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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 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

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

slide8

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
our clinics
Our Clinics

Opening soon in Bellevue!

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