Looking for some brainstorming ideas for this hypothetical presentation - Below is the information and at the end the possible topics to discuss in the proposal.
Your team is a group of consultant experts brought in to draft a strategic digital health plan and roadmap for your client,
a 4-hospital urban/rural IDN called Experios. Experios has already made significant investments in an Epic EHR for their
hospitals with a plan to transition 27 owned outpatient clinics from Allscripts and Greenway to Epic over the next 2
years. Experios maintains 900 licensed beds spread across 6 counties and competes with 2 large ($4+B) academic
medical centers. Experios has invested heavily in regional clinical specialties such as cardiology, oncology, and
orthopedics representing a growing geriatric retirement community.
Experios also operates a small Medicare Advantage plan (20,000 lives), MSSP1 (75,000 lives that Experios is interested in
converting to NextGen) and would like to expand into Medicaid shared savings/capitation in the future. While the
prominent IDN in the region, Experios has not had the capital to purchase regional outpatient clinics requiring it to
partner with independent providers to ensure rural and specialty access. A 300-physician independent multi-specialty
practice recently organized a fledgling ACO; grabbing a contract for 120,000 attributed commercial lives under shared
savings contracts. Experios revenue is 30% Medicare, 30% Medicaid, and 25% Commercial with the remaining being
self-pay/indigent. At the time of this request, Experios is grappling with the COVID-19 crisis which has upended its
business model and shifted its focus to identification, triage, isolation, and treatment of COVID+ and at-risk patients.
Experios believes that good public health is good population health and therefore, its digital health strategy is as
important as ever.
Experios maintains a license with a reputable HIE software vendor but has had limited success in onboarding nonExperios users/clinical records. Several CIN vendors are courting Experios as a better alternative to the HIE and there
exists certain aggregate data assets (ADT feeds, pre-adjudicated all-payer inpatient claims, ambulatory labs, Surescripts)
that Experios may be able to tap into to augment a CIN. Experios' CIO will be retiring soon and CEO is looking for your team to draft a robust but flexible 3 year digital health plan, including justification for why certain projects are
prioritized. At a minimum, the CEO would like the following:
Experios Project Phase 1 - "Findings": As part of your consulting agreement, your team will perform initial
research and present your working hypothesis
Teams should be covering assumptions and hypotheses so the CEO can ask clarifying questions.
Topics to address:
Overview and timing of key market drivers and trends likely to impact Experios.
Team's understanding of organizational priorities and goals including likely payer and community needs.
Articulation of assumptions made by the team in crafting this proposal.
Prioritization logic in defending why this proposal was promoted above alternatives.
Primary and supplemental technology assets and how they support the goals of the organization.
Summary of the estimated impact of your solution on Experios operations cost savings, public, and population health.
Sample Solution