Foundational Elements Our Mission We extend the healing ministry of Jesus by improving the health of our communities with emphasis on people who are poor and underserved Our Values CompassionHuman DignitySacredness of LifeExcellenceJusticeService ID: 748676
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Slide1
ADURO Foundry
1
June 2018Slide2
Foundational Elements
Our MissionWe extend the healing ministry of Jesus by improving the health of our communities with emphasis on people who are poor and under-served.
Our ValuesCompassion—Human Dignity—Sacredness of Life—Excellence—Justice—ServiceOur PromiseTo make lives better — mind, body and spirit.To genuinely enjoy being of service.To make healthcare easier.2Slide3
Mercy Health’s mission is to improve the health of our communities with emphasis on the poor and underserved
Catholic Ministry serving
7
regions across Ohio and Kentucky.
Merging with Bon Secours to create
5th largest
Catholic health system in country.
Almost
11M
patient encounters annually
Almost
$2M
in community benefit each day
1,000+
points of care
43
hospitals
2.1k+ Providers
57k+ Employees
3
Mercy Health
Bon SecoursSlide4
Achieving our vision: Strategic pillars are our pathway to success
Our 2020 Vision
Mercy Health is the preferred choice in our communities for reliable, compassionate, high value care at the time and place those we serve need or want it.Through innovative practices, processes and partnerships, we will grow the ministry and maintain financial stability.4Slide5
Challenges: Our workforce will grow in 5 major ways in our new strategic plan
5
Change healthcare delivery by adding micrositesPCPsOutpatientFreestanding EDs/Urgent careGrow our contingent (nonemployed) workforceAffiliate PhysiciansRevenue CycleFood ServiceAdd & transform other delivery systemsGrow our portfolio of health-related subsidiaries
Ensemble (Revenue Cycle)
Ensemble IQ (Analytics)
Transfer Center
Address external labor market forces
Union contract negotiations (RNs in SEIU & UAW)
Labor market shortages (Physicians, RNs, Medical Assistants)
Unemployment Rate (4.1%) at 16 year low
Shift from Boomer to Millennial workforce
Healthcare Employment Cost Index (ECI) is at an all-time highSlide6
Mercy Health Well-being Case Study
6Slide7
Disaggregated,
inefficient strategy and
designs Poor health of our caregiversUtilization of Mercy Health providers was a suggestion, not an expectation
Y
ear
over
year
pharmacy
trend
of
15%+,
including
40%+ specialty trendJust five years ago, Mercy Health’s benefits program was fractured and ineffective
4,500 employees and family members with diabetes; roughly 400 with out of control diabetes
Employee Emergency Room
u
tilization exceed
ed benchmark by 15%High risk individuals driving high plan cost
7Slide8
Aligned infrastructure and strategy needed to begin the journey
Single system team and strategy
Plan
#1
#2
#3
Streamlined administration
Focus on driving care to our high quality network
8
Limited menu of benefit design
optionsSlide9
Robust pharmacy management drives negative trend
Pharmacy
Tactics (2017
)
Plan design drives domestic, de-marginalized utilization
Aggressive PBM discounts & rebates
Variable copay program
Responsive, in-sourced formulary
Virtual and in-person medication therapy management
Move infusions to pharmacy plan
Pharmacy and Specialty Trend
9Slide10
In partnership with Mercy Health Select, we care for our sickest colleagues and their families
Care Management
(2016)
Leverage aligned EHR
Ambulatory Care Coordination
to manage rising risk
Care Transition Coordination
to manage inpatient discharges
Shared savings (with downside risk) motivates our providers
Manage robust network of care
Diabetes Management launched in 2018
percentage
of identified members with Diabetes
who are enrolled
Targeting our diabetics with a best practice diabetes management program42%expected improvement in medication and formulary adherence
reduction in PMPM costs for Rx related claims since program began in January22%5%expected improvement in number of patients with controlled HBA1C5%amount of incentive provided to members in reduced pharmacy copays
$600
10Slide11
Improving access to lower points of care
Nurse
Access
Line (2018)
Partnered with our 24/7/365
Transfer
Center
to launch
Guides employees
to
lower cost
care
if
an ER visit is not appropriateNon-emergent ER visits subject to $200 penaltyEnhance domestic utilization by referring to Mercy Health providers
Initial results are promising of our goal to reduce ER utilization below hospital benchmarks
number of calls in 58 days (Avg 17 Jan, Avg 20 Feb)1,082ER claims in Jan 2018, down from 595 (Q1 monthly Avg)463
Percentage of callers with a pre-call plan to go to ED were triaged and redirected to lower level of care26%
11Slide12
17% decrease in average health opportunities over three years, driving a projected $13M in savings in 2018 alone
Be Well Within (2014)
Incentive-driven, outcomes-based design
Naturally Slim mindful eating program
Online/mobile engagement platform
Mercy-supported screenings
Human performance coaching
Cultural campaigns w/ champions
Be Well Within encourages our caregivers to care for themselves
12Slide13
Data Point
2
0122017Medical and Rx Trend (PMPM)
$
3
92
$
370
Domestic Utilization (Total
Paid)
56% 72% ER Utilization (per 1,000)
256 219 IP Utilization (per 1,000) 100
65 Scripts (per member)9.78.9
Be Well Within Screenings 45% 69%
Successful five-year journey for Mercy Health’s health plan
13Slide14
Background: The Be Well Within Center
Our Home Office on-site clinic
Count of Level of Service By Appointment Length
All figures shown cover May 2017 – April 2018 unless otherwise stated
14Slide15
Background: The Be Well Within Center
Our Home Office on-site clinic
Patient Distribution by Member Type
New Patient vs. Established Patient Distribution
15Slide16
Background: The Be Well Within Center
Our Home Office on-site clinic
Count of Appointments by Time and Day
Patients per Home Zip code
Patients by Age Bucket
16Slide17
Background: The Be Well Within Center
Our Home Office on-site clinic
Number of Encounters by
Payor
Incoming Net Payment Including Copays
17