Master Your Value-Based Care Strategy: Introducing Health Catalyst Value Optimizer™
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The document provides an overview of Health Catalyst's Value Optimizer product, which is a web-based application that aims to help healthcare organizations develop data-informed strategies for value-based care. It describes three key capabilities of Value Optimizer: 1) Creating a comprehensive, benchmarked strategy using complete data, 2) Providing transparent and actionable insights into total cost of care and contracts, and 3) Enabling exploration of various clinical areas to uncover opportunities. The document includes several use cases that demonstrate how Value Optimizer can be used to analyze areas like inpatient utilization, pharmacy spending, imaging utilization, and more. It also discusses the support services that Health Catalyst provides to help customers implement and optimize the Value Optimizer
Master Your Value-Based Care Strategy: Introducing Health Catalyst Value Optimizer™
- 1. © 2021 Health Catalyst Master Your Value-Based Care Strategy: Introducing Health Catalyst Value Optimizer™ July 21, 2021
- 2. Agenda 1 - Product Demo: Health Catalyst Value Optimizer • Overview of Population Health Suite • Use Cases - Creating a Data-informed Strategy - Understanding Contracts and the Total Cost of Care - Exploring: Rx, End of Life, Imaging - Rapid Review 2 – Support 3 – Q&A
- 3. 1- Product Demo: Value Optimizer
- 4. Population Health Tools Our Population Health Management Offering Self-service Analytics Accelerator Library Data Models and APIs Healthcare.AI Strategy Solution + Strategic Guidance Services Value Optimizer Quality Gap Solution Care Management Solution Stratification Population Care Flow Population Care Insights Quality Measures EMR-embedded Insights + Measure and Workflow Services + Population and Care Management Design Services Data and Analytics Platform Strategy Data-driven insights to find greatest opportunity for ROI Targeted Interventions Analytically-driven solutions to drive better front-line decision-making Build-Your-Own Create your own analytics and access the best of our client-created solutions + Variety of services to maximize ROI and value
- 5. © Health Catalyst. Confidential and proprietary. Value Optimizer “To understand is to know what to do.” — Ludwig Wittgenstein Our Population Health Management Offering
- 6. The Problem: No Data-rich Strategy “I know my PMPM’s and other metrics—but are they good or bad?” “Do I need to compare to benchmark or is it sufficient to compare to last year?” “Is the benchmark like me or, more importantly, like my patients?” Wait, what about…. • Post-acute utilization? • Emergency department use? • Readmission rates? • Lengths of stay? • PCP paneling and scorecards? • HCC coding? • Retail pharmacy? • Generic drugs? • Polychronic patients? • High-cost Imaging? • Palliative care? • Infusions? • Out-of-network spending? • Home health? • Ambulatory-sensitive conditions? • SDOH? • Clinical variation? If you can’t access a complete list of benchmarked opportunities— and can’t compare them to one other—you don’t have an optimal, data-informed STRATEGY to win in Value-based Care.
