workflows with various types of EMR reminders, decision support tools and work flow facilitators to increase the reliability of the care provided.• Activate and engage the patient and their family. 11Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    12. 12. Reengineering Clinical Care Population Identification PopulationsPatients and Conditions Bundle Development 100% Care Processes and Protocols (Digital) Low Efficiency and Reliability High Workflow Modification Delegation and Regular Care Algorithms Automation Patient Activation 12Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    13. 13. Closing Care Gaps: Content, People and Health Information Technology (HIT) Content People HIT Prevention Outpatient Reengineering and Innovation Oversight Diagnosis Naming Conventions Diabetes Problem List Manager CAD Care Gaps Team Clinical Data Capture CKD Clinical Workgroups Heart Failure Patient Reported Data Capture Vascular Disease Innovation Osteoporosis Office-Based Decision Support Medical Informatics Obesity EPIC Design Team Automating orders HTN and Lipids Automating outreach Analytics and IT Asthma/COPD Scheduling Services Real-time opportunity reports *End of Life *Medication Safety Data Visualization *Atrial Fibrillation Care Gaps Manager Patient Communication 13Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    14. 14. Nurse Rooming Tool 14 14Heal • Teach • Discover • Serve 14 Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    15. 15. Improvements from Nurse Rooming Tool MyG Enrollments Urine Microalbumin8000 88 867000 846000 825000 80 784000 76 Delegate To3000 74 722000 Nurses 701000 68 66 0 Jul-07 Aug-07 Sep-07 Oct-07 Nov-07 Dec-05 Jan-06 Feb-06 Mar-06 15 15 Heal • Teach • Discover • Serve 15 Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    16. 16. Improving Preventive Care for 220,946 Patients 11/07 8/11Adult Preventive Bundle 9.2% 31%Breast Cancer Screening (q 2 40-49, q 1 50-74) 46% 61%Cervical Cancer Screening (q 3 yr Age 21-64) 64% 71%Colon Cancer Screening (Age 50-84) 44% 66%Prostate Cancer Discussion (Age 50-74) 72% 77%Lipid Screening (Every 5 yr M > 35, F > 45) 75% 87%Diabetes Screening (Every 3 yr > 45) 85% 90%Obesity Screening (BMI in Epic) 77% 97%Documented Non-Smokers 75% 78%Tetanus Diphtheria Immunization (every 10 yr) 35% 72%Pneumococcal Immunization (Once Age >65) 84% 86%Influenza Immunization (Yearly Age >50) 47% 59%Chlamydia Screening (Yearly Age 18-25) 22% 37% 16Osteoporosis Screening (every 3 yr Age > 65) without permission Heal • Teach • Discover • Serve Not for reuse or distribution 52% 73%Alcohol Geisinger HealthAssessment Copyright Intake System 2011 84% 92% Geisinger Health System Confidential and Proprietary
    17. 17. Practice Redesign: Diabetes • All or None “Bundle” measure for Diabetes • Clinical process redesign – Eliminate, Automate, Delegate, Incorporate, Activate • Clinical decision support – Health Maintenance and Best Practice Alerts • Patient specific strategies using registry report data • Care Gaps • Patient centered strategies – Patient report cards • Financial incentives 17 17Heal • Teach • Discover • Serve 17 Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    18. 18. Improving Diabetes Care for 25,071 Patients 3/06 3/07 8/10 8/11Diabetes Bundle Percentage 2.4% 7.2% 13.0% 12.5%% Influenza Vaccination 57% 73% 75% 76%% Pneumococcal Vaccination 59% 83% 83% 82%% Microalbumin Result 58% 87% 78% 78%% HgbA1c at Goal 33% 37% 52% 50%% LDL at Goal 50% 52% 54% 55%% BP < 130/80 39% 44% 55% 57%% Documented Non-Smokers 74% 84% 85% 85% 18 Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    19. 19. ® ProvenCare– Establish evidence or consensus-based best practices.– Reliably deliver these by redesign of work flow supported by EMR when possible.– Activate patients and families, engaging them in the care processes. 19Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    20. 20. ® ProvenCare CABG: Process flow ReturnClinic Pre-op OR Post-op Clinic 20Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    21. 21. ProvenCare® CABG: Process flow Return Clinic Pre-op OR Post-op Clinic•Carotid Eval •Antibiotics •Antibiotics •Beta Blockade •Beta Blockade•Vascular Consult •Glycemic Control •Glycemic Control •ASA Therapy •Clopidogrel•Inf.MI/RV •IABP use •Beta Blockade •Lipid management •Warfarin •ASA Therapy•Clopidogrel •Atherosclerotic •Cardiac Rehab•Warfarin Aortas •Afib prevention •Smoking Cessation•Beta Blockade •Cardioplegia •Lipid management•Smoking Cessation •Arterial Conduits •Ant.MI/WMA •Smoking Cessation 21 Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    22. 22. ProvenCare® & the Electronic Medical Record (EMR) 22Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    23. 23. Patient Activation • Clinical, executive, and legal team developed a “Patient Compact” to engage patients and families – Reflects bilateral commitment to optimize outcomes • Engage as a “partner” in care process • Promptly notify team of all issues • Comply with recommended medications • Complete cardiac rehabilitation • Engage with GHS care management services • Stop smoking • Manage weight • Education workgroup revised all patient education materials to comply with ProvenCare® concepts 23Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    24. 24. ProvenCare® CABG Component Process Measure = “Compliance” All-or-None Measure = “Reliability” 24Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    25. 25. Reporting Period: FY2011 Q4 Apr-Jun Update Date: July 5, 2011 25Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    26. 26. Clinical Outcomes Comparison of before (n=132) and after (n=321) ProvenCare® • 80% improvement in In-hospital mortality • 61% reduction in re-intubations • 63% reduction in deep sternal wound infection rate • 40% reduction in neurologic complications 2626 • Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary 29% reduction in pulmonary complications Copyright Geisinger Health System 2011
