Accordant Health Services Inc.- Background
advertisement
Accordant Health Services Inc.- Background Founded in March of 1995 - Greensboro, NC 40,000 sponsored members from 19 customers representing over 30 million covered lives Over 200 Employees – 2 full time Medical Directors, Integrated RN – MSW clinical operations teams, 14 Medical Advisors Fully integrated tele-web communications backbone Focused on 15 complex, progressive chronic diseases Wholly Owned Subsidiary of AdvancePCS Inc. 1 AccordantCare Product Specification A Population Disease Management Program Focused On 15 Complex, Chronic Diseases averaging $9700 per year, 7200 per million covered lives, over $70 million total claims cost per million covered lives Seizure Disorders Multiple Sclerosis Parkinson's Disease Rheumatoid Arthritis Systemic Lupus Cystic Fibrosis Hemophilia Myasthenia Gravis 2 Sickle Cell Anemia ALS Dermatomyositis Polymyositis Scleroderma CIDP Gaucher Disease Population Disease Management Produces Sustainable Total Cost Savings Result: Population DM produces cost savings by diminishing the magnitude of existing high cost cases and preventing crises from occurring. Least costly Regression to the Mean tendencies counteract one another through time Case management interventions accelerate natural “high to low” RTM migration Disease Management interventions blunt disease progression and reduce low to high RTM migration 3 Most costly Accordant Results: Cost Reductions PMPM (Constant Dollars) PMPM by LOTIP $1,000 $800 $600 $400 $200 $- 1 2 3 4 5 6 LOTIP Quarters Source: Claims Data through 8/31/00 (Constant Dec. '99 Dollars) 4 7 8 AccordantCare Process CQI Patient Identification CQI Lower Risk and Stable Program Introduction Class Activation Specialized Patient Management Disease Management Ongoing Assessments, Education/Intervention Ongoing Assessments, Education/Intervention Outcomes & Reporting CQI 5 Assessment and Education Higher Risk and Crisis CQI Client Server Computing Serves as the Perfect Metaphor for Accrodant’s Complex, Chronic Care Management… Client Server Computing Mainframe and Mini Computers Data Processing Revolution Local desktop not dependable or Networked Incredible Single Promise Exponential Increase in Dependability Exponential Information Sharing LAN, 6 Data Repository WAN, Wireless, Secure, Distributed Computing Disease Management Evolves Integrated Delivery... “Integrated Delivery Model” “Traditional Delivery Model” Physician MCO MCO Hospital Physician Chronically Ill Patient Same Patient AHS Hospital Same Patient Patient Data Processing Limited to Physicians Client Disparate Collection and Storage of Patient/Clinical Record(s) (Patient) Served by Accordant Exponential Dramatic “Best Practices” Education is Limited to Academia 7 Information Sharing Outcomes Improvement Tele-Web Platform for Population DM Routine Broadcast Mail Bulletins Wireless(TBD) Phone Internet Community CTI Backbone Unified Messaging Technology levers IVR Fax Voice E-mail Web Chat Personalized Educational Content Driven form RDMS Ongoing Patient Interactive Inputs Integrated Web & Call Center RN Support Rules engine allows for rapid relational 8 configuration AccordantCare Assessment IT Workflow 9 MD FYI Letter 10 Accordant ‘s 4 R’s: Reach the Population, Build a Relationship by demonstrating Results thereby earning their Respect Platinum Award Content Gold Award – Best eCare DM Site Top 10 DM Site HIRC - 2000 11 Top DM Web Application – DMAA 2000 Technology As The Enabler:Today Streamline Call Center Operations Through Interactive Voice Response (IVR) Techniques, Skills Based Call Routing and Unified Messaging Platforms Enable “Real Time” Response by Integrating CrossPlatform Communications (Fax, Phone, E-mail, Internet, Etc.) Into One PC-based User Interface Build On-line Communities and Self-management Opportunities Via Customized Web Applications 12 Technology As The Enabler:Tomorrow “Push” Customized Clinical Content to Patients Based on Computer-generated User Profiles and Content Build Brand Loyalty and Recognition Through the Use of Participatory Multimedia and On-line Interactive Techniques Successfully Integrate All Points in the Healthcare Delivery System (Patients, Physicians, Health Plans, Ancillary Health Providers, Etc.) Through Online Connectivity and Other Technology Pathways 13 IT Open Architecture Enables A Powerful Healthcare Dynamic Corporate/Organizations make available information and transact in a virtual environment MCO Patient Centric = Patient Empowerment Firewall Integrated Delivery System are Defined by Connectivity Individual patients discover self serve through web connectivity 14 Hospital AHS Patient Physician Accordant’s Client Server Application - Today Nurse Trained Case Managers One to One relationships Expert Training in Disease State Content Medical Advisory Board Branching Logic Assessment Dialogue Dynamic, Tailored Education Connectivity 24/7/365 Phone Access to Nurse Outbound, Proactive Model-Daytime Coverage Auto Generation of Patient/Physician Communication delivered by Fax and US Mail 15 Empowerment Disease Profile and Severity Dictate Frequency of AHS Interaction Nurse Contact and Education Dependent on Above Stratification Accordant’s Client Server - Tomorrow Nurse Trained Case Managers One to One Relationship Leveraged Case One Medical Advisory in disease Line Decision Support through the Web Current Model Intact and Dependable Board Patient Initiated Discovery and Publishing Exponential Load Expert Connectivity Content Growth Unified Multimedia Messaging at the Desktop Patient Defines Platform through Interaction: Inbound and Outbound through Secure Email Offering in Disease Experiences and Related Topics Dynamic, Customized Interaction now available through Self Service Audio, 16 Video, Email, Fax, Telephony, Web chat enabled at the desk top for patient and nurse partner Empowerment Disease Profile and Severity Dictate Frequency of AHS Interaction Nurse Contact and Education Dependent on Above Classification Patient dictates unique interaction above and beyond required frequency