- 7. The Solution: Finally, a Data-informed Way to Win at VBC Value Optimizer leaves no stone unturned in the discovery of improvement opportunities within value-based care—allowing you to master your strategy and achieve profitability. Strategy drives interventions—interventions drive results seen in Value Optimizer. Repeat. Post-acute care chronic patients are high- spending and need prioritization. (Population Builder) Diabetes population is overspending to benchmark. (Care Management) Preventable care is driving too many admits. (Measures program) HCC coding shows opportunity to benchmark. (Embed intel into EMR at point of care) DATA High out-of-network activity to key competitor needs constant reporting. (Leading Wisely) STRATEGY INTERVENTION OPPORTUNITIES
- 8. Value Optimizer: The New Industry Standard for VBC Analytics How the Health Catalyst Value Optimizer, a web-based application, will lead the industry: 1. Data informed strategy to win in VBC Population Health Executives have struggled to lead their analysts to create an optimal data- informed strategy, including benchmarking and sized comparison. Until now… 2. Total Cost of Care: comprehensive, transparent, actionable Population Health Executives and Analyst Teams want to know how they are doing in their contracts & want comprehensive, transparent & actionable exploration of the Total Cost of Care including condition specific research to network analytics. Making pop health profitable requires intelligent analytics that account for your context. 3. Exploring for Insights: Rx, End of Life, Imaging Population Health Executives and Analyst Teams want to know every major area of spend so they can master their pop health strategy and own their future. Use cases follow…
- 9. Value Optimizer Use Case 1: A complete, data-informed strategy Pop health teams can be confident they understand the data that will help them win at VBC. Area Gap Target Intervention(s) Inpatient $21M $15M • Care management program/product to address ACSC • Measures management to monitor chronic patient and prevent admissions through focus on ACSC • Readmissions program and care management analytics Post-Acute $12M $8M • Partner with the best organizations • Institute LOS and readmission goals and appropriate committees • Improve risk identification through stratification models Network Management $143M $30M • Support FFS margin and better patient care by keeping care in network • Deepen PCP to patient relationships • Establish CIN to improve coordination of care (De-prioritize) High-Cost Imaging $5M $0 • Less gap than anticipated devote resources to above initiatives • VBC success comes from prioritizing and pursuing only the most valuable opportunities – what you DON’T do matters. GOAL $53M
- 10. Value Optimizer Use Case 2 & 3: Total Cost of Care & More, More, More Pop Health Teams should start to get this feeling…
- 11. Value Optimizer: The New Industry Standard for VBC Analytics How the Health Catalyst Value Optimizer, a web-based application, will lead the industry: 1. Data informed strategy to win in VBC Population Health Executives have struggled to lead their analysts to create an optimal data- informed strategy, including benchmarking and sized comparison. Until now… 2. Total Cost of Care: comprehensive, transparent, actionable (detail next page) Population Health Executives and Analyst Teams want to know how they are doing in their contracts and want comprehensive, transparent, and actionable exploration of the Total Cost of Care including condition specific research to network analytics. Making pop health profitable requires intelligent analytics that account for your context. 3. Exploring for Insights: Rx, End of Life, Imaging Population Health Executives and Analyst Teams want to know every major area of spend so they can master their pop health strategy and own their future. Use cases follow…
- 12. Health Catalyst Value Optimizer: Analyst Explorer The Health Catalyst Value Optimizer leaves no stone unturned in the discovery of improvement opportunities— empowering you to master your value-based care strategy. 2. Total Cost of Care and Contracts Use Case Population Health Executive and Analyst teams have variation across contracts and need to understand the nuance unique to their situations. Among many questions, they are focused on these three at their organization: 1. How am I doing in MY contracts overall? 2. Where can I see individual and polychronic patients across the entire continuum of care (compared to benchmark)? 3. Where can I free-form explore for use cases that I haven’t even thought of yet?
- 13. © Health Catalyst. Confidential and proprietary. Poll: Challenges to Creating a Data-informed Strategy What do you find is the greatest hurdle to creating a data-informed strategy today? • Building the claims model • Using complete benchmark data • Covering the breadth of categories needed • Combining all of the above • Other
- 14. Value Optimizer: The New Industry Standard for VBC Analytics How the Health Catalyst Value Optimizer, a web-based application, will lead the industry: 1. Data informed strategy to win in VBC Population Health Executives have struggled to lead their analysts to create an optimal data- informed strategy, including benchmarking and sized comparison. Until now… 2. Total Cost of Care: comprehensive, transparent, actionable Population Health Executives and Analyst Teams want to know how they are doing in their contracts and want comprehensive, transparent, and actionable exploration of the Total Cost of Care including condition specific research to network analytics. Making pop health profitable requires intelligent analytics that account for your context. 3. Exploring for Insights: Rx, End of Life, Imaging (detail next page) Population Health Executives and Analyst Teams want to know every major area of spend so they can master their pop health strategy and own their future. Use cases follow…
- 15. Health Catalyst Value Optimizer: Retail Rx The Health Catalyst Value Optimizer leaves no stone unturned in the discovery of improvement opportunities— empowering you to master your value-based care strategy. Retail Rx Use Case Your Population Health Executive has asked you, the Population Health Analyst, to understand more about Retail Rx in the employee plan you are at risk for. You hope you can do the following three things: 1. Make sure you can translate data into real insights and a clear “so what” answer. 2. What detail can I provide on generic vs brand use? 3. Do we have members over the limit for MME/opioid use? What is their PCP assignment?
