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OPERATIONS • TECHNOLOGY • CONSULTING
Health Datapalooza
Data at the Point of Care
June 3, 2013
Proprietary and Confidential. © 2013 Lumeris, Inc.
WHO WE ARE
2
Proprietary and Confidential. © 2013 Lumeris, Inc.
SHIFT TO RISK
3
Accountable Care and The Shift To Risk
Proprietary and Confidential. © 2013 Lumeris, Inc.
WHAT WE DO
4
• Cloud-Based Enterprise IT
• 22 ACO Core Competencies
• 1,000+ Man-Years Invested
• 70% of Clinicians and Hospitals
• Multi-Payer
• 300M Annual Transactions
• Innovation and Best Practices
• Provider Transformation
• 4.5 star rated MAPD plan
• 61% MCR (before incentives)
• # 1 plan in marketProof
Platform
Connectivity
Transformation
Proprietary and Confidential. © 2013 Lumeris, Inc.
THE RIGHT CARE,
in the Right Setting,
at the Right Cost
WITH CLEAR ACCOUNTABILITY FOR
Clinical, Financial, and
Quality Outcomes
Population
Health
Management
Lower Per
Capita Costs
Physician
Satisfaction
Enhanced
Patient
Experience
Triple
Aim*
+ 1
Ensuring every patient receives…
5
LUMERIS’ SUCCESS
Proprietary and Confidential. © 2013 Lumeris, Inc.
Support the Transition to Population Management
TECHNOLOGY TOOLS
6
Proprietary and Confidential. © 2013 Lumeris, Inc. 7
Proprietary and Confidential. © 2013 Lumeris, Inc.
PATIENT CARE PROFILE
8
Proprietary and Confidential. © 2013 Lumeris, Inc. 9
CLINICAL WORKFLOW
Proprietary and Confidential. © 2013 Lumeris, Inc. 10
CLINICAL OUTCOMES
Proprietary and Confidential. © 2013 Lumeris, Inc. 11
COST OUTCOMES
Proprietary and Confidential. © 2013 Lumeris, Inc. 12
PHYSICIAN SATISFACTION
Proprietary and Confidential. © 2013 Lumeris, Inc. 13
PATIENT SATISFACTION
Proprietary and Confidential. © 2013 Lumeris, Inc.
CONNECT WITH LUMERIS
14

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Health Datapalooza 2013: State of the Art - Lumeris

Notes de l'éditeur

  1. Our success is in helping our clients achieve the Triple Aim Plus One, and ensuring every patient receives the right care, in the right setting, at the right cost; with clear accountability for clinical, financial and quality outcomes. We do this by aligning incentives, information and technology tools. There are a lot of cool apps and technology out there, but what we are finding is the best technology in the world will never get used unless there are incentives driving its usage.
  2. Now, on to a patient-level view. Meet our hypothetical patient, Betty Ellis. This is her care profile within the ADSP.
  3. How does the ADSP fit into the clinical workflow?At the point of care, patients like Betty Ellis are set up for a better outcome. That is because Betty’s doctor has her complete care profile on her desktop, and through our health risk assessment and enhanced encounter programs we are helping physicians see beyond their EMR/clinical data to every encounter, lab and prescription Betty has throughout the health system. One of our customers – a physician in Wisconsin - relayed the message to us that their patient feels like this system is looking out for them.
  4. How does the ADSP affect cost outcomes?Several sources suggest that physicians in this country are directing approximately 80% of the heath care spend. That is why having both clinical and cost information available for physicians at the point of thought is so important – if they are to meet cost-effectiveness metrics set forth in their value-based contracts. It is estimated that nearly 30% of health care is waste in terms of unnecessary/duplicative tests. The ADSP is helping to reduce waste through effective cost utilization management.  In Betty’s case she has high blood pressure and there are a ton of medications to treat hypertension. Via the ADSP, physicians can see the brand name drug cost and the generic drug cost. Our platform brings transparency into the cost of care - not only for prescription drugs, but for all procedures and diagnostics. While each physician has about $2 million in annual spending authority, we hear from our clients all the time that physicians are in the dark about how much services cost, comparative quality and value of choices. Health systems, payers and providers have a huge opportunity to improve care through collaborative decision support and effective cost utilization and generic substitutions.