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FLORIDA’S TRANSPARENCY   INITIATIVES Lisa K. Rawlins Director, Quality and Process Improvement Broward Health [email_addre...
Florida’s Vision <ul><li>Governor Bush and Florida Legislature Leadership </li></ul><ul><li>Transparent health care delive...
Transparency Initiatives:  Pieces of the Puzzle <ul><li>1. Prescription Drugs retail prices </li></ul><ul><ul><li>www.MyFl...
Stakeholders: Building Consensus <ul><li>Agency for Health Care Administration (AHCA) </li></ul><ul><li> </li></ul><ul><u...
Stakeholders: Building Consensus <ul><ul><li>Each stakeholder brings unique ideas and perspectives. Experts include repres...
www.FloridaHealthStat.com <ul><li>Where Florida’s Health Data resides, including: </li></ul><ul><ul><li>list of licensed h...
Pieces of the Puzzle <ul><li>www.FloridaCompareCare.gov </li></ul><ul><li>Collaborative stakeholder approach </li></ul><ul...
www.FloridaCompareCare.gov (continued) <ul><li>Used 3M Health Information Systems Software for risk-adjustment for compari...
Public Reporting  (in-patient hospitals) <ul><li>November 2005  </li></ul><ul><li>Total Hospitalizations </li></ul><ul><li...
Florida Compare Care Portal
Search by pediatrics, adults, seniors, and obstetrics
First in the Nation   Search by  pediatric  condition or procedure
Geographic Search
Mortality Rates
<ul><li>By condition or procedure, search for: </li></ul><ul><li>Average Charges </li></ul><ul><li>Average Length  of Stay...
Facility Profiles include: Mortality Inpatient Rates for procedures and conditions.
Building a Better Site <ul><li>Publishing CMS SIP data  </li></ul><ul><li>Additional health care performance measurement s...
www.FloridaCompareCare.gov <ul><li>Health Plan Consumer Website   </li></ul><ul><li>Floridians have one-stop shopping, at ...
Welcome Page
Geographic Search for Health Plan Information Health Plan Consumer Information Website www.FloridaCompareCare.gov
Types of information to compare health plans www.FloridaCompareCare.gov
www.MyFloridaRx.com <ul><li>Consumers may shop for the lowest price for top 100 prescription name-brand and generic drugs ...
Top Five Sources of Health Information Consumers Use 2004
The  internet  is the  major source  of  information  for medical topics, prescription drugs and other health-related info...
When asked how important a role various factors play in contributing to rising healthcare costs,   more than three fourths...
More than  76% media  and  85% business decision makers  cited cost of prescription drugs as very important contributor to...
www.MyFloridaRx.com <ul><li>Consumers may shop for the lowest price for the top 100 prescription name-brand drugs and sear...
MIAMI-DADE County Xanax 1 mg Tablet Usual and Customary  (U & C) prices   February 1-28, 2007 (Continued) www.MyFloridaRx....
Highest: $322.77 Lowest: $5.50 5, 950% difference   in prices within  12  miles
<ul><li>Florida’s site essentially needed: </li></ul><ul><li>Access to Medicaid Pharmacy Claims Data </li></ul><ul><li>160...
Future Plans <ul><li>Strategic Planning Retreat:  Florida’s 1-, 3-, and 5-year vision with   State Consumer Health Informa...
Questions? <ul><li>Lisa Rawlins </li></ul><ul><li>BrowardHealth.org </li></ul><ul><li>Floridacomparecare.gov </li></ul><ul...
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Florida's Transparency Initiatives

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Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Lisa Rawlins

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  • Welcome to Medicaid’s training of the coverage and limitations of the Independent Laboratory Services program. My name is __________ and I am a ________ with ________. (You could talk a little about your work experience.) We are so glad that you could be with us today, going over the policies and principles of the program. This understanding will save you time, effort and money. In addition to the training you receive today, other support is available through: the provider handbook you received at enrollment, Consultec telephone customer service and area representatives access to local AHCA staff as well as having this information available on through FL Medicaid’s web site www.fdhc.state.fl.us/Medicaid. We will review some of our most frequently asked questions at the end of the presentation, but feel free to ask questions as we go along. Let’s get started.