- 16. Health Catalyst Value Optimizer: High-cost Imaging The Health Catalyst Value Optimizer leaves no stone unturned in the discovery of improvement opportunities— empowering you to master your value-based care strategy. High-cost Imaging Use Case As a Population Health Analyst your Population Health Executive has asked about high-cost imaging. It was challenging when you looked into this before…this time you’re really hoping to accomplish the following: 1. Make sure you can compare to benchmark and have clear, “so what” answers. 2. See a clear, clean grouping of codes for imaging, so you are not lost in detail. 3. Know which locations are above and below average pricing – leading to prioritized alignment.
- 17. Health Catalyst Value Optimizer: Hospice/End of Life The Health Catalyst Value Optimizer leaves no stone unturned in the discovery of improvement opportunities— empowering you to master your value-based care strategy. Hospice/End of life Use Case You noticed in some reading about the industry that end-of-life care often has significant spending and care opportunity. As a Population Health Analyst, you decided to be proactive to understand this for your populations so you can report to your leaders about it. You are hoping to understand: 1. Make sure you can translate data into real insights and a clear “so what” answer. 2. What is the spending and care that these members receive? What role does hospice play? 3. How do different hospice providers compare? Are we constructing our program and approach intentionally?
- 18. Product Demo Capabilities: Value Optimizer – Rapid Review (5)
- 19. Health Catalyst Value Optimizer: ED Analyzer The Health Catalyst Value Optimizer leaves no stone unturned in the discovery of improvement opportunities— empowering you to master your value-based care strategy. ED (Emergency Department) Analyzer Use Case A Population Health Executive has asked you, the Population Health Analyst, to understand more about emergency department use. You’re hoping you can do the following three things: 1. Make sure you can translate data into real insights and a clear “so what” answer. 2. Account for all the right codes, since that can be tricky in ED analytics. 3. Get a clear understanding of what is potentially avoidable and the patients who could receive better care (via care management, PCP visits?).
- 20. Health Catalyst Value Optimizer: Outpatient The Health Catalyst Value Optimizer leaves no stone unturned in the discovery of improvement opportunities— empowering you to master your value-based care strategy. Outpatient Use Case As a Population Health Analyst, you know outpatient spending is a key area to research for your populations. You are hoping to understand: 1. How to translate data into real insights and a clear “so what” answer. 2. What about expensive drugs administered in outpatient settings vs others? 3. How do my dialysis patients and providers compare?
- 21. Health Catalyst Value Optimizer: Physician Analyzer The Health Catalyst Value Optimizer leaves no stone unturned in the discovery of improvement opportunities— empowering you to master your value-based care strategy. Physician Analyzer Use Case As a Population Health Analyst, you often need to deep dive on physician- specific analytics. You are hoping to understand the following: 1. How do physician panels compare on any key metric in Value Optimizer? 2. How does my professional spending break down by service line? 3. Can I see and explain how patients are attributed to PCPs in Value Optimizer?
- 22. Health Catalyst Value Optimizer: HCC Analyzer The Health Catalyst Value Optimizer leaves no stone unturned in the discovery of improvement opportunities— empowering you to master your value-based care strategy. HCC Analyzer Use Case As a Population Health Analyst, you know accurate coding is important for both patient care and financial margin. You need to share with the Population Health Executive: 1. Real insights and a clear “so what” answer compared to benchmark. 2. How well you are recapturing codes in your risk populations. 3. When you are not coding because of access issues OR because of missed opportunities during visits—on a patient-by-patient basis. Does the gap warrant interventions at the point of care?
