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Population Health: Prediction in Sensitivity through Cluster Analysis

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Keynote by Katherine J Sullivan, PhD, PT, FAHA, CEO & Founder, Health, Education, & Technology Institute at the Smart Health Conference 2018, held at Bally's Las Vegas on the 26-27th of April, 2018.

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Population Health: Prediction in Sensitivity through Cluster Analysis

  1. 1. 527 Molino Street, Suite 307 Los Angeles, CA 90013 Population Health: Prediction in Sensitivity through Cluster Analysis Katherine J Sullivan, PhD, PT, FAHA CEO & Founder Health, Education, & Technology Institute
  2. 2. 811 Traction Ave Los Angeles, CA 90013 360wellness_solutions.net ASK THE RIGHT QUESTION HOW DO WE ACHIEVE THE TRIPLE AIM OF HEALTHCARE REFORM?
  3. 3. 811 Traction Ave Los Angeles, CA 90013 360wellness_solutions.net BETTER HEALTH OF LOCAL COMMUNITY. BETTER HEALTHCARE BY MEDICARE COMPLIANT ACO PROVIDERS. AT REDUCED COST TO MEDICARE, MEDICARE HMOs, & any global City
  4. 4. 527 Molino Street, Suite 307 Los Angeles, CA 90013 healthedtech.org Technology Inflection Point: Best care, at the right time, by the most appropriate provider Molina Healthcare - Rehabilitation Services Proposal Technology Partners Reduced health cost: Bundled payment Clinical Outcomes Rehabilitation & Disability Services
  5. 5. 527 Molino Street, Suite 307 Los Angeles, CA 90013 LA City Population 3,976,322 Children 0-18 yrs 918,530 Healthy 861,581 Special Needs 56,949 Adults 19-64 yrs 2,649,278 Healthy 2,485,581 Special Needs 163,697 Seniors 65+ 417,514 Healthy 229,633 Impaired 187,881 POPULATION HEALTH = PUBLIC HEALTH Dual eligible Children Adults Seniors 408,527 eligible for Rehab Services
  6. 6. 527 Molino Street, Suite 307 Los Angeles, CA 90013 MICRO ECONOMIES: The Art District/DTLA area is transitioning to a LA version of SOHO. Within a 2-mile radius of the Arts District, lives a population of 165,000; 44% are female girls, women, and seniors (72,600 pop). CLUSTER ANALYSIS:
  7. 7. 527 Molino Street, Suite 307 Los Angeles, CA 90013 The majority of residents are between 25 – 44 yrs with a median income of $27,000 compared to national median of $56,000. There is a serious shortage of Women’s Health professionals in the target area and business’ owned by women are floundering POPULATION ANALYSIS
  8. 8. 527 Molino Street, Suite 307 Los Angeles, CA 90013 MediCal City of LA Managed Medicare HOMELESS POPULATION ANALYSIS:  Mother’s & Children  Mentally ill  Physically disabled (need wheelchair)  Senior with dementia CONSEQUENCE:  High cost to City of LA  High cost to Hospital  Poor health of homeless  Health insurance but no healthcare to child or adult
  9. 9. Covered California HMO Membership 5/3/2018 Copyright - Intellectual Property of Dr Katherine Sullivan & Health, Education, & Technology Institute 6.3M “Big Brand” Members Full Services Healthy Temporarily Disabled Disability Services Poverty Services Eligible for Medicaid Social Services ≤ 200% FPL Eligible for Medicare Services Functional Disability Senior Services Developmental Disability Services Severe Mental & Physical Disability Homeless with dementia Homeless with substance abuse
  10. 10. DEGREES OF FREEDOM: 1-year Post-Acute Care Recovery Program Recovery Phases Acute Hospital Admission Physiologic Recovery Strength & Conditioning Resiliency Building Community Re- integration Estimated Timeframe Critically ill Acute or chronic infection 65+ or disabled Post-Acute 1 dy – 90 days Months 4-5-6 Months 7-8-9 Months 10-11-12 Settings Trauma Center, Community Hospital, Critical- access Hospital, ER Skilled Nursing Facility (SNF) Long Term Care Home with Home Health Inpatient Rehab Outpatient Medical, dental, mental health, rehabilitation practice settings Outpatient Medical, dental, mental health, rehabilitation practice