Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound...

26
2015-2016 Annual Report Current Reporting Period: 7/1/2015 – 6/30/2016

Transcript of Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound...

Page 1: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

2015-2016 Annual Report Current Reporting Period: 7/1/2015 – 6/30/2016

Page 2: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

2

2015-2016 Annual Summary 7/1/15 – 6/30/16

Best Doctors Value

• Gives your employees access to the top medical minds in the world to ensure they have the right diagnosis and right treatment plan

• Provides a resource for employees and their dependents to guide them through medical uncertainty

• Delivers superior clinical outcomes. We find that in the cases we review for our clients:

o 34% of the diagnoses required modification or correction

o 64% of treatment plans required modification or correction

• Delivers a low cost, high impact benefit

• Impacts high cost claims and complex cases

• Clinically integrates its services with your other vendors to ensure your members are enrolled in the appropriate programs that you offer outside of Best Doctors

• Decreases the risks and costs associated with misdiagnosis, incorrect treatment, needless surgeries, and unnecessary drugs, doctors’ visits and hospital stays

• Reduces employee concerns, anxieties and other productivity pressures

“Most Americans will encounter at least one diagnostic error in their lifetime, sometimes with severe consequences for their physical and mental health.”

How Best Doctors helps you and your employees

Page 3: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

3

2015-2016 Annual Summary 7/1/15 – 6/30/16

64%

Treatment plan refined or corrected

Through Best Doctors, the world’s top physicians review the medical cases of

your employees and their families to help avoid significant medical inaccuracies–

such as the 38% of patients who undergo unnecessary surgery each year.

Employers and their associates have immediate access to the Best Doctors

database of more than 53,000 expert physicians in over 450 specialties and

subspecialties. As a result, employees make better informed healthcare decisions

while your company decreases its medical costs.

34%

Diagnosis refined or corrected

3 year average

How we do it

53,000+ Leading doctors

worldwide

450+ Medical specialties and subspecialties

Top 5% Physicians nationwide

27 years Health care leadership

35M Covered members

Page 4: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

4

2015-2016 Annual Summary 7/1/15 – 6/30/16 Best Doctors continues to lead the marketplace

53,000 worldwide experts, in 450 specialty areas, allows us to make referrals everywhere

The most comprehensive engagement program out there, with dozens of plug and play options

In-house, fully integrated analytics capabilities to target population segments and intervene sooner

The only Gallup-certified polling process to individually select expert physicians, independent of facilities

Clients look to Best Doctors as their virtual medical director for guidance on plan design

Unmatched clinical history – 27 years in business and 100,000 member cases reviewed

Global operating presence (not outsourced), to support multi-national and growing clients

Retesting of pathology samples ensures diagnoses aren’t confirmed based on incorrect slides

Page 5: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

5

2015-2016 Annual Summary 7/1/15 – 6/30/16 Table of contents

Summary

Annual Summary

Activities

Target vs. Actual

Waterfall Case Flow

Origin

Clinical Integration

Referral Activity by Quarter

Member Engagement

Campaign Activity

2015 Engagement Calendar

2016 Engagement Calendar

InterConsultation Cases

Member Experience

Demographics

Reasons

Specialties

FindBestDoc Cases

Specialties

Page 6: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

6

2015-2016 Annual Summary 7/1/15 – 6/30/16

How members reported they heard about Best Doctors

95 78 77 Total member

contact Cases

opened Cases closed

Activity in reporting period Clinical impact

38% Change in diagnosis

67% Change in treatment

16% Postcard 100%

Highest satisfaction

Percentage of survey respondents who

gave the highest rating for Best Doctors’

overall ability to meet their needs and

would recommend Best Doctors to their

co-workers.

Member satisfaction

Top 3 responses of members of responding to the question

HR Human Resources

13%

Annual results summary

Page 7: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

7

2015-2016 Annual Summary 7/1/15 – 6/30/16

120

46

4

20

95

44

5

24

0 4

142

61

9

27

0 1

Contacts FindBestDoc Ask The Expert InterConsultation Critical Care eSummary

Contacts and Closed Cases Target Current Period Prior Period*

*Prior Period = 7/1/2014 – 6/30/2015

There were 3 InterConsultation cases

in process

Activities: target vs. actual

Page 8: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

8

2015-2016 Annual Summary 7/1/15 – 6/30/16

23 ICs Created

95 Total Contacts*

75

Actionable Contacts

78

Cases Created Actionable Contacts are Contacts that could be legitimately converted into cases. Examples of Contacts not considered workable: • Calls from members