- 23. Health Catalyst Value Optimizer: Pregnancy Analyzer The Health Catalyst Value Optimizer leaves no stone unturned in the discovery of improvement opportunities— empowering you to master your value-based care strategy. Pregnancy Analyzer Use Case As a Population Health Analyst, you’ve run into difficulty accounting for the nuance of data related to pregnancy. You want to understand: 1. What is the total spend (per total event – inclusive of all services) for pregnancies in my at-risk population? 2. How much of that volume is going outside my network? 3. What percentage of our pregnancies involve the ICU? Cesarean?
- 24. Value Optimizer – Comprehensive & Actionable
- 25. Why so much? To master your value-based care strategy, you must understand and benchmark all the major areas across the complete care continuum to select only the most impactful options. Value Optimizer was built to instantly compare 10,000 benchmarked opportunities and show a comprehensive, transparent and actionable solution to help clients master their VBC Strategy.
- 26. 2- Support
- 27. Value Optimizer Solution Strategic Opportunity Analysis Prioritize your best opportunities for short- and long-term care improvement and cost savings initiatives to operationalize your strategic plan Strategic Consulting Partner with nation-wide experts to devise a population health strategy that is grounded in current realities, informed by and accounting of organizational goals, and aligned with your overall vision. Strategy Deployment Industry-leading technology and services bundle to help systems manage risk contracts and achieve profitability in population health management. Value Optimizer Product Transparent, actionable, flexible self-service financial analytics application Product Optimization Services Technology-enabled, expert-led, industry-experienced Partner with our experts to tune the technology tools to your populations and contracts • Explore feasibility of success • Plan and operationalize • Guided interventions Insights mined from your data support a holistic analysis of VBC performance and its drivers • Aggregate data for a comprehensive view • Analyze populations, risk, performance, and opportunities • Access timely and actionable data to guide financial and operational decisions Implementation plan and operational model redesign that are grounded in your current realities and aligned with your overall strategy and vision Contract Performance Consulting Access a strategic, data-informed approach to evaluating your value- based contracts and improving performance in specific governmental and commercial arrangements. Expert services to help deliver real ROI (optional add-on services)
- 28. Supporting Materials Health Catalyst Support & Community • Configured installation • Your network • Your department structure • Your PCP organization • Benchmarks built on your populations • Health Catalyst Community • Training courses available for clients – levels I through IV • Covers broad application use & core principles to upgrade knowledge • Robust FAQ available • searchable knowledge base of hundreds of population health analytics related to Value Optimizer to get started deepening expertise.
- 29. 3- Questions?
- 30. The Healthcare Analytics Summit 2021 - Virtual Visit hasummit.com to register and learn more • Industry-Leading Featured Speakers • 21 Educational Breakout Sessions • CME Accreditation for Clinicians • Analytics and AI Showcases, Networking, and More • Virtual Platform optimized for a live experience Sept. 21 – 23, 2021 (half-day sessions) o Steve Kerr o Rana el Kaliouby, PhD o Vin Gupta, MD, MPA, MSc o Chris Chen, MD o Amy Compton-Phillips, MD o Brent C. James, MD, Mstat o Sadiqa Mahmood, DDS, MPH “The virtual experience was beyond any other that I've attended. You all did a wonderful job of creating an "in- person" feel and I appreciate that as a learner. The virtual platform was very intuitive and fun.”
- 31. Thank you!
- 32. Appendix
- 33. © Health Catalyst. Confidential and proprietary. Transparent and Enriched: DOS is the “Secret Sauce” Content + 1,000,000 lines of code + 10,000 Benchmarks Risk Scores • CMS-HCC, HHS-HCC Metrics • Hundreds of metrics from combined data (PMPM, LOS, Imaging, ED, Post-Acute) PCP Attribution • PCP visit-weighted attribution • Client provided attribution Groupings • Clinical Hierarchy • NPI Reference & maintenance • CPT Code Reference & maintenance • Ambulatory Sensitive Conditions • Inpatient events • Risk hierarchies Standardized Data Model • Many files into one standard • Allow connection to clinical • Available for other applications • Allows additional fields & adaptations • Adds more than 500 fields to standard payer files • Solve for claim type & grain • Single model allows deep benchmarking Diagnosis • Historical & current • Chronic Condition Warehouses Value add • SDOH, American Community Survey • Ambulatory Sensitive Conditions • Bundles