Post on 17-Jan-2017
Keeping the Pediatric Population Healthy
Steve Allen, MD
CEO, Nationwide Children’s Hospital
………………..……………………………………………………………………………………………………………………………………..
2
………………..……………………………………………………………………………………………………………………………………..
3
~330,000 lives
Flow of Funds
4
5
Pay For Performance Top To Bottom Alignment
ODM State targets measures
Health Plans
Health Plans incentivized
PFK PFK engaged in performance based contract
Doctors Physician incentives on HEDIS and Quality
6
Plan HEDIS Performance
68%
75%
83%
90%
Rx for URI Asthma Meds
PFK
PFK
Collaborative Pharmacy Workgroup with MCPs
Prescription Drug Management
Guideline development
and dissemination
Minds Matter
Care Coordination for high cost kids
8
Preventing Antibiotic Resistance
75%
80%
85%
90%
95%
100%
2009 2010 2011 2012 2013 2014 2015 2016
Hundreds
Appropriate Treatment for Upper Respiratory Infection by Year - PFK Data
% C
ompl
ianc
e
9
Complex Care Cohort Utilization
0
20
40
60
80
100
2011 2012 2013 2014 2015
Census Patient Days per 100 Feeding Tube Patients
# of
Day
s
0
5
10
15
20
25
30
35
40
45
2012 2013 2014 2015
# of
ED
Vis
its p
er 1
00 p
atie
nts
per
mon
th Managing Epilepsy
14
Prematurity Prematurity
Women Receiving Progesterone
0
50
100
150
200
250
300
350
400
2013 2014 2015 2016
15
Infants Born <37 weeks
25
27
29
31
33
35
37
39
2013 2014 2015 2016
%
16
Infants Born <32 weeks
5
6
7
8
9
10
11
12
13
2013 2014 2015 2016
%
17
Bending the Cost Curve
Pediatrics 2015: 135; 2014-2725 15
Challenges
Social Determinants
Genomics/ High cost
drugs
Beyond Financial Metrics
Chronic Disease
Prevalence
17
Healthy Homes
Before
Healthy Homes
Before
Impacted more than
200 residential properties
After
20
0
50
100
150
200
250
2013 2014 2015 2016 2017
22
Hires