Thursday, January 26, 2012

#CISummit Care Delivery Care Innovation - The discussion

Care Delivery/Primary Care Innovation Case Study

Moderator: Mohit Kaushal, MD, MBA

Executive Vice President of Business Development and Chief Strategy Officer, West Wireless Health Institute 

Christopher Chen, MD

Chief Executive Officer, ChenMed 

Frank Ingari

President and Chief Executive Officer, Essence Healthcare 

Brian Prestwich, MD

Assistant Professor of Family Medicine, Keck School of Medicine, University of Southern California 

Lonny Reisman, MD

Chief Medical Officer, Aetna 

David P Kirchhoff

President and Chief Executive Officer, Weight Watchers

2% incentive for Docs is a small number. Small number = small change.

FI: Aggregation to deal with scale. Episodes of care has issues with boundaries of care.
Capitation is the long term solution. 

LR: A continuum of solutions for delivery solutions. starting from basic EMR implementation building to full risk management/share.
AETNA doing a lot of consultation that leads to development of payment models that work for the delivery system.

Orientation around the patient is an awakening. The solution to health is not in the doc's office or hospital

FI: The model today is a reactive patient presentment model. We need to flip the model so that the provider is reaching out before the patient presents.

CC: We need a cultural change for doctors. We should expect docs to help innovate. 

BP:  Risk-based registries are critical to population care. We need time to reflect on patient story and payment options to allow e-consults.

DK:  Working with Cleveland Clinic,  State of Oregon.  We need to move to focus on prevention. eg. for avoiding diabetes.  Alignment works. Patient, Payer, Provider

FI:  Reducing obesity would have massive ROI for Medicare participants. 

LR: Technology is essential but not sufficient.  Support and incentives are a critical addition. More collaboration needed to achieve success.

 CC: After a heart attack a patient has an average of 11 drugs to take. Put the drugs in their hand don't send them to a pharmacy. This removes one barrier. 

BP:  We need to help patients do workflow on their own life/health.

BP: The LA Innovation Corridor covers 11M people. 

 What would you do to help achieve the Triple Aim:
DK: Rewire the system so that incentives align with processes.  We need proactive preventive care.
BP: HIT  that supports the patient and population view. Dashboards that guide care. Take care of patients well and the risk takes care of itself.
CC: Scaling culture is hard. We need to rewire from transactions to outcomes.
FI: Use Meaningful Use Phase 2 /3 to be more open. Allow information to flow in AND out.
LR: We need to spend more time thinking about Health - Engagement and motivation. Patients don't automatically do what the doctor suggests. 

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