The fundamental question of the future for population health management is, “How much will it cost our system to achieve a unit of improvement in this patient’s outcome?” At Health Catalyst, we call that Return on Engagement (ROE), and we measure the numerator and denominator, analytically. Engaging patients in their own care is not just an altruistic gesture. It is an economic imperative for healthcare organizations who are at financial risk for achieving clinical outcomes and value based care contracts. Join Dale Sanders and Russ Staheli as they share their observations about population health management from across the industry and how those observations are influencing the Health Catalyst product roadmap. Simply put, achieving optimal care for a population of patients begins with providing optimal care for a single patient, then repeating that over and over again for an entire community of patients. What public health is for infectious disease, population health is to chronic disease; the same concepts for engaging patients in their socio-economic context are applicable to both. In the last half of this webinar, Russ will demonstrate Health Catalyst’s Care Management suite. The five applications in the suite are powered by the Health Catalyst Analytics Platform and were designed by synthesizing concepts from Customer Relationship Management and social networking applications— blending data collection, suggestive and predictive analytics, and decision support into a seamless software experience— and applying that to population health management, one patient at a time.

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Health Catalyst Webinar
March 23, 2016
Return On Engagement:
The Fundamental Metric of Population Health Management

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Introductions
• Dale Sanders, Executive Vice
President, Product Development
• Russ Staheli, Vice President,
Product Line Manager, Population
Health

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Our observations on Population Health
Details of Care & Patient Relationship Management
strategy and application
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How we approach everything
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Founded 2008
Employees 450+
HQ Salt Lake City, UT
Patients Hospitals
65M+ 200+
Clinics
2000+
Integrated Delivery Systems
Accountable Care Organizations
Community Hospitals
Children’s Hospitals
Academic Medical Centers
Health Catalyst Clients

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Population Health Management is to chronic
disease what Public Health Management has been
to infectious disease
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”…the science and art of preventing disease, prolonging life and
promoting health through organized efforts and informed choices of
society, organizations, public and private, communities and
individuals."
”…the health outcomes of a group of individuals, including the
distribution of such outcomes within the group."

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Someday, we’ll drop the adjective
It won’t be a new “thing”… it will just be
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Return On Engagement

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Robert Wood Johnson &
University of Wisconsin
Public Health Institute

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Our current state of
existence in US
healthcare
Norman, G (2003) New Strategies in Disease and Utilization Management. Society of Actuaries: San Francisco Spring. Meeting, June 24-22, 2002.
Proceedings in: Record 28(2), 2003.

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Challenges to the Change
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Two Basic Types of Professional
Services Contracts
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Any wonder why physicians are burned out?
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What the leaders are doing

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Courageous, visionary CEO
In 2010, she took the negotiations and data to the payers

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Cost of Care @ Point of Care
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Multiple payer contracts, one comp model
Complex allocation models have been a failure

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Her proposal for fixed-fee contracts
Inpatient procedures
• Knee replacement
• Hip replacement
• Hip and knee
replacement revisions
• Hip and knee
arthroscopy
Outpatient procedures
• Cataract removal
• Perinatal care
• Hysterectomy
• Maternity
Chronic conditions
• Asthma
• Diabetes
• End stage renal
Acute conditions
• Upper respiratory
infection
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For better and worse,
software has overtaken the
impact of heroic leadership
as the greatest agent of
change in human behavior.
We have to build software
that deliberately borrows
lessons from the software
that has changed human
behavior.

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Care Management
Getting patients involved in the numerator and denominator of ROE

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Agenda
• Definition & Key Driver
• Care Management Strategy
• Product Demos
• Open Discussion

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Population Health
Care Mgmt.
Disease
Mgmt.
Sometimes referred to as Care
Coordination
Broader than traditional Case or
Disease Management.
More narrow than full Population
Health
Source: Frost & Sullivan 2015
• Under “Fee-For-Service” only the health plan was incented to
optimize care across settings
• “At-Risk” value based reimbursement aligns the incentive with
care providers
Care Management
our definition of care management

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1%
5%
Patients that account for
20%
of your costs
Patients that account for
50%
of your costs
-2012 study by NIHCM Foundation
Care Management
key driver of care management

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Poll Questions
• Which of the following depicts your perception of the “financial
value” care management will provide over the next 3-5 years?
• 300 respondents
a) It will have a high financial ROI – 54%
b) It will have a neutral financial ROI – 31%
c) It will have a negative financial ROI, needs reformation – 15%
• Which of the following depicts your perception of the “clinical
quality” care management will provide over the next 3-5 years?
• 181 respondents
a) It will have a major positive impact – 59%
b) It will have a slightly positive impact – 36%
c) It will have a neutral/negative impact, needs reformation – 5%
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Agenda
• Definition & Key Driver
• Care Management Strategy
• Product Demos
• Open Discussion

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Care Management Strategy
• Review Existing Frameworks and Market Need
• Define Health Catalyst’s Framework
• Demonstrate Product Flow
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Care Management Strategy
review existing frameworks and market need
1st Half 2015 - Leveraged;
- Internal;
- Visioning from internal Catalyst leadership
- Partners Health System iCMP initiative
- External;
- 10+ 3rd party companies in this space assessed in build vs
buy
- 10+ requests for proposals (RFPs)
- 3+ current client requests
- Competitive analysis report
- Market capitalization report
- SI Patient Engagement Model
- Many other discussions and meetings…
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Care Management Strategy
review existing frameworks and market need

