1. #HASummit14 Session #11: Partners HealthCare Analytics Strategy for Bundled Payments and Risk Management Helen Chan, Senior Manager, Business Planning Pre-Session Poll Question On a scale of 1-5, how effective is your organization’s population health and accountable care strategy? 1)Not at all effective 2)Somewhat effective 3)Moderately effective 4)Very effective 5)Extremely effective 6)Unsure or not applicable Sree Chaguturu, MD, VP, Population Health Management

2. #HASummit14 About the organization Two large academic centers, multiple inpatient and outpatient facilities, 6,000 physicians Not-for-profit integrated delivery system, ACO Preparing for accountable care, population health management 2

3. #HASummit14 Population health management priority programs Primary Care Patient-Centered Medical Home (PCMH) High-risk care management (palliative care) Mental health integration Virtual visits Specialty Care Active referral management (curbsides) Virtual visits Procedural decision support (appropriateness) Patient reported outcomes Episodes of care (bundles) Care Continuum SNF care improvement (network/waiver/SNFist) Home care innovation (mobile observation/telemonitoring) Urgent care Patient Engagement Shared decision making Customized decision aids and educational materials Infrastructure Single EHR platform with advanced decision support Data warehouse, analytics, performance metrics 9

4. #HASummit14 And a reminder of why these programs… Primary Care Specialty Care Care Continuum Patient Engagement Infrastructure Develop team-based care Demonstrate value in bundles/procedures Reduce post-acute variation Empower patients in their care Information -> Insight -> Action Promote Medical Neighborhood 10

5. #HASummit14 Providing the Tools for PHM 11 Bundled payment management Managing at-risk populations Drivers impacting hospital, outpatient, and physician billing volume and margin 1 2 3

6. #HASummit14 Partners Population Insights: How are we performing on our risk populations? a) How does our trend compare to prior year and benchmark? b) What are the major changes in TME trend by key categories? - Resource area and site of care ‒ Service grouping ‒ Unit of action ‒ Demographics c) What are effective ways to visualize data to drive managerial action? d) What ways to leverage data to construct a story about PHM trend performance? 6

7. #HASummit14 Partners Population Insights: Dynamic QlikView Application to Analyze Trend 14

8. #HASummit14 Partners Population Insights: How the tool engages physicians in risk Empowered physicians and practices to assess trend performance of the system and of their own patients Used tool to engage physicians using their own data to identify areas of clinical and managerial action Developed a self-service model to make data easy, accessible, and not intimidating Generated more bi-directional communication between administrators (corporate and local) and clinical practices 16

9. #HASummit14 DRAFT Partners Episodes of Care: Improving clinical care while preparing for future payment arrangements 9 Identify areas of clinical variation with the greatest opportunity and/or within the physicians’ control Engage specialists Manage utilization, cost, and quality Objective: to reduce cost of episode (TME) and internal PHS costs; improve quality Prepare for CMS Episodic Payment  Assess Clinical Variation  Go to Market with Employers  Commercial Contracting  CMS Mandate on Hips/Knees Bundles to begin Jan 2016 in 75 geographic regions Objective: to reduce cost of episode (Total Medical Expense TME) Opportunity to Engage 3 rd parties directly (Employers, Other ACOs, etc.) Minimal traction with commercial payers historically Expect to follow CMS footsteps Not immediate priority

10. #HASummit14 Partners Episodes of Care: Screenshot of Variation Analysis 13

11. #HASummit14 DRAFT Partners Episodes of Care: Key questions answered by the tool 1) What is the average cost by episode and how is this shifting? 2) What is the distribution of episodes by cost and how is this trended? 3) How does my hospital and physician group compare with others and where are the outliers? 4) At the MD level, which cases are driving outlier status and why? 5) What caused complications for outlier cases? Did patients come in with that or caused by hospital/physician? 6) How much unmanaged variation is there month to month, year to year? Does the variation exceed what can be managed? 11

12. #HASummit14 12 Partners Healthcare Directions: Monitor hospital volume and margin trends when system is in both FFS and Risk Key Business Questions: How are the following impacting PHS volume and margin? Cost pressures and changing market dynamics Our local / system initiatives How are our Population Health Management efforts impacting our hospital business? Focus: System and hospital level volume and margin trends 1. Site of Care (Shift of high / low acuity cases) 2. Population Health Management 7. Patient Consumerism 6. EMASS Referrals / Market Consolidation 8. Shift in payer mix and other market dynamics 3. PHS Referral Strategy Drivers of Volume / Margin Change 5. Partners Employees Benefit Design 4. Primary Care Growth/ Ambulatory Planning

13. #HASummit14 Partners Healthcare Directions: Key questions and intended audiences In a fluid market environment, build an analytics tool that monitors actual hospital volume and margin trends in near real time Purpose Value Add Bring together data from multiple sources in one place to identify key drivers of trend across facets of our business Generating market context for observed trends Focus analysts’ time on high value areas Intended Audiences Provide business intelligence to Senior Finance, Clinical, and Administrative leaders to develop strategy and understand trends Serve as basis for a new quarterly report to senior system and hospital leaders 13

14. #HASummit14 Understanding Impact of PHM on Hospitals 14

15. #HASummit14 Poll Question #2 15 On scale of 1-5, how effectively is your organization using healthcare analytics to support population health and manage at-risk contracts? 1)Not at all effective 2)Somewhat effective 3)Moderately effective 4)Very effective 5)Extremely effective 6)Unsure or not applicable

16. #HASummit14 Results Developed and implementing a comprehensive PHM strategy Successfully integrated hospital, provider, and claims information to evaluate, compare, and improve clinical and financial performance Made actionable information readily accessible to managers Used customized groupers to develop service and clinical groups to accurately attribute TME Identified non-analytic criteria for success Made meaningful progress toward a data-driven culture 16

17. #HASummit14 Future Plans 17 Continue journey to a data-driven culture Continue to enhance PHM applications Continue to improve governance capabilities Increase adoption and tracking of outcomes and effectiveness

18. #HASummit14 Lessons Learned 18 1.Know what business and clinical questions you want to answer 2.Involve the right people 3.Take a rapid-cycle failure and improvement approach 4.Data is not enough – need to build clinical programs that take advantage of the insights garnered from the data 5.Building these self-service tools can become overwhelming for the organization

19. #HASummit14 Analytic Insights A Questions & Answers 19

20. #HASummit14 Choose one thing… 20 Write down one thing will you do differently after hearing this presentation

21. #HASummit14 Thank You 21

22. #HASummit14 22 Session Feedback Survey 1.On a scale of 1-5, how satisfied were you overall with this session? 1)Not at all satisfied 2)Somewhat satisfied 3)Moderately satisfied 4)Very satisfied 5)Extremely satisfied 2.What feedback or suggestions do you have?

23. #HASummit14 Upcoming Speakers 3:45 PM – 4:35 PM 16)Delivering Excellence at Stanford Health Care Amir Dan Rubin, President and CEO, Stanford Health Care 4:35 PM – 5:00 PM 17)The Future World of Value-Based Healthcare (Documentary featuring Michael Porter) Caleb Stowell, MD, Vice President, Research and Development, International Consortium for Health Outcomes Measurement (ICHOM, Senior Researcher, Harvard Business School) 23 Location Grand Ballroom