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1 © Greenway Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons. Population Health: A Fundamental Shift in Practice Reimbursement
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2 © Greenway Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons. Why Population Health In 2013 the United Sates spent $3.8T – 21% GDP – on healthcare Kaiser 75% of the healthcare spend in the US is on patients with chronic conditions Heart Disease, Diabetes, Lung Disease Etc. “Medicare is Going Broke” Baby Boomers are entering Medicare at an alarming rate USA Today - 1 every 8 seconds in 2013 – 3.942M - 1 every 3 seconds by 2020 - 4.2M per year These numbers are staggering and have forced payers to reform healthcare
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3 © Greenway Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons. What has Medicare Done Lower Cost per Patient Reduce unnecessary ED Admissions Reduce ED Readmissions Reduce Duplicate Tests Population Health Risk Stratify Population Focus on high risk patients Prevention Experience of Care Engage Patients in their care Monitor and influence behavior
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4 © Greenway Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons. How Are Commercial Payers Responding Fee for Services Contracts are Declining in Reimbursement Within the next five years, over 80% of Reimbursements will be from “Value Based Contracts” – this will fundamentally shift Healthcare Economics Providers Will need to adjust to these changes to avoid seeing reimbursement reductions and ensure their participation in these higher reimbursement plans
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5 © Greenway Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons. Where Does the Data Come From How Does It Impact My Visibility Risk Stratification Care Gap Identification Patient Engagement Analytics Reporting Provider Engagement Care Coordination
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