Insights Series, Issue 25: "An ounce of prevention is worth a pound of cure"

Insights Series Issue 25 siemens-healthineers.com/ transforming-care-delivery An ounce of prevention is worth a pound of cure Population health management in Germany’s Black Forest A thought leadership paper on how to “Manage population health” SIEMENS Healthineers Preface The Insights Series The Siemens Healthineers Insights Series is our preeminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. The Series explores emerging issues and provides you with practical solutions to today’s most pressing healthcare challenges. We believe that increasing value in healthcare – delivering better outcomes at lower cost – rests on four strategies. These four principles serve as the cornerstones of the Insights Series. 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Please visit siemens-healthineers.com/insights-series Executive summary Delivering “sick care” instead of healthcare—this might Sixteen years later, Gesundes Kinzigtal is frequently cited be shorthand for the issues many countries around the in international research and media as a potential model world are facing. for solving some of healthcare’s most vexing problems.2–5 Researchers point to better patient outcomes such as They need to cope with sub-optimal patient outcomes, longer lifespan and fewer injuries, as well as increased rising healthcare costs, and health systems that are patient satisfaction and lower overall healthcare costs— resistant to change. For many years now, health literature 7% lower compared with average costs across Germany.6 has featured references to, and stories about, something called population health management. This is, simply put, Gesundes Kinzigtal has been so successful that OptiMedis an approach to healthcare delivery that aims to improve is now implementing similar models in other regions of the health of the entire population and to reduce health Germany as well as in other countries. What began 16 inequities among population groups. Until recently however, years ago as an experiment in Germany’s Kinzig Valley is the concept of population health has been one that is today a template for a model that has the potential to more discussed than acted upon.1 transform the way we think about, and deliver, health- care—reducing costs and helping people to live longer, Population health management has not been featured healthier lives. prominently in discussions about how to improve health- care systems. But it has not been entirely lacking either. One example can be found, surprisingly, in a remote area of Germany where you wouldn’t necessarily expect to find healthcare innovation. Sixteen years ago, in the Kinzig Valley region of Number of publications on the topic Germany’s Black Forest, a group of physicians decided to of “population health management” shake things up a little. They partnered with the health management company OptiMedis AG, enlisted a couple of insurance providers, and launched a population health 300 management company called Gesundes Kinzigtal, or 250 “Healthy Kinzig Valley”. Together, they offered a new 200 model of care, one based on working with patients to 150 prevent disease and injury, and on integrating care 100 across the region in order to better treat diseases and 50 injuries when they occur. 0 - 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Numbers based on a keyword search for “manage population health“, “managing population health“ and “population health management“ within the publications‘ full text listed in the EBSCO platform and MEDLINE database. Siemens Healthineers Insights Series · Issue 25 3 The model The Kinzig Valley, or Kinzigtal, in Southwest Germany is home to several small villages and a population of approximately 71,000. These are, by and large, lower to Gesundes Kinzigtal middle income people with a relatively high level of Accountable Care Organization chronic disease. Kinzigtal is located in Germany’s historic founded 2005 Black Forest region. The area is said to have been a setting, or at least an inspiration, for many of Grimms’ 30 Fairy Tales, still told today to children everywhere. It is Staff known to be the birthplace of the cuckoo clock, and is 50+ renowned for its rural beauty, gothic buildings and world- Healthcare providers famous spas. And in recent years, it has been at the 70+ center of an experiment in managing population health Partners organizations, e.g., gyms, self aid that may well be one of the models on which future groups etc. health systems are based. 