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PatientBond HFMA Tri-State conference September.12.2019.presentation
This document discusses using psychographic segmentation to enhance revenue collection from patients. It begins by outlining how patient financial responsibility is increasing and how patients prefer more digital payment options. It then describes five common psychographic patient segments - Self Achievers, Balance Seekers, Priority Jugglers, Direction Takers, and Willful Endurers - and how their characteristics relate to likelihood of paying bills and preferred payment methods. The rest of the document discusses how a digital platform can implement psychographic segmentation to personalize patient financial communications and improve collections rates.
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PatientBond HFMA Tri-State conference September.12.2019.presentation
- 1. Psychographic Segmentation: UsingConsumer Industry Methods to Enhance Revenue and Patient Collections Brent Walker, SVP Marketing & Analytics Mike Schiller, SVP Sales
- 2. 2 Psychographic Segmentation –The Foundation https://www.patientbond.com/patient-classifier
- 3. 3 Patient Responsibility –The Changing Landscape Patient Balances Are and Increasing Portion of Healthcare Provider Revenue • Patient Out-Of-Pocket Healthcare Costs – Increased 30% since 2015 • 2016 – 68% Failed to pay of Medical Balances • 2020 – Estimated 95% will fail to pay Medical Balances • 2018 - > 30% of the average healthcare bill comes from the patient pocket! • It costs 4x more to collect from a patient than an insurance company
- 4. 4 Patient Responsibility –Have We Changed? How Patients Feel About Paying Their Balances • 70% of Patients are frustrated with the self pay billing process • 65% of Patients would consider switching providers if payment experience was easier AND more convenient! • 79% of Patients STILL receive a paper bill • 80% of Patients would prefer to pay their bill via their own secure mobile device Thank you for visiting Priority Medical on 7/10. We have submitted your claim to insurance. Please call us with any questions @ 312-445-8750. Reply X to opt out.
- 5. 5 Patient Responsibility Increasing everyyear (>30%) Aggressiveness of Collection Effort Balance Patient Satisfaction and Loyalty PFR – The Dilemma Facing Healthcare Providers Providers need to meet the Healthcare Consumer how THEY prefer, when they want and how they want with options and convenience aligned to what motivates them in order for them to act. Hint: It is not a paper statement!
- 6. 6 WHAT’S THE PROBLEM? WHILEHEALTHCARE CONSUMERS AND PROVIDERS SEE VALUE, PATIENT ENGAGEMENT TECHNOLOGY SIMPLY ISN’T VERY ENGAGING D E L I V E R Y “One channel fits all” doesn’t engage or activate C O N T E N T “One message fits all” approach doesn’t resonate “Digital Health is not a computer science or an engineering science. It is a … behavioral science. Creating the tech isn’t the hard part. The hard part is using the tech to change patient behavior”. Dr. Brennan Spiegel Cedars-Sinai Medical Center Fortune – April, 2018 R E S I S TA N C E Lack of compelling content and delivery causes patients to ignore or procrastinate U N D E R P E R F O R M A N C E Patient outcomes and practice operations miss expectations
- 7. 7 INFLUENCING BEHAVIOR WITHDIGITAL RELATIONSHIPS CLOUD MANAGED SERVICES PLATFORM FOR HEALTHCARE CONSUMER ENGAGEMENT U N D E R S TA N D G R O W M A R K E T S H A R E I M P R O V E PAT I E N T C O L L E C T I O N S O P T I M I Z E C A R E Self Achievers Balance Seekers Willful Endurers Direction Takers Priority Jugglers DELIVER FIVE VARIATIONS OF THE SAME CORE MESSAGE BY CHANNEL ANALYZE PATIENT RESPONSES AND DETERMINE NEXT ENGAGEMENT CLASSIFY INTO FIVE DISTINCT PYSCHOGRAPHIC SEGMENTS OK OK Alert care team Send next email in 2 days + text in 5 days OK October Campaign Two way SMS Texts Email Messaging Phone with IVR/Live Transfer Smartphone Apps Third Party Web Portals Print Server for Mailings C o n s u m e r I n s i g h t s E N G A G E D i g i t a l O u t r e a c h A D J U S T N e x t B e s t A c t i o n
- 8. 8 Psychographics and TheHealthcare Consumer
- 9. 9 Healthcare Consumer Segmentation SURFACE DEEP I N S I G H T S Behavioral ValuesAttitudes Interests Motivations Buying habits Website Visits Search History Age Race Income Gender Psychographics Demographics *Advantages – More effective in resonating with a consumer’s motivations and unarticulated needs
- 10. 10 PSYCHOGRAPHIC SEGMENTATION APPLYING A CONSUMERMARKETING APPROACH TO HEALTHCARE SERVICES AND COLLECTIONS • Attitudes, values, lifestyles and personalities and are the key to understanding healthcare consumers’ motivations. • Segmenting people by these characteristics allows you to target and deliver communications that resonate more effectively and increase the likelihood of behavior change.
