quarterly business reviewrm.rutherfordcountytn.gov/documents/onsite clinic bid/q2 2019...

© 2019 Premise Health. All material contained in this

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Quarterly Business Review

Rutherford CountyQ2 2019

2© 2019 Premise Health. All material contained in this


Attendees

• Ed Elam, Director, Insurance and Risk

Management

• Sonya Stephenson, HR Director

• Rebecca Dexter, Vice President, Operations

• Dr. Cathy Womack, Regional Medical Director

• Shannon McNair, Director, Client Operations

• Jay Brown, Partner and Tennessee Office Leader

• Jake Davis, Principal Consultant



Agenda

A Joint Roadmap

B Key Discussion Points: Roadmap

C Performance Metrics

D Primary Care Metrics

E Member Experience

F Industry Trends

G Best Practices

H Future Considerations / Next Steps



Client: Strategic & Tactical Premise

Joint RoadmapA

Mobile Wellness

• Pilot at Risk Management Office for surrounding offices 1 day/

month

• Third Tuesday of every month (times TBD pending interest)

• Starting October 15, 2019

Mobile Biometric Screenings for 2019

• Pilot mobile biometric screenings in 2019 at school clusters?

Marketing Campaign for Virtual Health

• Offer members virtual appointments for lab result review as an

option in place of an onsite visit.

Changes to phone logistics to allow decrease in drops

before voicemail picks up

Review Mercer Assessment Report

• Member Engagement/Utilization

• Complete Mercer assessment of MedPoint clinics:

• Environmental Inspection

• Clinical Quality

• Administration

• Member Engagement

• Risk, Safety, Quality

• Technology, Integration, Reporting



Areas for Continuous

Improvement

Performance Success

• Wait times are down at all three sites this quarter with an

aggregate wait time of 8.0 minutes.

• Portal Awareness and Active rates have fallen to 75.6% and

63.5%, respectively. Will continue to promote portal use.

• Out of 1,689 unique members this quarter, 1,535 saw a provider

for a visit resulting in 2,338 visits.

• Despite A1c screening falling to 95.65%, the number of attributed

diabetics who received a screen increased from 9 in Q1 to 23 in

Q2.

• Portal utilization remained strong with 178 medical advice and

114 medication refill requests this quarter, as well as 1,137

appointments scheduled through the portal. This accounted for

31.1% of all scheduled appointments

B Key Discussion Points: Roadmap



Performance MetricsC

Metric Result Target

Performance

Guarantees

• Penetration Rate• 25.3% • >25%

• Budget Adherence• 96.8% • <105%

• Patient Satisfaction • NPS 90 • NPS>60

• Invoice Accuracy • 0 adjustments • <5% adjustment



Wait Time (min) Third Next Available (days)

Completed Appointments

Clinical Quality Value

Operational EfficiencyMember Experience

HTN: BP Screening

DM: HbA1c

Screening

Primary Care MetricsD



Value – Visits

Provider Visits Trend

Completed Appointments TrendCompleted Appointments by Top 5 LOS

Provider Visits by Top 5 LOS


Provider Visits

Insight:

2,338 Provider Visits

completed.



Value – Members

Unique Members

Unique Members TrendUnique Members by Top 5 LOS

New Members by Top 5 LOS New Members Trend

Insight:

1,535 Unique

members saw the

provider in Q2.



Value – Count of Unique Members by Completed Appointments

Count of Unique Members by Completed Appointments



Local Virtual Health

VH – Video Visits Trend

VH – Phone Consults Trend

VH – Video Visits

VH – E-Visits TrendVH – E-Visits

VH – Phone Consults



Value – Appointments

Scheduling Method

Walk-In, Same Day and Scheduled



Visit Value Year to Date

Total Clinic VisitsProvider Primary Care

VisitsUnique Members

Q1 20192,761 2,471 1,635

Q2 20192,736 2,338 1,689

Q3 2019

Q4 2019

YTD 5,497 4,809 2,550



Clinical Quality – Diagnoses

Top 10 Diagnoses – Unique MembersPreventive and Wellness

Services – Unique Members

Hypertension continues

to be the top diagnosis

for MedPoint members in

Q2. Hypertension was

the diagnosis that

resulted in the highest

percent of total plan

spend in 2018 per the

Cigna CAP Report.



Member Experience – My Premise Health Portal

Medication Refill Requests Trend

Medical Advice Requests Trend

Medication Refill

Requests

Medical Advice

Requests

E



Key Industry TrendsF

As we look towards 2020, research suggests that healthcare costs may rise at a faster rate than in the

past years, so employers will need to respond to the following developing trends to stem this increase

• Increasing prices

- Americans with Employer Sponsored Insurance are not getting any additional care at the aggregate level, but the care they are receiving has a

larger and larger price tag

- Employers will need to continue finding solutions to facilitate smart shopping by members and ensuring members are receiving care from the

highest value doctors at the highest value facilities

• Increasing prevalence of chronic diseases

- Studies indicate that 62% of members in a given employer population have a chronic or complex chronic condition, which drives 85% of the

total employer based healthcare spending

- Recent report identified ~20% of ER visits occurred for complications or issues associated with chronic conditions that could have been treated

in primary or ambulatory care setting

• Increasing dissatisfaction with rising deductibles

- Studies indicate that 42% of members on an employer-sponsored plan surveyed in the report said they were dissatisfied with their deductible;

frustration has been building as growth in employee cost sharing has surpassed wage growth in the past few years