34,000 Population In 2005, a regional network of physicians called Medical Quality Network Doctors’ Initiative Kinzigtal (MQNK), together with the health management company Opti- Medis, founded a regional health management company they called Gesundes Kinzigtal, which translates as “Healthy Kinzig Valley.” Their goal was to promote a population- Germany based, integrated care approach throughout their region, one that would connect patients, providers, and health insurers, which are Germany’s version of publicly funded “Healthy Kinzig Valley” health insurance. Source: Gesundes Kinzigtal Key figures (as of 2020) 4 Issue 25 · Siemens Healthineers Insights Series Together MQNK and OptiMedis were able to convince € two large statutory health insurances, Allgemeine Ortskrankenkassen Baden-Württemberg (AOK BW) and Landwirtschaftliche Krankenkasse Baden-Württemberg -7% -7% (LKK BW)a to sign on with the project. Together, they insure roughly half the area’s population, and Gesundes Kinzigtal In 2019 the Gesundes Kinzigtal approach 93% is responsible for managing and delivering their care. reduced healthcare spendings by 7% By way of an overarching organizational goal, Gesundes compared to the rest Kinzigtal adopted the Triple Aim Framework, which was of Germany.6 first developed by the Institute for Healthcare Improve- ment (IHI). The framework describes an approach to opti- mizing health system performance. It involves the simul- taneous and coordinated pursuit of three goals—thus, the “Triple Aim”: • Improving the health of populations • Improving the patient experience of care • Reducing the cost of healthcare Fifteen years after startup, Gesundes Kinzigtal is entirely financed by the savings from the model. Compared to the average healthcare spending in the rest of Germany, the Gesundes Kinzigtal approach reduced their health- care expenditures by 7% in 2019.6 Overall the organiza- tion has always generated savings in the last 14 years. It has also seen sustained improvements in health outcomes across its patient base. This paper examines the population health approach taken by Gesundes Kinzigtal in the context of the challenges facing healthcare organizations everywhere. It looks at the results that have been achieved, which are by all accounts extraordi- nary. And it makes the case that in light of current trends and considering today’s realities, the model created in Germany’s Kinzig Valley 15 years ago may well help light the way to the future of healthcare systems around the world. a Since 2013 part of SVLFG (Sozialversicherung für Landwirtschaft, Forsten und Gartenbau) Siemens Healthineers Insights Series · Issue 25 5 The challenge The challenges facing healthcare in Kinzigtal are by no • There is insufficient communication among healthcare means unique to that region. Nor are they unique to providers within the same sector, as well as across sectors, Germany. Around the world, healthcare systems are leading to redundant services, missing information, and grappling with sub-par outcomes, inconsistent patient higher costs safety, and rising costs that are likely not sustainable. • Reimbursement schemes reward treating diseases instead In Germany, the problem of rising costs has been vexing of promoting prevention system planners for many years. The country ranks in the top three spenders on healthcare in the OECD.7 Healthcare Kinzigtal has had to contend with a challenge well-known expenditures rise by approximately 4% annually every to many remote and rural areas. Remote locations such year.8 Germany spent close to €5,000 per person in as these have a harder time attracting physicians. The 2019, for a total expenditure of more than €411 billion. proportion of privately insured individuals (which allow That is 11.9% of overall GDP.8 for higher reimbursements), is below the German average of about 10.6%.9 They also have less access to transportation The reasons for the increasing cost pressures in healthcare services than many other regions, and consequently delivery are not hard to understand, though considerably travel between villages to access healthcare services is less easy to solve. There is a checklist of obstacles that is not always possible. likely familiar to health planners worldwide: In addition, Kinzigtal has a relatively low population density, • The healthcare system is fragmented and made up of and people there are older—17.8% of the female and 11.5% sectors that are well established and deeply entrenched of the male enrolled population are older than 75— in their own way of doing things and thus are at elevated risk for chronic diseases such as osteoporosis. • There is little or no coordination among, and integration of, different health services such as ambulatory care, The question that was asked by a team of healthcare inpatient care, rehab and public health providers in 2005 was, “how can we overcome barriers within the current system to create an integrated health- • There is little focus on prevention and wellness care system that works for our patients and is cost-effec- tive and sustainable?” The answer, as it turned out, was • Adoption of cost-saving and collaboration-enhancing Gesundes Kinzigtal. technologies such as the electronic health record has been very slow 6 Issue 25 · Siemens Healthineers Insights Series The solution Gesundes Kinzigtal’s model was designed specifically to 1. Create a fully integrated network counter the way things have traditionally been done. The approach is based on the core belief that institutional 2. Implement a “fee for value” fragmentation—primary care, public health, community incentive scheme care and hospitals all planning, organizing and working independently from one another—is not in the best 3. Pursue a culture of quality among interests of patients, nor is it in the best interests of the healthcare providers healthcare system itself. 