Industry Trends

Health Care Crisis: Time for Fundamental Change

• Healthcare Costs for Employers, Unions, Pensions, and Individuals have increased steadily for the last 40 years.
A large and growing administrative burden has outpaced Provider growth by 2300% over the last 40 years.

• Healthcare pricing is Opaque, Confusing, and Incentivizes Volume of Care versus Quality of Care.
Patient / Consumer choice is rarely available, difficult to understand, and challenging to engage absent information and tangible consumer information.

• Useful information is available but is not readily accessible to patients.
Normal transaction information and options that help drive informed purchasing for everything we consume; is absent in healthcare.

• Providers are burdened and discouraged by the amount of non-medically related demands that consume their time.

The Need for Change is Widely Recognized and EquityHealth Delivers a Vetted and Engaging Solution

Targeting Runaway Administrative Costs

Transparent and Direct Payment = Improved Outcomes / Reduced Admin Costs

  • Fee-for-Service is complex, costly, and rewards the volume of care, not the quality of care.
  • Value-Based pricing rewards the quality of care and improves Provider income.

Transparent Pricing and Value-Based Healthcare Work!

Improving the Quality of Care; Costs Less!

Key Player Benefits are Focused and Concise

Payers benefit with Providers comfortable with Defined Pricing based on their above average historical performance. In general, higher quality Providers cost less and have better outcomes.

Providers Benefit through Reduced Administrative Costs and Predictable Efficient Compensation that Allows them to Focus on Patient Care!

The Opportunity and Solution are Confirmed

CMS (Medicare/Medicaid) – HHS Press Office

CMS has 48 episodes of care to which they would like to reimburse using a bundled format, along with chronic episodes; which account for up to 70 percent of Medicare spending.

  • Providers have a financial incentive to coordinate care for their patients – decreasing duplicative or unnecessary x-rays, screenings, and tests delivers significant savings.

 

More Employers join push for Value-Based Healthcare /  Shelby Livingston  Modern Healthcare

  • Currently 11% of employers said they reduce point-of-care costs for high-value services, 47% may do so by 2018, according to the survey. Nine percent of employers increase such costs for commonly overused services, but 41% may do so by 2018.

 

Fee-For-Value Drives Trillion-Dollar Healthcare Opportunity  Jan 9, 2016 by Steve KrausAndrew Hedin, Andrew Walsh

  • Since PPACA was enacted, nearly 20 percent of all healthcare payments are value-based. Healthcare industry experts expect this to increase to 75 percent or more by the year 2020. By our account, that’s easily a trillion-dollar-value shift that will take place in the next five-10 years. That’s not just a big, but a massive market opportunity for entrepreneurs and venture capitalists to pursue.

Incentives and Information Resources Drive Consumer Engagement

While overall increases in specific behaviors and attitudes associated with consumer engagement are small, the good news is that transformation is happening faster among those who may benefit most — individuals with major chronic conditions and serious, acute health issues.

The increased involvement of these consumers in decisions about care, communication with providers, self-monitoring, and treatment adherence holds great promise for improving health outcomes and getting better value from care.

  • One in two consumers says the availability of online capabilities to access medical records, schedule appointments, and order prescription refills would be important for them to feel satisfied with their overall health care experience with a network of hospitals and doctors.
  • Two in five say health management programs and online tools factor into their choice of a health plan.
  • One in three wants health plans to prioritize the enhancement of programs, tools, and incentives that support health improvement.

When asked which types of resources would most help them change their habits and take steps to improve their health, respondents put financial incentives and information resources at the top of the list.

Special programs involving education, self-monitoring tools, and reminders are rated highly by one-third of consumers (one-half of consumers who have major chronic conditions).

Two in five consumers give high ratings to secure websites offering various kinds of digital supports; one in four rates mobile apps highly.

Source: Deloitte Center for Health Solutions Survey of US Health Care Consumers, 2015

Consumerism Demands a New Health Care Model

Technology and Data Facilitate Consumer Engagement

Employer Benefit Strategies Must Adapt to the Changes Ahead

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