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MH Finalist Presentation_Applied Medical

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Michelle Rosowsky

on 8 June 2015

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Transcript of MH Finalist Presentation_Applied Medical

What's most important to you?
Proposed Scope of Services for Applied Medical
Primary Care Services
Acute & Urgent Care Services
Annual Exams & Screenings
Pregnancy Support / Education
Chronic Condition Management
Prescription Management
Referrals Management
Biometric Screenings
Blood Pressure Screens
Health Risk Assessments
Comprehensive Health Review
Fitness and Nutrition Coaching
Lifestyle and Risk Reduction
Population Risk Stratification
First Treatment of Injury
Drug Screening
Travel Consults and Vaccinations
Emergency Responder, First Aid, and Safety Training

OTC Medications
Rx Dispensing
Therapeutic Formulary
Medication Management
Drug Utilization Review
ePrescribing/PBM Data Integration
Coronary Artery Disease
Heart Failure
Back Pain

“During our review of employee health solutions, we were looking for more than just a medical provider to operate our center. We wanted a partner that could add value, bring innovation, and energize our employees about their health. We believe we found that partner in Marathon Health as their philosophy, track record, and approach closely aligns with the County’s goals and objectives.” ​

- Johnna Rogers, Wake County Deputy County Manager

“The patient-centered medical home requires a holistic approach to care, the ability to integrate all health services, and a technology platform that facilitates care coordination and reporting. We are moving our health services in this new direction with Marathon Health to continue our history of high-quality care, while adding the integration and reporting capabilities that are critical in monitoring our investment.”

- Donna Kelley, City of Chattanooga Administrator of Personnel

“Achieving an engagement rate of 97% with a distributed workforce can be attributed to several factors. We have strong program champions at the local level to coordinate the activities. We offer an incentive program to get people involved with the screenings and assessments. And through Marathon Health, we provide high-quality coaching and outreach programs.”

- Tricia McCall, Vice President of Human Resources, Lake Region Medical
A partnership
Creating value
The path forward
Where our customer are
Passionate and Involved Team
Better health,
better business.

Inspiring people
Source: www.emergentconsultants.com
Cost Plus vs. Fixed Fee
Collaborative Customer Care
Recruiting and Training
9.6 out of 10
willing to serve as reference
likelihood to recommend,
across book of business
Jerry Ford, CEO
Jeff Shea, Executive VP, Sales
David M. Demers, MPH, VP, Business Intelligence
October 16th, 2014

1. Introductions
2. Culture and Business Approach: Marathon
Health and Applied Medical Resources
3. About Marathon Health
4. Value Proposition and Business Case for
Applied Medical
5. Pricing, ROI, and Pro Forma Operational Data
6. Performance Guarantees and Reporting
7. Implementation Plan
8. Medical Team Recruitment
9. Account Management
10. Communications

Culture and Business Approach
Implementation Project Plan
Pre-Planning Process
Implementation Team Expectations
Ability Profiling

History Profiling
Work Experience

Culture Matching
Corporate Disciplines
Company Mission
Leadership Vision
Organizational Core Values
Company Core Behaviors
Personality Matching
Professional Images
Interpersonal Communication
Primary Care, Occupational Health, Onsite Rx
Identify Risk
Data Mining
Health Risk Assessment
Biometric Screen
Population Stratification
Mitigate Risk
Comprehensive Health Review
Action Plans
Health Coaching
Chronic Condition Management
Personal Health Record & Electronic Medical Record
Change Utilization
Alter Risk Profile
Discover & Treat Undiagnosed Conditions
Reduce Hospital Admissions, Emergency Care and Specialist Visits

Capture Savings
Lower Claims
Fewer Lost Work Days
Higher Productivity
Healthier people cost less, are more productive, and lead richer more rewarding lives.
Consider speaking with...
Medical device manufacturer, formerly know as Accellent
KKR owned company
Marathon Health client for 5+ years
2,300 EE’s in 14 locations, 3 with health centers, 12 with circuit riding
70% engagement rate of 1,100 high risk and/or chronic condition patients
58% reduction in prevalence rates for hypertension, 18% reduction for high cholesterol, 30% reduction for glucose
Modulation in claims trend from 9%+ pre go-live to 3%-7% post go live
90%+ patient satisfaction with quality and service
Proposal to Applied Medical
Core Metrics
Results -- other clients
and across book of business
Health Center Operation Data
Value of Population Health Risk Management
at Applied Medical
Key Population Health Risk Management Metrics at Applied Medical
Applied Medical
Health Center ROI
Fixed Fee Pricing
Flat Fee Pricing Includes:
All Medical Services Provided in Health Center: Acute, Primary, Occ. Guaranteed to 110% of Pop.
All Staff Expenses: Salary, Benefits, Absence Coverage, etc.
All Insurance Costs: Malpractice, Workers Comp, etc.
All Staff Continuing Education Expenses
All Medical Equipment Expenses to include Repair and Replacement
All Medical Supply Costs
All CLIA Waived Laboratory Costs, i.e., Rapid Strep Test, Urine Dipstick, etc.
All Single Dose OTC drugs
All Technology Costs, i.e., Electronic Medical Records, Personal Health Records, Decision Support, etc.
All Wellness, Health Promotion and Disease Management Services Detailed in Scope of Services.
All Member Communications
All Standard Data Analytics & Employer Reporting
All Flat File Data Transfers, i.e., Carrier Feeds, Incentives Feeds, DM Feeds, etc.
All Health History Risk Appraisals (Questionnaire Only)
All Implementation & Account Management and Support
Facility Design Support

Only Cost Outliers Are:
Facility Expenses, i.e., Construction, Maintenance, Lease, etc.
* Note we will provide design support
Non Medical Clinic Furnishings, i.e., Desks, Chairs, Conference Tables, etc.
Cost of Any Drugs, Serums or Vaccines Dispensed
Pass Through Cost with $0.00 Markup.
Cost of Any Mass / Group Biometric Screenings
Pass Through Cost with $0.00 Markup.
Cost of Any Externally Processed Labs – Labcorp, Quest, etc.
Billed to Plan by Lab Directly.
All Care that is Necessarily Referred Out, i.e., Specialist, Imaging, etc.

Performance Guarantees
10% of the total annual fixed cost is at risk in each year of the contract term.
Risk is tied to the IHI Triple Aim.

Monthly Dashboard -- Key Trends at a Glance
Encounter volume by type, screening rates, engagement for whole population and high risk population, and progress on biometric risk factors
Step 1: Risk ID
Step 2: Engagement
Step 3: Reduce risk
Annual Customer Forum
Presentation to Applied Medical Resources
Onsite Health Center and Population Health Management

Modeled net savings of $368,606/year or $14.16pmpm at run rate
How much impact can we have?
Patients Making Progress Vs. Triple Aim Metrics
Health Outcomes in Matched Cohort
Current vs. Baseline
Utilization Analysis
2012 vs 2013
Book of Business Results
Year over year medical claims trend, pre- and post-go live
Book of Business
Book of Business
Claims Trend Analysis -- Southern Municipality
Claims Trend Analysis -- Retail, Wholesale
Full transcript