- 11. 11 15 minutes could saveyou 15% or more on insurance! Segmentation In Action
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- 13. 13 EXT ENSI VE RESEARCH OUTCOME : ONE SI ZE F I TS ONE PATIENTBOND COMBINES PROPRIETARY BEHAVIORAL SCIENCE WITH MULTI-CHANNEL COMMUNICATIONS TO AMPLIFY DIGITAL RELATIONSHIPS PRIORITY JUGGLERS Busy with things other than health Reactive to personal health Proactive with family health DIRECTION TAKERS Deeply trust healthcare providers Visit doctor at first sign of issue May not follow advice due to other responsibilities SELF ACHIEVERS Proactive, driven by appearance Treatment and screening diligence Task oriented, challenge driven 18%19% 15% WILLFUL ENDURERS Live in the here and now Do what they like, when they like Self-reliant and resilient Only visit doctor when necessary 31% BALANCE SEEKERS Proactive and wellness-oriented Open to ideas and options Self-defined success Providers are resources 17%
- 14. 14 14 Self Achievers • Themost proactive when it comes to their wellness, investing what is necessary toward their health and appearance • Task oriented, and will tackle a challenge if they are given measurable goals
- 15. 15 15 Balance Seekers • Generallyproactive in their health and are wellness- oriented • Open to many ideas, sources of information, and treatment options when it comes to their healthcare • Physicians are just one of many sources of healthcare information
- 16. 16 16 Priority Jugglers • Verybusy with many responsibilities • May not take the time to invest in their own wellbeing • However, very proactive when it comes to their family’s health
- 17. 17 17 Direction Takers • Believetheir physician is the most credible resource • Look to healthcare professionals for direction and guidance because of their expertise and credentials
- 18. 18 18 Willful Endurers • Livein the “here and now” • Self-reliant; go to the doctor only when they must • Focuses on the first/next step
- 19. 19 LIKELIHOOD to PayMedical Bills If facing financial hardship, how likely would you pay your bills on time for the following healthcare providers Self Achievers and Priority Jugglers are the likeliest segments to pay their medical bills Willful Endurers and Balance Seekers are the least likely to pay their medical bills (however, Balance Seekers are generally healthy and do not utilize the healthcare system frequently)
- 20. 20 ATTITUDES Around PayingMedical Bills Why the segments are likely (or unlikely) to pay their medical bills Willful Endurers are the most likely to believe that financial hardships challenge their ability to pay their medical bills HOWEVER: There is no statistical difference among the segments in annual household income below $80K (median U.S. household income is $59K) This is a matter of priorities and choices and the ability to motivate positive health (and payment) behaviors
- 21. 21 Preferred Method ofBalance Due Notification – Our Data PatientBond knows, and can execute, the right segment-specific messaging and channel mix to make each segment aware of Balances Due…
- 22. 22 Paying Healthcare Bills– Preferred Method – Our Data Preferred Method for Making an Out-of-Pocket Payment for a Balance Due Self Achievers a Balance Seekers b Priority Jugglers c Direction Takers d Willful Endurers e Online payment via credit card (Digital) 44% 45% 44% 40% Online payment via Paypal 8% 6% c 3% 5% Online payment via HAS (Health Savings Account) card 7% 8% d 6% 5% Payment by phone (call provider with payment information) 5% 4% 4% 4% Payment by smartphone app (fill out form on phone with payment information) 1% > > > Mail in payment (e.g., U.S. Postal Service) 18% 17% e 22% be 22% be Pay in person at the provider’s facility 13% 15% 15% 15% Other 1% 2% a 2% 3% ae None of these 3% 3% 3% 6% ab … AND PatientBond knows each segment’s preferred Method of Payment and can steer them there to maximize the likelihood of paying Balances Due
- 23. 23 Self Achievers 19% Achieve theGoal; Improvement Balance Seekers 17% Choices, Options; Knowledge; Context Priority Jugglers 18% How the Family/Others Benefit; Commitment, Duty Direction Takers 15% Expert, Credentialed Physician Says So Willful Endurers 31% Here & Now; Live For Today; First Step 23 Every Segment Has a Different Engagement Strategy
- 24. 24 “We are lookingat healthcare choices through the eyes of the healthcare consumer NOT how we think the consumer sees healthcare choices!” How Patients View Things
- 25. 25 COMMUNICATIONS PREFERENCES BYSEGMENT PFR MARKETING SURVEYSCLINICAL Balance Seeker Every month Every 2 months Every 2 monthsEvery month Willful Endurer Every 3 weeks Every 3 weeks Every 3 weeks Every 2 weeks Priority Juggler Every month Every 2 months Every 2 monthsEvery month Self Achiever Every 2 weeks Every 2 weeks Every 2 weeks Every 2 weeks Direction Taker Every month Every 2 months Every 3 weeks Every 2 months
- 26. A Digital PatientFinancial Responsibility (PFR) Solution – How To Do It!
