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Hint Summit 2017 Health Rosetta Institute Ecosystem overview - Dave Chase april 2017
1. HOW TO DELIVER WORLD
CLASS HEALTHCARE TO
YOUR EMPLOYEES AT HALF
THE COSTCEO’S GUIDE
TO
2. HEALTHCARE COLLATERAL DAMAGE
$1M LESS SAVED FOR RETIREMENT
BY AVG BABY BOOMER FAMILY DUE
TO 20+ YEAR WAGE
STAGNATION/DECLINE
70% OF AMERICAN HOUSEHOLDS
HAVE LESS THAN $1K IN SAVINGS
4. LARGEST GENERATION IN HISTORY (MILLENNIALS) OVER
HALF OF LIFETIME EARNINGS SLATED FOR HC
MEDICARE TAXES & PREMIUMS
DEDUCTIBLES & OUT-OF-POCKET EXPENSES
INSURANCE PREMIUMS
EMPLOYER PREMIUMS
EMPLOYER MEDICAID TAXES
FEDERAL & STATE TAXES
VISIBLE
PAYMENTS
$.6M
HIDDEN
PAYMENTS
$1.3M
+
$1.9MGRAND TOTAL
TOTAL LIFETIME EARNINGS $3.8M
5. THE FUTURE HEALTH ECOSYSTEM WILL
FOCUS ON TRUE DRIVERS OF OUTCOMES
HEALTHY CITIZENS ARE
THE GREATEST ASSET
ANY COUNTRY CAN
HAVE
– WINSTON CHURCHILL
6. CATASTROPHIC MISALLOCATION OF RESOURCES
+37%
HEALTHCARE SPENDING
-50% LOCAL AID
-31% PUBLIC HEALTH
-22% MENTAL HEALTH
-14% INFRASTRUCTURE, HOUSING & ECON. DEV.
-13% LAW & PUBLIC SAFETY
-12% EDUCATION
-11% HUMAN SERVICES
HEALTHCARE SPENDING DEVASTATES SOCIAL DETERMINANTS OF HEALTH
(FY01 - FY14 - STATE OF MASSACHUSETTS)
7. 50+ years of optimizing for
flawed financial incentives.
Healthcare’s root cause of “morbidly obese” healthcare system
Operational waste
Clinical waste
Paid for volumeCost-plus models
Would be world’s
16th largest
economy
8. Who pays for healthcare
$2.7T in annual spending (2014)
(excluding pharma)
Government 48%
Employers 52%
($1.4T)
Medicare
24.8%
Medicaid
19%
Fully
insured
19.7%
Self-insured
32%
Least flexibility
Most homogenous
Most politicized
Most flexibility
Least homogenous
Least politicized
Other
4.5%
9. $191B
Operations waste
Fraud
Excessive admin costs
Unnecessarily high prices
28% of $1.4T is systemic “obesity”
$204B
Clinical waste
Unnecessary services
Inefficient delivery
Missed prevention
$395
B
annually in
employer
segment
Individual behaviors like obesity = ~$200B
13. HEALTH ROSETTA ECOSYSTEM
MULTI-CHANNEL MEDIA
(BOOK, FILM, BEST
PRACTICES)
EDUCATION &
CERTIFICATIONS
FINANCIAL RETURN
ON FOCUSED
CAPITALGROUND BATTLE
AIR COVER
FOCUSED ON SCALING ADOPTION OF PROVEN FIXES TO THE ROOT CAUSES OF
HEALTHCARE’S DYSFUNCTION. A LEED-LIKE BLUEPRINT FOR PURCHASING HEALTHCARE
BENEFITS.
14. BLUEPRINT TO ENABLE EVERY GROUP HEALTH
BENEFITS PURCHASER TO ADOPT PROVEN
SOLUTIONS
RESTORE THE AMERICAN DREAM FOR
EMPLOYEES/MEMBERS OF PRIVATE & PUBLIC SECTOR
EMPLOYERS/UNIONS, REGARDLESS OF EMPLOYER
SIZE/INDUSTRY
MODERN BENEFITS PLANS HAVE REDUCED COSTS
20-55%, WHILE SIGNIFICANTLY IMPROVING HEALTH
OUTCOMES
15.
