Proprietary & Confidential
On-Site Health & Wel lness Centers
February 19 th, 2014
1
On-Site Health & Wel lness Centers
Ben Baker Chief Operating Officer, CareHere
Proprietary & Confidential 2
AGENDA
Background & History
Healthcare Reform & Self-Funding
Benefits of Onsite Healthcare &
Wellness
Data Analysis
Reporting & ROI
Implementation
Q&A
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CareHere History & Ownership
• Formed in January 2004
• Headquarters: Brentwood, TN
• 163 health centers, located in 22 states
• 850+ on payroll
• Medical services provided to 95,000+
employees nationwide
• Named the 6th Fastest Growing Private
Company in Middle Tennessee
(2013 Nashville Business Journal Award)
Public59%
Private
41%
CURRENT ENTITIES • City, County & State Governments
• School & Utility Districts
• Manufacturers (Auto, Food, Equipment)
• Banking & Insurance Companies
• College/University
• Construction
• Transportation
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Tier 1 supplier to Ford,
General Motors and Toyota
CareHere Clients
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US Health Care
Reform
Insurance Reform
Delivery System
Reform
Coverage
Expansion
Individual
Mandate
Medical-Loss
Ratio
New Org
Structures
ACO
PCMH
Payment
Reform
Value-Based
Payments
Bundled
Payments
2010 U.S. Healthcare Reform
• PCMH = Patient Centered Medical Home
• ACO = Accountable Care Organization
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Patient Centered
Healthcare
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Benefits of a CareHere Health & Wellness Center
Reduce
Healthcare
Claims Cost
Identify/Treat
Chronic
Illness
Increase
Productivity
Improve
Employee
Morale
Save Money
With No
Co-Pay
No
Appointment
Wait Times
Access to
Wellness
Programs
Trust in
On-site Care
Providers
Employer Benefits:
Employee Benefits:
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Benefits to the Provider
• Build Trust with the Patient
• Educate and Provide Treatment
• No Double or Triple Booking
• Not a Fee for Service Model
• No Daily Patient Quota
• Covered Medical Malpractice Insurance
• Care-Coordination with Specialist, Health Coaches, and Outside
Primary Care Providers
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Specialist Referrals
• Referrals are made within the provider network
• Establishing a high performance network
• Outside provider access to the CareHere EMR
Specified EMR accessibility
Fax
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Local Hospital Alliance
• Specialized Services at Contracted Rates
• Hospitalist Established
• Bypass the Emergency Room
• Avoid the cost of the Emergency Room
• 24/7 Service
• Provides a higher level of service and convenience to the
employee
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Market Place VS. Onsite Health Centers
No relationship
between patient and
Provider
Co-Pays
5-7 minutes on average
with the Provider
Poor or No communication
between Providers
No Co-Pays
20 minute Appointments
Care flows through onsite
Provider
Access to integrated wellness programs
Market Place Onsite Centers
Profit Driven Patient-
Centered Approach
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Personalized Cover Letter Summarized Lab Results
Color-Coded Health Summary
20-30 Core Report
Health Risk Assessments
On-Site and Off-Site Blood Draw for Employees
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CareHere Coaches
Exercise Health Coach | Registered Nurse | Behavioral Health Coach
Pharmacist | Tobacco Cessation | Registered Dietitian
CareHere has 185 Case and Disease Management (CM/DM)
programs developed for 2014!
Sample CM/DM Programs:
•Weight Management
•Smoking Cessation
•Diabetes Management
•Beginning Exercise
•Basic Nutrition
•Grocery Store Tours
Provider Driven Wellness & Case Management
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Wellness Tracking Application
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Patient interaction notes are
accessible by:
• On-Site Clinic Medical Provider
• CareHere Wellness Coaches
• Telemedicine Provider
• 24/7 Nurse Line Providers
• Outside Providers
EMR Differentiators:
• Ability to share CareHere EMR notes with Outside
Providers
• Ability to separate occupational health/workers
compensation notes from primary care notes within the
EMR while maintaining HIPAA compliance.
• Transmission of eligibility and claims data in a fully
integrated 837 file.
Electronic Medical Records
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“…Among employees
who are at low-
moderate risk for
Cardiovascular Disease
and adhere to an online,
interactive, web-based
Work Health Program,
significant reduction in
multiple Cardiovascular
Disease risk factors(…)
is attained within only 90
days.”
