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MH Finalist Presentation_Sanofi

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Michelle Rosowsky

on 11 December 2014

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Transcript of MH Finalist Presentation_Sanofi

Proposed Scope of Services for Sanofi
PRIMARY CARE
PREVENTION
Primary Care Services
Acute & Urgent Care Services
Annual Exams & Screenings
Pregnancy Support / Education
Chronic Condition Management
Immunizations
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
OCCUPATIONAL HEALTH
ONSITE MEDICATION DISPENSING
First Treatment of Injury
Physicals
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
Diabetes
Asthma
Hypertension
Heart Failure
Obesity
Back Pain
Allergies
Migraines
CHRONIC CONDITION
COACHING
Testimonials

“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
Core competencies
Where our customer are
Passionate and Involved Team
Better health,
better business.

Inspiring people
Cost Plus vs. Fixed Fee
Communication
Technology
Collaborative Customer Care
Recruiting and Training
100%
9.6 out of 10
willing to serve as reference
likelihood to recommend,
across book of business
Jerry Ford, CEO
Greg Hiss, Vice President, Sales
Martha Brace, Vice President, Project Management Office
Lisa Murphy, National Director of Clinical Education & Training
Marie Edwards, Account Manager

Implementation Project Plan
Pre-Planning Process
Implementation Team Expectations
Ability Profiling
Competencies
Behaviors
Aptitudes
Knowledge
Technology

History Profiling
Qualifications
Education/Training
Credentials/Certifications
Work Experience
Skill

Culture Matching
Corporate Disciplines
Company Mission
Leadership Vision
Organizational Core Values
Company Core Behaviors
Personality Matching
Relationships
Confidence
Professional Images
Interpersonal Communication
Demeanor
Healthier people cost less, are more productive, and lead richer more rewarding lives.
Having an impact...
Awarded No. 16 by FORTUNE Magazine in 2014

"Among the factors that led to us being awarded No. 16 are the two on-site health centers we added to our office locations. In independent surveys, CHG Healthcare employees also praised our comprehensive benefits program and robust lineup of team events."
Proposed model
Value of Population Health Risk Management
Savings opportunities at Sanofi
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.

Sample monthly CAT report
Encounter volume by type, screening rates, engagement for whole population and high risk population, and progress on biometric risk factors
Step 2: Engagement
Step 3: Reduce risk
Annual Customer Forum
November 11, 2014
Agenda

Modeled net savings of $426,880/year or $11.12 PMPM at run rate (3% reduction)
Patients Making Progress Vs. Triple Aim Metrics
Health Outcomes in Matched Cohort
Current vs. Baseline
Utilization Analysis
2012 vs 2013
MH
Book of Business
Data
Book of Business Results
Year over year medical claims trend, pre- and post-go live
MH
Book of Business
Data
Client
Example
Claims Trend Analysis -- Southern Municipality
Claims Trend Analysis -- Wholesale
Example
Data
Client
Examples
Illustrative
Data
DEMO
patient portal & web tools
EXCEPTIONAL SERVICE
Innovation
New release: clinician-friendly, patient-centric EMR
Medicomp: online clinical decision-support tool
Integration with wearables (e.g. FitBit, etc)
Nimble in responding to new developments (e.g. Ebola)
New services, e.g. test kitchens, Registered Dieticians, circuit riding model
Continuously learning culture
Community involvement
Reporting & Results
Making a difference
Culture of health
Employee engagement
Acting ethically
Shared accountability
Change and innovation
Employer of choice
Results driven
2. Proposal for
Sanofi
4. Recruiting & Training
6. Account &
Clinical
Management
7. Reporting
& Results
9. Pricing
& ROI
5. Communication
3. Implementation
8. Technology
DEMO
10. Performance Guarantees
1. Marathon Health
Differentiators &
Innovation
Proposal to Sanofi
1
2
3
4
Discover
Dream
Design
Deliver
action.
sustainable behavior change
acceptance.
meet them where they are
evocation.
looking at change in a positive way
collaboration.
plan-do-study-act

Based on Triple Aim Metrics
Cooking for a Cause
Clinical staff outreach
Implementation
Clear and coordinated
for a smooth transition
Communication
storefront
Specialized project plan
Identify Risk
Mitigate Risk
Change
Utilization
Capture
Savings
Data Mining
Health Risk Assessments
Biometric Screen
Population Stratification
Comprehensive Health Reviews
Action Plans
Coaching
Chronic Condition Management
Electronic Medical Record
Alter Risk Profile
Discover / Treat Undiagnosed Conditions
Lower Claims
Fewer Lost Work Days
Higher Productivity
Reduce Emergency, Urgent Care, Specialist visits
Fewer hospital admissions
Population Health Management
Getting individuals to
"opt in"
Agile and flexible
Results oriented
Putting people first
What's most important to you?
Pricing and ROI
Savings Report - Example
A Different
Approach
Aligning Actions with Values
Step 1: ID risk
MH
Book of Business
Data
Test kitchen
Penetration
Sample
patient visit
workflow
Full transcript