ARE ALL CONSUMERS EQUAL? Navneet Kathuria, MD, MPH, MBA, VP, Population Health and Clinical Quality, Meridian Health

ARE ALL CONSUMERS EQUAL? Navneet Kathuria, MD, MPH, MBA, VP, Population Health and Clinical Quality, Meridian Health

Overview Definitions Health Population Consumer Provider Patient

Average Health Care Spending per Capita, 1980 2012 Adjusted for Differences in Cost of Living Dollars ($US) * 2011. Source: OECD Health Data 2014.

Health Care Spending as a Percentage of GDP, 1980 2012 Percent GDP refers to gross domestic product. Source: OECD Health Data 2014.

Spending per Hospital Discharge, 2012 Adjusted for Differences in Cost of Living Dollars ($US) * 2011. ** 2010. Source: OECD Health Data 2014.

Mortality Amenable to Health Care Deaths per 100,000 population* 150 100 76 88 89 81 88 1997 98 2006 07 116 109 106 99 97 97 134 115 113 127 120 50 55 57 60 61 61 64 66 67 74 76 77 78 79 80 83 96 0 FR AUS ITA JPN SWE NOR NETH AUT FIN GER GRE IRL NZ DEN UK US * Countries age-standardized death rates before age 75; including ischemic heart disease, diabetes, stroke, and bacterial infections. Analysis of World Health Organization mortality files and CDC mortality data for U.S. Source: Adapted from E. Nolte and M. McKee, Variations in Amenable Mortality Trends in 16 High-Income Nations, Health Policy, published online Sept. 12, 2011.

Efficiency = Medicare Spending Per Beneficiary (MSPB) Navneet Kathuria, MD, MPH, MBA

13 7 7 7 7 6 6 6 5 5 5 5 4 4 4 4 4 3 3 3 3 3 VIRTUA WEST JERSEY HOSPITALS BERLIN 1.04 Efficiency = Medicare Spending Per Beneficiary (MSPB) CAPITAL HEALTH MEDICAL CENTER - HOPEWELL 1.03 DEBORAH HEART AND LUNG CENTER 1.03 HUNTERDON MEDICAL CENTER 1.03 INSPIRA MEDICAL CENTER WOODBURY 1.03 KENNEDY UNIVERSITY HOSPITAL - STRATFORD DIV 1.03 OUR LADY OF LOURDES MEDICAL CENTER 1.03 MEMORIAL HOSPITAL OF SALEM COUNTY 1.02 INSPIRA MEDICAL CENTER ELMER 1.01 NEWTON MEDICAL CENTER 1.01 LOURDES MEDICAL CENTER OF BURLINGTON COUNTY 1.00 ST LUKE'S WARREN HOSPITAL 1.00 SHORE MEDICAL CENTER 0.99 CAPE REGIONAL MEDICAL CENTER INC 0.98 Navneet Kathuria, MD, MPH, MBA => 1.10 1.05 to 1.09 1.02 to 1.04 0.99 to 1.01 0.96 to 0.98

Daily Sugar Consumption Navneet Kathuria

Alcohol Consumption Navneet Kathuria

Navneet Kathuria

Top 10 causes Top 10 Causes of disease of Death: 1900 vs. 2010. vs. 2010 Jones DS et al. N Engl J Med 2012;366:2333-2338.

Population Health Navneet Kathuria, MD, MPH, MBA

Definition of Health WHO formulated in 1948, state of complete physical, mental and social well-being and not merely the absence of disease or infirmity Navneet Kathuria

Navneet Kathuria

Defining Populations Geographic State of Health Disease State Access method Contracted Financial Risk Gender Age Hair Color, Eye Color, etc Genetic trait Navneet Kathuria, MD, MPH, MBA

Patient - Consumer Consumer a person who buys and uses up goods Patient Original meaning - expend by use a person who is under medical care or treatment a person or thing that undergoes some action Original meaning one who suffers Navneet Kathuria

Patient - Consumer The empowered patient movement encourages patients to become hyper-informed and to take control over their care. But providing greater information, access and autonomy so often successful in consumer settings does it drive better care or experience. Treating patients as typical proactive, in control, well-informed consumers requires them to take on increasingly complex decisions and digest ever-larger amounts of information, the consumer find themselves placed often by design in the driver s seat. High-deductible insurance plans Genetic testing Navneet Kathuria

Patient - Consumer Patients don t want to be there: People seek out healthcare when something is wrong and patients want to solve it and get back to normal. Patients aren t equipped to be there: Even when patients are willing to be decision makers, they may not have the tools. At a time of unusual stress, the system asks them to absorb technical information and make difficult decisions that require specialized expertise. Patients aren t in it alone: To design for patients alone is to forget that they are part of a complex system and aren t often independent decision-makers. Navneet Kathuria

Consumption Consumer spending, consumer demand, consumption, or consumption expenditure is the purchasing of goods and services by individuals or families. It is the largest part of aggregate demand at the macroeconomic level. There are two components of consumption in the basic model: induced consumption (which is affected by the level of income) and autonomous consumption (which is not). Navneet Kathuria

The Holy Grail Navneet Kathuria