4. Foster prevention and self-managed And so, for the past 15 years, the organization has executed treatment among the population a population-based, integrated model of healthcare that has improved patient outcomes, increased patient 5. Leverage innovative technology satisfaction, and lowered costs. The approach is five-pronged: 1 2 5 Integrator: Create a fully Insurer and incentive scheme: Technology: integrated network Implement a “fee for value” Leverage innovative technology driven incentive scheme 3 Provider: Pursue a culture of quality among healthcare providers 4 Council Population: Foster prevention and self-managed treatment among the population Siemens Healthineers Insights Series · Issue 25 7 “We created a solution that didn’t exist in the everyday practice. The whole process of healthcare is more binding, focused. Patients are given a greater share of the responsibility concerning their own health and wellbeing.” Dr. Christoph Löschmann CEO of Gesundes Kinzigtal 1. Create a fully integrated network The lynchpin of the Gesundes Kinzigtal approach is the In addition, the system encourages joint decision-making integration of all relevant stakeholders in the region. This between patients and providers with a patient advisory of course includes those patients who are insured board and a patient ombudsperson, ensuring that patient with the two public health insurers, and they are linked with perspectives are always considered, and patient rights primary care physicians, specialists, nurses, social care, always respected. therapists and pharmacists. In all, the organization encompasses more than 50 healthcare providers, including Gesundes Kinzigtal has also introduced the concept of a hospitals, physiotherapists, ambulatory care services, “trusted physician”—a primary care doctor chosen by pharmacies, and nursing homes. More than half of the patients to be the first and ongoing point of contact along general physicians in the area and 75% of specialists are their healthcare journey. This trusted physician works part of the Gesundes Kinzigtal team. with patients to develop personal care and treatment plans, and helps them navigate the different parts of the system. The result of this is that if and when a patient contracts a serious illness or chronic disease, he or she is quite literally at the center of care, being attended by a team of different providers with different skills but one common goal, which is a positive health outcome for that patient. The organization also has approximately 75 partners peripheral to, but outside, healthcare, such as gyms, sports clubs, self-aid groups, seniors’ groups and community organizations. They have thus been able to create a strong regional network that enables successful integrated health. 8 Issue 25 · Siemens Healthineers Insights Series “For us, integrated care is more than just the integration of a general practitioner and specialist, rescue services and submission of care etc., but it is also about the integration of public health for prevention and health promotion. I believe that 20-30% of our effect comes from this area alone.” Dr. h.c. Helmut Hildebrandt Chairman of the Board of OptiMedis AG, co-founder of Gesundes Kinzigtal 2. Implement a “fee for value” incentive scheme Gesundes Kinzigtal was launched on the strength of a adjusted population budget—due to the successful health €4 million initial investment by AOK BW, and immediately management of the insured population—they share those became accountable both for the health of the insured benefits with Gesundes Kinzigtal. In this way, Gesundes population and for the cost of that health. It has successfully Kinzigtal providers are rewarded not only for helping their met that challenge by linking overall population health patients get better when they are sick or injured, but also quality to physician compensation. for helping them not get sick or injured in the first place. Because, obviously, this reduces health costs as people The way it works is that the two statutory health insurance need less healthcare. companies (or sickness funds) receive their funding from a central allocation pool that collects wage contributions In turn, Gesundes Kinzigtal invests its part of these from across the country. The amount of this funding shared savings to further develop integrated care. This is matches the predicted cost of delivering healthcare to a type of “virtuous circle”—healthcare providers deliver their insured patients, based on comparable, risk-adjusted better services to their