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Health Datapalooza 2013: Employer Use of Healthcare Data and Evidence to Improve Quality and Value - Cristie Upshaw Travis
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Health Datapalooza 2013: Employer Use of Healthcare Data and Evidence to Improve Quality and Value - Cristie Upshaw Travis

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Health Datapalooza IV: June 3rd-4th, 2013 …

Health Datapalooza IV: June 3rd-4th, 2013
Employer Use of Health Care Data and Evidence to Improve Quality and Value: What Is Working and How Do We Facilitate It

Moderator:
E.J. “Ned” Holland, Jr., Assistant Secretary for Administration, US Department of Health and Human Services (HHS)

Panelists:
Cristie Upshaw Travis, Chief Executive Officer, Memphis Business Group on Health
Lisa Wear-Ellington, President & Chief Executive Officer, South Carolina Business Coalition on Health
William Freeman, Staff Service Fellow, Center for Delivery, Organization, and Markets, Agency for Healthcare Research & Quality (AHRQ)
Keith T. Kanel, Chief Medical Officer (CMO), Pittsburgh Regional Health Initiative
Discussants:
Deborah Greene, Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services, Centers for Medicare and Medicaid Services (CMS)
Niall Brennan, Director, Office of Information Products and Data Analytics, Centers for Medicare & Medicaid Services (CMS)
Irene Fraser, Director, Center for Delivery, Organization, & Markets, Agency for Healthcare Research & Quality (AHRQ)

New variations in health care quality and value are a huge priority for employers. Poor quality and unnecessary cost negatively affect the health of employees and their families, the firms’ bottom line, and firm productivity and competitiveness. The panel will review four strategies with existing examples that employers, employer coalitions, and multi-stakeholder groups are using to improve health care quality and value. Discussion will focus on several questions: How can data and tools for each strategy be strengthened? How can the power and utility of data and supporting evidence be increased? How can the alignment and combined power of public and private efforts be maximized?

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  • Is the plan leveraging information and capabilities to ensure no harm to patients during course of care?Medication safety tacticsPayment rewards to incent medication safetyMonitoring drug-drug interactions and opioid use with alertsTracking & reducing hospital readmissions ratesSending patients to hospitals reporting to Leapfrog and better performing hospitalsReducing hospital-acquired conditions (HAC), serious reportable events (SREs/Never Events)Paying rewards to improve other patient safety measures (mortality/complication rates)

