What is our current focus for 2018?

1. M A N A G E D H E A LT H C A R E
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D O W E H AV E C L E A R D I R E C T I V E S

2. Current pulse of the healthcare business
❖ Federal repeal and replace will not make 1/1/18
‣ States are budgeting for Medicaid changes, some are complete overhauls
‣ CMS focuses on a value based business model
‣ Payers are seeing a shift by Employers to ASOs in an attempt to reduce overhead
‣ Internal IT budgets and staffing are growing accordingly
❖ What is the industry expectation from technology
‣ Patient inputs via phone, desktop, tablet, mobile text and website interfaces
‣ Targeted chronic conditions - reporting consistently across demographics
➡ Separating adult and pediatric measures
➡ Status of symptoms, quality of life, physical function and general health
perspective
‣ Educate healthcare client partners on “infrastructure and operational maturity” needs

3. C M S
❖ Value based reimbursement model
‣ Providers stressing over compliance, quality and accuracy
• What data…. What benchmarks…. How to report it….
‣ Engaging consumers to qualify outcome measures
❖ Challenges of integration and interoperability
‣ Data sharing is a must for end to end accountability and validation
‣ Cyber security challenges
‣ Item data banking must be a single repository

4. State Medicaid programs prepare
• Challenge: Change management response time
• Capitation will require a seamless integration process
• Benefit configuration changes should be expedient and
controlled
• Goals: Cost savings using technology
• Patient-Doctor telecommunications will reduce ER visits
• Wellness program monitoring requires flexible inputs

5. Consumer inputs
• Clinical review systems - keep it simple
• Integrate suggestions for the variations
• its day 3, you should notice …
• quantify variations
• baseline with metrics from National Institute of Health (NIH)
Not at all Mild Moderate Severe Can’t take it anymore
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6. What are the effects of the disease and the treatments
❖ Disease targeted measures using input scale 0-10
• Specific feeling, function and perception that you want to measure
➡ Anxiety and depression
➡ Physical function
➡ Quality of Life
➡ Symptoms
• Demographic Separations in Data Bank
➡ Adult vs Pediatric - specific measures, capturing age accurately
➡ Baselines separated as well

7. Consumer self reported inputs
❖ Cognitive interview assessments
• Understanding - must have a 9th grade reading level (minimum)
• Assumptions - must remove ALL assumptions in question relativity
➡ Flexible, sensitive and broadly applicable
➡ Consider physical, mental and social feedback for each measure
• Response - predetermined response mapping with all options
• Recall Period - target measures to reduce fluctuation considerations
➡ Acute conditions will not provide continuous measure
➡ 7 days may not be enough time for sexual activity measurements

8. Sustainable Development Goals
❖ SDG3 = good health and wellbeing, turning every patient
experience into a champion experience
❖ Global Healthcare Accreditation - GHA standards
❖ Charting Centers of Excellence - CCOE benchmarks
❖ World Health Organization - global health stats
❖ Best practice case studies
❖ To Be Process - breakdown workflows and management to
create a whole new eco system

9. Thank you for your time and feedback
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