Charting the Changes in the Physician-Patient Relationship

Austin Regional Clinic’s Accountable Care andPatient Centered Medical Home

Navigating the Future of HealthcareRound Rock, TexasOctober 14, 2011

1,000,000 patient visits ● 380,000 active patients1,400 employees ● 290 physicians ● 18 locations

15 specialties ● 6 cities ● 3 counties ● 1 medical group ● 1,000 square miles

Austin Regional Clinic

4

Fee-for-Service Pay-for-Performance

Episodic Bundling

Global Payment

Full Risk / % of Premium

Episodic Cost Total Cost

Provider Accountability

Continuum of Payment Models

Patient Centered Medical Home Accountable Care Organization

Enter Reform

Patient Centered Medical Home

Trusted personal physician Physician who provides, manages and facilitates

care

Care is coordinated or integrated across healthcare system

More accessible practice with increased hours and easier scheduling

• 1% of the population accounts for more than 25% of health costs.

• 10% of the population account for 70% of health care expenditures.

• 78% of national health care expenditures can be attributed to chronic illness. On order of $2 trillion.

The Chronically Ill Drive Cost

Advanced Care Coordination Clinic

• Data analytics to identify highest-risk members.

• Outreach process to engage and enroll these members.

• Comprehensive multi-disciplinary care team.• 24/7 access by patient to care team.• Goal is reducing unnecessary ER and Inpatient

services, referrals, medications, and testing in highest utilizing patients.

• Personal Health Guides are the primary point of contact with members. They assist physicians in coordinating care, educate members about their illnesses, and use motivational interviewing to inspire members improve their health.

• Nurse Navigators help manage the care process and coordinate clinical care.

• Extensivist Physicians, with assistance of Advanced Practice Nurses, take responsibility for the “whole” patient, providing hour long initial visits and frequent and extended follow-up appointments.

• Behavior Health support to identify co-morbid illness and address barriers to lifestyle change

ACCC Care Team

• More emphasis on proactive and comprehensive care

• More emphasis on preventative care• More emphasis on access to care• More emphasis on coordination of care• More emphasis on primary care

What Does It Mean for You?

Contacts

Greg Sheff, MDMedial Director, ARC Care Management

Austin Regional Clinicgsheff@austinregionalclinic.com

512-231-5500 (o)512-789-0926 (m)