Transcript

  • 1. Employer Use of Health Care Data and EvidenceWhat’s Working: eValue8Cristie Upshaw TravisCEO, Memphis Business Group on HealthJune 4, 20136/11/2013 1©2013 Memphis Business Group on Health
  • 2. Memphis Business Group on Health• Non-profit coalition of employers sharing solutionsand providing tools to manage the cost and quality ofhealth benefits in an ever-changing environment• 12 members with 300,000+ covered lives in Memphisand Tennessee• Our work focuses on:o Creating a culture of health at the worksiteo Aligning health benefit programs with overall goals foremployee and family healtho Setting strong purchaser expectations for safe, high quality,cost effective, affordable health care services through theleverage of employers as clients and purchasers• Member of the National Business Coalition on Health6/11/2013 ©2013 Memphis Business Group on Health 2
  • 3. What is eValue8?• A vendor management/accountability resourceo Collection of plan responses as well as information from third partysources on accreditation and HEDIS/CAHPS performance on keymeasureso Responses assigned scores/weighted based on evidence-based bestpractices, percentile ranking; subset are verifiedo National database provides ability to benchmark and understandwhat is possibleo Catalyst for discussion on performance improvementDeveloped by the National Business Coalition on Health totranslate data into meaningful information for employers andcoalitions6/11/2013 3©2013 Memphis Business Group on Health
  • 4. What is eValue8?• Collects information on how health plans use resourcesand information to:o Improve and maintain the health ofmembers/employeeso Improve health care delivery system• Results used by Coalitions and Purchasers to partner withplans to improve qualityeValue8 measures performance and motivates improvement6/11/2013 4©2013 Memphis Business Group on Health
  • 5. What is eValue8?6/11/2013©2013 Memphis Business Group onHealth5• Standardized evaluation process that:o Is evidence-based focused on the “drivers” of costand health status• Significant input from CDCo Uses results from recognized third parties (e.g.NCQA, Leapfrog) to align strategieso Puts plans face-to-face with Purchaser clients in amarketo Serves as a foundation for continuousimprovement and value-based purchasing
  • 6. Aligned with quality criteria6/11/2013 6©2013 Memphis Business Group on Health
  • 7. Zeros in on underlying issuesSource: eValue8 20116/11/2013 7©2013 Memphis Business Group on Health
  • 8. Compares performance6/11/2013 8©2013 Memphis Business Group on Health
  • 9. 0%10%20%30%40%50%60%70%80%90%100%Plan A PPO Plan B PPO Plan B HMO Plan C PPO Plan D PPO Plan E PPO Plan F PPO Possible Best42% 38% 38% 42% 39% 35%30%47%11%7% 7%8%0%0% 8%13%5%7% 7%7%0% 4%5%7%12%6% 9%12%6%0%4%12%12%16%16%9%0%0%3%21%80.8% 74.8% 77.9% 78.3%45.6%39.1%50.8%100.0%PercentofPossiblePointseValue8 2012Patient SafetySeries6Payment Incentives -Other Patient Safety Measures (e.g.,Complications, Mortality, )Readmissions (Performance and Payment)Medication SafetyAdmissions to hospitals reporting to Leapfrog and better performing hospitalsTracks strategies that drive change6/11/2013 9©2013 Memphis Business Group on Health
  • 10. Covers the country6/11/2013 ©2013 Memphis Business Group on Health 10*Full responsesFull & Partial Responses*Partial Responses*Aetna PPOCigna PPORegence PPOUHC PPOGroup HealthHMOKaiser HMOPacificSource HMOPacificSource PPO*Cigna PPO*UHC PPOKaiser N Cal HMOKaiser S Cal HMOHealthNet HMOCigna PPOHealthNet PPOUHC PPO*Aetna PPOHealthNet HMOHealthNet PPO*Cigna PPOCigna HMOKaiser HMOCigna PPOUHC PPO*Cigna PPOAetna PPOExcellus PPOCDPHP HMOCDPHP PPOCigna PPOMVP HMPMVP PPOUHC PPOAetna PPOCapital BC HMOCapital BC PPOCigna PPOHealthAmericaPPOHighmark BSPPOUHC PPO*CignaPPO*UHCPPOCignaPPOUHC PPO*AetnaPPOKaiserHMO*CignaPPO*UHCPPO*CignaPPO*CignaPPO*UHC PPO*Cigna PPOKaiser HMO*Cigna PPOBCBS PPOCigna PPO*UHC PPOBCBSHMOBCBSPPOTuftsHMOTuftsPPO*CignaPPOKaiser HMO*Aetna PPOMD /DC/VA*Cigna PPO*UHC PPOCigna PPO*UHC PPO*Partial response to ~ 80% RFI – consists of responsesthat apply irrespective of market (e.g., consumer tools)as well as market-specific HEDIS and CAHPSCigna PPO*CignaPPOTufts HMOTufts PPO*Cigna PPO*UHC PPOSponsoring CoalitionsColorado Business Group on HealthHealthCare 21Lehigh Valley Business Coalition on HealthCareMemphis Business Group on HealthNortheast Business Group on HealthPacific Business Group on HealthPuget Sound Health AllianceeValue8 2012 respondents
  • 11. Used by manyPublic/State Purchasers• State of TN• WA State Health CareAuthority, King andPierce Counties, City ofSeattle• NYC Transit Authority• Schools Large and Small PrivatePurchasersMulti-state/NationalCarriers• Aetna• Cigna• UHC• KaiserSelect regional plansand Blues Plans6/11/2013 11©2013 Memphis Business Group on Health
  • 12. Summary• What gets measured gets improved - eValue8 is a “readymade” evidence-based measurement tool based on whatmatters to employers/purchasers• eValue8 is a cost-effective way for employers to fulfilltheir fiduciary responsibilities of plan selection andperformance evaluation.• Standardization of measures that matter goes a long waytoward quality improvement - eValue8 provides a high-leverage, collaborative mechanism to address theunderlying problems in health care that contribute to highcost, waste and uneven quality.6/11/2013 12©2013 Memphis Business Group on Health
  • 13. Thank You!6/11/2013 ©2013 Memphis Business Group on Health 13For more information contact:Cristie Upshaw TravisCEOMemphis Business Group on Healthctravis@memphisbusinessgroup.org