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Contact:
DavidParpart,D.C.,CEO
Socially Relevant Inc
408-421-9508
drparpart@impactmeds.com
What’s an ACO?
Accountable Healthcare Platform for Patient Engagement Solutions
Pharmacist Counseling | Mobile Applications | Remote Monitoring
Drivers of Healthcare Reform
Economics
Healthcare Reform Puts
6% of Hospital Revenue at Risk
2% annual payment
update at risk by FY2017
1% DRG payment
penalty FY2013, rising
to 3% by FY2015
1% DRG payment
penalty for hospitals in
worst quartile
beginning FY2015
•Value-based Purchasing
•Process of care
•Patient experience Begins
FY2013
•30-Day Readmissions
•Up to 8 conditions
targeted including AMI, HF,
PNA
•Hospital-Acquired
Conditions
•Up to 8 conditions
targeted
Confidential- Socially Relevant Inc.
What’s an ACO?
Confidential- Socially Relevant Technology
Confidential- Socially Relevant Inc.
Confidential- Socially Relevant Technology
Al a Carte All Inclusive
A Business Model
Volume vs. Capitation
Accountable Care Organization (ACO)
Accountable Care Organization (ACO)
Risk and Reward
Every Hospital has risk of loss/penalties
2/3 penalized in Oct 2012
Health Organizations APPLY to form an ACO
Assume risk
Gain NEW REVENUE OPPORTUNITY through
Medicare Shared Saving Program
ACO’s Need New Patient Engagement Strategies
Section H of the MSSP Application
ACO – Healthcare’s New Business Model
Value Based Purchasing and Shared Savings
Better
Care
Experience
Lower
Costs
Better
Population
Health
Metrics:
Patient Experience
Patient Activation Measures
Metrics:
Readmission Rate
Total PMPM & Trend
Metrics:
HEDIS
Cost Savings  New
Revenues
Capitated Payment
ACO – Healthcare’s New Business Model
Example: Nephrology
Better
Care
Experience
Lower
Costs
Better
Population
Health
Doctor/Pharmacist/Patient
Collaboration
$178M Reduction in Part A
$ 23M Increase in Part D
$155M net savings
Cost Savings  New
Revenues
Capitated Payment
$155M net savings X 60% = $90M
What is the Lowest Hanging Fruit
for ACO Profitability?
$700Bn
$290Bn
$30Bn
• Duplication of
Services
• Fraud
• Poor Med
Adherence
• Avoidable
Hospitalizations
Confidential Do Not Distribute
Value based purchasing prebacked
Value based purchasing prebacked

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Value based purchasing prebacked

  • 2. Accountable Healthcare Platform for Patient Engagement Solutions Pharmacist Counseling | Mobile Applications | Remote Monitoring Drivers of Healthcare Reform Economics
  • 3. Healthcare Reform Puts 6% of Hospital Revenue at Risk 2% annual payment update at risk by FY2017 1% DRG payment penalty FY2013, rising to 3% by FY2015 1% DRG payment penalty for hospitals in worst quartile beginning FY2015 •Value-based Purchasing •Process of care •Patient experience Begins FY2013 •30-Day Readmissions •Up to 8 conditions targeted including AMI, HF, PNA •Hospital-Acquired Conditions •Up to 8 conditions targeted
  • 4. Confidential- Socially Relevant Inc. What’s an ACO? Confidential- Socially Relevant Technology
  • 5. Confidential- Socially Relevant Inc. Confidential- Socially Relevant Technology Al a Carte All Inclusive A Business Model Volume vs. Capitation
  • 7. Accountable Care Organization (ACO) Risk and Reward Every Hospital has risk of loss/penalties 2/3 penalized in Oct 2012 Health Organizations APPLY to form an ACO Assume risk Gain NEW REVENUE OPPORTUNITY through Medicare Shared Saving Program ACO’s Need New Patient Engagement Strategies Section H of the MSSP Application
  • 8. ACO – Healthcare’s New Business Model Value Based Purchasing and Shared Savings Better Care Experience Lower Costs Better Population Health Metrics: Patient Experience Patient Activation Measures Metrics: Readmission Rate Total PMPM & Trend Metrics: HEDIS Cost Savings  New Revenues Capitated Payment
  • 9. ACO – Healthcare’s New Business Model Example: Nephrology Better Care Experience Lower Costs Better Population Health Doctor/Pharmacist/Patient Collaboration $178M Reduction in Part A $ 23M Increase in Part D $155M net savings Cost Savings  New Revenues Capitated Payment $155M net savings X 60% = $90M
  • 10. What is the Lowest Hanging Fruit for ACO Profitability? $700Bn $290Bn $30Bn • Duplication of Services • Fraud • Poor Med Adherence • Avoidable Hospitalizations Confidential Do Not Distribute

Editor's Notes

  1. Today, only a couple EMRs have an app store and basic developer sandbox for innovators.
  2. Today, only a couple EMRs have an app store and basic developer sandbox for innovators.