Tuesday, July 7, 2009

A PAY FOR PERFORMANCE SYSTEM FOR HEALTH MANAGEMENT

1. CASH FOR HEALTH is a ROLL-UP to cooperatively convert independent medical 
practices into cash businesses.
2. CASH FOR HEALTH is a solution for employers to afford better health care for employees for less money.
3. CASH FOR HEALTH is a cash reward system for patients as an incentive to improve annual health scores.


THE CASH FOR HEALTH SYSTEM:
PAY-FOR-PERFORMANCE PREVENTION MANAGEMENT
$200 (min.) - $500 (max.) PER MONTH FOR ANYONE TO ENROLL

FOR PATIENTS: 
  • CASH FOR HEALTH MANAGES ALL YOUR HEALTH MAINTENANCE COSTS WITH YOUR CASH FOR HEALTH DEBIT CARD 
  • WIN CASH POINTS BACK BASED ON YOUR HEALTH PERFORMANCE OR WHEN YOU LOSE WEIGHT
CASH FOR HEALTH uses required annual personal health scores to create smart, managed care plans for H2O members and rewards members with cash points back when health scores improve or their catastrophic risk level is reduced. The CASH FOR HEALTH system motivates members to compete against themselves and members are supported by peers and CASH FOR HEALTH coaches to motivate individual success collectively.

I combined the best functioning parts of various systems (including those by Dr. Mehmet Oz, Dean Ornish and Safeway) and I added a special sauce; a cash reward system for members! That is the missing link and sets it apart from anything else on the table now. Another compelling feature, CASH FOR HEALTH separates catastrophic insurance from daily health management costs. As an CASH FOR HEALTH member based on your current health scores and risk level you can opt-in to purchase hospital care coverage from CASH FOR HEALTH insurance partners based on a dollar figure to cover anything from potential hospital visits ($100,000) or for cancer care ($1 million).

CASH FOR HEALTH DEBIT CARD INTERCHANGE REVENUE
iCASH FOR HEALTH financial services collects monthly payments from members, transfer payments (or government or employer subsidized transactional credit) onto individual member debit cards, that are coded for use only for health care services and products from CASH FOR HEALTH suppliers and merchants. 

 Interchange fees will support CASH FOR HEALTH health rewards programs. In other issuer models paying for rewards programs consumes 44% of the interchange costs, processing 13%, network branding 3%, and 35% covers cost of funds and profit margins. As franchisor CASH FOR HEALTH makes money from franchise fees, royalties, and CASH FOR HEALTH debit card interchange fees from suppliers.

TEST BEFORE NOT AFTER YOU'RE SICK. CASH FOR HEALTH TAKES THE GUESSWORK OUT OF HEALTH CARE

The dynamic CASH FOR HEALTH system is centered on empowering members to reduce health risk and win cash for health improvement and maintenance. The solution to smart health is to test before, not after, you are sick. We take the guesswork out of health care. Start with a health plan based on facts. Your facts. If the test determines a specific health issue, or if you have a wellness goal, we design a plan to solve the problem. 

CASH FOR HEALTH monthly plans cost between $200 minimum to $500 maximum (for chronic care patients). CASH FOR HEALTH transfers your monthly payment (from you, your employer, or government subsidy) onto your CASH FOR HEALTH member card (works like a debit card) that you use to redeem day-to-day health related services according to your plan; for medication, chiropractor visits, vitamins, yoga, gym memberships, CASH FOR HEALTH health coach visits, etc. CASH FOR HEALTH is able to provide maximum dollar value and best prices of services for our individual members by working together with vendors as a cooperative group.

Chronic care CASH FOR HEALTH members are managed by a team specifically engaged in care to reduce risk for hospitalization and to manage costs to be affordable for the long-term and to reverse disease. CASH FOR HEALTH membership also allows you to apply for catastrophic health insurance that makes sense. Based on your assessed health risk level determined by CASH FOR HEALTH tests, you can select insurance based on a dollar figure to cover anything from potential hospital visits ($100,000) or for cancer care ($1 million). The CASH FOR HEALTH system motivates members to compete against themselves and members are supported by peers and H2O coaches to motivate individual success collectively (CASH FOR HEALTH Member Circles). Peer support is what keeps people healthy over the long term. Outlined here.


THE CASH FOR HEALTH KEY TO BALANCING PATIENT DEMAND WITH APPOINTMENT SUPPLY

Doctors who see more patients and work more hours, make more money. But there is a fine balance between patient demand and appointment supply to maintain quality care. The ideal practice has 1800-2000 patients per doctor, works 240 days of the year, sees 24 patients per day, 3 times per year. Using that formula doctors can't afford to stay in business due to badly negotiated third party payor relationships with insurers who pay doctors $24 per patient visit. Some patients only come once per year, if at all, and some come too much. Too many uncontrollable variables to manage.

So it occurred to me for doctors to make a profit, we need to control it from the other end! Control the patient! Patient flow and care has to be systemized, and this "control" is "sold" to patients as "wellness care" and prevention attention!

On average 60% of medical practice income goes to salaries, staff benefits, supplies, malpractice insurance, 15% to debt service, 2-5% to state and local government taxes. 

Based on this research 50%-75% primary care visits can be handled by a nurse or healthcare practitioner. Using a nurse managed clinic network healthcare for 10,000 patients costs $800,000 vs. $3-$5 million to operate a traditional model.

CASH FOR HEALTH Volunteer Coaches receive free CASH FOR HEALTH health services. Every 5,000 CASH FOR HEALTH members is managed by one doctor, five practitioners, and 5 volunteers. 

CASH FOR HEALTH : 
5000 MEMBERS PER DOCTOR'S OFFICE CASE EXAMPLE

$21,000,000 Average Annual Doctor Member Revenue 
(5000 Patient Members @ $350 per month x 12 months = $21,000,000)

$1,680,000 Financial Management Fee 8%
$500,000 Doctor Salary $100 per member/per year
$750,000 Practitioner Salaries ($150,000 per year x 5 practitioners per 5000 members)
$500,000 Operations (Rent, Supplies, Equipment Lease, Insurance)
$16,500,000  CASH FOR HEALTH Member Maintenance Actual Cost for 5000 Members
$19,930,000 Total CASH FOR HEALTH Doctor Member Costs
$1,070,000 Profit

CASH FOR HEALTH Member who pays $350 per month = $4200 per year
Actual Annual Per Member Costs = $3,300
$1000 Diagnostic Tests
$250 Plan Analysis
$250 EMR
$400 Exercise Program (Gym, Yoga, etc.)
$100 Doctor Visit (1)
$300 Practitioner Visits (4 @$75 each)
$1000 Medication, Supplements

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