Henry Ford Medical Group

Radical Convenience: A New Wave of Patient Care

Presented by:

Diane George, DO HFMG Associate Chief Medical Officer

Thomas S. Nantais

HFMG Chief Operating Officer

The Henry Ford Medical Group

40-specialty academic Medical Group practicing in 30 HFMG Medical Centers

1300 Employed Senior Staff Physicians & Researchers; 3100 non-physician providers & support staff

$750M in net revenue (33% of total HFHS provider revenue)

70% FFS, 30% risk capitated (120,000 HMO commercial & Medicare Advantage)

2.1 M clinic visits annually

3

.6

HFMG Medical Center

HFMG MC & UC

MC & 24 Hour ER

Hospital & ER

Macomb UC

Wyandotte MC & ED

Henry Ford Health System

Same Day Clinic

Monday-Friday 8 a.m. to 8 p.m.

Weekends & Holidays

10 a.m. to 2 p.m.

HFMG’s Competitive Environment

Six major health systems

competing for a patient

population base of 3.8M people

Little to no growth in that

population

Difficult for the populace to

differentiate one health system from another

ENTER Henry Ford’s

Radical Convenience

Model

“Call, Click or Come In” Henry Ford Medical Group June 11, 2014

Radically convenient access to Primary Care “Call, Click or Come-In”

Call (telephone)

HFMG Nurse-On-Call program to address primary care medical concerns (Internal Medicine, Family Medicine, Pediatrics & Women’s Care)

Click (computer)

Increase the number of active MyChart users

• Directly schedule appointments online with Primary Care, Behavioral Services, and Women’s Health physicians on line (96% patient satisfaction)

• Real time test results

• Timely communication with your physician

• E-visits

6

Radically convenient access to Primary Care “Call, Click or Come-In”

7

Come-In (office visits)

• Provide evenly distributed, broad access by reconfiguring sites in Primary Care, Medical Center or Super Center models

• Formal MinuteClinic relationship

• Expanded collaboration with CVS Health

• Develop our own “QuickCare” product

• Pursue offering some level of concierge service

• Grow Same Day Clinic (walk-in) – have five 7-day sites open in 2015

• Pilot Clockwise MD

Same Day Clinic Growth

0

1,000

2,000

3,000

4,000

5,000

6,000

Sep

-12

Oct

-12

No

v-1

2

Dec

-12

Jan

-13

Feb

-13

Mar

-13

Ap

r-1

3

May

-13

Jun

-13

Jul-

13

Au

g-1

3

Sep

-13

Oct

-13

No

v-1

3

Dec

-13

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

Dec

-14

Open Fairlane Open Detroit Northwest

Open Sterling Heights

TELEMEDICINE

Henry Ford Medical Group

Henry Ford Health System Telehealth

Healthcare Transformed:

- Primary Care telemedicine visits facilitated by

Teladoc

- Remote Consulting

- Convenience Clinics

Triple Aim Opportunity

Henry Ford Medical Group is working in partnership with Teladoc to offer a co-branded telemedicine product delivered by primary care physicians

● Telemedicine provides what patients, employers & Insurance companies are looking for – their Triple Aim

● HFMG is the first System in the Detroit Market to offer true telemedicine to its patients via this modality

● Offered directly to patients, but also the employees

● Very popular with the 53 HFMG primary care physicians who have agreed to participate

● Timely Access + Lower Cost + Quality Care = Our Objectives

Growth

• Timely Access

• Lower Cost

• Quality Care

The Teladoc Approach is Working

13

How Teladoc Works

Access Teladoc service through

HFHS Website or Teladoc webpage

Access Modalities Phone Mobile

Video

Kiosk

15

Teladoc Clients

Customers are using Teladoc across multiple market segments, including Commercial and Government-Sponsored Plans, Providers and Employer Groups

Managed Medicaid

Employers Health Plans

Providers

Marketing Focus ● HFMG is looking to

target a new employer-based market and insurance companies

● This will include our owned health plan – Health Alliance Plan

● Quote from patient: “I have used Teladoc 15 times this year for my family and me"….Home Depot employee/HFMG patient

