Cardinal Health, Inc. · NYSE:CAH
Cardinal Health — Repositioning for an ACO World webinar (September 2013)
35 slides from Cardinal Health's conference presentation, Sep 18, 2013
Slide 1: Repositioning for an ACO World
Repositioning for an ACO World Hosted by: Cardinal Health & NetRx, LLC Barmi Akbar Deborah Taylor September 18, 2013 © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
Slide 2: Agenda
Agenda • Overview of Health Reform Act – Focus: SNF and Medicare Patients • Major Trends in the Marketplace • Response of the Skilled Nursing Facilities • Opportunities for LTC Pharmacies © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 2 ESSENTIA
Slide 3: Healthcare Reform
Healthcare Reform • Impacts many elements of healthcare including: – Personal insurance coverage – Government programs – Employer healthcare plans – Providers: • Hospitals • Post-acute providers • Ancillary Services – A far reaching impact… © Copyright 2013, Cardinal Health. All rights reserved. CAR
Slide 4: Why does it matter to SNFs?
Why does it matter to SNFs? © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 4 ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
Slide 5: INTENT
INTENT Provide better care, while eliminating waste. © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 5 ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
Slide 6: In the beginning…
In the beginning… • Hospitals: – Looked at physician alignment, through consolidation and acquisitions. – Improved internal clinical processes. – Emergency room changes for SNF readmissions: • Hospital admission • Observation stay • ER visit, no admission or overnight stay © Copyright 2013, Cardinal
Slide 7: Current Priorities
Current Priorities Readmissions Alignment © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 7 ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
Slide 8: Hospital Readmissions
Hospital Readmissions Impact to Hospital? Impact to SNF? Increasing penalties for Critical indicator for referral avoidable readmissions for sources and payors. Medicare patients. © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 8 ESSENTIAL TO CAR
Slide 9: Components of INTERACT v3
Components of INTERACT v3 • Admission/Readmission • Medication Reconciliation • Advanced Care Planning Tools • Stop and Watch • SBAR • Change in Condition • Others © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 9 ESSENTIAL TO CARE are trademarks
Slide 10: Did you say ACO?
Did you say ACO? ACO: The Acetoxy group, abbreviated AcO or OAc, is a chemical functional group of the structure CH3-C(=O)-O-... • Correct, but NOT EXACTLY for SNF providers. © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 10 ESSENTIAL TO CARE ar
Slide 11: Accountable Care Organization (ACO)
Accountable Care Organization (ACO) • An ACO is a network of doctors and hospitals which share responsibility for providing coordinated care to patients in hopes of limiting unnecessary spending. At the heart of each patient’s care is a primary care physician. (Kaiser Health) • Over 150 Medicare ACO
Slide 12: Establishing Preferred Networks
Establishing Preferred Networks • Many hospital systems and payors are developing scorecards to rate each SNF within their marketplace. • These are used to select network members. • Network members are anticipated to receive majority of referrals. • How do your SNF clients rank? © Copyright 2013, Ca
Slide 13: Scorecard Criteria
Scorecard Criteria • Volume • Patient Information – DRG, Payor, Zip code, etc. • Clinical capabilities • Outcomes – Five Star – Quality Indicators – Survey results • Readmission rates • Physician involvement • Physician affiliation • Ancillary Service Utilization – Lab, HHA, etc. © Copyright 2013, C
Slide 14: Implementations
Implementations • In addition to the establishment of preferred provider networks, hospitals are implementing: – Clinical Care Paths – Joint-venture SNFs • SNF licensed beds built as a sub-acute center – Care transition coordination teams © Copyright 2013, Cardinal Health. All rights reserved. CARDI
Slide 15: How are SNFs responding?
How are SNFs responding? Some are doing this…. While others do this…. © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 15 ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
Slide 16: With or without ACOs, one thing is certain……
With or without ACOs, one thing is certain…… • Preferred provider networks will exist! © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 16 ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
Slide 17: What are proactive SNF providers doing?