- 27. 27 A Psychographic SegmentedPFR Platform 41% 20% 19% 10% 10% • Client Satisfaction - Patients Prefer It! • Cost Avoidance • Labor – Outbound Collection Effort • Paper – Statement Volume and Collection Letters • Collection Agency Fees (Small Balance example) • Utilize text, IVR, and email channels (By Segment) to facilitate faster payments • Drive traffic to your online bill pay portal • Reduce Average Days Outstanding (DSO) for patient responsibility bills • Reserve recovery – EBITDA improvement
- 28. 28 SEGMENTED MESSAGE PFRDIGITAL WORKFLOW OPTIONS Interventions in the PFR Revenue Cycle • Billing Process – Education and Payment options (70% Confused) • PFR Notification of Balance Due and will be sent via (text, email or statement) Pre-Statement • Statement sent (If Provider chooses) • Text, email or statement sent • Thank You - Payment received notification • 2nd reminder if no payment received • 3rd, 4th or 5th reminder if no payment received – Different channels • Opt out and notification • Small Balances - Digital 0 – 90 Days (Early Out) + Suppressed statements and small balances + Payment Plan options by segment + Pre-Collections notification 90+ Days and Bad Debt Patient Financial Responsibility (PFR) Revenue Cycle Prior To Statement Single Statement No Statement
- 29. 29 Regulatory Compliance 41% 20% 19% 10% 10% TheTelephone Consumer Protection Act (TCPA) regulates telemarketing calls, auto-dialed calls, pre-recorded calls, text messages, and unsolicited faxes. The TCPA primarily applies to telemarketing calls. The following messages (among others) are excluded (these types of communications are allowed under TCPA). • Debt collection calls by a creditor, the consumer has given the cell phone number to creditor for use in normal business communications • Health Care messages made by, or on behalf of, a “covered entity” or its “business associate,” as those terms are defined in the HIPAA Privacy Rule *PatientBond always provides Opt-Out capabilities Best Practice: use an Opt-In I understand that Priority Medical may contact me by telephone (including mobile phone), and its affiliates or agents may use pre-recorded/artificial voice messages, an automated telephone dialing system, text messages or email for any communication related to my account(s). I understand and acknowledge that such communication methods may not be secure.
- 30. 30 How Do YouSegment a Healthcare Consumer? Classifier – 91.1% Pre-Segmentation Psychgraphic Segment Client Nat Average Variance 1 -Self Achiever 17.18% 18.40% -1.22% 2 -BalanceSeeker 13.86% 17.39% -3.53% 3 -Direction Taker 14.13% 15.42% -1.29% 4 -Priority Juggler 20.99% 17.41% 3.58% 5 -Willful Endurer 33.84% 31.32% 2.52%
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- 32. 32 Early Out Workflows– Education and Status 41% 20% 19% 10% 10% Day 0-30: Charge is submitted to insurance Thank you for visiting Priority Medical on 7/10. We have submitted your claim to insurance. Please call us with any questions @ 312-445- 8750. Reply X to opt out. * The goal of Early Out Workflow is to work with the current process that is being used and to inject digital messages into the workflow. Ultimately, this will allow the customer to decide whether 2nd or 3rd statements and collection letters are needed or not. PatientBond recommends doing both and within 60 days of live date to determine steps on statement suppression.