settings Outpatient Medical, dental, mental health, rehabilitation practice settings Medicare covered services Medicare Part A Hospital (inpatient) Medicare Part A IRF/ SNF/LTAC (inpatient) Medicare Part B Medical Medicare Part B Medical Medicare Part B Medical Medicare Part B Medical Medicare Part B non- physician professional services (Inpatient rehab) Medicare Part B non- physician professional services Medicare Part B non- physician professional services Medicare Part B non- physician professional services Patient experience Location & Services Complicated discharge plan (homeless, no family, severe) Transitional care (Inpatient SNF/ homeless mental health) Nursing & Rehab Services Assisted living at home with in-home support Rehab Services Team Occupational therapy Rehab Services Team Work re-entry Rehab Services Team
  11. 11. Technology Inflection Point: Do Well & Do Good Molina Healthcare - Rehabilitation Services Proposal
  12. 12. 527 Molino Street, Suite 307 Los Angeles, CA 90013 https://youtu.be/gQFpsIdRF6s How can block chain technology transform the healthcare space? What could this mean to increasing access to affordable, timely, effective healthcare for underserved populations?
  13. 13. 527 Molino Street, Suite 307 Los Angeles, CA 90013 Case Study: Child Poverty Collaborative of Cincinnati & Northern Kentucky
  14. 14. 527 Molino Street, Suite 307 Los Angeles, CA 90013
  15. 15. 527 Molino Street, Suite 307 Los Angeles, CA 90013 Technology Partner Health Services Parner Financial Partner
  16. 16. 527 Molino Street, Suite 307 Los Angeles, CA 90013 Bringing goodness together. https://innovation.cms.gov/initiatives Next-Generation-ACO-Model/
  17. 17. 527 Molino Street, Suite 307 Los Angeles, CA 90013 Better health of our families. Coordinated care between Medicare professionals. Savings for Medicare.
  18. 18. 811 Traction Ave Los Angeles, CA 90013 360wellness_solutions.net Los Angeles Population eligible for Medicare Part B Rehab & Recovery Health Home Services 57,000 CHILDREN 164,000 ADULTS 188,000 SENIORS 409,000 HEALTH HOME MEMBERS
  19. 19. 527 Molino Street, Suite 307 Los Angeles, CA 90013 healthedtech.org  3+ health conditions  2 or more ADL limitations (difficulty walking, talking, living alone, homeless)  severe cognitive (dementia) or motor (paralysis)  85 or older  Developmental Disabilities  Chronic Health Conditions  Mental Health Conditions with or without Addiction  Long Term or End-of-Life Care Management HMO Payor plans control practice, payments, and hospitals: Technology can create savings through coordinated care Referral from: Disability Service Providers for Children & Adults with: Primary Care Doctor Hospital ER Or Community Clinic HMO Managed MediCal or Medicare health plan
  20. 20. 811 Traction Ave Los Angeles, CA 90013 360wellness_solutions.net Financial projections for LA based on NY State Medicaid Health Home mid-severity rate: 40,900 (10% capture of 409,000) $235 per member per month 9.6M per month (115M per yr)
  21. 21. 527 Molino Street, Suite 307 Los Angeles, CA 90013 The Touchstone Survey notes that “participants appear to be in a "wait and see" mode – rather than considering broader and more transformational changes, they continue to use traditional cost-shifting approaches to control health spend;” and that “57% of participants expect to continue to increase employee contributions in the next three years, while 38% (29% for Rx) plan to increase employee cost-sharing through plan design changes.” Accountable Care: Better health. Better healthcare. Reduced cost to society.
  22. 22. 811 Traction Ave Los Angeles, CA 90013 360wellness_solutions.net BETTER HEALTH OF LOCAL COMMUNITY. BETTER HEALTHCARE BY MEDICARE COMPLIANT ACO PROVIDERS. AT REDUCED COST TO MEDICARE, MEDICARE HMOs, & any global City ASK THE RIGHT QUESTION HOW DO WE ACHIEVE THE TRIPLE AIM OF HEALTHCARE REFORM?

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