patients, resulting in better health and matched insurers costs from around the country. If outcomes that reduce costs, which in turn allows healthcare the health insurances spend less on healthcare than the risk- providers to deliver even better services to patients. And the circle continues. Insurance companies Shared savings Risk adjusted costs of the Gesundes Kinzigtal German national benchmark Total costs of the insurees in the Kinzig Valley Investment in quality, efficiency and effectiveness Siemens Healthineers Insights Series · Issue 25 9 “It is our common aim not only to secure the quality of outbound care in our region, but to improve healthcare for our patients.” Dr. Dörte Tillack Specialist in general medicine 3. Pursue a culture of quality among healthcare providers The Gesundes Kinzigtal remuneration structure is designed • In addition, healthcare providers are compensated for to make it worthwhile for providers to use all of their steps they take to constantly improve the quality of knowledge and skill on behalf of their patients. It is the their practice, and of the services they provide. Examples antithesis of a system that rewards doctors for seeing as of this include a consulting service to improve IT many patients as possible every day. infrastructure of individual practices and enhance internal communication, training of employees and health The Gesundes Kinzigtal system follows a balanced, two- coaching for complicated cases, and support in level remuneration system for cooperating healthcare developing and evaluating patient surveys and then providers. The first level is the kind of regular remuneration incorporating patients’ feedback. from health insurers to which physicians all across Germany have access. The second level, however, is what It is important to remember the “fee for value” nature of changes everything. It is at this level that physicians in this model. If the health insurers spend less on healthcare Kinzigtal are encouraged to go the extra yard for their than expected, because Gesundes Kinzigtal physicians patients, and are fairly compensated for doing so: help their patients incur fewer healthcare costs in the first place, the health insurers share those savings with • Over and above the normal reimbursement from health Gesundes Kinzigtal. insurance contracts, health providers receive additional fee-for-service payments for special additional services requested by their patients, such as arranging last minute, unplanned appointments in specialty care for patients in order to avoid bottlenecks, and offering regular and more comprehensive patient check-ups. 10 Issue 25 · Siemens Healthineers Insights Series A versatile network for integrated patient care Healthcare providers 51 16 10 8 6 5 GPs and specialists Pharmacies Nursing homes Physiotherapists Hospitals Ambulatory care services 34,000 Population “Beyond health” providers 43 23 8 Clubs (activity/ Companies Gyms sports) Siemens Healthineers Insights Series · Issue 25 11 4. Foster prevention and self-managed treatment among population If the lynchpin of the Gesundes Kinzigtal approach is It is important to note that the plan does not need to be integration of stakeholders, the philosophical heart restricted to medical treatments. Gesundes Kinzigtal is of the approach is fostering prevention and self- strongly focused on self-care, emphasizing health literacy management. It recognizes a fundamental truth of training, first aid classes, and fitness. Over the years, healthcare, which is that you do not have to cure illnesses Gesundes Kinzigtal has offered programs such as “Strong that do not happen. For that reason, the Gesundes Heart”, “Better Mood”, “Staying Mobile” and “Healthy Kinzigtal model emphasizes self-empowerment and Weight”. Indeed, in the Kinzig Valley town of Hausach, education about the importance of movement, nutrition Gesundes Kinzigtal makes its home in a building it calls and avoiding risky behavior. “Gesundheitswelt Kinzigtal” or “Health World Kinzigtal”, which contains a full gym and “health academy”, It should be no surprise that one of the first programs ever including several classrooms where self-care and fitness offered by Gesundes Kinzigtal was a smoking cessation seminars are taught. program. To be a patient of Gesundes Kinzigtal is to almost certainly enter into a conversation with your physician about your lifestyle as it relates to your health, and approaches you can take to reduce any risks. The “trusted physician” approach referenced earlier is particularly relevant here. Patients and their trusted physician discuss and agree on “establishing an objective”— that includes health goals and a (treatment) plan to achieve them. 12 Issue 25 · Siemens Healthineers Insights Series 5. Leverage innovative technology The essence of integration in healthcare is the collecting, 2. Business intelligence solutions sharing and acting on of information. In light of that fact, the fifth prong in the Gesundes Kinzigtal approach The