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