- 33. 33 Pre or InitialStatement Messaging 41% 20% 19% 10% 10% Msg from Priority Medical- We received your insurance payment for your 8/5 visit. Your remaining balance of $45 is now ready for payment. Click here to pay online or call 312-445-8750 to pay by phone. Your acct# is 4321. Thank you. Reply X to opt out. Day 9-23: Claim is paid, PFR is established • Message sharing with the patient that his/her statement is processed and ready for payment. Frequency or channel varies based on patient segment. • Facilitate quicker payments and keep patients out of the statement cycle Easy to do now! Msg from Priority Medical-Your insurance has paid and the payment for Mike’s visit on 8/5 for $45 is due. Please go to ppay.url or call us @ 312- 445-8750 to make the payment. Your account # is 65432. Thanks for your prompt attention! Reply X to opt out this campaign. Willful Endurer
- 34. 34 Payment Options –Segmented Email + 2nd Notice (Text first) + Worries about effect of healthcare bills on their finances + Optional – Offer payment alternatives 5 days after 1st notice to this segment earlier based on consumer insights + Prefers online bill payment and doesn’t need detail Willful EndurerDear first name last name, You want to make every day the best day possible, and we thank you for choosing Organization Name to help make this happen! We have billed your insurance for your last office visit, and according to your financial plan, your portion of the balance is now due. As a service to you, we have several ways for you to make this payment. Please click on the link that is best for you: • Client Name payment portal • Patient portal for eStatement and balance detail • If you have any questions related to you bills or to make a payment, please contact our billing office at organization phone. Thank you for addressing this immediately and letting us strive to earn your trust Sincerely, Organization Name This email was sent from a notification-only address. PLEASE DO NOT REPLY TO THIS EMAIL. (NOTE-Add standard Opt Out Language)
- 35. 35 Sample (Non Segmented)Past Due Workflows 41% 20% 19% 10% 10% Day 30: Patient is now past due Courtesy reminder from Priority Medical that the payment for your visit on 6/10 for $45 is now 30 days past due. Click here to pay online or call 312- 445-8750 to pay by phone. Your acct # is 4321. Thanks for your prompt attention! Reply X to opt out. Day 60 Reminder from Priority Medical that the payment for your visit on 5/10 for $45 is now 60 days past due. We understand you may be busy, so you can easily click here to pay online or call 312-445- 8750 to pay by phone. Your acct # is 4321. Reply X to opt out. Day 90 Your payment of $45 for the 4/10 visit to Priority Medical is now more than 90 days past due. It is urgent that you call us @ 312-445-8750 or go to ppay.url to make the full payment to protect your credit rating. Your account # is 4321. Reply X to opt out.
- 36. 36 Bad Debt, SmallBalances and Suppressed Statement Workflows 41% 20% 19% 10% 10% • Digitally reach out to those patients that have balances that have been written off or statements are being suppressed due to small balances. • PatientBond recommends, for bad debt, that the customer identify balances for patients that have a balance due and have not been to a client facility in a determined period of time (for example; the last 6 months). Msg from Priority Medical- You have an outstanding balance of $45 from your 10/15/18 visit. Click here to pay online or call 312-445- 8750 with any questions or to pay by phone. Your acct# is 4321. Thank you. Reply X to opt out.