generation and aggregation of data has opened up a is the leveraging of innovative information technology. range of possibilities for improving patient outcomes and The Gesundes Kinzigtal model leverages innovative tech- delivering more cost-effective care. Gesundes nology in three basic ways: Kinzigtal and OptiMedis are able to take the volumes of aggregated data and run business intelligence solu- tions to analyze and operationalize it, using it to build predictive modeling that allows for the identification of cohorts and high-risk patients. Providers can then 1. Electronic health records for physicians to proactively reach out to patients, adapting healthcare generate and aggregate data services and preventative programs that help them before it is too late. Finally, dependable cost-benefit Electronic Health Records (EHRs) are currently used to analysis allows OptiMedis to evaluate the outcome of ensure that health providers have the information those programs. they need to properly care for their patients. Gesundes Kinzigtal created these records early on. The system allows providers to immediately access general infor- 3. e-Health applications to foster prevention mation, medical history, medical findings, diagnosis, and and self-treatment the patient’s therapy plan, regardless of where the data has been entered into the system. Electronic technology offers real potential for supporting patients in the active management of their In this respect, Gesundes Kinzigtal has been well own care. Mobile health apps make it possible for ahead of the rest of Germany. In 2003 the federal providers to collect important data from their patients, government announced it would be introducing elec- which is especially useful in the case of elderly people tronic patient records throughout, across the who have a harder time visiting their doctors. Gesundes country.10 It has taken 18 years, with a first pilot Kinzigtal is involved in a number of national and Euro- version becoming available to patients and healthcare pean research projects, one into what is called Ambient providers in early 2021. Assisted Living technology. This technology involves what are often referred to as digital companions for the In addition, Gesundes Kinzigtal is developing software elderly: computing systems that help older people with tools to connect different management systems everything from detecting smoke to controlling music used in physicians’ practices in order to allow and improve to turning lights on and off. data exchange. This will allow for quick access to patient data by any provider who needs it, thorough In addition, Gesundes Kinzigtal is exploring the use and reliable documentation, easier patient interaction, of technology that can support the relatives of elderly and patient-focused cooperation between physicians, and frail patients. A good example would be live video which will result in less redundancy, higher productivity, consultation services for relatives, to help them be and improved clinical decision-making. better informed about how best to care for their loved ones. Siemens Healthineers Insights Series · Issue 25 13 Results Gesundes Kinzigtal began as a long-term pilot project. It would be a surprise, to say the very least, if the pilot is deemed not to have succeeded. As noted earlier, Gesundes 91.8% 8.2% Kinzigtal has been driven from the start by a commitment to healthcare’s Triple Aim Framework. And if we look at 91.8% of Gesundes the three goals that make up that framework, we can see Kinzigtal enrollees say 91.8% that significant progress has been made towards achieving they would recommend all three. membership to others.12 • Improving the health of populations • Improving the patient experience of care • Reducing the cost of healthcare Improving the health of populations Patients live longer and get injured less often. That is the story of patients under the Gesundes Kinzigtal model. The only real way to assess the success of this type of healthcare model is to compare their patient outcomes to the outcomes of patients not in the model. A 2021 study showed that average age of death for those enrolled in the Gesundes Kinzigtal program is 79.9 years, compared to 77.1 years for non-Gesundes Kinzigtal participants. Overall, the risk of death, in the six years following enrollment in the study, is 19% lower for Gesundes Kinzigtal participants compared to non-Gesundes Kinzigtal participants.6 In addition, patients who have participated in osteoporosis programs suffer 45% fewer fractures than patients who do not.11 14 Issue 25 · Siemens Healthineers Insights Series “It was a bet on something that is scientifically known: You can create better care that is economically effective at the same time. We could prove that.” Dr. h.c. Helmut Hildebrandt Chairman of the Board of OptiMedis AG, co-founder of Gesundes Kinzigtal Improving the patient Quadruple Aim – Improved experience of care Clinical Experience It is never easy to assess the quality of a patient’s “I can work more efficiently, because experience with care. Health outcomes are easily I can see which medications or treatments the family doctor or another specialist measured; patient satisfaction less so. Researchers do has already prescribed.” make the attempt, however, and studies have shown that patients are indeed happy with the quality of care they Dr. Christian Daxer, ENT physician receive through the model Gesundes Kinzigtal introduced. One such study showed that more than 40% of respon- Since its inception, the Triple Aim has proven dents felt “somewhat” or “considerably better cared for” to be an invaluable tool in optimizing health systems. In recent years, however, many after they had enrolled in Gesundes Kinzigal. 