- Outsized deductibles are now leading to members delaying or forgoing care, which has the potential to increase costs in future year

Sources: Medical cost trend: Behind the numbers 2020; Health Research Institute; June 2019; Ready, Risk,

Reward: Improving Care for Patients with Chronic Conditions, February 2019



Best PracticesG

Member Engagement

• Making it easy for members to find the health center is

critical to success but can be challenging for Clients for

a variety of reasons

• Best practices include (1) clear and frequent signage

across the campus, (2) reminders included in HR and

benefits-related emails, and (3) location details on Client

intranet sites

Clinical Quality

• Design a benefit plan to incentivize participation in

condition improvement programming

• Effective incentives include (1) waived co-payments for

condition-related visits, (2) subsidized or free condition-

related medications, and (3) waived fitness center

membership fees for the duration of participation in the

condition management program

Biometric Health Screening

• An annual screening event drives prevention and early

detection of health risk and potential underlying

conditions

• Results from these events increase the likelihood of

engagement in additional employers sponsored

wellness programs and the onsite wellness center,

leading to improved health outcomes and lowering the

trajectory of employer related healthcare trends

Wellness

• Promoting and enabling a culture of self-care – any

activity that we do deliberately in order to take care of

our mental, emotional, and physical health – is

increasingly recognized as foundational to successful

Wellness programs

• According to the Harvard Business Review, wellness

programs are less effective without a culture in which it

is acceptable and encouraged to prioritize self-care



Future Considerations / Next StepsH

Next Steps:

• Mercer Site Assessment

Report

• Support open enrollment

efforts and education of

clinic opportunities

• Health Fair- flu shots and

wellness booth

Accountable Party: Timeline:

• Mercer

• Premise Health

• Premise Health

• September/October 2019

• Present- October 2019

• October 2018, 2019



Appendix



Rutherford County Medpoint Clinics - Blackman – Q2 2019 Quarterly Report





HTN: BP Screening

DM: HbA1c

Screening

Rutherford County Medpoint Clinics - Blackman



Rutherford County Medpoint Clinics - Stewarts Creek – Q2 2019 Quarterly Report





HTN: BP Screening

DM: HbA1c

Screening

Rutherford County Medpoint Clinics - Stewarts Creek



Rutherford County Medpoint Clinics - Walter Hill – Q2 2019 Quarterly Report





HTN: BP Screening

DM: HbA1c

Screening

Rutherford County Medpoint Clinics - Walter Hill



Metric Definitions



• Wait Time

- Average wait time in minutes is measured between a member checking in or appointment time, whichever is later, androoming documentation being entered by the first clinician that the member sees. Wait times over 24 hours areexcluded from the Wait Time calculation.

• Third Next Available

- This metric shows the number of days (not counting non-worked days) until the third available appointment slot, acommon industry-wide business metric. This information is used to estimate clinician accessibility and is automaticallycalculated by the system which looks for the first third appointment by date and time when an appointment request ismade. This metric is calculated over PC/Occ departments only.

• Completed Appointments

- This metric tracks the number of scheduled appointments with a status that is considered completed with any clinicianor visit type.

• New Members

- A New Member is any member who has not had a completed encounter with any clinician at a location in 36 months.

Metric Definitions



• Unique Member

- Unique Member is the count of members with a visit, including completed appointments and other face-to-faceencounters (i.e. mass campaigns like Flu or Biometric events) which create an encounter but not an appointment onthe schedule. Members are only counted once during the time frame. The number in the box represents the totalunique member count for the time frame. The unique member count shown in the department represents the uniquecount for that department.

• My Premise Health Active or Offered

- My Premise Health Activation Rate is the percentage of completed appointments where the member was My PremiseHealth active or offered prior to or within 30 days following the visit.

• DM: HbA1c Screening

- Percentage of diabetics aged 18-75 who are Attributed to the health center who had a HgbA1c screening in the past 12months.

• HTN: BP Screening

- Percentage of hypertensives aged 18-75 who are Attributed to the health center who had a blood pressure screening inthe past 12 months.

Metric Definitions



• Walk In

- The appointment was scheduled within 1 hour of the appointment.

• Same Day

- The appointment was scheduled on the same day as the appointment, but more than 1 hour before the appointment.

• Scheduled

- Appointment was scheduled prior to day of appointment.

• Phone Activity

- Count of phone call activity performed by staff. These phone calls are not billable encounters. This count is not included in the phone consult count in local virtual health.

• Outgoing Referrals –

- Count of total referrals made to providers who are not affiliated with the Premise Health Center that were not cancelled or denied.

• Internal Referrals –

- Count of total referrals that are made to services that are supplied by Premise Health that were not cancelled or denied.

• Vendor Referrals

- Count of total referrals ordered for external vendors (these services are not provided by Premise Health Center).

Metric Definitions

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