Looking out at the San Francisco skyline from the top floor of the Westin St. Francis on Day 3 of the 42nd Annual J.P. Morgan Healthcare Conference, the iconic Transamerica pyramid is not too far away. But my mind, being chock-full of value-based care presentations, quickly imagines the building as the shining pyramid of patient segmentation and risk stratification, envisioning the proper way to sort patients for effective intervention and total cost of care reduction. John Kao, CEO of Alignment Healthcare, shared today that only 12% percent of their Medicare Advantage membership accounts for approximately 74% percent of their institutional cost (hospital and facility costs), while conversely their “healthy” membership of 74% accounted for only 5% of their institutional costs. These days, institutional costs and pharmaceutical costs are almost equal, according to the Advisory Board, and together far outweigh professional physician and other provider costs. Therefore, keeping patients out of the hospital and post-acute facilities as medically possible and appropriate and effectively managing medications should result in a large reduction in the total cost of care, right? So, what’s not happening that should be?Continue Reading Day 3 Notes from the 42nd Annual J.P. Morgan Healthcare Conference
