The New Health Age: The Future of Health Care in America Jonathan Fleece Co-Author Advisor Health Care Attorney
IT IS MUCH MORE THAN THE QUOTE Health Insurance & Benefits Going Forward IT IS MUCH MORE THAN THE QUOTE
The Current Landscape of Health Care in America “America’s state of health, the economic models driving health care choices and costs, and America’s health care delivery systems do not adequately foster the right incentives for American Stakeholders to (1) increase the quality of their health, (2) improve health care service to everyone, or (3) control health care costs. This reality is contributing to the rapid decline of America’s pride, financial strength, and competitive advantage in a global marketplace. It is, therefore, essential for America to acknowledge, embrace, and foster The New Health Age.”
Who Are America’s Health Care Stakeholders? American companies of all sizes Individuals of every age - young, old and in between Public and private sectors Workers and employers Unemployed and employed Patients and health care providers, including physicians, nurses, hospitals, and long term care providers Payers and their beneficiaries Teachers and students Governments and citizens
The Dynamic Flows of the New Health Age There are nine dynamic flows that are and will reshape health care in the New Health Age They are grouped into three categories: How we THINK about health care How we DELIVER health care The ECONOMICS of health care
The Dynamic Flows About How We THINK About Health Care Sickness Wellness Ignorance Awareness/Understanding Opposition Alignment
The Dynamic Flows About How We DELIVER Health Care Treatment Prevention Reactive Proactive Episodic Wholistic
The Dynamic Flows of the ECONOMICS of Health Care Procedures Performance Isolation Integration Non-Efficient Efficient
The New Structure of Health Care Medical Homes Integrated Delivery Systems (IDS) ACOs and EACOs Star Rated Medicare Advantage Plans Health Insurance Exchanges
Medical Homes “Medical homes will function at the center of health care and be the catalyst for community-based collaborative care networks, expanding access to primary care and general health care services.” - David Houle and Jonathan Fleece “The New Health Age: The Future of Health Care in America”
Medical Homes Not physical structures Physician driven Patient centered Coordinated care Appropriate care
Integrated Delivery Systems
Accountable Care Organizations Think of top health care players coming together to collaborate in a board room Agree on sharing bundled, capitated, and performance bonus payments Contract with payers (government and private) Appropriate care Performance based
Employer Accountable Care Organizations (EACOs) Employer funded health care benefit plans New world around health management Health care network design and partnering Absenteeism management Workforce productivity oriented
Total Health Management Health Delivery Alignment EACOs EACOs Analytics Benefit Design Total Health Management Health Delivery Alignment
Workforce Health Management Today Employees Flu Injury Risk
Workforce Health Management Tomorrow Risk Flu Injury
What is the #1 Enemy Against a Workforce Health Incident?
Private Medicare Plans High Performance Provider Networks Agree on sharing bundled, capitated, and performance bonus payments 5 Star Rating System 85% of Medicare Funds Go To Health Care Services
Health Insurance Exchanges Travelocity, Expedia, Orbitz for health care insurance Shopping place for small business and “free riders” Must address health management
New Models for Agencies & Brokers Defining your market Health management Creating a competitive advantage Can smaller agencies survive?
The New Health Age version of the Race to the Moon Goal: to make America the healthiest country in the world by 2025 www.theracetoahealthyamerica.org
Welcome to The New Health Age! jfleece@blalockwalters.com Twitter @JonathanFleece 941.920.0494