  • Transcript of "Florida's Transparency Initiatives"

    1. 1. FLORIDA’S TRANSPARENCY INITIATIVES Lisa K. Rawlins Director, Quality and Process Improvement Broward Health [email_address]
    2. 2. Florida’s Vision <ul><li>Governor Bush and Florida Legislature Leadership </li></ul><ul><li>Transparent health care delivery system </li></ul><ul><li>“ The 2004 Affordable Health Care for Floridians Act” </li></ul><ul><ul><li>2004 - HB 1629 </li></ul></ul><ul><ul><li>2006 – HB 7073 </li></ul></ul><ul><li>Stakeholder Advisory Council </li></ul><ul><li>Consumer – focused websites </li></ul><ul><li>“ Shopping” for quality health care </li></ul>
    3. 3. Transparency Initiatives: Pieces of the Puzzle <ul><li>1. Prescription Drugs retail prices </li></ul><ul><ul><li>www.MyFloridaRx.com (July 2005) </li></ul></ul><ul><li>2. Health Care Facilities </li></ul><ul><ul><ul><li>www.FloridaCompareCare.gov (November 2005) </li></ul></ul></ul><ul><ul><ul><ul><li>Hospitals (includes pediatrics) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Ambulatory Surgery Centers (ASCs) </li></ul></ul></ul></ul><ul><li>3. Health Plans </li></ul><ul><ul><ul><li>www.FloridaCompareCare.gov (October 2006) </li></ul></ul></ul><ul><li>4. Physicians </li></ul><ul><ul><ul><li>www.FloridaCompareCare.gov (Summer 2007 release) </li></ul></ul></ul>
    4. 4. Stakeholders: Building Consensus <ul><li>Agency for Health Care Administration (AHCA) </li></ul><ul><li> </li></ul><ul><ul><li>State Consumer Health Information and Policy </li></ul></ul><ul><ul><li>Advisory Council </li></ul></ul><ul><ul><li>(Formerly known as the Comprehensive Health Information System <CHIS> Advisory Council) </li></ul></ul><ul><li> </li></ul><ul><ul><li>Technical Workgroups: </li></ul></ul><ul><ul><ul><ul><ul><li>Health Plan </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Facilities/Ambulatory Surgical Center </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Hospital Acquired Infections </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Physicians </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Public Relations </li></ul></ul></ul></ul></ul>
    5. 5. Stakeholders: Building Consensus <ul><ul><li>Each stakeholder brings unique ideas and perspectives. Experts include representatives from: </li></ul></ul><ul><ul><li>Hospitals </li></ul></ul><ul><ul><li>Physicians </li></ul></ul><ul><ul><li>Health Plans </li></ul></ul><ul><ul><li>Consumers </li></ul></ul><ul><ul><li>Employers </li></ul></ul><ul><ul><li>Academic </li></ul></ul><ul><ul><li>State Agencies </li></ul></ul>
    6. 6. www.FloridaHealthStat.com <ul><li>Where Florida’s Health Data resides, including: </li></ul><ul><ul><li>list of licensed health care facilities in Florida; </li></ul></ul><ul><ul><li>medical help resources; </li></ul></ul><ul><ul><li>detailed information on patient data from hospitals and ambulatory surgery centers; </li></ul></ul><ul><ul><li>information on insurance programs such as Medicare, Medicaid, and KidCare; </li></ul></ul><ul><ul><li>prescription drug programs; </li></ul></ul><ul><ul><li>concerns for seniors; </li></ul></ul><ul><ul><li>consumer publications; </li></ul></ul><ul><ul><li>statistical health reports, and much more. </li></ul></ul>Pieces of the Puzzle
    7. 7. Pieces of the Puzzle <ul><li>www.FloridaCompareCare.gov </li></ul><ul><li>Collaborative stakeholder approach </li></ul><ul><li>Consumer-friendly, dynamic database and verbiage </li></ul><ul><li>Helpful information for consumers’ health care decisions </li></ul><ul><li>Assists self-pay patients as well as those with insurance </li></ul><ul><li>Customer Satisfaction Survey </li></ul>
    8. 8. www.FloridaCompareCare.gov (continued) <ul><li>Used 3M Health Information Systems Software for risk-adjustment for comparing facilities </li></ul><ul><li>Agency for Health Research and Quality (AHRQ) performance measures and quality indicators </li></ul>Pieces of the Puzzle
    9. 9. Public Reporting (in-patient hospitals) <ul><li>November 2005 </li></ul><ul><li>Total Hospitalizations </li></ul><ul><li>Average Charges Risk Adjusted </li></ul><ul><li>Average Length of Stay Risk Adjusted </li></ul><ul><li>Readmission Rates Risk Adjusted </li></ul><ul><li>Complication/Infection Rates (first in America) </li></ul><ul><li>Mortality Rates </li></ul><ul><li>Hospital Characteristics/Services </li></ul><ul><li>July 2006 </li></ul><ul><li>Pediatric specific conditions and procedures (first in America) reported separately </li></ul><ul><li>Improved search abilities including facilities descriptions and 200 mile search radius, including: </li></ul><ul><ul><ul><ul><li>Rural Hospitals </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Critical Access Hospitals </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Primary Stroke Centers (designated by AHCA/JCAHO) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Organ transplant by type </li></ul></ul></ul></ul><ul><ul><ul><ul><li>NCI Comprehensive Cancer Center </li></ul></ul></ul></ul><ul><li>Cesarean and vaginal deliveries (all ages) and newborns (normal baby and baby with complications). </li></ul>
    10. 10. Florida Compare Care Portal
    11. 11. Search by pediatrics, adults, seniors, and obstetrics
    12. 12. First in the Nation Search by pediatric condition or procedure
    13. 13. Geographic Search
    14. 14. Mortality Rates
    15. 15. <ul><li>By condition or procedure, search for: </li></ul><ul><li>Average Charges </li></ul><ul><li>Average Length of Stay </li></ul><ul><li>Volume </li></ul>
    16. 16. Facility Profiles include: Mortality Inpatient Rates for procedures and conditions.
