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QuadMed

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

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  1. QuadMed Innovations in Population Health Management – Delivered On-site Raymond Zastrow, M.D. Chief Medical Officer QuadMed LLC West Allis, Wisconsin

  2. We provide innovative, high-value health care solutions to companies, improving the overall health and productivity of their people.

  3. 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

  4. 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

  5. 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

  6. 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

  7. Cost Reduction • Specialty Care • Hospital Inpatient • Pharmaceutical • Emergency Department • Diagnostic Imaging

  8. QuadMed Track Record Average healthcare cost per employee Average Cost Trend 1999-2008: 5.6%

  9. 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)

  10. 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?

  11. Payer Risk-Adjusted PMPM Fee-For-Service Pay for Performance ACO RVUs Coding Accuracy Chart Completion Schedule Efficiency EBM Patient Satisfaction Salary + Providers

  12. 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

  13. 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.

  14. Contact Information Raymond J. Zastrow, M.D. Chief Medical Officer / QuadMed raymond.zastrow@quad-med.com 414-566-8057

  15. Innovations in Health Care Delivery Bruce Nash, M.D., M.B.A. Capital District Physicians’ Health Plan Senior VP, Chief Medical OfficerAlbany, NY

  16. 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

  17. CDPHP Pilot Practice Reform Payment Reform

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