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- 38. 38 RESULTS LEARN MORE By month2 (60 Days) of deployment 5x ROI Reduction in Statement Volume 24% Increase in patient payments within 10 days of ”Go Live” 4x Increase in patients making payments from Baseline 60.9% Increase in amount of payments paid via portal 49.5% Increase Bad Debt Balances Collected 14-25%
- 39. 39 RESULTS LEARN MORE 50 LocationClient (10,000+ Patients) Statements Suppressed 5 days (By Design) Pre Statement Messaging – PatientBond Digital Workflow 24% Paid PRIOR to Statement Run Within 5 Days of PFR Transfer Date Estimated 22% Statement Cost Reduction
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- 41. 41 THANK YOU Mike Schiller SeniorVice President mike.schiller@patientbond.com (303) 453-9484 Brent Walker SVP Marketing & Analytics brent@patientbond.com (513) 314-5981
Editor's Notes
- #4 PATIENT ACQUISITION Patient Surveys New patient welcome and information Wellness program enrollment and adherence Wellness program reactivation New patient campaigns Patient Marketing Patient Portal Promotion Explanation of Benefits / Deductible / Co-pay / Patient Responsibility Communications On site Clinic / Telemedicine promotions PATIENT LOYALTY Care gap screening reminders - Breast cancer screening, Colorectal cancer screening, Cervical Cancer screening, Hypertension screening, Diabetes Eye exams, Clinical Depression screening, etc. General Health and Wellness notifications (Exercise, Activity, Diet) Immunizations and Vaccinations Reminders – Flu, Infant and Baby, Tetanus, Pneumonia, etc. Appointment Reminders Referral reminders and Patient Payment Reminders Health Reminders: Annual Physicals, Flu shots, Sports Physicals, Employer Physicals, Drug Screenings, Biometric Provider feedback-NPS score Visit Follow ups Screenings, BMI Screenings, etc. IMPROVED PATIENT OUTCOMES Readmission Reduction: CHF, COPD, AMI, Hip/Knee, Pneumonia, CABG Discharge Management: Spine, Oncology, CABG, Neuro, Stroke, etc. Physician Attribution (Choosing a Primary Care Physician) Chronic Disease Management: Diabetes, Heart Failure, Hypertension, Asthma, etc. Care Coordination Unnecessary ER Use Reduction Appointment set up after ER visit Treatment Adherence (such as complete all prescribed physical therapy appointments, or health coaching sessions) Medication Adherence (Specialty Pharmacy) Medication Refills
- #5 PATIENT ACQUISITION Patient Surveys New patient welcome and information Wellness program enrollment and adherence Wellness program reactivation New patient campaigns Patient Marketing Patient Portal Promotion Explanation of Benefits / Deductible / Co-pay / Patient Responsibility Communications On site Clinic / Telemedicine promotions PATIENT LOYALTY Care gap screening reminders - Breast cancer screening, Colorectal cancer screening, Cervical Cancer screening, Hypertension screening, Diabetes Eye exams, Clinical Depression screening, etc. General Health and Wellness notifications (Exercise, Activity, Diet) Immunizations and Vaccinations Reminders – Flu, Infant and Baby, Tetanus, Pneumonia, etc. Appointment Reminders Referral reminders and Patient Payment Reminders Health Reminders: Annual Physicals, Flu shots, Sports Physicals, Employer Physicals, Drug Screenings, Biometric Provider feedback-NPS score Visit Follow ups Screenings, BMI Screenings, etc. IMPROVED PATIENT OUTCOMES Readmission Reduction: CHF, COPD, AMI, Hip/Knee, Pneumonia, CABG Discharge Management: Spine, Oncology, CABG, Neuro, Stroke, etc. Physician Attribution (Choosing a Primary Care Physician) Chronic Disease Management: Diabetes, Heart Failure, Hypertension, Asthma, etc. Care Coordination Unnecessary ER Use Reduction Appointment set up after ER visit Treatment Adherence (such as complete all prescribed physical therapy appointments, or health coaching sessions) Medication Adherence (Specialty Pharmacy) Medication Refills
- #7 PROBLEM DEFINITION WHILE HEALTHCARE CONSUMERS AND PROVIDERS SEE VALUE, PATIENT ENGAGEMENT TECHNOLOGY SIMPLY ISN’T VERY ENGAGING So we asked ourselves, why is that? With all the focus on the benefits, all the incredible communications and collaboration technologies out there and a true desire by providers and patients alike to embrace patient engagement, why is it underperforming? The tools that providers have available today, no matter whether they are embedded in an EMR system, leveraging a powerful CRM system or as a stand alone mass communications tool are hindering actually progress and real world impact: A one message fits all approach disenfranchises people – they process information differently, they’re motivated by different stimuli, they place value of different elements of information Blasting email messages into the ether may connect with some, but not the majority of the desired audience The results: People feel overwhelmed People aren’t motivated to act People don’t make it a priority People can’t make a decision Dr. Brennan Spiegel from Cedars-Sinai sums it up: “Digital Health … is a behavioral science. Creating the tech isn’t the hard part. The hard part is using the tech to change patient behavior”.
