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Value Based Care.
For Home Healthcare
Ahi Satapathy.
I run a company called DocEngage
Homecare is one of our primary focus and We help providers
to manage sales & marketing, operation, clinical workflow
and, patient engagement. We enable providers to implement
value based care delivery structure.
2
Based on the research of
Professor Michael Porter, Value-
Based Healthcare Delivery is a
framework for restructuring health
care systems around the globe
with the overarching goal of value
for patients
3
Value Myth in Healthcare
Value = Cheap
Value = High Patient Satisfaction Score
4
Key Concepts
The Outcome that matters most to Patient ÷ Cost = Value
This Outcome must be measurable from a clinical and
operational standpoint.
Value Based Care is a framework that helps healthcare
ecosystem collaborate to provide value to patient for entire
care-cycle. It also enables providers to iterate by measuring
outcome and cost to maximize value over time.
5
Home Health Care Services deals with
long term care services, therefore Value
Based Care makes perfect sense for
Home Health Providers
6
Integrated Practice Units (IPU)
Organize care around patient
medical conditions and distinct
patient segments.
Measure Outcomes & Cost
Measure health outcomes for
every patient. Measure the
actual costs of patient care.
Enable Integrated Technology
Platform
Use technology to help
restructure care delivery and
accurately measure results.
Bundled Prices
Reimburse the full care
cycle for medical conditions.
Geographic
Expansion:
Increase the
geographic
reach of leading
providers
7
Modelling IPU
Design medical practice around value for patients
Focus on volume in particular medical conditions
Achieve true excellence in select conditions, rather than try
to do a little of everything
Focus on the full cycle of care
8
Measure Outcomes & Costs for Every Patient
Outcomes are the ultimate measure of quality
Demonstrate good results. Report outcomes to patients
For example, for patients with diabetes, their medical
condition includes co-existing hypertension, renal disease,
and retinal disease. Success in treating diabetes incorporates
the combined effect of caring for all of these needs.
9
Measuring Cost
Cost is the actual expense of patient care, not the
charges billed or collected
Use Time-driven activity-based costing (TDABC) to
improve resource allocation and value.
10
The
Outcome
Measures
Hierarchy
Time to Recovery & Time to Return
to Other Activity
Sustainability of Health or Recovery
and Nature of Recurrences
Tire 1: Health
Status Achieved
& Retained
Survival
Degree of Health or Recovery
Disutility of Care or Treatment
Process
Long Term Consequences of
Therapy
HomeCare
Tire 2: Process
of Recovery
Tire 3:
Sustainability
of Health
Care-induced Illness
Recurrences
11
Move to Bundled Payments
for Care Cycles
Allows providers to take control and
navigate the shortest path to deliver
better care.
Patients receive proven and
effective care for their medical
conditions.
Providers earn a positive margin for
efficiently treating patients and
producing good outcomes; over
time, they attract more patients in
their area of expertise, enabling their
total margins to increase.
Suppliers of drugs, devices, and
diagnostic tests that improve
outcomes and/or lower total costs
will find their products incorporated
into the treatments used by effective
and efficient providers.
12
Homecare Growth Strategy
Grow areas of excellence across geography: Expand satellite
pre- and post-acute services using a hub-and-spoke model
Affiliate with community providers to extend the reach of
Integrated Practice Units (IPUs)
Increase the volume of patients in medical conditions
13
Improving Technology Platform in Restructuring
Care Delivery and Measuring Results
1. Establish common data standard to measure outcome
2. Combine all types of data (e.g. notes, images) for patients
3. Aggregate full care cycle data
1. Allow access and communication among all involved parties
1. Create standardized templates for medical conditions to improve usability
2. Collect structured data, rather than free text, in patient records
1. Allows easy extraction of outcome, process, and activity-based cost measures for
each patient and medical condition
2. Adopt interoperability standards enabling communication among different provider
14
Benefit
Matrix
Traditional Value Based Care
Consumer
Experience
Confused and frustrated - Patient manage
their own care
more coordinated and better experience
Care Delivery
Reactive care delivered in response to an
injury or illness.
Proactive care - with an emphasis on
keeping people healthy
Care
Coordination
Lack technology and incentives for coordinate
patient care
providers are empowered by new technology,
access to data and financial incentives to
coordinate care
Data &
Information
No data or not accessible
Data is analyzed across a care provider’s
organization to identify specific health risks
Cost
Costs climb without corresponding
improvements in health
Value is the new standard for insurance
companies and care providers, and pay is
based on quality and patient health
improvements 15
Thank You
care@docengage.in
16

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Value based care.

