Presentation to 2014 Virginia
Health Care Conference
June 5, 2014
2
Trusted Advisor to America’s Leading Health Systems
Three Decades of Experience Translating Policy into Practice
Broad Membership Yields Deep Insights
3,600
99
Members among
Member institutions, including
health systems in all 50 states1
>1,000
165,000
Small-to-medium Health care leaders
the 100 largest US
community
participating in
health systems
hospital members
memberships
2,200
10,000
Key Areas of Expertise
• Health care delivery system transformation
targeted at higher quality and more efficient
care, including development of ACOs and
medical homes
• Improvements in clinical operations and
health care cost reduction, such as strategies
to decrease readmissions
• Development and effectiveness of health
information technology and data analytics
Advisory Board health care
professionals worldwide
• Health care financing and revenue
management, including technologies to
administer risk-based payments
Research interviews annually
with health care leaders
• Health care workforce, leadership
development, and staffing strategies
1) Includes urban and rural health systems; academic
medical centers and community hospitals; safety net
hospitals; non-profit and for-profit hospitals; and the VA.
©2014 The Advisory Board Company • advisory.com
Source: The Advisory Board Company.
3
Our Firm in Numbers
3,600+
Hospitals and health care
organizations in our membership
2,200+
Health care
professionals employed
1,500+
Hospitals using our
performance technologies
RESEARCH
AND INSIGHTS
PERFORMANCE
TECHNOLOGIES
CONSULTING
AND MANAGEMENT
TALENT
DEVELOPMENT
Memberships Offering
Strategic Guidance and
Actionable Insights
National Peer Collaboratives
Powered by Web-Based
Analytic Platforms
Seasoned, Hands-On
Support and Practice
Management Services
Partnering to Drive
Workforce Impact
and Engagement
• Dedicated to the most
pressing issues and
concerns in health care
• Leading provider:
Over 50% of inpatient
admissions in the United
States flow through our
technology platforms
• 2,500+ years of “operator”
experience in hospital and
physician practices
• Impacted the achievement
of 76,000+ executives,
physicians, clinical leaders,
and managers
• 300+ industry experts
on call
• 200+ customizable
forecasting and decisionsupport tools
165,000+
health care leaders
served globally
©2014 The Advisory Board Company • advisory.com
• Over 1.5 million user
sessions annually
• Key challenges addressed:
physician performance,
population health, revenue
cycle, referral growth,
surgical profitability, and
supply/ service cost
$500+
million in realized
value per year
• Principal terrains: hospitalphysician alignment/practice
management, transition to
value-based care, revenue
cycle optimization, hospital
margin improvement
• 17,000+ outcomes-driven
workshops tailored to
partners’ specific needs
Survey Solutions
• Range of engagements from
strategy/diagnostic to best
practice installation to interim
management to fully
managed services
• Customized strategies for
improving employee and
physician engagement
1,300+
engagements
completed
6,200+
employee-led
improvement projects
• National health care-specific
benchmarking database of
480,000 respondents
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Advisory Board Approach to Innovation
Scaling “Best Practices” to Accelerate and Sustain Transformation
Health Care’s Original
“Big Data” Asset
•
Field Intelligence
•
Data Science
Our Sustainable ROI Model
Care Variation
Directive
Technologies
Performance
Blueprints
Action,
Not Analysis
Roadmaps to
Rapid Results
Proprietary
Methodology
• Scalable, sustainable
BDPs
• Member activation
model
©2014 The Advisory Board Company • advisory.com
Labor and Supply
Cost
Referral
Management
Clinical
Integration
• Tomorrow’s
problems today
• 80/20 process
leverage points
Driving EnterpriseLevel Outcomes
Network-Driven
Innovation
Applied
Expertise
Iteratively
Attacking Hard
Problems
Right Expert
Against Right
Lever
Network
Optimization
Predictive Care
Plans
Patient
Engagement
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Offering Data and Analytics to Improve Cost, Quality
Performance Technologies Improving Value at Front Lines of Care
Advisory Board Technology Suite
 Improving Quality of Care
• Population Risk Management
• Preventive and Chronic Care
• Cross-continuum Care Management
• Patient Engagement and Experience
• Patient Safety and Care Quality
 Lowering Cost of Care
• Supply and Labor Costs
• Care Variation Reduction
 Aligning Incentives
• Value-based Contracting
• ICD-10 Transition
Advisory Board Technologies
360,000
Physician cost and quality
profiles
Hospitals using Advisory
Board technology
1,500
US admissions flowing through
Advisory Board IT tools
50%
Representative Results Achieved by ABC Members
$385K $354K
$25.38
$17.61
Year 1
Claims ($) Incurred
for ED Visits
©2014 The Advisory Board Company • advisory.com
PMPM Claims ($)
Incurred for CT Scans
Source: The Advisory Board Company.