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Data Integration
(EDW)
Patient
Stratification &
Intake
Care
Coordination
Patient
Engagement
Performance
Measurement
Care Management Strategy
define health catalyst’s framework

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Care Management Strategy
demonstrate product flow
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A
B
A
B
A
A
B
A
B
A
A
A
A
A
A
A
B
A Care Program A
Care Program B
Claims Clinical
EDW
Population
Under at Risk
Contract
Configurable Catalyst
Patient Complexity Score
& Stratification
Configurable cut
point and initial;
program, PCP, and
team attribution
Pre-enrollment patient list
refinement (add/remove)
Final attribution to Care
Program
FinalattributiontoCare
TeamandPCP
Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
Measurement

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Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
MeasurementCare Management Strategy
demonstrate product flow
Agreement on:
- Patient Centered Goals
- Tasks to drive to Goals
Initial tasks are prioritized,
scheduled, and dispersed
On an ongoing basis;
- Goals are modified
- Tasks are modified
- Tasks are re-assigned
- Alerts are created and sent based on
task
- Extended care team members are
added (or removed) as needed
- Secure SMS communication between
all players
Types of tasks for patients include;
- Education materials to be reviewed
- PROM surveys to be completed
- Daily activity and measurements to be
entered
Types of tasks for care team include;
- Active medications review
- Follow up appointment creation
- Identify local resource/support for
patient
Patient “discharged” from care
program

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Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
MeasurementCare Management Strategy
demonstrate product flow
How are our patients doing?
How are we performing to our plan?
Is it working? Are we getting “Return on Engagement”
What do we do more of… what do we change?
Outcome
Process
Balance
Insights

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Poll Question
• Those of you who are a part of a health system, which of the
following best describes your current state in care management?
• 141 respondents
a) We do not have a program and don’t plan on adding one – 9%
b) We do not have a program and are evaluating starting – 25%
c) We have a program, that isn’t working well – 19%
d) We have a program that is successful but can get better – 47%
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Agenda
• Care Management Strategy
• Product Demos
• Open Discussion

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- Patient Stratification
- Patient Intake
- Care Coordination
- Care Companion
- Care Team Insights
Care Management Products

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Care Management Products
Patient Stratification
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Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
Measurement
A
B
A
B
A
A
B
A
B
A
A
A
A
A
A
A
B
A Care Program A
Care Program B
Claims Clinical
EDW
Population
Under at Risk
Contract
Configurable Catalyst
Patient Complexity Score
& Stratification
Pre-enrollment patient list
refinement (add/remove)
Final attribution to Care
Program
FinalattributiontoCare
TeamandPCP
Configurable cut
point and initial;
program, PCP, and
team attribution

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Care Management Products
Patient Stratification
Demo
40
Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
Measurement

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Care Program A
Care Program B
Claims Clinical
EDW
Population
Under at Risk
Contract
Configurable Catalyst
Patient Complexity Score
& Stratification
FinalattributiontoCare
TeamandPCP
Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
Measurement
Configurable cut
point and initial;
program, PCP, and
team attribution
A
B
A
B
A
A
B
A
B
A
A
A
A
A
A
A
B
A
Final attribution to Care
Program
Pre-enrollment patient list
refinement (add/remove)
Care Management Products
Patient Intake

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Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
MeasurementCare Management Products
Patient Intake
Demo

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Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
MeasurementCare Management Strategy
Care Coordination
Agreement on:
- Patient Centered Goals
- Tasks to drive to Goals
Initial tasks are prioritized,
scheduled, and dispersed
On an ongoing basis;
- Goals are modified
- Tasks are modified
- Tasks are re-assigned
- Alerts are created and sent based on
task
- Extended care team members are
added (or removed) as needed
- Secure SMS communication between
all players
Types of tasks for patients include;
- Education materials to be reviewed
- PROM surveys to be completed
- Daily activity and measurements to be
entered
Types of tasks for care team include;
- Active medications review
- Follow up appointment creation
- Identify local resource/support for
patient
Patient “discharged” from care
program

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Care Management Products
Care Coordination
44
Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
Measurement
Demo

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Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
MeasurementCare Management Strategy
Care Companion
Agreement on:
- Patient Centered Goals
- Tasks to drive to Goals
Initial tasks are prioritized,
scheduled, and dispersed
On an ongoing basis;
- Goals are modified
- Tasks are modified
- Tasks are re-assigned
- Alerts are created and sent based on
task
- Extended care team members are
added (or removed) as needed
- Secure SMS communication between
all players
Types of tasks for patients include;
- Education materials to be reviewed
- PROM surveys to be completed
- Daily activity and measurements to be
entered
Types of tasks for care team include;
- Active medications review
- Follow up appointment creation
- Identify local resource/support for
patient
Patient “discharged” from care
program

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Care Management Products
Care Companion
46
Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
Measurement
Demo

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Care Management Products
Care Team Insights
47
Data
Integration
Patient
Stratification
& Intake
Care
Coordination
Patient
Engagement
Performance
Measurement
Demo

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Agenda
• Care Management Strategy
• Product Demos
• Open Discussion