ineligible for Best Doctors benefits

• Calls from members who already have a case

79% BOB – 87%

104% BOB - 85%

6 ATEs Created

45 FBDs Created

8% BOB - 2%

29% BOB - 34%

58% BOB - 58%

*All the data is as of the last day of the quarter

Waterfall case flow – Contact results

Page 9: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

9

2015-2016 Annual Summary 7/1/15 – 6/30/16

Service Line (closed cases) Phone Calls Online Form Member Portal Email Total

Total Contacts 59% 3% 35% 3% 95

InterConsultation® 71% 4% 21% 4% 24

Find a Best Doctor 57% 0% 43% 0% 44

Ask The Expert 60% 0% 40% 0% 5

Critical Care 0% 0% 0% 0% 0

Esummary 100% 0% 0% 0% 4

Activities: contacts and closed cases by origin

Page 10: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

10

2015-2016 Annual Summary 7/1/15 – 6/30/16 Clinical integration is IN!

• Boosts engagement • Identifies members in need

Clinical collaboration creates real results

• Higher program utilization due to clinical referrals • Cost savings for referred cases are higher than self referral (based on referrals of

many high-cost claims cases)

• Members report confidence in medical decision making (survey results show 88%)

Client communication is key

• Quarterly referral expectations • Claimants in excess of specified dollar amount

• Condition-specific

Seamless and effective

Page 11: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

11

2015-2016 Annual Summary 7/1/15 – 6/30/16

Of total member contacts, 1% were members referred by University of Alaska benefit providers. Of total member contacts, Best Doctors referred 12% to benefit providers.

Q1 Q2 Q3 Q4 Total

Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound

Premera Blue Cross 0 2 0 1 0 0 0 1 0 4

Travel Medical Support Program Link

0 0 0 1 0 0 0 0 0 1

ComPsych (EAP) 0 0 0 1 0 0 0 0 0 1

Healthyroads 0 2 0 2 0 1 0 0 0 5

Member cannot identify

1 0 0 0 0 0 0 0 1 0

Total 1 4 0 5 0 1 0 1 1 11

Referral activity by quarter

Clinical integration results

Page 12: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

12

2015-2016 Annual Summary 7/1/15 – 6/30/16 Member engagement campaign results

0

1

2

3

4

5

6

0

2

4

6

8

10

12

14

16

Jul'15 Aug'15 Sep'15 Oct'15 Nov'15 Dec'15 Jan'16 Feb'16 Mar'16 Apr'16 May'16 Jun'16

Event Contacts Avg contacts* ICs

Co

nta

cts

ICs

Cre

ate

d

*Avg. Contacts – sum of the # of client contacts divided by the # of months in this reporting period

Event Date Description 7/8/2015 Webinar: Orthopedic Sports Medicine 8/1/2015 July Postcard: “Getting better”

8/12/2015 Health Matters: Knee & Hip Replacement; included reminder of Premera Travel Support Benefit

11/20/2015 October Postcard: “Peace of Mind” ** Additional campaigns on 2015 Engagement Calendar **

Page 13: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

13

2015-2016 Annual Summary 7/1/15 – 6/30/16 2015-2016 Member engagement plan

Engagement Activity Responsibility Target Date Completion Date

Home Mailing – “Getting Better” postcard Best Doctors Jul 2015 Jul 21, 2015

Webinar: Sports Medicine – Orthopedic Best Doctors Jul 8, 2015 Jul 8, 2015

Health Matters: Knee & Hip Replacement article sent to all benefits-eligible employees. Included mention of Premera Travel Support Benefit

UA Aug 2015 Aug 12, 2015

Home Mailing – “Peace of Mind” postcard Best Doctors Oct 2015 Nov 6, 2015

Webinar: How to Help Your Doctor Make the Right Diagnosis

Best Doctors Dec 15, 2015 Dec 15, 2015

Webinar: Autoimmune Disorders Best Doctors Mar 16, 2016 Mar 16, 2016

PDFs of posters for printing and distribution – ER vs UC, Cancer, Member portal (provided by Best Doctors)

UA Apr 2016 Apr 6, 2016

Home Mailing – General Cancer Best Doctors May 2016 May 2, 2016

Promote Best Doctors 2016 Quarterly Webinars on intranet UA Quarterly

Post Health Matters flyers to intranet (Provided by Best Doctors)

