Hint Summit 2017 Health Rosetta Institute Ecosystem overview - Dave Chase april 2017
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This document discusses strategies for delivering lower cost, higher quality healthcare benefits to employees. It notes that healthcare costs are consuming over half of lifetime earnings for many Americans. The current system focuses on flawed financial incentives that have led to waste and misallocation of resources. The document proposes a voluntary certification ecosystem called Health Rosetta that would establish best practices and help groups adopt proven solutions to reduce costs while improving outcomes. It suggests starting with certifying benefits consultants to accelerate transitioning to fiduciary advisors who can guide purchasers to better benefit plans.
Hint Summit 2017 Health Rosetta Institute Ecosystem overview - Dave Chase april 2017
- 1. HOW TO DELIVER WORLD CLASS HEALTHCARE TO YOUR EMPLOYEES AT HALF THE COSTCEO’S GUIDE TO
- 2. HEALTHCARE COLLATERAL DAMAGE $1M LESS SAVED FOR RETIREMENT BY AVG BABY BOOMER FAMILY DUE TO 20+ YEAR WAGE STAGNATION/DECLINE 70% OF AMERICAN HOUSEHOLDS HAVE LESS THAN $1K IN SAVINGS
- 4. LARGEST GENERATION IN HISTORY (MILLENNIALS) OVER HALF OF LIFETIME EARNINGS SLATED FOR HC MEDICARE TAXES & PREMIUMS DEDUCTIBLES & OUT-OF-POCKET EXPENSES INSURANCE PREMIUMS EMPLOYER PREMIUMS EMPLOYER MEDICAID TAXES FEDERAL & STATE TAXES VISIBLE PAYMENTS $.6M HIDDEN PAYMENTS $1.3M + $1.9MGRAND TOTAL TOTAL LIFETIME EARNINGS $3.8M
- 5. THE FUTURE HEALTH ECOSYSTEM WILL FOCUS ON TRUE DRIVERS OF OUTCOMES HEALTHY CITIZENS ARE THE GREATEST ASSET ANY COUNTRY CAN HAVE – WINSTON CHURCHILL
- 6. CATASTROPHIC MISALLOCATION OF RESOURCES +37% HEALTHCARE SPENDING -50% LOCAL AID -31% PUBLIC HEALTH -22% MENTAL HEALTH -14% INFRASTRUCTURE, HOUSING & ECON. DEV. -13% LAW & PUBLIC SAFETY -12% EDUCATION -11% HUMAN SERVICES HEALTHCARE SPENDING DEVASTATES SOCIAL DETERMINANTS OF HEALTH (FY01 - FY14 - STATE OF MASSACHUSETTS)
- 7. 50+ years of optimizing for flawed financial incentives. Healthcare’s root cause of “morbidly obese” healthcare system Operational waste Clinical waste Paid for volumeCost-plus models Would be world’s 16th largest economy
- 8. Who pays for healthcare $2.7T in annual spending (2014) (excluding pharma) Government 48% Employers 52% ($1.4T) Medicare 24.8% Medicaid 19% Fully insured 19.7% Self-insured 32% Least flexibility Most homogenous Most politicized Most flexibility Least homogenous Least politicized Other 4.5%
- 9. $191B Operations waste Fraud Excessive admin costs Unnecessarily high prices 28% of $1.4T is systemic “obesity” $204B Clinical waste Unnecessary services Inefficient delivery Missed prevention $395 B annually in employer segment Individual behaviors like obesity = ~$200B
- 13. HEALTH ROSETTA ECOSYSTEM MULTI-CHANNEL MEDIA (BOOK, FILM, BEST PRACTICES) EDUCATION & CERTIFICATIONS FINANCIAL RETURN ON FOCUSED CAPITALGROUND BATTLE AIR COVER FOCUSED ON SCALING ADOPTION OF PROVEN FIXES TO THE ROOT CAUSES OF HEALTHCARE’S DYSFUNCTION. A LEED-LIKE BLUEPRINT FOR PURCHASING HEALTHCARE BENEFITS.