HFHS Access HFHS patients & newly acquired employers will have

dedicated access points by telephone and the HFHS webpage

● Payments to HFHS

● % of the per encounter per member (PEPM) for newly acquired employer contracts

● Payment from employer is $40 split between Teladoc & HFMG Physician (covered by employer)

● Fixed $ per encounter for non-employer aligned patients

● Payments to HFHS physicians

● Physicians are paid independently regardless of the source of the patient

● Physicians may also service non-HFHS patients

Telemedicine Reduces Cost Telehealth is redirecting ER and UC utilization to an

affordable alternative.

Not a replacement of the PCP relationship ● Member communications reinforce importance

of PCP relationship

● Evidenced-based medicine

● Every patient is asked before every consult if they would like a copy of their consultation sent to their PCP

● Referrals to the HFHS network

● Patient does not select their physician or develop an on-going relationship

● Overutilization of Teladoc services is closely monitored

● Credentialing, rigorous QA, maintenance of evidence-based protocols, adherence to 125+ proprietary telehealth guidelines

Teladoc supports the Patient / Physician

Medical Home

Teladoc refers patients to their PCP for any

follow up care

HFMG Implementation Progress Progress to date:

Initiated in January

2015

Marketing to patients

and employers

Monitoring physician

and patient satisfaction

levels

HFMG Dr. Passerman quote: “6 encounters in one evening….a lot of fun! “

The industry isn’t standing still HFMG, in partnership with Teladoc, is committed to

transforming healthcare, pursuing better….

Timely Access

Lower Cost

Quality Care

Member Engagement

Employer Engagement

Provider Engagement

Together, We Can

TELE-CONSULTING

Henry Ford Medical Group

Tele-Consulting

Remote access to

HFMG specialists

Works extremely

well for rural

facilities

“Box” cloud

technology transmits video link & images to HFMG

Virtually “meet”

consulting physician

Convenient follow up on post-

procedural issues

remotely

Tele-Consulting (continued)

Long distance Structural Heart and Neurosciences Consults

Local Dermatology Consults (less costly technology)

Community Health Fairs – specialty on-call physician consults on patient

Convenience Clinics

Chrysler World Headquarters Clinic

PA run clinic operating within Chrysler for 7 years

Physician presence 1 day per week

Online scheduling for employees

Point of care testing for common viruses/infections

Pharmacy on site

High satisfaction from Chrysler & employees

Significant impact on lost workdays

Chrysler World Headquarters Clinic Lessons Learned

• Pros: – Used as an incubator for our

future “convenience clinics”

– Supported on work time by employer (not at lunch or break)

– Excellent payer mix (insurance or employer reimbursed)

– Tech saavy employees (love the scheduling technology)

– Confidentiality (sequestered waiting room)

• Improvements: – Not much downstream

business to secondary care HFMG clinics

– Generated a slight loss (but is covered by employer)

– Demand was variable; significant volume decrease when employee based dropped from 12,000 to 9,000 during recession

Downtown Detroit “Quick Care” Clinic

Clinics staffed by mid-level providers

with tele-health consulting

capabilities to any HFMG physician

Quick and Easy way to meet healthcare

needs

Expanding urban professional market

in central core of city

Use learning from Chrysler experience

to plan & design

Downtown Detroit “Quick Care” Clinic (continued)

• Service offerings include: – Remote travel clinic

services

– Immunizations and vaccinations

– Point of care testing for viruses and infections

– Remote access to a HFMG specialist

– A healthy Juice Bar

• Pharmacy on site

• Clinics will use pre-established treatment protocols

• Delivery of DME supplies and equipment on a real-time basis

• Opening April 2015

“Radical Convenience”: Future State

Same Day Specialty Appointments

Complete Video visits with PCPs

HealthSpot

-On the spot self serve health care kiosks

Questions and Discussion