  • 1. Value Based Care. For Home Healthcare Ahi Satapathy.
  • 2. I run a company called DocEngage Homecare is one of our primary focus and We help providers to manage sales & marketing, operation, clinical workflow and, patient engagement. We enable providers to implement value based care delivery structure. 2
  • 3. Based on the research of Professor Michael Porter, Value- Based Healthcare Delivery is a framework for restructuring health care systems around the globe with the overarching goal of value for patients 3
  • 4. Value Myth in Healthcare Value = Cheap Value = High Patient Satisfaction Score 4
  • 5. Key Concepts The Outcome that matters most to Patient ÷ Cost = Value This Outcome must be measurable from a clinical and operational standpoint. Value Based Care is a framework that helps healthcare ecosystem collaborate to provide value to patient for entire care-cycle. It also enables providers to iterate by measuring outcome and cost to maximize value over time. 5
  • 6. Home Health Care Services deals with long term care services, therefore Value Based Care makes perfect sense for Home Health Providers 6
  • 7. Integrated Practice Units (IPU) Organize care around patient medical conditions and distinct patient segments. Measure Outcomes & Cost Measure health outcomes for every patient. Measure the actual costs of patient care. Enable Integrated Technology Platform Use technology to help restructure care delivery and accurately measure results. Bundled Prices Reimburse the full care cycle for medical conditions. Geographic Expansion: Increase the geographic reach of leading providers 7
  • 8. Modelling IPU Design medical practice around value for patients Focus on volume in particular medical conditions Achieve true excellence in select conditions, rather than try to do a little of everything Focus on the full cycle of care 8
  • 9. Measure Outcomes & Costs for Every Patient Outcomes are the ultimate measure of quality Demonstrate good results. Report outcomes to patients For example, for patients with diabetes, their medical condition includes co-existing hypertension, renal disease, and retinal disease. Success in treating diabetes incorporates the combined effect of caring for all of these needs. 9
  • 10. Measuring Cost Cost is the actual expense of patient care, not the charges billed or collected Use Time-driven activity-based costing (TDABC) to improve resource allocation and value. 10
  • 11. The Outcome Measures Hierarchy Time to Recovery & Time to Return to Other Activity Sustainability of Health or Recovery and Nature of Recurrences Tire 1: Health Status Achieved & Retained Survival Degree of Health or Recovery Disutility of Care or Treatment Process Long Term Consequences of Therapy HomeCare Tire 2: Process of Recovery Tire 3: Sustainability of Health Care-induced Illness Recurrences 11
  • 12. Move to Bundled Payments for Care Cycles Allows providers to take control and navigate the shortest path to deliver better care. Patients receive proven and effective care for their medical conditions. Providers earn a positive margin for efficiently treating patients and producing good outcomes; over time, they attract more patients in their area of expertise, enabling their total margins to increase. Suppliers of drugs, devices, and diagnostic tests that improve outcomes and/or lower total costs will find their products incorporated into the treatments used by effective and efficient providers. 12
  • 13. Homecare Growth Strategy Grow areas of excellence across geography: Expand satellite pre- and post-acute services using a hub-and-spoke model Affiliate with community providers to extend the reach of Integrated Practice Units (IPUs) Increase the volume of patients in medical conditions 13
  • 14. Improving Technology Platform in Restructuring Care Delivery and Measuring Results 1. Establish common data standard to measure outcome 2. Combine all types of data (e.g. notes, images) for patients 3. Aggregate full care cycle data 1. Allow access and communication among all involved parties 1. Create standardized templates for medical conditions to improve usability 2. Collect structured data, rather than free text, in patient records 1. Allows easy extraction of outcome, process, and activity-based cost measures for each patient and medical condition 2. Adopt interoperability standards enabling communication among different provider 14
  • 15. Benefit Matrix Traditional Value Based Care Consumer Experience Confused and frustrated - Patient manage their own care more coordinated and better experience Care Delivery Reactive care delivered in response to an injury or illness. Proactive care - with an emphasis on keeping people healthy Care Coordination Lack technology and incentives for coordinate patient care providers are empowered by new technology, access to data and financial incentives to coordinate care Data & Information No data or not accessible Data is analyzed across a care provider’s organization to identify specific health risks Cost Costs climb without corresponding improvements in health Value is the new standard for insurance companies and care providers, and pay is based on quality and patient health improvements 15

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