16. SCALE SUCCESSFUL MODELS VIA
LEED-LIKE ECOSYSTEM FOR
PURCHASING BENEFITS
1. GOOD HOUSEKEEPING STAMP OF APPROVAL
CREATES TRUST & CLARITY
2. VOLUNTARY 3RD-PARTY CERTIFIED
ECOSYSTEM & NETWORK DRIVES ADOPTION
CATEGORIES OF CERTIFICATIONS IN 3 PHASES
1. PEOPLE: BENEFITS CONSULTANTS, PURCHASERS, TOPICAL EXPERTS
2. PRODUCTS/SERVICES: BENEFIT PLAN COMPONENTS (E.G. PRIMARY CARE,
MSK) CARE PROVIDERS, TECHNOLOGY (E.G. PAYMENT INTEGRITY)
3. PLACES (REAL ESTATE COMMUNITIES (E.G. SENIOR HOUSING), TOWNS,
SCHOOLS
17. WHY GROUP PURCHASERS?
DESIRE & PURCHASING POWER
1. SHOULDERING INCREASING COSTS
2. ABLE TO CHANGE INCREMENTALLY
3. EACH ACTS INDEPENDENTLY
WE PROVIDE WHAT THEY LACK
• INDEPENDENT VETTING: TRUSTED ADVISORS, PRODUCTS, SOLUTIONS &
OTHERS
• KNOW-HOW: BLUEPRINTS AND BEST PRACTICES
• GUIDANCE: OVERCOME RETENTION FEARS & INCREASE MARKET
EXPECTATIONS
18. BEACHHEAD CERTIFICATION
CERTIFIED BENEFITS CONSULTANTS
ACCELERATE THE TRANSITION OF BENEFITS ADVISING
IN THE MODERN WORLD:
FROM BROKER (LIKE 80’S STOCKBROKERS) TO
FIDUCIARY/ADVISOR (LIKE FINANCIAL ADVISORS)
WHY START HERE?
• LARGE INFLUENCE ON PURCHASING DECISIONS
• EMERGING MARKET PRESSURE TO MAKE THIS CHANGE
Problem solution leverage catalyst (fiduciary opportunity/duty: shareholder - hc last place not addressed by corps and ERISA duty)
Didn’t get better lighting in homes & cities by optimizing candle and oil lamp technology
Since Medicare passed 50 years ago, all consumer goods/services went up 8x. HC went up 274x.
Orgs like IOM & PwC say ⅓ to ½ of all hc spending doesn’t add value; Imagine if you had that failure rate in anything else in your supply chain
Except the poor & old, most get hc through work. Baked into virtually every legacy business model in hc is assumption that employers remain derelict in their fiduciary duty. There’s an event that should be on the frontpage of the WSJ in the coming weeks that will be the canary in the coal mine of an Enron-like event. As we know, corporate governance was forever changed as a result. This creates great investment opportunities if focused in the right areas.
Let’s just look at the employer side of the equation. People worry about things like obesity and smoking but that pales in comparison to systemic “obesity”
Unnecessary: 40% of planned transplants, 90% of spinal procedures
Fraud: 1st case is >500k claims for >$400M at last count -- one of the most famous/fierce law firms in the world is readying cases that are in the tobacco/asbestos range
PPO: Perhaps the biggest joke in the hc system
A fractal is a never-ending pattern. Fractals are infinitely complex patterns that are self-similar across different scales. They are created by repeating a simple process over and over in an ongoing feedback loop. Driven by recursion, fractals are images of dynamic systems – the pictures of Chaos. Geometrically, they exist in between our familiar dimensions. Fractal patterns are extremely familiar, since nature is full of fractals. For instance: trees, rivers, coastlines, mountains, clouds, seashells, hurricanes, etc. Abstract fractals – such as the Mandelbrot Set – can be generated by a computer calculating a simple equation over and over.
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