What are proactive SNF providers doing? • Tracking readmissions • Monitoring patient outcomes • Clinical pathways • Care transition teams • Hospital alignment © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 17 ESSENTIAL TO CARE are trademarks or
Slide 18: Tracking Readmissions
Tracking Readmissions • By hospital and diagnosis • Reveals clinical strengths and weaknesses • Identifies areas of opportunity • Illustrates why a hospital system should align with the SNF © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 18 ESSEN
Slide 19: Patient Outcomes
Patient Outcomes • Hospitals choose providers who produce positive patient outcomes which translates to lower readmission rates. • Proactive SNFs communicate positive results through individual and diagnosis based outcome reports. • Great providers are the masters of their data. Track, analyze and c
Slide 20: Clinical Pathways
Clinical Pathways • Tools used to manage the quality in healthcare • Care interventions are defined, optimized and sequenced • Involves standardization of care • reduces variability in clinical practice • Evidence based best practices • Improves outcomes © Copyright 2013, Cardinal Health. All rights
Slide 21: Hospital Readmissions
Hospital Readmissions Fact: • Over 80% of readmissions occur within the first 30 days. • The significant amount of avoidable 30 day readmissions include: • Congestive heart failure • Respiratory infection • Urinary tract infection • Sepsis • Electrolyte imbalance • Acute MI © Copyright 2013, Cardina
Slide 22: Patient Navigators
Patient Navigators • Coordinates appointments to ensure timely diagnostic & treatment services. • Maintains communication with patients, families & care providers to monitor patient compliance. • Ensures appropriate medical records are available at scheduled appointments. • Arranges language transla
Slide 23: New World of Opportunity
New World of Opportunity • INTERACT v3 • System Integration – Care Transitions – Technology © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 23 ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
Slide 24: INTERACT v3: Medication Reconciliation
INTERACT v3: Medication Reconciliation • Why does this matter? – Patients admitted to the hospital receive new medications – Poor access to complete medication list – Upon discharge needed medications may be omitted – Medication discrepancies occur in nearly 1/3 of patients admitted to the hospital
Slide 25: Medication Reconciliation
Medication Reconciliation • Why does this matter? – National Patient Safety Goal #2, 2012 for LTC – National Patient Safety Goal #3, 2012 for Hospitals – Improving the safety of medication use – Identify and resolve discrepancies – CMS guidance to surveyor © Copyright 2013, Cardinal Health. All righ
Slide 26: Medication Reconciliation
Medication Reconciliation F-tag 329 Recommended Evaluation of Medications • Admission or readmission • Change in condition • New, persistent or recurrent symptom • Worsening of an existing problem • Unexplained decline in function • New medication order • Pharmacist’s monthly regimen review © Copyri
Slide 27: Medication Reconciliation F-tag 329
Medication Reconciliation F-tag 329 • Unnecessary medications • Excessive dose • Excessive duration • Without adequate monitoring • Without adequate indications for use • In the presence of adverse consequences • Any combination of above • Noncompliance of medication regimen – Inadequate indications
Slide 28: Medication Reconciliation
Medication Reconciliation © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 28 ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
Slide 29: Medication Reconciliation
Medication Reconciliation • Barriers to an Accurate Medication List – Not enough time to speak with the resident – We need to make time, this must be a priority for resident safety and prevention of potential fatal consequences. • Resident doesn’t know the medications that they are taking – Contact
Slide 30: Medication Reconciliation Summary
Medication Reconciliation Summary • Medication Reconciliation is an important task for resident safety during any transition of care • We need to gather all of the information • Goal is for accurate, concise list moving forward • Communication with all care providers is extremely important • Medicat
Slide 31: System Integration
System Integration • Care Transitions • Technology • Navigating the care continuum • EMR – Hospital SNF – SNF Home • Remote dispensing • Some LTC pharmacies may be approaching SNFs and hospital systems as a partner in care transition models. • What role is your SNF client playing in care transit
Slide 32: Change Fosters Opportunity
Change Fosters Opportunity • Skilled nursing providers who fail to adapt to the changing marketplace will suffer significant revenue losses in the coming years. • Bundled payments and other parts of healthcare reform will further reward or punish providers. Every partner, including LTC pharmacies ha
Slide 33: Q&A
Q&A © Copyright 2013 Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 33 ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
Slide 34: Speakers' Contact Information
Speakers’ Contact Information Barmi Akbar, MS, MBA Deborah Taylor, MPA COO/ VP Operations Dir. Business Development LeaderStat LeaderStat [email protected] [email protected] 877.699.7828 877.699.7828 © Copyright 2013, Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Healt
Slide 35: Thank you!
Thank you! © Copyright 2013 Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO and 35 ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health.
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