12 Close to healthcare leaders have begun citing 60% indicated they had gained a better understanding of “Improved Clinical Experience” as a critical “how to maintain or improve” their own health.12 And more fourth aim. The widely accepted theory is that if providers do not see improvement than 30% felt that their health behavior was more effective in their experiences, the chances of the than it had been prior to enrollment.12 other three aims being fully achieved will be reduced. Thus, the Quadruple Aim has begun to be widely adopted. Reducing the cost of health Looked at in light of the fourth aim, the Gesundes Kinzigtal model is still an undeniable success. The analysis of Gesundes Kinzigtal is food for thought for health systems concerned with rising costs. Data gathered The network itself is set up in a way that over 15 years suggests that the Gesundes Kinzigtal does not make providers competitors, but rather comrades-in-arms with a common approach can significantly reduce healthcare costs. Studies goal.15 Through their partnership agreement, from 2014 and 2016 indicate that more than US$200 can the members of the MQNK (Medical Quality be saved annually per participant.13,14 In 2019 total savings Network - Doctors’ Initiative Kinzigtal) receive a bonus for sustainable economic amount to 6.7 million euros (7% less than the average success.15 comparable spending in the rest of Germany).6 S Closer cooperation with other Financial benefits report Advantageous networking and Would recommend the service providers report exchange of information report membership to others 69% 77% 73% 90% of primary doctors of primary doctors of primary & specialist doctors of primary doctors 61% 44% 73% of specialist doctors of specialist doctors of specialist doctors Siemens Healthineers Insights Series · Issue 25 15 “The approach of Gesundes Kinzigtal is not limited to the black forest. It can work everywhere.” Dr. Christoph Löschmann CEO of Gesundes Kinzigtal Conclusion Continued success The spread of an idea The Kinzig Valley is a small area, and its population makes These various tools and technologies are now in use beyond for a relatively small sample size. These are factors the Kinzig Valley, as word of the Gesundes Kinzigtal that undoubtedly should be considered when assessing the model has spread, and other regions have begun reco- success of the Gesundes Kinzigtal model. But the fact gnizing the synergies and benefits of integration and remains that over the past 15 years, this model has checked cooperation. every box for success that researchers have thought important to consider. In May 2018 OptiMedis successfully implemented an integrated, patient-centered care network in the north Patient outcomes – Better of Hesse called “Gesunder Werra-Meißner-Kreis”, that was Patient satisfaction – Higher followed three vears later by neighbouring “Gesunder Healthcare costs – Lower Schwalm-Eder-Kreis+” in Northern Hesse. Gesundes Kinzigtal is an integrated model of care that In addition, Dr. h.c. Hildebrandt’s team has become more focuses on, and rewards, prevention when possible, active in other European countries such as the UK, Belgium and a coordinated, patient-centered approach to treating and France. disease when necessary. Over the years, Gesundes Kinzigtal, OptiMedis, and MQNK learned from shortcomings and mistakes and used those lessons to advance their knowledge Requirements for success and capacity. Today, they are responsible for the existence of several available, and scalable, standards, technologies For jurisdictions looking to adapt the Gesundes Kinzigtal and tools that enable population-based integrated care. model, there are three basic requirements for success. These include: 1. Integrator • Evaluation protocols • Investment models This regional integrator will setup and coordinate the • Health and prevention programs model owned by service providers in combination • Compensation models with a health management organization. • Quality indicators • Management manuals • Data warehouses • Business intelligence systems • Standardized reporting • Business plan tools 16 Issue 25 · Siemens Healthineers Insights Series Suggested follow-up on siemens-healthineers.com/insights/ transforming-care-delivery • 2. Sustainable finance model Insights Series, Issue 19: Unlocking the Digital Front Door: How healthcare can be made more accessible. Any new integrator organization will need up-front Available at: siemens-healthineers.com/ investment to cover operating costs for at least the insights/news/unlocking-the-digital-front-door first three years. In addition, the organization must • Insights Series, Issue 15: Achieving healthcare offer a reimbursement model that has the support happiness—The Finland model. and acceptance of the insurance companies. It focuses Available at: siemens-healthineers.com/ insights/news/the-finland-model on value, not volume. It emphasizes prevention as much as cure. The integrator will have to find a way to • Insights Series, Issue 7: Do one thing, and do it convince insurers of the potential in sharing in the better than anyone else. Available at: siemens-healthineers.com/ profitability that comes from reduced health costs. insights/news/martini-klinik-specialization- optimization.html 3. Stakeholder involvement i Information: The entire point of an integrated system is that it The Siemens Healthineers Insights Series is our depends on buy-in from everyone involved. This preeminent thought leadership platform, drawing means regional service and healthcare providers, on the knowledge and experience of some of the physician networks, population and health insurers world’s most respected healthcare leaders and innovators. It explores emerging issues and provides and, of course, patients. In addition, the local popula- practical solutions to today’s most pressing healthcare tion must be willing to participate and share health challenges. data, as must the health insurance companies. All issues of the Insights Series can be found here: siemens-healthineers.com/insights-series If all of these requirements can be met, then organizations looking to adapt the Gesundes Kinzigtal Contact: model stand a good chance of success, in Germany and around the world. The fact is, the basics of good health- For further information on this topic, or to contact the authors directly: care really do not change. It is much better to prevent disease than to ever have to cure it. But if you do have to Dr. Herbert Staehr cure it, the more smart people you can bring together to Vice President do so, the better off you will be. And the better off your Global Head of Transforming Care Delivery at Siemens Healthineers patients will be. staehr.herbert@siemens-healthineers.com Siemens Healthineers Insights Series · Issue 25 17 About the authors Dr. phil. Christoph Löschmann Dr. rer. medic. h. c. Helmut Hildebrandt CEO at Gesundes Kinzigtal GmbH Chairman of the Board, OptiMedis AG Dr. phil. Christoph Löschmann has been CEO of Gesundes Kinzigtal Dr. Helmut Hildebrandt is Chairman of the Board at OptiMedis AG. GmbH in Hausach, southwest Germany, since 2019. He holds a His focus is on building and managing regional, population-based degree in psychology and has more than 30 years of experience in integrated care systems. Dr. Hildebrandt was among those who worked the healthcare sector. For about 15 years, he worked at the Univer- on the 2013 recommendations of the Heinrich-Boell-Foundation for sity of Freiburg’s Department of Psychology and at University reforming the existing incentive and reimbursement system to improve Hospital Freiburg in the fields of research, teaching and patient care. its quality and efficiency. He spent many years on the board of the He then joined a nationwide hospital group after having been CEO International Foundation for Integrated Care, and is a long-serving of numerous subsidiaries. Starting in 2009, Dr. Löschmann served at member of the board at the German Managed Care Association, the management level in setting up a hospital group with more than where he works on optimizing incentives to improve health outcomes 1,700 employees. He was responsible for quality management and for patients in Germany and abroad. A pharmacist and health scientist, corporate strategy, marketing and PR, and IT. In 2014, Dr. Löschmann Helmut has a wealth of experience in qualitative research (medical co-founded a management firm that supports healthcare businesses sociology) and in conceptual work in the field of health promotion based in Offenburg. Parallel to this, he served as CEO of a private and organizational development. He spent many years working with psychiatric and psychotherapy clinic from 2015 to 2019. Dr. the WHO on prevention projects, and over 30 years advising health Löschmann lives with his family in Emmendingen, southwest insurance providers, associations, businesses, and healthcare institu- Germany. tions on their organization, strategy, and system development. He also spent several years leading hospitals as CEO. Dr. Herbert Staehr Dr. Ralf Meinhardt Vice President Senior Global Marketing Manager at Global Head of Transforming Care Delivery Siemens Healthineers at Siemens Healthineers Ralf Meinhardt leads Siemens