1. From AM Radio to Pandora: The Health Care Innovators Next Frontier PrimeHealth September 19, 2012

2. Todays Agenda Why we have to fix the system now The tsunamis that are forcing change What we are being asked to do to create a sustainable system How entrepreneurial innovation can be part of the solution

3. 3 © 2009-2012 Center for Healthcare Quality and Payment Reform, Network for Regional Healthcare Improvement Medicare+Medicaid is Largest Driver of Future Federal Spending

4. 4 © 2009-2012 Center for Healthcare Quality and Payment Reform, Network for Regional Healthcare Improvement Huge Increases in Costs for Both Employers & Workers Employer Contribution More Than Doubled Employee Contribution Nearly Tripled

5. 5 © 2009-2012 Center for Healthcare Quality and Payment Reform, Network for Regional Healthcare Improvement Health Care Costs Have Wiped Out Real Income Gains $ 95 for spending $ 945 for health care $ 870 for inflation $1910 more income

6. The Second Tsunami: Information Moores law: number of transistors on a chip doubles every 18 mos. (trend true for >50 years) Corollary: Information is increasing at an exponential rate Conclusion: The tools and methods we used twenty years ago are obsolete, and are being replaced

7. The Third Tsunami: Consumerism Customer expectations are rising exponentially as well Other industries have taught Americans to expect their experiences to be individualized and automated: mass customization Disruptive innovation: minute clinics, other professionals, telemedicine, remote monitoring, personal health records, communities of care; geography increasingly irrelevant

8. Old Chinese curse: May you live in interesting times. Federal deficit over next decade will be driven largely by growth in HC spending. Employer contributions have doubled over the last decade; employee contributions have tripled. We owe the Chinese $1.2 trillion; I think theyre on to us. Being out of money has an amazing clarifying effect on peoples thinking.

9. The challenge of doing the opposite of what youve been doing Old Game Maximize billable activity Biggest network of unconnected providers Value based on credentials Patients as passive recipients Care centered on providers New Game Maximize health outcomes for least price Providers who produce best outcomes together Value based on outcomes Patients as activated partners Care centered on patients

10. Source: Modified version of slide from Shih et al, The Commonwealth Fund, August 2008. Transformation of Payment and Delivery

11. Big Data + Empowered, Demanding Consumers = Mongo Opportunity for Innovations That Inform and Empower

12. Berwick: Kano Model of Innovation Kano I: reduction in defects (Dissatisfiers) Kano II: reduction in cost while maintaining or improving customer experience (Satisfiers) Kano III: new service or product that costs more money (Delighters)

14. Transformation Opportunity Moving beyond Kano III to offer solutions to enhance health care experiences, contain costs, and improve the health of Coloradans. Less of:More of:

15. Opportunities for Innovation Coverage + Coordination + Collaboration Clinica Family Health Services | Access 1.Providing high-quality treatment in small groups, plus: Education Screening Answers Support 2.90-minute session with coordinated team of caregivers 3.Improved outcomes, better adherence + Connection? What would it take to offer a new level of interactions and support to patients using the channels theyre already using?

16. Opportunities for Innovation Connection + Performance Improvement Adherence is a $290 Billion/year problem* 1.Interventions impact adherence 2.Medication adherence leads to lower health care costs * New England Healthcare Institute. Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease, 2009.

17. Opportunities for Innovation Data on Outcomes, Cost and Quality Society of Thoracic Surgeons and Consumer Reports: 1.Data to report on: complication and survival rates whether groups used the best surgical technique whether patients were sent home with certain medicines 2.Examining whether giving patients access to this kind of information could improve heart surgery outcomes

18. Thank you! Jay Want, MD Chief Medical Officer CIVHC | Center for Improving Value in Health Care Phone: 720-583-2095 e-mail: info@civhc.org Web site: www.civhc.org