This PowerPoint is proprietary and confiden3al and not intended for distribu3on.

Transcription

1 This PowerPoint is proprietary and confiden3al and not intended for distribu3on. September 10, 2014

2 Aspire s Pallia,ve Care Approach Pallia2ve Care: A Medical Specialty Life-Prolonging Care Medicare Hospice Benefit Old Key Ques2on Would you be surprised if this pa,ent passed away within the next year? Life-Prolonging Care Palliative Care Medicare Hospice Benefit New Common Disease Categories Cancer (Stage IV) Advanced Heart Failure (Class III- IV) Advanced COPD (Stage III- IV) Advanced ESRD Advanced Demen,a Dx Death

3 The Advantages of a Na,onal Pallia,ve Care Provider Pallia2ve Care Today Outpa,ent pallia,ve care is the Wild West with many models and pilots but few with sufficient scale Lack of clarity on mechanism for iden,fying target pa,ent popula,on Limited pallia,ve care clinicians in many markets Lack of on- the- ground management and opera,onal capacity in most markets Inadequate support systems (e.g., IT systems) No standard quality metrics and limited ability to track exis,ng metrics Concerns about financial return on investment Investment of $$$, people and 2me Aspire s Pallia2ve Care Prac2ces Developing a consistent, systema,c approach to outpa,ent pallia,ve care with sufficient scale to develop and implement best prac,ces Establishing consistent processes for iden,fying the target pa,ent popula,on Each of Aspire s prac,ces is led by an established local pallia,ve care physician from that market Inves,ng in addi,onal on- the- ground management and opera,onal capacity in each market Developing scalable systems including a proprietary EMR, 24/7 call center, and policies and procedures Developing clear quality metrics, including systems for monitoring and repor,ng these metrics Demonstra,ng the business case for pallia,ve care, in part by taking on financial risk

4 Aspire s Pallia,ve Care Model Customer & Aspire Health - Iden,fy pa,ents using a combina,on of Aspire s algorithm and the customer s data Customer - Regularly receives data on pa,ent s status & provides Aspire Health monthly cost and u,liza,on data by pa,ent Customer - Medicaid Managed Care Plans - Commercial Health Plans - Medicare Advantage Plans - ACOs - Specialist Physician Groups Under Bundled Payments Ini2al Pallia2ve Care Assessment - A pallia,ve care NP conducts a comprehensive pallia,ve care assessment in the pa,ent s home or an outpa,ent clinic Pallia2ve Care Support Team - Home or outpa,ent clinic pallia,ve care visits from physicians, NPs, SWs and chaplains as needed - Regular telephonic outreach to the pa,ent and their family - 24/7 access to pallia,ve clinicians, including home visits - Access to Aspire s pa,ent & family educa,onal materials - Weekly care support team mee,ngs led by a pallia,ve care physician to review each pa,ent s status Aspire Health core service PCPs & Specialists - Refer pa,ents directly to pallia,ve care depending on the preferences of the customer PCPs & Specialists - Consulted on care plan changes & receives alerts on pa,ent s status changes as desired

5 Aspire s Pallia,ve Care Support Team Field- Based Clinicians Lead Physician Nurse Prac22oner Social Worker Chaplain Aspire Pa2ent Office- Based Clinicians Registered Nurse Social Worker Engagement PCC Opera2ons PCC

6 Aspire s Capacity: Pa,ent Iden,fica,on Analy,cs Aspire has created a pa2ent iden2fica2on algorithm that allows Aspire to partner with health plans and ACOs to iden,fy pa,ents who may benefit from Aspire s services Revenue & Costs: Pallia2ve Popula2on Last 7 Months of Life For large health plans, Aspire is willing to conduct an analysis of the health plan s claims data to iden,fy how many pa,ents could benefit from Aspire s services as well as project the poten,al cost savings opportunity from providing Aspire s services to those pa,ents A sample output from an analysis is on the right Month 6 Month 5 Month 4 Month 3 Month 2 Month 1 Month 0

7 Aspire s Capacity: Proprietary EMR Aspire has built its own proprietary EMR that contains pallia2ve care specific assessments and workflows The EMR has an e- prescribe capability that includes allowing for the prescrip,on of controlled substances This EMR allows Aspire to track pallia,ve care specific outcomes data such as changes in symptom scores and advanced care planning This EMR also generates one- page pa2ent summary reports that are automa,cally sent to a pa,ent s primary physician (see sample at right) Aspire s EMR can also produce customized reports for health plans as well as build API or HL- 7 interfaces to facilitate data sharing with health plans as desired

8 Aspire Outcomes Data: Enrollment Rate Referred Pa2ents Enrolling in Aspire Program 12% Enrolled Decline 88%

9 Aspire Outcomes Data: Primary Diagnosis Primary Diagnosis of Pa2ents Enrolled in Aspire Program Other ESRD CHF Demen2a Cancer COPD

10 Aspire Outcomes Data: Advanced Care Planning 100% 90% 80% Advanced Care Planning: Aspire Program vs. Na2onal Benchmark 70% 60% 50% Aspire AHRQ Benchmark 40% 30% 20% 10% 0% Advanced Care Plan / Living Will / POST Completed Recent Advanced Care Plan Discussion

11 Aspire Outcomes Data: Hospice U,liza,on Reason for Discharge: Aspire Program Hospice Median Length of Stay: Non- Aspire vs. Aspire Referrals Pa,ent or Family Declines Other Death Hospice Non- Aspire Hospice Referral Median Length of Stay Aspire Hospice Referral Median Length of Stay

12 Aspire Outcomes Data: Hospitaliza,ons Admissions Per Thousand: Aspire Program vs. Non- Aspire Program - 72% - 56% Non- Aspire Pa,ents in Last Seven Months of Life Non- Aspire Pa,ents Who Met Enrollment Criteria Aspire Pa,ents

13 Aspire s Leadership Team Sen. Bill Frist (Board Chair) Mike Tudeen (Member) Gene Fleming (Member) Ma^ Downs (Member) Brad Smith (CEO) Dr. Andrew Lasher (CMO) Jay Benn (COO) Diane Seloff (CAO) Clinical Leadership Corporate Leadership Board Members Dr. Martha Twaddle (Illinois) Dr. Janet Bull Dr. Elizabeth Kvale Dr. David McGrew (North Carolina) (Alabama) (Florida)