Perennial Care Care Coordination for the Senior Life Stage In collaboration with the Mayo Clinic Center for Innovation
May 21, 2009 Designing + Leading a Business Carnegie Mellon University Professors Boni, Evenson + Weingart
Melissa Cliver Dave Passavant Christina Payne
Objective We intend to increase the holistic value delivered by the healthcare system by designing a disruptive business concept that delivers new value for all stakeholders with a reduced and sustainable cost structure.
Our Concept
Our Concept Perennial Care is a long-term support service for seniors to navigate the complexity of the health care system and create partnerships, enabling informed health care decisions.
Why It’s Disruptive • An affordable, convenient gatekeeper coordination service directing seniors to customized social and medical care networks.
• Health care delivery and coordination that is not physician led and not based on acute episodic health management.
• Integrates both the general practitioner and the specialist physician as expert consult.
Why Seniors? • 77 million baby boomers are aging. • Medicare costs 27% of total federal budget by 2030 • 70% of health care cost is for chronic care. • 55% of medicare patients ages 65 - 74 have 3 and 4 chronic conditions simultaneously.
• Another 20% have 5 chronic conditions simultaneously.
Seniors GOAL Manage complex deteriorating life Maximize quality of life
VALUE PROPOSITION Time and specialty with experts Monitor medications
Care Givers GOAL Facilitate best possible quality care for aging loved one Balance senior care with life tasks VALUE PROPOSITION Able to formally track observations Time management and efficiency Access to quality medical research
Payers GOAL Maximize profits Minimize overhead Fund quality care VALUE PROPOSITION Reduced ER visits Better patient Rx adherence Lower costs, non-doctor led care
Providers GOAL Deliver quality care Minimize risk Minimize administrative overhead VALUE PROPOSITION Better summary of patient history Better patient Rx adherence Holistic view of patient health
Relationship with GP • Recognizing there is a shortage in US, integrate tele-med potentially integrating global support.
• Focus on a holistic view of general care, allopathic and osteopathic.
• Prevention and specialist referrals (acute).
Perennial Team
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Basic testing
Life stage planning
Medical records
Monitoring
Social Resources
Insurance
Drug management
Relationships
Expert Awareness
Perennial Focus
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Services • Supplement the existing PCP and specialist care model. • Organize patient’s data and needs. • Partner for cost efficiency: labs, supplies, payment. • Research and recommend life stage options. • Guide patients and caregivers to external innovators and specialists.
Technology • EMR/EHR • Drug interaction software • Caregiver tracking software • Telemedicine • 24/7 support line
Research
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Christensen Models Solution Shops Provide intuitive, specialized recommendations of solutions to unstructured problems.
Christensen Models Value-Adding Process Transforms inputs into outputs of higher value via a repeatable process.
Christensen Models Facilitated Networks Institutions that operate systems in which customers buy and sell, and deliver and receive things from other participants.
“Any program for resolving our runaway health-care costs that does not have a credible plan for changing the way we care for the chronically ill can’t make more than a small dent in the total problem.” Clayton Christensen, The Innovator’s Prescription
Current Trends • Shortage of PCPs and incentives created by the 3rd party payer system result in 7-minute visit.
• ER visits per capita are increasing. Many due to acute occurrence of complex care and drug mismanagement.
• Caregivers are acting as untrained coordinators.
• Services are not aggregated for easy access.
Source: NYTimes
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Value Proposition Recap REDUCED ER VISITS COST STRUCTURE better drug management
cost effective labor force
alternate high availability option for acute care
leverage technologies for efficiency
better holistic care management
partner with specialized businesses to deliver low cost services
BUSINESS MODEL focused on care coordination
Go to Market Strategy
INSURANCE
MEDICARE
Charge per capita Pursue reimbursement % of cost savings
Care coordination
SENIORS Membership fee Cost per visit
Pareto Economics 140
• 7M of 36M seniors drive 80% of costs. 560
• A 1% cost reduction for 50% of the those seniors would yield $2.8B in savings
• A 10% of savings fee model would result in $280M in revenue
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36M seniors
$700B costs 20% of seniors drive 80% of costs
Customer Funded Model
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Opportunities Perennial Care is a long-term support service for seniors to navigate the complexity of the healthcare system, while increasing value and lowering costs. We recommend starting with a pilot project in the Florida or Arizona Mayo Clinic facilities for validation with seniors.
Thank you. Special thanks to Bill and Maggie. Questions?
May 21, 2009 Designing + Leading a Business Carnegie Mellon University Professors Boni, Evenson + Weingart
Melissa Cliver Dave Passavant Christina Payne