- #8 WHAT WE DO Left side (how our solution works) UNDERSTAND Segment Healthcare Consumers by psychological type (survey or population database statistics) Robust segmentation model built on years of Healthcare Consumer marketing ENGAGE Communication using an adaptive digital workflow technology Configurable based on business and Healthcare Consumer requirements and desires Event, Intervals, Actions, Reactive, Proactive Channels: Email, Text, Phone Deliver customized content to change Healthcare Consumer behavior Impact Healthcare Consumers on their terms, driving engagement and action ADJUST Dashboards to Monitor Results and Adjust Tactics if Necessary Right side (business impact of our solution) GROW MARKET SHRE Increased appointments Reduced marketing costs More positive online reviews OPTIMIZE CARE COSTS Reduced readmissions Chronic care management Care gap closure Better treatment adherence PATIENT FINANCIAL RESPONSIBILITY / SELF_PAY Receivables reduction Increased staff productivity
- #11 PSYCHOGRAPHICS EXPLAINED Psychographic segmentation – it’s a big fancy term – but what it means is understanding consumer beliefs, motivations, attitudes and priorities as a way for to explain and predict consumer behaviors. Doing so enables them to connect with people and drive action – in the case of P&G, it’s generating sales and maintaining brand loyalty Several PatientBond team members have deep research and strategy experience in psychographics, they lead the psychographic development & research work for Procter & Gamble’s Healthcare division for over 20 years. READ SLIDE
- #14 SLIDE #3: PATIENTBOND IS THE SOLUTION Our solution is still rooted in technology as the great enabler everyone believes in, but with an important precursor – deep expertise in behavioral science that takes people’s feelings, values and beliefs into account FIRST. To truly change behaviors, PatientBond believes that your messaging must: Align with the patient’s values and beliefs Resonate with their priorities and preferences Speak in their “language” Makes sense to patients based on how they see the world By first thinking about “WHY” people do what they do, we’re able to help providers, hospitals, systems and payers amplify their digital patient relationships and actually realize behavioral changes and desired outcomes. Our proprietary research is rooted in the science of psychographics, which is the study and classification of people according to their attitudes, aspirations, and other psychological criteria. Our team comes from the consumer products goods industry, spending 2 decades developing customer profiles for Proctor + Gamble, one of the largest CPG companies in the world and one of the biggest users of behavioral science in marketing and advertising. The PatientBond team has spent the last 6 years developing highly accurate and dependable patient profile models for the healthcare industry that distill patient personas into 5 distinct types: Balance seekers Willful endurers Priority jugglers Self achievers Direction takers Our solution enables a sender to engage and communicate with their audience in a highly targeted and highly effective way by tailoring both the content of the message AND the communications channel of the message based on the specific needs, motivations and behaviors of the patient type.
- #20 Our proprietary PTP model is based on the
- #21 We have 6 years of technology development to establish robust, secure, and adaptive communications platform including emails, texts, IVRs, Apps Complex architecture supports simple user experience to dynamically adjust our outreach efforts…couple of items about the platform I want to point out…CLICK…..CLICK…CLICK
- #26 This is a sample of the type of the power of the data—this slide has dummy information, I wouldn’t give away the keys to the kingdom that easily….
- #29 PATIENT ACQUISITION Patient Surveys New patient welcome and information Wellness program enrollment and adherence Wellness program reactivation New patient campaigns Patient Marketing Patient Portal Promotion Explanation of Benefits / Deductible / Co-pay / Patient Responsibility Communications On site Clinic / Telemedicine promotions PATIENT LOYALTY Care gap screening reminders - Breast cancer screening, Colorectal cancer screening, Cervical Cancer screening, Hypertension screening, Diabetes Eye exams, Clinical Depression screening, etc. General Health and Wellness notifications (Exercise, Activity, Diet) Immunizations and Vaccinations Reminders – Flu, Infant and Baby, Tetanus, Pneumonia, etc. Appointment Reminders Referral reminders and Patient Payment Reminders Health Reminders: Annual Physicals, Flu shots, Sports Physicals, Employer Physicals, Drug Screenings, Biometric Provider feedback-NPS score Visit Follow ups Screenings, BMI Screenings, etc. IMPROVED PATIENT OUTCOMES Readmission Reduction: CHF, COPD, AMI, Hip/Knee, Pneumonia, CABG Discharge Management: Spine, Oncology, CABG, Neuro, Stroke, etc. Physician Attribution (Choosing a Primary Care Physician) Chronic Disease Management: Diabetes, Heart Failure, Hypertension, Asthma, etc. Care Coordination Unnecessary ER Use Reduction Appointment set up after ER visit Treatment Adherence (such as complete all prescribed physical therapy appointments, or health coaching sessions) Medication Adherence (Specialty Pharmacy) Medication Refills