Trends and Directions in Integrated Care Innovations

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Trends and Directions in Integrated Care Innovations Helmut Hildebrandt CFO International Foundation for Integrated Care CEO OptiMedis AG & Gesundes Kinzigtal GmbH [email protected] www.integratedcarefoundation.org

Transcript of Trends and Directions in Integrated Care Innovations

Trends and Directions in Integrated Care Innovations

Helmut Hildebrandt

CFO International Foundation for Integrated Care

CEO OptiMedis AG & Gesundes Kinzigtal [email protected]

www.integratedcarefoundation.org

International Foundation for Integrated CareWho are we?

Mission Statement

The International Foundation forIntegrated Care (IFIC) is a networkthat crosses organisational andprofessional boundaries to bringpeople together to advance thescience, knowledge and adoption ofintegrated care policy and practice.

The Foundation seeks to achieve thisthrough the development andexchange of ideas among academics,researchers, managers, clinicians,policy makers and users and carers ofservices throughout the World.

Our Purpose

• To develop a membership network that provides a central, authoritative, resource for information and expertise on integrated care

• To advance the study and science of integrated care

• To develop knowledge on the evidence for, and application of, successful approaches to integration

• To bring people together from a range of backgrounds to network and exchange ideas to promote integrated care

OptiMedis: Health science put into practice: realizing Triple Aim

Cooperation Contract / Regional Health Management Company

Cooperation – in development:

Hamburg Billstedt-Horn Bielefeld Berlin/BrandenburgMannheim Greifswald Bayern Leipzig

Switzerland

Austria

Helmut HildebrandtPharmacist, studies in sociology, over 30 years management and consulting experience for WHO and ministerial boards, hospitals, physician networks and others

Population Health in the Times of Global Financial Crisis: The Problem

Ageing societies with growing chronic care

needs

Working habits / eating habits / physical

habits

Complex societal risks and challenges –

traditional intergenerational families not

living together anymore

Growing scarcity of public funding & money

Integration of care delivery and financing around the

patient is needed

to make significant improvements in care, health and

thus costs: triple aim!

• Diabetes

• Cardio vascular

• COPD/Asthma

• Bones/joints

• Loneliness

• Depression

• Dementia

• …

• Health

Insurance

• Pension

• LTC

• Subsidies

• Own

payment

• ...?

• GP

• Homecare

• Relatives

• Specialists

• Psychologist

• Pharmacist

• Paramedics

• iHealth …?

Healthcare systems not oriented towards health outcomes, but cure and care inputs

Maria

Population Health in the Times of Global Financial Crisis: The Essential Questions

? How to get a sustainable interest in

investments in health and in

delivering the best results?

? How to get local health care providers

motivated for health/public health ?

? …. and how do we get this installed in

multi payer / multi provider as well as

beveridge (NHS) systems

a. Law allowing health gains to be contracted and paid out = contract innovation rewarding and sharing health gains against total costs of care

b. Regional ‘integrator’ organisation/cooperation/leadership

c. Triple Aim approaches: back to the real heart of medicine

d. Longterm contracts rewarding investments in health and prevention

e. Population data, data, data…..

National conditions

Local implementation

Making Population Health happen today: the solution

Gesundes Kinzigtal (GK): Population Health & Integrated Care Network Management

• Start and duration contract: 2006-2015, now in negotiation for indefinitely

with AOK & SVLFG

• Shared savings Insurers/GK: ~ 1:2

• Total costs of care (2013)*: 73 Mio. €

• Population insurers: ~ 33.000 = 46%

• Total GK participants: ~ 9.750

• Ø-age pop. / participants 45,7 / 61,6

• Integrator organization

• Reg. cooperation partners: ~ 160

• Number of programs: ~ 20

• Population data: all claims data anonymous from insurers

* AOK + SVLFG, without dentistry

Basic conceptual framework

Success is possible

• 4.65 € absolute increase of the contribution margin in Kinzigtal for the whole AOK-population (total costs of care without dental)

Shared between AOK and

Gesundes Kinzigtal GmbH

„Transformative solutions will be needed“ says World Economic Forum (Davos)

“…The purpose of the project – and this report – is to support strategic dialogue among various stakeholders on what health systems are now, what

they might be in the future and how they could adapt to be sustainable. Sustainability is unlikely to be achieved through incremental changes. Instead, transformative solutions will be needed – solutions that require cooperation across industry sectors and governments, and thereby challenge the current boundaries of healthcare and established norms of operation. …”

http://www.weforum.org/issues/scenarios-sustainable-health-systems

BM, IT and Patient Participation= Central Challenges ahead

• What is needed for „Disruptive Innovations“ ?

– Business Model

– Improved Technology: IT + M-Health + Data Analysis

– Scientific Knowhow – Patient Engagement andParticipation

We are very much interested in cooperation and your feedback !

Helmut Hildebrandt, Vorstand,

OptiMedis AG, Borsteler Chaussee 53,

D – 22453 Hamburg

e-mail: [email protected]

www.gesundes-kinzigtal.comwww.optimedis.com

See website in engl.

International Cooperation

Currently:

Netherland

Australia

In discussion:

Switzerland

Austria