Obesity Awareness Symposium: Advocate’s Approach to Population Health Management October 25 th 2013 Pankaj Patel MD MSc Senior Medical Director, Quality Improvement Advocate Physician Partners and Advocate Medical Group

“Knowing is not enough, we must apply Willing is not enough, we must do” Goethe

Market Trends and Health Reform: It’s A New Day Pressure on Commercial Payers Medicare Insolvency Medical Inflation>Economic Inflation Population Aging and Uninsured ‘Tragedy of the Commons’ Population Health Patient ExperienceCost Per Capita

Insurers Acknowledge Difficulty in Controlling… Utilization of High End Imaging Readmissions Outpatient Trend New Drugs & Technologies Ambulatory Sensitive Conditions 4

Options Reduce Unit Price ACO with aligned incentives to pursue ‘Triple Aim’ Pankaj Patel Population Health Cost Per Capita Patient Experience

Value Based Agreements 6 14 ACO=Accountable Care Organization

Population Health Management Patient Engagement Patient Wellness/ Self Management Support 7 Acute Disease Management Chronic Complex CM PCP Practice Team Model Of Care Medical Home Behavioral Health Data/Analytics Health Risk Appraisal Claims DataRisk Stratification Low Volume/High Dollar High Volume/Low Dollar

Obesity: Impact on Population Health – BMI>30 results in % increase in Mortality – Increase in HTN, DM, CVD, DJD – 36% increase in Medical costs Gluttony or Sloth or Both – Imbalance: Energy consumed and Used – BMJ 1995 Energy consumed declining but obesity increasing

Evolution of Clinical Integration 5 Performance Domains: – Chronic Disease Care – Health and Wellness – Efficiency – Care Coordination – Patient Experience Incentives For All Physicians: Move from pay for performance to pay for value contribution Value Contribution = Performance x Volume of patients managed x Coordination of Care factor

Obesity Related Measures 2012 – BMI Assessment 2013 – BMI Assessment and Follow Up 2015?

Summary Emerging payment models create a focus on population health management Population health requires –A new focus on wellness and health status –A team approach