UA Monthly

Include Best Doctors information in open enrollment and new hire kits

UA On-Going

Page 14: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

14

2015-2016 Annual Summary 7/1/15 – 6/30/16 2016-2017 Member engagement plan

Engagement Activity Responsibility Target Date Completion Date

Update Best Doctors content on UA benefits intranet Best Doctors July 2016 5/31 – Edits and

updated presentation provided

Webinar: Heart health Best Doctors July 18 7/18

Webinar: Back pain Best Doctors September 9/22

Home Mailing – Relaunch/Welcome kits Best Doctors October 2016 Pending mail file

Best Doctors services webinar recording – to be posted on UA benefits portal (recorded by Best Doctors)

UA October 2016

PDF posters for printing and distribution – TBD theme (prostate cancer, surgery, cardiac conditions) (provided by Best Doctors)

UA January 2017 5/18

Home Mailing – TBD theme (prostate cancer, surgery) Best Doctors February 2017

Tabletop displays in lunch/break rooms (PDF provided by Best Doctors)

UA March 2017

Best Doctors digital display content (provided by Best Doctors) UA Quarterly 5/6 – Released 4 themes

Promote Best Doctors 2016 Quarterly webinars on intranet UA Quarterly

Post Health Matters flyers to intranet (provided by Best Doctors)

UA Monthly

Include Best Doctors information in open enrollment and new hire kits

UA On-Going

Page 15: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

15

2015-2016 Annual Summary 7/1/15 – 6/30/16 Health fair season is almost here

The Best Doctors materials for health fair events

Best Doctors will supply giveaway items to help promote the Best Doctors benefit

Digital display TV screens

Ball-point pen with soft touch stylus

Adhesive card holder

Personal hand sanitizer

Magnet

Table tents

Hand sanitizers

Ball-point pen with soft touch stylus

Page 16: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

16

2015-2016 Annual Summary 7/1/15 – 6/30/16 Monthly communications from Best Doctors

Upcoming monthly communications

Webinars

July

Aug

Sept

Oct

Nov

Dec

Webinars

Cardio health

Analytics excellence

Back pain and surgery

Healthy pregnancy

Cancer concerns and screening

2017 health care outlook

Health Matters Articles

Lupus

Migraines and cluster headaches

Lyme disease and flu like symptoms

Polycystic ovary syndrome (PCOS)

Cancer(s) and the many treatments

Depression and hypothyroidism

Page 17: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

In-depth medical review Have your medical case fully reviewed by one of the world’s Best Doctors with our patented InterConsultation™ service. Get a detailed report and a confidential recommendation about your diagnosis and/or treatment plan.

17

Page 18: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

18

2015-2016 Annual Summary 7/1/15 – 6/30/16 University of Alaska Systems Member Experience

Case # USGH-1125923

“I would like a second opinion regarding abdominal problems that have been ongoing since earlier this year.”

Dr. Richard Saad Gastroenterology •Assistant Professor of Medicine, University of Michigan Health System

Best Doctors Expert

The member is a 30-35 year-old woman with onset of abdominal pain earlier this year. An underlying gallbladder dysfunction was considered despite negative testing and she underwent a cholecystectomy which did not help the symptoms.

She has been seen in the ER, required hospital admissions, and had undergone extensive testing including abdominal scans. One test showed bile duct narrowing which was opened with a stent and sphincterotomy, but her symptoms persisted.

An upper endoscopy was suggestive of celiac disease, but additional testing was negative. She was directed to avoid gluten. Numerous medications have been tried, a few of which helped initially but were stopped due to adverse side effects and concerns regarding medication interactions.

The member was on intravenous TPN nutrition due to concerns about malnourishment. She continues to report recurrent and intermittent nausea, diarrhea, and abdominal pain. She has been referred to an academic medical center and is now taking promethazine as needed for nausea.

Clinical History

The Expert clarified the diagnosis, stating that the symptoms, testing and response to therapy indicate the member may suffer from gastroparesis with a possibility of celiac disease. He also stated that gallbladder issues appear resolved, with no evidence of any liver, pancreas or colon disease.

The Expert changed the treatment plan, reinforcing the need for expert managed care. He advised stopping TPN as it is very toxic to the liver with long-term use, and suggested trial medication to deal with the member’s pain, nausea and poor appetite.

Member Impact Member Response

The member was very happy with Best Doctors report and will share it with her doctor. She plans to pursue further testing for celiac disease and try medications for irritable bowel syndrome. She stated, “Someone has always been in contact with me through the whole process.”