    27. 27. Financial Results: CAB Base Line Look Back Variance (FY2006) (FY2010) Cases 116 131 15 LOS 7.60 6.28 (1.32) CM Per Case 17,810 21,949 4,139 Net Revenue per Case 35,482 43,429 7,947 27 Heal • Teach • Discover • Serve Not for reuse or distribution without permission27 Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    28. 28. ProvenHealth® Navigator: (Advanced Medical Home)• Partnership between primary care physicians and GHP that provides 360-degree, 24/7 continuum of care• “Embedded” nurses• Assured easy phone access• Follow-up calls post-discharge and post-ED visit• Telephonic monitoring/case management• Group visits/educational services 28• Personalized tools (e.g., chronicdistribution without permission cards)Heal • Teach • Discover • Serve Not for reuse or disease report Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    29. 29. 5 Core Components of Geisinger’s Medical Home • Patient and family engagement & education Patient-centered • Enhanced access and scope of services primary care • PCP led team-based care • Population segmentation and risk stratification • Chronic disease and preventive care optimized with HIT Integrated • GHP employed in-office case management population • Disease management management • Micro-delivery referral systems Medical • 360°care systems – SNF, ED, hospitals, Home Health, etc Neighborhood • Patient satisfactionQuality Measurement • HEDIS and bundled chronic disease metrics ••Fee-for-service with P4P payments based on quality of care Preventive services metrics Value-based • Physician and practice transformation stipends reimbursement • Value-based incentive payments 29Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    30. 30. Embedded Case Management Personal Care Link Embedded Case Manager Recognized Team Member -High risk patient case load Regular follow-up of high risk Comprehensive Care Review – - 15 - 20% Medicare patients medical, social support - 5% commercial Facilitates access – PCP, specialist, - 125 - 150 pts per CMTOC follow-up – acute care, SNF, ED - 1 CM per 800 Medicare lives ancillary - 1 CM per 5000 commercial lives Direct phone access – questions, Facilitate special arrangements – exacerbation protocols home care, hospice, AAA - Not disease management focused - Focus on those at most risk Patient, family support contact Links health care team to payer - Focus on driving issue within the case 30 Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    31. 31. Acute admissions show improvement in the Medicare population 31Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    32. 32. Readmissions are also lower 32 | 32Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    33. 33. Cumulative Percent Difference in Spending Attributable to PHN 0%-2%-4% 95% Confidence Interval-6% Median Es tim ate 95% Confidence Interval-8%-10% Q1 2005 Q3 2005 Q3 2006 Q1 2007 Q1 2008 Q1 2009 Q1 2006 Q3 2007 Q3 2008 Q3 2009-12%Cumulative percent difference in spending (Pre-Rx Allowed PMPM $) attributable to PHN in the first 21 PHN clinics for calendaryears 2005-2009. Dotted lines represent 95% confidence interval. P = < 0.003 33 Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    34. 34. Geisinger PGP Year over Year Per Capita Trend Geisinger PGP Results •Quality Rating •Shared Savings •PY 1 73% •PY 1 $0 •PY 2 100% •PY 2 $0 •PY 3 100% •PY 3 $1.95M •PY 4 100% •PY 4 $1.79M •PY 5 100%* •PY 5 $0* •Geisinger is the only group to achieve •Year 5 had the lowest cost trend 100% years 2-5 34 Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    35. 35. Medical Neighborhood• Micro-delivery referral systems – High volume specialties – Ancillary services – Radiology, Lab• 360 degree care systems – Hospital care – Home Health – SNF’s – ER coverage – Community resources 35Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    36. 36. Early Results for Nursing Homes Look Promising Nursing Home Baseline PY 1 Readmissions Reduction Readmissions 2009 2008 Nursing Home A 34% 18.5% - 45.5% Nursing Home B 18.5% 14.5% - 21.6% Nursing Home C 27% 9% - 66.6% Nursing Home D 44% 33% - 25% Nursing Home E 42.5% 31% - 27% 36 Nursing Home F Heal • Teach • Discover • Serve 27.5% 24% - 12.7% Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    37. 37. Geisinger’s Transitions Approach• Screening of all admissions• Daily interdisciplinary communication• Transition planning• Timely transition communication• Post-discharge engagement 37 | 37 Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    38. 38. Transition Bundle• Electronic Discharge Instructions – Signed copy to patient prior to discharge• Electronic Discharge Summary – Delivered within 48 hours of discharge over 90% of time• Automatic Document Delivery – At time of document authentication• Discharge Appointment within 7 days 38 – Leave hospital with appointment 88% of time Heal • Teach • Discover • Serve Not for reuse or distribution without permission | 38 Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    39. 39. Aspiration of New Geisinger Center for Health Care Transformation (CHCT)• Become known as the premier place in the country for development and evaluation of innovations that are designed to reduce cost of care and improve quality of care. 39 | 39Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    40. 