- 14. BLUEPRINT TO ENABLE EVERY GROUP HEALTH BENEFITS PURCHASER TO ADOPT PROVEN SOLUTIONS RESTORE THE AMERICAN DREAM FOR EMPLOYEES/MEMBERS OF PRIVATE & PUBLIC SECTOR EMPLOYERS/UNIONS, REGARDLESS OF EMPLOYER SIZE/INDUSTRY MODERN BENEFITS PLANS HAVE REDUCED COSTS 20-55%, WHILE SIGNIFICANTLY IMPROVING HEALTH OUTCOMES
- 16. SCALE SUCCESSFUL MODELS VIA LEED-LIKE ECOSYSTEM FOR PURCHASING BENEFITS 1. GOOD HOUSEKEEPING STAMP OF APPROVAL CREATES TRUST & CLARITY 2. VOLUNTARY 3RD-PARTY CERTIFIED ECOSYSTEM & NETWORK DRIVES ADOPTION CATEGORIES OF CERTIFICATIONS IN 3 PHASES 1. PEOPLE: BENEFITS CONSULTANTS, PURCHASERS, TOPICAL EXPERTS 2. PRODUCTS/SERVICES: BENEFIT PLAN COMPONENTS (E.G. PRIMARY CARE, MSK) CARE PROVIDERS, TECHNOLOGY (E.G. PAYMENT INTEGRITY) 3. PLACES (REAL ESTATE COMMUNITIES (E.G. SENIOR HOUSING), TOWNS, SCHOOLS
- 17. WHY GROUP PURCHASERS? DESIRE & PURCHASING POWER 1. SHOULDERING INCREASING COSTS 2. ABLE TO CHANGE INCREMENTALLY 3. EACH ACTS INDEPENDENTLY WE PROVIDE WHAT THEY LACK • INDEPENDENT VETTING: TRUSTED ADVISORS, PRODUCTS, SOLUTIONS & OTHERS • KNOW-HOW: BLUEPRINTS AND BEST PRACTICES • GUIDANCE: OVERCOME RETENTION FEARS & INCREASE MARKET EXPECTATIONS
- 18. BEACHHEAD CERTIFICATION CERTIFIED BENEFITS CONSULTANTS ACCELERATE THE TRANSITION OF BENEFITS ADVISING IN THE MODERN WORLD: FROM BROKER (LIKE 80’S STOCKBROKERS) TO FIDUCIARY/ADVISOR (LIKE FINANCIAL ADVISORS) WHY START HERE? • LARGE INFLUENCE ON PURCHASING DECISIONS • EMERGING MARKET PRESSURE TO MAKE THIS CHANGE
- 20. Twitter/LinkedIn/Gmail: chasedave Health Rosetta Institute: www.healthrosetta.org Health Rosetta Group: www.healthrosetta.com The Big Heist: www.bigheistmovie.com
Editor's Notes
- #2: Problem solution leverage catalyst (fiduciary opportunity/duty: shareholder - hc last place not addressed by corps and ERISA duty)
- #6: Didn’t get better lighting in homes & cities by optimizing candle and oil lamp technology
- #8: Since Medicare passed 50 years ago, all consumer goods/services went up 8x. HC went up 274x. Orgs like IOM & PwC say ⅓ to ½ of all hc spending doesn’t add value; Imagine if you had that failure rate in anything else in your supply chain
- #9: Except the poor & old, most get hc through work. Baked into virtually every legacy business model in hc is assumption that employers remain derelict in their fiduciary duty. There’s an event that should be on the frontpage of the WSJ in the coming weeks that will be the canary in the coal mine of an Enron-like event. As we know, corporate governance was forever changed as a result. This creates great investment opportunities if focused in the right areas.
- #10: Let’s just look at the employer side of the equation. People worry about things like obesity and smoking but that pales in comparison to systemic “obesity” Unnecessary: 40% of planned transplants, 90% of spinal procedures Fraud: 1st case is >500k claims for >$400M at last count -- one of the most famous/fierce law firms in the world is readying cases that are in the tobacco/asbestos range PPO: Perhaps the biggest joke in the hc system
- #18: A fractal is a never-ending pattern. Fractals are infinitely complex patterns that are self-similar across different scales. They are created by repeating a simple process over and over in an ongoing feedback loop. Driven by recursion, fractals are images of dynamic systems – the pictures of Chaos. Geometrically, they exist in between our familiar dimensions. Fractal patterns are extremely familiar, since nature is full of fractals. For instance: trees, rivers, coastlines, mountains, clouds, seashells, hurricanes, etc. Abstract fractals – such as the Mandelbrot Set – can be generated by a computer calculating a simple equation over and over.
- #21: ALL proceeds going to support the Health Rosetta Institute