American Heart Journal Mayo Clinic Study
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Incentives/Disincentives
•Mandatory HRAs
•Biometric Benchmarks
•Wellness Program Participation
•Premium Differentials
•Reward Programs
•Contests
Clinic and Wellness Marketing, Tools
and Education
• Employee Presentations
• Free HRA Events
• Open House
• Wellness Groups
• Health Events
• Mailers and Emails
• Health Educator Presentations
• On-Site Flu Vaccinations
• Paycheck Stub Announcements
• Targeted Notifications/Reminders
Creating Employee Engagement
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Creating Employee Engagement
• Promoting the Health Center
• Educating the employees
• Incentives and Rewards
• Customized to the employer
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0%
10%
20%
30%
40%
50%
60%
70%
80%
Client 1 Client 2 Client 3 Client 4 Client 5 Client 6 Client 7 Client 8 Client 9
Negative Negative Positive Positive Positive Pos./Neg. None None None
71%
62%
70% 68%
54%
47%
37%
13%
4%
53%
63%
19% 26%
19% 21%
2% 2% 0%
Count of Unique Patients/Engaged in Wellness Count of Unique Patients Assigned Programs/Completed Programs
Employer Incentive Impact
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On-Site Provider Dispensing
• Zero-revenue venture for CareHere
• 30/60/90 Day Supply
• 150 to 200 Generic Drugs Stocked On-Site
• Pharmaceutical Mail Order Plan
Top 5 Comparison (Brand vs. Generic)
Name Brand Marketplace
Price
Generic or
Equivalent
CareHere
Price
Nexium $5.71 Esomeprazole
(therapeutic sub to
Pantoprazole)
$0.08
Prilosec $1.02 Omeprazole $0.15
Protonix $1.17 Pantoprazole $0.08
Lipitor $5.00 Atorvastatin $0.24
Claritin $1.00 Loratadine $0.07
CareHere Differentiators:
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“What should
this cost?”
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With data analytics, you can:
• Control health costs
• Measure performance
• Assess risks
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• Cholesterol Management
• Weight Management
• Pre/Diabetes Management
• Tobacco Cessation (COPD)
• Hypertension Management
High Risk
Moderate Risk
Low Risk
John’s Hopkins ACGs
Data analytics enables you to evaluate
the total disease experience of a patient
and predict cardio respiratory
failure/shock, among other conditions.
Disease Management Protocols:
Quality Care Delivery
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Member Analysis
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Preventable Conditions
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Data Analytics: Regression
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Regression: BMI/All patients - $9
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Regression: BMI > 30 - $14
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Regression: BMI $22 + HbA1C $133
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Claims Trend and Savings Analysis
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OVER $15 MILLION SAVED
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Health Risk Assessment Condition Savings
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Services
Medical & Health Services
• Primary Care
• Acute Care
• Episodic Care
• Patient Medication Adherence
• Pharmaceutical Dispensary
• Mail Order Medication
• Immunizations
• Sports Physicals
• Plan of Care Compliance
Wellness
• Case Management
• Weight Management
• Hypertension Management
• Addiction Intervention
• Pre-Diabetes Management
• Lipid Management
• Stress Management
• Nutritional Counseling
• CareHere Staffing
• Wellness Coaches
• Accounting
• Training
• Pharmacist
• Director of Client/Clinic Operation
• Care Coordinator/Case Manager
• Medical Staff Management
• Medical Provider Management
• Medical Provider Recruitment
• Medical Staff Recruitment
• Medical Malpractice Insurance
Technology
• Electronic Medical Record
• CareHere Connect
• Information Technology
• Online Appointment Scheduler
• Smartphone Application
• EMR Access & Integration with
Outside Specialist/PCP/ER
Support Services
• 24/7 Call-Center
• 1-800 Customer Support
• Education Tools
• Marketing
• Information Technology Support
• HRA Employee Events
Clinical Outcome
Services
• Reporting
• Purchasing Coordination
• Clinic Inventory Management
• Patient Survey Feedback
• Clinic Best Practices Sharing
• Integration of Services
• ROI Analysis
• Budget Adherence
Staffing
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Workers’ Compensation • Medical Management of Work Related
Injuries/Illnesses
• Ergonomic Job Analysis
• Coordination of Care/ Collaborative
Model
• Maintain Productivity
Restriction of Work Vs. Disability
• Integrated Disability Case
Management: Systems Approach
Understand Workplace Culture
Negotiate & Manage Referrals
Disability Management
• Understanding Clients Environment
• Control Costs
• Preserve Patient Satisfaction
Occupational Health Services • DOT Physicals
• Random Drug Testing Program
• Assist with Job Placement
• Hearing Testing
• Hearing Protection Training
• Hearing Conservation Program
Management
• Annual Fit for Duty (FFD) Exams
• Respiratory Fit Testing
• Spirometry Testing (Pulmonary Function
Testing)
• EKG Testing
• HazMat Physicals
• Lift Testing
• Breath Alcohol Testing (BAT)
Worker’s Compensation and Occupational Health
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Implementation
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Waiting Room
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Nurse Triage
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Exam Room
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Exam Room
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