1 Telehealth Extends EM Opportunities to Participate in CCMRobert J. Wagner, MD, FACEP And Sylvan Waller, MD, FACEP George Washington University School of Medicine & Health Sciences

2 Bio Robert J. Wagner, MD, FACEPPartner Consulting Services, Schumacher Clinical Partner Dr. Robert Wagner is a Partner with the Consulting Services Division of Schumacher Clinical Partners. In this role he has had the opportunity to help multiple hospitals and health systems managing strategies to drive clinical, operational and financial excellence. Recently he has worked with clients to develop telehealth strategies, free standing emergency department development, transitions of care and denials management. Dr. Wagner has been with SCP since 2010 in multiple roles including Medical Director, President of Care Management and Chief Medical Information Officer. Dr. Wagner is a graduate of Albany Medical College. He did his internship in General Surgery at the University of Maryland and completed his Emergency Medicine residency at Shands Hospital in Jacksonville, FL.

3 Defining the Problem Average wait time to see a doctor in the US is 18.5 days,

4 Where We are Today Technology ACA MedicineConfluence between Technology, Medicine, and the Affordable Care Act: Consumers awareness of coverage Focus on consumerism and transparency Proliferation of technology ACA Medicine

5 Acute Episodic Care Most common medical issues being treated by Telemedicine today: Allergies Colds / Sinus Infections Ear infections Eye infections / Styes Headaches Influenza (flu) Sexually Transmitted Diseases Skin Conditions / Eczema / Rash Sprains and Strains Stomach flu (gastroenteritis) Strep / Sore throat Urinary tract infections (UTIs)

6 Future of Telemedicine

7 Confluence of Technology, Medicine, and Consumerism- Mobile first -Video - Connected devices Medicine - Personalized care - Efficiency - Cost transparency - Integrated into fabric Consumerism - Services delivered on demand - Concierge quality - Greater consumer choice for seeking care

8 Technology Advances Today we rely on physical exams and clinical algorithms Tomorrow, with the proliferation of technology we will be able to transform healthcare with digital connected devices:

9 Increased Exposure FSED’s, Hybrid Models and UC increase our exposure and ability to manage chronic conditions Create models that allow for identification and navigation of chronic conditions Increased accessibility will result in increased opportunities for EM physicians to actively participate in CCM Source:

10 The Future of Chronic CareIncreased access to care through the ACA increases the number of individuals in need of chronic care management Payment models continue to shift from volume to value-based payment requiring more Chronic Care Management (CCM) specific programs Effective use of health care resources allocated across the entire system Innovative payment models create incentives for health providers and systems to improve care models Attention placed on prevention and wellness - from reactive to proactive care Innovative care models will continue to drive enhanced value Advancing technology will provide greater value

11 ROI vs. VOI

12 Drivers of Telehealth in CCM

13 Telehealth Value Proposition in CCM

14 Benefits to Tele-CCM

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16 Thank you Sylvan Waller Rehan Virani Monica Leslie Jeff Jones