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Caroline R. Piselli RN, DNP(c), MBA, FACHE PricewaterhouseCoopers Health Industries Advisory Director Building Your Plan to Get from Here to There: Steps.

Published byCharlene Perkins Modified over 8 years ago

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Presentation on theme: "Caroline R. Piselli RN, DNP(c), MBA, FACHE PricewaterhouseCoopers Health Industries Advisory Director Building Your Plan to Get from Here to There: Steps."— Presentation transcript:

1 Caroline R. Piselli RN, DNP(c), MBA, FACHE PricewaterhouseCoopers Health Industries Advisory Director Building Your Plan to Get from Here to There: Steps Required to Achieve a Blended Services Model

2 Source: PwC Health Research Institute National Trends / Role of Government Payment Methodologies Shifting Demographics New Customers Empowered Consumer Care Anywhere, Anytime Agenda

3 Source: PwC Health Research Institute New Health Economy Transformation TRANSFORMATION from a fee for service environment to population health aligned with risk is a current to future state process. Key critical success factors expand well beyond payment methodology design, actuarial computation and include some of the following: 1- INNOVATIVE Design 2- Population Health- OUTCOMES focused 3- Current to future state VISION driven 4- RISK linked to OUTCOMES, not process 5- Flexible & Adaptable to CONTINUAL IMPROVEMENT 6- CONTINUAL COLLABORATION 6- Sense of URGENCY and ACCELERATION

4 Source: PwC Health Research Institute Is Your Organization Prepared for the New Health Economy ?

5 Source: PwC Health Research Institute

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10 ACA Implementation

11 Source: PwC Health Research Institute

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13 13 Some Published Examples to Follow

14 Source: PwC Health Research Institute

15 MD Statewide Experience: PPC Cost Savings Source: Health Affairs December 2012 Source: Health Affairs, December 2012 31:12; doi: 10.1377/hlthaff.2012.0357

16 Source: PwC Health Research Institute Potentially Preventable Events

17 Source: PwC Health Research Institute

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20 20 PDF picture

21 Source: PwC Health Research Institute

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24 Balancing insurer risks in the reformed insurance market: Incentivize health plans to participate

25 Source: PwC Health Research Institute

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38 Population Management Readiness Develop a network across a geography that delivers evidence-based care to improve the quality, efficiency and coordination of health care services Leveraging: Data Transparency Critical Mass Long Term Commitment Consumer Value

39 Source: PwC Health Research Institute

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53 Questions? Caroline R. Piselli, RN, MBA, FACHE Health Industries Advisory Director PricewaterhouseCoopers caroline.r.piselli@us.pwc.com caroline.r.piselli@us.pwc.com

54 Source: PwC Health Research Institute

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