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QuadMed. Innovations in Population Health Management – Delivered On-site. Raymond Zastrow, M.D . Chief Medical Officer QuadMed LLC West Allis, Wisconsin. We provide innovative, high-value health care solutions to companies, improving the overall health and productivity of their people.
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QuadMed Innovations in Population Health Management – Delivered On-site Raymond Zastrow, M.D. Chief Medical Officer QuadMed LLC West Allis, Wisconsin
We provide innovative, high-value health care solutions to companies, improving the overall health and productivity of their people.
QuadMed Clinic Locations QG Lomira, WI• Primary Care• EAP, AODA• Rehab • Fitness Center• Dental• Vision • MillerCoors Brewing• Primary Care• Fitness Center• Occupational Med• Rehab • Briggs & StrattonHealth Center• Primary Care• Fitness Center• Occupational Med• Rehab • Northwestern Mutual • Health Centers (2) • Primary Care • Occupational Med • Briggs & StrattonHealth CenterPoplar Bluff, MO• Primary Care• Rehab QG Sussex, WI• Primary Care• Surgery• EAP, AODA• Rehab • Fitness Center QGWest Allis, WI• Primary Care• ENT• Orthopedics• Cardiology• Occupational Medicine• EAP, AODA• Rehab• Fitness Center• Dental• Vision Care QG Saratoga Springs, NY• Primary Care• EAP, AODA• Rehab • Fitness Center • QG Martinsburg, WV• Occupational Med• Primary Care • EAP / AODA • Fitness • Rehab
QuadMed Model • Onsite Employer-directed Primary Care • Organized as PCMH • Self-funded / Self-administered • Value-based Benefit Design • Our Strategic Directives: Triple Aim / Lean • Not Presently Serving Medicare / Medicaid Populations
Care Improvement • Population Health Management • From a Primary Care Platform • Proactive – Across the Care Continuum • Incentivized Wellness • Coaching / Behavior Modification • Chronic Condition Management • Complex Case Management
Population Care Continuum Short Term Acute Good Health Complex Catastrophic Preventative Care Chronic Robust Analytics & Predictive Modeling Plan Design and Incentives Communications and Change Management Integration across the Continuum HRA High Performance Network Patient Centered Primary Care (platform for managing population health ) Wellness Programming Chronic Condition Management Case Management Fitness Centers Lifestyle Coaching Integration Population Health Management delivered from a Primary Care Platform
Cost Reduction • Specialty Care • Hospital Inpatient • Pharmaceutical • Emergency Department • Diagnostic Imaging
QuadMed Track Record Average healthcare cost per employee Average Cost Trend 1999-2008: 5.6%
Regional Collaboration • WI Collaborative HC Quality • WI Health Information Organization • WI Health Information Exchange • ED Linking Project • PCMH (WAFP, Jackson Clinic) • IHI Triple Aim (Bellin) • Lean (Theda)
Accountable Community Partnerships • Value-based Contracting • Terrific Whitepaper at CHVI site • http://www.vbhealth.org/wp-content/uploads/CHV_OBC-Cover_Text_REV8-30-10c.pdf • Narrow, High-Performance Networks • Service Level Agreements • QuadMed External to QG • Cost-Plus Contracting • Performance Guarantees • Future: Risk-adjusted PMPM?
Payer Risk-Adjusted PMPM Fee-For-Service Pay for Performance ACO RVUs Coding Accuracy Chart Completion Schedule Efficiency EBM Patient Satisfaction Salary + Providers
Current Challenges • Integration of Worldcolor into Quad • Fighting for Transparency • e.g. Pharmacy Benefit Design • Extending the QuadMed Model to multiple smaller legacy WC sites • Consumer Health IT • Telemedicine • Paying More for Care Under ACA • Understanding Ramifications of Exchanges heading into 2014
Collaboration With CMMI • QuadMed has developed a healthcare enterprise that has been successful in controlling cost and improving quality of care for Quad/Graphics and other employers with a focus on: • Accountable / Empowered Primary Care • Wellness and Prevention • Practice of Evidence Based Medicine • Outcomes-based Contracting • QuadMed features are applicable to healthcare systems in general and can be successfully implemented at other large organizations with similar results.
Contact Information Raymond J. Zastrow, M.D. Chief Medical Officer / QuadMed raymond.zastrow@quad-med.com 414-566-8057
Innovations in Health Care Delivery Bruce Nash, M.D., M.B.A. Capital District Physicians’ Health Plan Senior VP, Chief Medical OfficerAlbany, NY
Not-for-profit network model health plan • Physician-founded and guided for 27 years • 350,000+ members in 29 counties in upstate New York • Top-ranked plan nationally for Commercial, Medicare Advantage and Managed Medicaid products Who We Are
CDPHP Pilot Practice Reform Payment Reform