Healthineers’ thought leadership Herbert Staehr serves as Global Head of Transforming Care Delivery activities related to Transforming Care Delivery. Previously, Ralf for Siemens Healthineers, driving the company’s activities and worked in the pharmaceutical industry, as well consulting and messaging around delivering high-value care. In this capacity, he scientific research. Ralf holds a Doctor of Economics and Social develops and executes programs and outreach strategies aimed at Sciences degree from the University of Erlangen-Nuremberg. He healthcare providers around the world, as well as stakeholders in also holds a Master of Science degree in Management as well as a every branch of the healthcare industry. Before joining Bachelor of Arts degree in Business Administration. In addition to Siemens Healthineers, Herbert spent several years with one of his academic work at the University of Erlangen-Nuremberg, he also Germany’s leading private hospital groups, as head of the Corporate studied at the Indian Institute of Management, Bangalore (IIMB). Development department and serving as Managing Director of an His scientific background is in the field of corporate strategy, acute care and a post-acute care hospital in Germany. He also spent a subject on which he has authored several publications. several years with McKinsey & Company with their healthcare prac- tice, providing strategic advice to a wide range of international clients. Herbert holds a doctorate in Healthcare Economics from the University of Hohenheim. 18 Issue 25 · Siemens Healthineers Insights Series References 1. Ekram T. At the core of population 8. Gesundheitsberichterstattung des 14. Busse R, Stahl J. Integrated care health management—a higher level of Bundes. Health expenditures in experiences and outcomes in Germany, communication [Internet]. Becker’s Germany in millions of Euro [Internet]. the Netherlands, and England. Health Hospital Review. 2018 [cited 2021 Apr 27]. [cited 2021 Apr 27]. Available from: Aff. 2014;33(9):1549–58. Available from: beckershospitalreview. gbe-bund.de/gbe/abrechnung.prc_ com/care-coordination/at-the-core-of- abr_test_logon?p_uid=gast&p_ 15. Siegel A, Stößel U. 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Individueller Pati- health-systems-kingsfund-feb15.pdf entennutzen im „Gesunden Kinzigtal“ – Zwischenergebnisse einer Trendstudie. 6. Gröne, O., Langenberger, B., Catalá, Z Evid Fortbild Qual Gesundhwes E., Wendel, P., Hildebrandt, H. [Internet]. 2018;130:35–41. Erfolgspotenziale durch ein optimiertes Available from: dx.doi.org/10.1016/j. Versorgungsmanagement. Von der zefq.2017.12.003 Prädiktion von Hochkostenpatienten zur Populationsorientierung (2021). In: 13. The Advisory Board Company. The Hildebrandt, H., Stuppardt, R. (Hrsg.) Business of Population Health Zukunft Gesundheit – regional, vernetzt, Management. Gesundes Kinzigtal patientenorientiert. medhochzwei Verlag GmbH. Int Glob Forum Heal Care Innov [Internet]. 2016;1–15. Available from: 7. OECD. Health expenditure and financing gesundes-kinzigtal.de/wp-content/ Share of gross domestic product uploads/2017/01/Global-Forum_ - [Internet]. OECD.Stat. 2019 [cited 2021 Gesundes-Kinzigtal_Case_study_ Apr 29]. Available from: stats.oecd.org/ 2016.pdf Index.aspx?ThemeTreeId=9 Siemens Healthineers Insights Series · Issue 25 19 At Siemens Healthineers, our purpose is to drive innovation to help humans live healthier and longer. Through our products, services and solutions we help physicians, medical staff, and healthcare providers prevent illnesses from occurring and to correctly diagnose and determine siemens-healthineers.com/ the right treatments for people who do become ill— insights-series resulting in fewer complications, shorter hospital stays, and faster patient recovery. Our mission is to enable healthcare providers to increase value by expanding precision medicine, transforming Did you enjoy the read? Make sure to subscribe to care delivery, improving the patient experience, and our newsletter to always receive the latest thought leadership insights. digitalizing healthcare. With our comprehensive portfolio— from in-vitro diagnostics and imaging to therapy and All issues of the Insights Series can be found here: follow-up care—we address the complete care continuum siemens-healthineers.com/insights-series for many of the world’s most threatening diseases. Every hour, more than 240,000 patients are touched by technologies provided by Siemens Healthineers. We are at the center of clinical decision making with almost three-quarters of all critical clinical decisions influenced by our solutions. We are a leading medical technology company with over 120 years of experience and more than 65,000 highly dedicated employees around the globe who are innovating every day, truly shaping the future of healthcare. Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com Published by Siemens Healthcare GmbH · HOOD05162003222582 · online · 10866 0721 · ©Siemens Healthcare GmbH, 2021