1. 2009 + Integrated Primary Health Care

8. Group Health – Medical Home Make team roles and GP leadership explicit to patients Point of care Outreach Best practice alerts Longer appt times (30mins) Planned care exception reporting MyGroup health Health maintenance reminders Secure messaging – secure emails High risk outreach Health Profile Pr – visit reviews and outreach Call management Hospital outreach Health Coaching Collaborative care Plan Birthday letters After visit summaries New patient outreach Feedback Group Visits Performance reporting Huddles Exception reporting Living well with chronic conditions

11. Breaking the cycle First level funding DAR SIA C+ Etc…..

12. Breaking the cycle First level funding DAR SIA C+

14. North Hamilton - IFHC North Hamilton 15,000 patients 3 existing practices On site pharmacy at all practices All staff employed by PHCL (not for profit) Physical space for change On site pharmacy at all practices Current spend $148 per patient on staff (excludes other expenses) SIA, HP, CarePlus = $80k (one site for mobile nurse + small SIA service income) High quality, accredited sites Access to 100% above + + additional contracts eg: medications review, sexual health, PMH etc would add additional flexibility

15. A new look - 1900 $303,000 (excluding expenses) per 1,900 patients ($159 esu) $282,800 Current income( excluding expenses): capitation, Quality, co-payments, diabetes, SIA ($148 esu) $297,905 = 100% above + 100% SIA, HP, C+, DAR & Imms ($156 esu) $159 per ESU + expenses vs $148 per ESU + expenses GP Nurse Admin Pharm Specialist Nurse Mobile Nurse 1 0.7 0.7 0.2 0.2 0.1 $200,000 $35,000 $31,500 $17,000 $13,000 $6,500