    17. 17. Building a Better Site <ul><li>Publishing CMS SIP data </li></ul><ul><li>Additional health care performance measurement standards: </li></ul><ul><ul><li>Agency for Healthcare Research and Quality (AHRQ) </li></ul></ul><ul><ul><li>Joint Commission on Accreditation of Healthcare Organizations (JCAHO) </li></ul></ul><ul><ul><li>Leapfrog Group, physician information </li></ul></ul>
    18. 18. www.FloridaCompareCare.gov <ul><li>Health Plan Consumer Website </li></ul><ul><li>Floridians have one-stop shopping, at their fingertips and can search for a health plan by county. </li></ul><ul><ul><ul><ul><ul><li>plan benefits; </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>costs; and </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>member satisfaction using national measures. </li></ul></ul></ul></ul></ul><ul><li>Released October 12, 2006 </li></ul>Pieces of the Puzzle
    19. 19. Welcome Page
    20. 20. Geographic Search for Health Plan Information Health Plan Consumer Information Website www.FloridaCompareCare.gov
    21. 21. Types of information to compare health plans www.FloridaCompareCare.gov
    22. 22. www.MyFloridaRx.com <ul><li>Consumers may shop for the lowest price for top 100 prescription name-brand and generic drugs (>350 drugs) </li></ul><ul><li>Compare pharmacy store prices on a local and statewide level, 4,305 pharmacies reporting </li></ul><ul><li>Updated monthly </li></ul><ul><li>Data source: Usual and Customary Charges (retail prices) billed to Florida Medicaid </li></ul><ul><li>Collaborative effort of AHCA and the Office of Attorney General </li></ul>Pieces of the Puzzle
    23. 23. Top Five Sources of Health Information Consumers Use 2004
    24. 24. The internet is the major source of information for medical topics, prescription drugs and other health-related information.
    25. 25. When asked how important a role various factors play in contributing to rising healthcare costs, more than three fourths of business decision makers and the media cited cost of prescription drugs as very important.
    26. 26. More than 76% media and 85% business decision makers cited cost of prescription drugs as very important contributor to healthcare costs
    27. 27. www.MyFloridaRx.com <ul><li>Consumers may shop for the lowest price for the top 100 prescription name-brand drugs and search by city or county </li></ul><ul><li>Searches automatically include generic alternatives and the site publishes prices for more than 650 prescriptions in the most frequently dispensed dosages </li></ul><ul><li>3,457 pharmacies authorized as a Medicaid providers </li></ul><ul><li>Data source: Usual and Customary Charges (retail prices) billed to Florida Medicaid, required in addition to negotiated rate </li></ul><ul><li>Updated monthly from billing statements </li></ul><ul><li>Collaborative effort of AHCA and the Office of Attorney General </li></ul>
    28. 28. MIAMI-DADE County Xanax 1 mg Tablet Usual and Customary (U & C) prices February 1-28, 2007 (Continued) www.MyFloridaRx.com
    29. 29. Highest: $322.77 Lowest: $5.50 5, 950% difference in prices within 12 miles
    30. 30. <ul><li>Florida’s site essentially needed: </li></ul><ul><li>Access to Medicaid Pharmacy Claims Data </li></ul><ul><li>160 hours to Design, Develop, Test, and “Go-Live” (Two weeks time with a web designer and programmer) </li></ul><ul><li>Monthly data extraction (approximately 1 hour, once report developed) </li></ul><ul><li>Automated 14 hour process, per month, to clean the Medicaid data (approximately 1 hour staff time to update the website each month) </li></ul>How can you create a prescription website in your state?
    31. 31. Future Plans <ul><li>Strategic Planning Retreat: Florida’s 1-, 3-, and 5-year vision with State Consumer Health Information and Policy Advisory Council and Workgroups, June 19-20 </li></ul><ul><li>Outreach and Education </li></ul><ul><ul><ul><li>Consumers </li></ul></ul></ul><ul><ul><ul><li>Employers, payers </li></ul></ul></ul><ul><ul><ul><li>Providers </li></ul></ul></ul><ul><ul><ul><li>Media </li></ul></ul></ul><ul><li>Continue long term relationships </li></ul><ul><ul><ul><li>Providers – Hospitals, Physicians </li></ul></ul></ul><ul><ul><ul><li>Consumers – focus groups, surveys </li></ul></ul></ul><ul><ul><ul><li>Employers </li></ul></ul></ul>
    32. 32. Questions? <ul><li>Lisa Rawlins </li></ul><ul><li>BrowardHealth.org </li></ul><ul><li>Floridacomparecare.gov </li></ul><ul><li>MyFloridaRx.com </li></ul>
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