Page 19: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

19

2015-2016 Annual Summary 7/1/15 – 6/30/16

Primary Age Range

Male Female Employee Dependent

University of Alaska 50-59 29% 71% 71% 29%

Best Doctors Book of Business 50-59 44% 56% 84% 16%

1

3

5

3

2

2

1

1

2

1

1

2

2

4

6

4

1

1

1

4

1

90+

80-89

70-79

60-69

50-59

40-49

30-39

20-29

11-19

0 -10

InterConsultation results

Demographics

Page 20: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

20

2015-2016 Annual Summary 7/1/15 – 6/30/16

38%

17%

25%

8%

4%

8%

26%

15%

22%

15%

4%

19% 21%

7%

57%

14%

0% 0%

28% 26% 25%

6% 6% 8%

Symptoms notimproving

Need help decidingamong multiple

treatments

Questioning needfor surgery

Skeptical of theirdoctors

Don't understanddiagnosis

No diagnosis

July 2015 - June 2016 July 2014 - June 2015 July 2013 - June 2014 Best Doctors

InterConsultation results

IC Reason for calling

Page 21: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

21

2015-2016 Annual Summary 7/1/15 – 6/30/16

4%

4%

4%

4%

8%

8%

8%

13%

13%

29%

Pediatric Specialist

Surgery

Medical Oncology and Hematology

Rheumatology

Internal Medicine

Cardiovascular Disease

Neurological Surgery

Neurology

Gastroenterology

Orthopaedic Surgery

University of Alaska Top 10

4%

4%

4%

5%

5%

6%

7%

7%

8%

22%

Urology

Obstetrics and Gynecology

Cardiovascular Disease

Pediatric Specialist

Neurological Surgery

Physical Medicine and Rehabilitation

Gastroenterology

Medical Oncology and Hematology

Neurology

Orthopaedic Surgery

Best Doctors Book of Business

Top 10

InterConsultation cases by specialty

InterConsultation results

Page 22: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

22

Find a Best Doctor Need an oncologist? Want the best surgeon in your area? Looking for a world-class medical specialist? Just contact us and we will help you locate the doctor who is right for you.

Page 23: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

23

2015-2016 Annual Summary 7/1/15 – 6/30/16

3%

3%

3%

3%

5%

5%

5%

7%

12%

31%

Physical Medicine and Rehabilitation

Rheumatology

Neurology

Psychiatry

Endocrinology and Metabolism

Gastroenterology

Neurological Surgery

Family Medicine

Internal Medicine

Orthopaedic Surgery

University of Alaska Top 10

3%

3%

4%

4%

5%

6%

6%

12%

12%

17%

Endocrinology and Metabolism

Otolaryngology

Gastroenterology

Neurology

Psychiatry

Dermatology

Obstetrics and Gynecology

Family Medicine

Orthopaedic Surgery

Internal Medicine

Best Doctors Book of Business

Top 10

FindBestDoc results

FindBestDoc cases by specialty

Page 24: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

24

Our Mission The Best Doctors mission is simple. Bring together the best medical minds in the world, to get our members the right diagnoses and treatments.

Page 25: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

25

2015-2016 Annual Summary 7/1/15 – 6/30/16

ASK THE EXPERT (ATE) Best Doctors offers personalized answers to medical questions from leading physicians based on a member’s specific situation.

AVG. CONTACTS Sum of the # of client contacts divided by the # of months in this reporting period.

CONTACTS Contacts encompass a variety of member outreach methods, including calls, online form submissions, member portal, and email. A breakdown of contacts by specific origin can be found in the report.

CRITICAL CARE (CC) After a member is admitted into emergency care and Best Doctors is contacted, Best Doctors will collect all of a member’s relevant medical records in real time and have them reviewed by an expert within 72 hours. Best Doctors can also provide a nurse to coordinate care locally.

CROSS REFERRALS/ INTEGRATION

Inbound integration referrals are received and tracked by vendor as reported by vendor contact or member. Outbound integration referrals are made by the Best Doctors operations team to one of a client’s additional vendor services.

FIND A BEST DOCTOR (FBD) Best Doctors helps locate a physician from a Gallup certified database of over 54,000 top medical experts. The physician is chosen based on member specific criteria such as specialty, location, and if he/she is in the member’s health plan.

INTERCONSULTATION (IC) An in-depth medical review by a leading physician to confirm a diagnosis or treatment, or suggest a recommended change.

TARGETS 2016 Best Doctors contact and service lines targets were created to align a client’s goals and Best Doctors Book of Business trending. The targets take into account the client size, goals, historical utilization, and industry trends.

Definitions

Page 26: Current Reporting Period: 7/1/2015 6/30/2016...2015-2016 Annual Summary ... Benefit Partner Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Inbound Outbound Premera

Thank You!

26

Chris Chesterfield

Account Manager

[email protected]

Direct: 757.585.9014