Gaining Buy-In Toolkit
Showcasing the Value of the MLP Approach
2
Gaining Buy-In Toolkit
Prepared Slides to Showcase Value of MLP Approach
What should you use the toolkit for?
Hospital board
meeting presentations
Provider education on
benefits of MLP model
Other hospital or
community meetings
Directions for using toolkit
• Copy and paste slides 3-8 into the beginning of
your presentation to hospital / clinic executives
• Insert data from your MLP into slide 8
– *Note: If suggested data points are unavailable,
select accessible and relevant metrics that
showcase value of MLP
©2015 The Advisory Board Company • advisory.com
Source: The Advisory Board Company interviews and analysis.
3
Social Determinants Driving Patient Outcomes
Social and Environmental Risk Factors
15%
Substandard,
Unsafe Housing
Unstable
Family Income
Lack of Health
Insurance
2x
Environmental Insufficient Access
Hazards
to Food
©2015 The Advisory Board Company • advisory.com
Inadequate
School Services
Premature deaths in the
U.S. attributed to social
circumstances
Annual short-stay hospital
episodes for children in
poverty compared with
children in non-poverty
Source: J. Michael McGinnis, et. al, “The Case For More Active Policy Attention To Health Promotion”, Health Affairs, March 2002, available
at: http://content.healthaffairs.org/content/21/2/78.long. Katherine Magnuson and Elizabeth Votruba-Drzal, “Enduring Influences of Childhood
Poverty”, Vol. 26, 2009, available at: http://www.irp.wisc.edu/publications/focus/pdfs/foc262f.pdf; Jeanne Brooks-Gunn, “The Effects of
Poverty on Children”, Children and Poverty, Vol. 7, No. 2,1997, available at:
http://www.princeton.edu/futureofchildren/publications/docs/07_02_03.pdf/; The Advisory Board Company interviews and analysis.
4
Medical Approach Alone Often Not Enough
Legal Intervention Required for Complex Social Needs
Medical
Needs
Patient presents with problems
that may be managed through
a standard medical intervention
50%
1-3
Health and wellness impacted
by psychosocial factors that
Psychosocial require social worker, case
manager support
Needs
Average number of unmet
legal needs among lowincome households
”
Demand for
Multifactorial
Intervention
Low to moderate income
households with at least
one unmet legal need
Unfulfilled Legal Needs
Legal
Needs
Outcomes affected by broader
socioeconomic causes that are
best addressed through legal
intervention
“Most at-risk individuals might not know when their
social problems actually have legal solutions. And
even if at-risk individuals realize the legal nature of
their problems, they then must struggle to find legal
assistance.”
Megan Sandel, MD, MPH,
Department of Pediatrics,
Boston University School of Medicine
©2015 The Advisory Board Company • advisory.com
Source: Beck, Andrew, et. al., “Doctors and Lawyers Collaborating to HeLP Children—Outcomes from a Successful Partnership between Professions”, Journal
of Health Care for the Poor and Underserved, 24(2013): 1063-1073. Sandel, Megan et. al., “Medical-Legal Partnerships: Transforming Primary Care By
Addressing The Legal Needs Of Vulnerable Populations”, Health Affairs 29, No. 9 (2010): 1697–1705, The Advisory Board Company interviews and analysis.
5
Medical-Legal Partnerships Fill Important Gap
Strengthening Health System Ability to Identify, Treat Legal Needs
Legal Needs That Impact Health (I-HELP Model)
Income/Insurance
•
•
•
•
Insurance access and benefits
Food stamps
Disability benefits
Social Security benefits
Housing & Energy
•
•
•
•
•
Shelter access
Access to housing subsidies
Sanitary housing conditions
Utilities access
Foreclosure prevention
Legal Status
• Immigration (asylum, Violence
Against Women Act)
• Criminal record issues
©2015 The Advisory Board Company • advisory.com
Education/Employment
• Americans with Disabilities
Act compliance
• Discrimination
• Individuals with Disabilities
in Education Act compliance
Personal/Family Stability
•
•
•
•
Guardianship, custody, divorce
Domestic violence
Child abuse and neglect
Advance directives, estate planning
Source: National Center for Medical –Legal Partnerships, “Core Components and Activities”, http://www.medicallegalpartnership.org/model/core-components, The Advisory Board Company interviews and analysis.
6
The Shift from Volume to Value
Incentives Moving Toward Population Health Focus
Strategic Growth Levers Across Payment Models
Fee-for-Service World
Value-Based
Fee-for-Service World
Shared Savings/RiskBased World
Profitable Procedures
Efficiently-Managed
Care Episodes
Engaged Patients
Procedural Specialists
Multidisciplinary
Care Teams
Payer Price Escalation
Episodic Payment
Margin Expansion
©2015 The Advisory Board Company • advisory.com
Cross-Continuum Care
Management Infrastructure
Total Cost of Care
Reduction
Source: The Advisory Board Company interviews and analysis.
7
MLPs Strengthen Value-Based Strategy
Partnerships Essential Component of Higher Quality, Lower Cost Care
Role of Medical-Legal Partnerships Under Value-Based Care
Performance
Category
Utilization
Accountable Care Imperatives
Role of Medical-Legal Partnership
• Proactively manage chronic
illness to avoid low-margin
inpatient utilization
• Improves at-risk patient management and
ongoing wellness, reducing unnecessary
hospitalizations
• Reduce inappropriate or
duplicative care delivery
Expense
Management
• Manage total cost of care
for a defined patient
population
• Minimizes overall costs by addressing the
social determinants driving downstream
spending
• Target avoidable spending
across health system
Clinical
Outcomes
• Minimize preventable
admissions, readmissions
• Promote community wellness
for at-risk populations
©2015 The Advisory Board Company • advisory.com
• Supports better population health by
targeting the environmental risk factors
influencing clinical outcomes
Source: The Advisory Board Company interviews and analysis.
8
Delivering Results for Underserved Patients
MLP Approach Resolving Legal Issues Impacting Health
Suggested Data
Timeframe
$XX
Recovered back benefits
associated with MLP
#
Positive legal outcomes
as a result of MLP
#
Patients assisted by
MLP
©2015 The Advisory Board Company • advisory.com