The Qliance Direct Primary Care Medical Home:  Improving Care and Reducing Costs
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The Qliance Direct Primary Care Medical Home: Improving Care and Reducing Costs Presented to: CLG Employer Resources PowerPoint PPT Presentation


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The Qliance Direct Primary Care Medical Home: Improving Care and Reducing Costs Presented to: CLG Employer Resources Erika Bliss, MD – President & CEO of Qliance August 9, 2012. Current Healthcare Costs: Fiscal Cancer. 17% of GDP, projected to be >19% by 2017

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The Qliance Direct Primary Care Medical Home: Improving Care and Reducing Costs Presented to: CLG Employer Resources

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The qliance direct primary care medical home improving care and reducing costs presented to clg employer resources

The Qliance Direct Primary Care Medical Home: Improving Care and Reducing Costs

Presented to: CLG Employer Resources

Erika Bliss, MD – President & CEO of Qliance

August 9, 2012


Current healthcare costs fiscal cancer

Current Healthcare Costs: Fiscal Cancer

  • 17% of GDP, projected to be >19% by 2017

  • 62% of bankruptcies in 2010 were due to medical expenses

  • Primary care is severely underfunded (only represents 3% of medical expenditures)

  • Burdensome fee-for-service insurance billing system undermines potential of primary care

Total annual healthcare costs = $2.6T ($8047 per person per year)

Qliance Confidential & Proprietary


The effect of inadequate primary care

The Effect of Inadequate Primary Care

($$$) Emergency Care

($$$) Hospital Care

An ineffective primary care system pushes patients to expensive down-stream care.

The result is an increaseinhealth care costsfor employers and employees.

PrimaryCare

($$$) Specialist Care

($$$) End of Life Care

Qliance Confidential & Proprietary


Effective primary care changes the dynamic

($)

Hospital Care

($) Emergency Care

Effective Primary Care Changes the Dynamic…

  • Primary care can address 80-90% of medical issues

  • Primary care can catch little problems(hyperglycemia) before they become big problems (diabetes)

  • Robust primary care reduces need for expensive downstream care

  • But, good primary care requires doctors to spend time with their patients

PrimaryCare

($) Specialist Care

($)

End of Life Care

Qliance Confidential & Proprietary


The solution

The Solution:

  • Operate outside of traditional insurance

    • reserve insurance for undesirable, costly events

    • pay direct for primary care which is desirable and low-cost

    • eliminate high administrative overhead for primary care practices

  • Charge a monthly fee

    • low-cost: $64 per month

    • eliminates negative incentives of the fee-for-service system

    • incentivizes doctors to focus on holistic care

    • no co-pays or additional charges for visits and services

  • Provide great access

    • limit patient panel size

    • offer 30-60 minute appointments

    • multi-modal access, including office, phone, and e-visits

    • extended office hours and weekend hours

    • 24x7 physician coverage

Qliance Confidential & Proprietary


The qliance mission

The Qliance Mission

  • Re-establish the direct relationship between doctor and patient, allowing time to develop trust and foster a partnership that promotes and sustains health.

  • Dedicate ourselves to providing care that is personal, high-quality, accessible, and most of all, humane.

“If you give them enough time, your patients will tell you what is wrong with them. Time to listen to a patient is what is missing in today’s system.”

-Garrison Bliss, MD, Qliance Founder

Qliance Confidential & Proprietary


Qliance all inclusive primary care

Preventive Care

Qliance: All-Inclusive Primary Care

Urgent Care

Wellness Care

Specialist & Hospital Care Coordination

Chronic Disease Management

Enhance primary care to increase quality & control costs

Behavior & Lifestyle Management

Qliance Confidential & Proprietary


The qliance direct primary care medical home improving care and reducing costs presented to clg employer resources

Qliance Patients Use Less Downstream Care

* Based on best available internal data, may not capture all non-primary care claims.

** Based on regional benchmarks from Ingenix and other sources.

*** Based on average costs in WA State.

****No additional cost for additional primary care visits in the Qliance model.

Source: Qliance Medical Group non-Medicare patients, 2010 (n=3,088)


How does qliance improve member health

How DoesQlianceImprove Member Health?

  • Gives members the care and resources they need the way they want it. They want:

    • To feel better

    • To not feel rushed, with:

      • Enough time with their doctor to understand what’s wrong and what they need to do next

      • Enough time with their doctor to understand their choices

    • Appointments when they need them

    • Convenience (onsite lab, common DME, X-rays, etc.)

    • Help over the phone or by email instead of coming in

    • Expert advice on the best specialists or hospitals to get the best care


How does qliance reduce the overall cost of care

How Does QlianceReduce the Overall Cost of Care?

  • By shifting focus to primary care that includes at no extra cost to the member:

    • Longer appointments

    • Basic x-rays and labs onsite

    • First fill drug dispensary

    • Routine DME

  • Establishing trusting relationship with patients so we can positively influence their decisions and behaviors

  • Being available when patients need us so they don’t have to go to urgent care or emergency rooms

  • Reducing self-referral to specialists

  • Coordinating specialist, ancillary, and hospital care, making sure they get the right care at the right time


Plan integration examples

Plan Integration Examples


Our clinics

Our Clinics

Opening soon in Bellevue!

Qliance Confidential & Proprietary


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