40. Three Part Mission • Improve Quality and Efficiency of Health Care • Identify opportunities to improve the quality and clinical outcomes of care, as well as patient satisfaction with care delivered by Geisinger Health System • Identify opportunities to improve the quality and clinical outcomes of care, as well as patient satisfaction with care delivered by a spectrum of health care providers other than Geisinger • Identify opportunities to reduce the cost of care delivered by Geisinger Health System through improved efficiency and elimination of unwarranted variation in practice • Identify opportunities to reduce the cost of care delivered by a spectrum of health care providers other than Geisinger through improved efficiency and elimination of unwarranted variation in practice 40 | 40Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    41. 41. Three Part Mission • Improve Quality and Efficiency of Health Care (cont.) • Develop 1) incremental improvements in and 2) new models for care delivery that can increase health care value at Geisinger Health System (in all instances) and at a broad spectrum of other health care delivery systems (in some instances) • Determine how to integrate those incremental improvements and innovations into clinical work flow at Geisinger, and elsewhere, so they are delivered consistently • Enhance Geisinger’s national and international reputation as a leader in health care innovation and quality and efficiency of health care delivery 41 | 41Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    42. 42. Three Part Mission (continued) • Product Development • Develop a platform and system for development of products that enhance quality and/or efficiency of health care at a broad spectrum of health care delivery systems • Develop prototypes of products that could be used by a broad spectrum of health care delivery systems to improve the quality and efficiency of health care. 42 | 42Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    43. 43. Three Part Mission • Evaluation • Quantify the effects of particular incremental improvements and major innovations on: • care-process reliability • quality of care • patient outcomes (including satisfaction) • cost of care • at GHS and in different types of health care delivery • organizations and market environments • Identify the factors associated with successful (and unsuccessful) adoption, use and performance of particular changes in health care delivery • Center personnel will strive to develop credible, but practical methods for evaluation of the products of rapid cycle innovation 43 | 43Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    44. 44. What Will Differentiate the Center? • Although much of the focus of the Center will be on development of incremental improvements and major innovations that are useful at GHS, the Center also will focus on development of value-improving innovations that can be employed by a spectrum of health care delivery systems that lack Geisinger’s resources. • In an effort to help the Center’s work have a broad impact, the Center will put substantial effort into development of prototypes of products that can be used by a broad spectrum of providers. • There will be a focus on producing evidence regarding the impacts of innovations at Geisinger and elsewhere – and on development of credible, but pragmatic methods for evaluation of rapid cycle innovation • There will be a focus on helping to ensure that best practice is delivered consistently – not on determining what constitutes best practice • We will employ Geisinger as a laboratory for testing and adapting innovations developed by others 44 | 44Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011
    45. 45. The Market Need• Anticipation of changes in the way health care is paid for is prompting many health care providers to begin to change how they are organized and deliver care.• Most providers lack the capabilities that will be required to be successful under risk- and/or performance-based payment.• Geisinger is ideally positioned to assist health care providers who want to prepare themselves for a value-, rather than volume-oriented payment system. 45 | 45 Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    46. 46. Planned Products and Services• Services to Support Value-Driven Care - Population Health Data Analytics - Care Management• Consulting Services• Licensing Geisinger IP to product manufacturers and health care delivery systems• Software apps based on Geisinger IP 46 | 46 Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and Proprietary Copyright Geisinger Health System 2011
    47. 47. Questions We Seek to Answer Re: Dissemination 1. Can particular approaches Geisinger has used to provide high value care be replicated in other health care environments? 2. If so, which approaches can be replicated and under what circumstances? 3. Do those approaches produce the same improvements in quality of care and patient outcomes, the same reductions in cost of care, and the same improvements in patient and provider satisfaction in other settings as they have at Geisinger? 4. If so, under what circumstances? | 47 47 | 47Heal • Teach • Discover • Serve Not for reuse or distribution without permission Geisinger Health System Confidential and ProprietaryCopyright Geisinger Health System 2011

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