Year 2
6
Opportunity to Personalize Care
Gaps in awareness of all available information lead to sub-optimal
outcomes
Current Attempts to Improve Precision Fraught with Shortcomings
Nurses Screen for
Delirium Risk
ICU
Case Manager Assesses
Risk of Readmission
6th
Floor
Cardi
ac
Care
Unstandardized
Care Managers Assess
Risk of Non-Compliance
M.D.
Office
Missing Data
©2014 The Advisory Board Company • advisory.com
Static
7
Crimson Real-Time Clinical Analytics
Natural Language Processing to Detect Risk Factors Buried in Clinician
Notes
Sample Findings of Text Analytics
©2014 The Advisory Board Company • advisory.com
8
Crimson Real-Time Clinical Analytics
Algorithmic Early Warnings Enabling Proactive Risk-Reducing Interventions
across Care Settings
Customized Surveillance Alerts
Clinical Utilization
Risk
Referral Flags
•
Pain management
consult
•
Risk of
readmission
•
Risk of avoidable
admission
•
Risk of extended
length
of stay
•
Risk of extended
ICU LOS
Palliative care
consult
•
Social work
consult
•
©2014 The Advisory Board Company • advisory.com
•
Mental health
consult,
undetected
depression
Clinical Risk
Surveillance
Revenue Risk
Management
•
Risk of DVT
•
•
Core measure
patient
identification
Ensure medical
necessity is met
•
Alert to present on
admission
•
Sepsis early
warning score
•
Documentation
opportunities
•
Risk of mortality
•
ComputerAssisted Coding
9
Enabling Readmission Reduction within the
Medicare Population at Baylor Health
Precise Risk Stratification, Risk Factor Identification Drives Reduction
20
Quarterly Readmission Rates:
Heart Failure
16% relative
reduction
N = 343
19,6
19
18
17,9
17,39
17
16,6
16,4
16
15
Quarterly Readmission Rates:
Pneumonia
Readmissions Rate (%)
Readmissions Rate (%)
Change in HF and PN Readmissions Rates at Baylor Health System
20
16
N = 243
16,67
70% relative
reduction
12
8
5,56
5,88
7,04
5
4
0
14
2012:Q3 2012:Q4 2013:Q1 2013:Q2 2013:Q3
Quarter (Time)
©2014 The Advisory Board Company • advisory.com
2012:Q3 2012:Q4 2013:Q1 2013:Q2 2013:Q3
Quarter (Time)
Identifying Population Level Risk Factors Enables
Efficient Resource Allocation
1 in 4 Patients with Depression Conditions at High Risk for Readmission
©2014 The Advisory Board Company • advisory.com
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11
Unlocking the Full Value of “Big Data”
Complementary Changes Required to Create a Value-based System
Stages of Analytical Progression and Value Creation
Predictive
Descriptive
How many of my
diabetic patients are
overdue for their a1C
test?
Prescriptive
Which of my diabetic
patients is least likely
to respond to my
outreach to get a
blood test?
Which outreach
message should I
send to each diabetic
patient to maximize
response rate?
Cultural
Transformation
Incentives
Alignment
Integration with
Workflow
IT
Interoperability
•
Comfort with
performance
transparency
•
Right rewards for
clinical
transformation
•
Minimally-disruptive
to native workflows
•
•
•
Data “improvement”,
not data “perfection”
•
Lowering costs (and
perceived threats) of
data sharing
Contextuallyappropriate
“answers”
Lower the total cost
of accessing data,
systems
•
Data unification
across systems
©2014 The Advisory Board Company • advisory.com
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Policy Can Play Role in Fostering Interoperability
Lower Cost Connectivity Will Accelerate Innovation
Opportunities for Policymakers to Encourage Interoperability
Require standard APIs in
Meaningful Use Stage 3
Further specify standards
for data transport
•
•
•
Any API would need to
be published, public, and
open to use by any thirdparty
Commonly required APIs
should expand over time
©2014 The Advisory Board Company • advisory.com
•
Current standards make
data transfer possible,
but not financially viable
Reducing financial
barriers to data
integration would spur
rapid and broad
innovation
Drive greater data
sharing between
providers and payers
•
Would facilitate better
population health
management
•
At a minimum,
providers should have
access to full claims
data under risk-sharing
arrangements
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