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Incentivizing and aligning providers 23 jul12 final
The document discusses strategies for incentivizing and aligning healthcare providers to improve quality and affordability. It emphasizes understanding human behavior, redesigning processes for efficiency, and utilizing data to inform decisions. Key themes include the necessity for motivation, simplicity in actions, and gradual improvement in healthcare outcomes.
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Incentivizing and aligning providers 23 jul12 final
- 1. incentivizing and aligningproviders wayne pan, md, mba chief medical officer pacific partners management services, inc. The RISE 2nd Annual Summit on Integrating Risk Adjustment and Quality Measures • Westlake Village, CA • July 23, 2012
- 2. ...standing on the shoulders of giants Sir Isaac Newton
- 3.
- 4.
- 5.
- 6.
- 11. insanity: doing the same thing over and over and expecting different results
- 13. Let’s take a stepback... from: http://step-dad.blogspot.com/2010/04/step-back.html
- 14.
- 16.
- 17.
- 18.
- 19.
- 20.
- 21. human lazy social nature habit notgood@ change
- 22. human lazy social nature habit socialnorms
- 24. human lazy social nature habit statusquo
- 25. human lazy social nature habit socialnorms
- 26.
- 27.
- 28.
- 29.
- 30. doctor competitive nature independent curious formsilos
- 31. doctor competitive nature independent curious notgood@ cooperation
- 32. doctor competitive nature independent curious notgood@ collaboration
- 33. doctor competitive nature independent curious curious
- 34. doctor competitive nature independent curious competitive
- 35. doctor competitive nature independent curious competence
- 36. doctor competitive nature independent curious mastery
- 37.
- 38.
- 39.
- 40. assumptions about improving quality and affordability clinicianscare about both want to improve both want feedback on both
- 41.
- 42. PREFERRED NON-PREFERRED variation reduction Drug Utilization Pattern Drug A Drug B Drug C Drug D
- 43.
- 44. prescribing preferred drug increases average drug cost drops
- 45. prescribing preferred drug increases average drug cost drops savings over baseline accumulate
- 46.
- 47. prescribing preferred drug increases average drug cost drops
- 48. prescribing preferred drug increases average drug cost drops no adverse effect on quality
- 49. prescribing preferred drug increases average drug cost drops no adverse effect on quality savings begin to accrue
- 50.
- 52.
- 53.
- 54.
- 55. MOTIVATION Learning & Challenging Incentives & Punishment intrinsic extrinsic
- 56. MOTIVATION Learning & Challenging Incentives & Punishment intrinsic extrinsic
- 57. V Learning & Challenging Incentives & Punishment intrinsic extrinsic
- 58.
- 59.
- 60.
- 61.
- 62.
- 63.
- 64. from: Jeanne Liedtkaand Tim Ogilvie, Designing for Growth (2011)
- 66.
- 67. it’s also about whom your DATA serving data to
- 68.
- 69. not current errorprone MPASTEE no comparator
- 70.
- 71.
- 73.
- 74. “put hot triggers in thepath of motivated people” BJ Fogg, PhD Director, Persuasive Technology Lab Stanford University
- 77. Are incentives alignedproperly? How can I increase their motivation?
- 79. Have I madeit easy for people to act? How can I make it even simpler?
- 81. Are people beingtriggered at the most appropriate time and in their workflow (path)?
- 86. putting it alltogether: how does it work?
- 87.
- 88. patient front desk staff
- 89. patient analog to digital front desk staff converter
- 90. AMERICAN HEALTH PLAN 112 MARY SMITH 1/1/2011 1234567890 $5.00 $10.00 $25.00 analog to digital analog to digital eligibility check converter converter
- 91. Quality Access Express TM Management Click here to register for a password or request more information Powered by Access ExpressQ-v5.0.#.0.1 Build 2011.04.04.00
- 92. ACCESSEXPRESS Q New Eligibility Response New Message (3)
- 93. ACCESSEXPRESS Q New Eligibility Response New Message (3) AMERICAN HEALTH PLAN
- 94. ACCESSEXPRESS Q New Eligibility Response New Message (3) TH PA AMERICAN HEALTH PLAN E TH IN
- 95. ACCESSEXPRESS Q New Eligibility Response New Message (3) SMITH, MARY 8/15/1945 POP-UP 1234567890 MAMMOGRAPHY, CRC, CARDIO CARE, BLUE SHIELD OF CA DIABETES CARE, HYPERTENSION, GLAUCOMA, MED MONITOR, FLU VAC, PNEUMO VAC, DEXA, OSTEOPOROSIS, RHEUM, COPD
- 96. digital to analogconverter module
- 97. x x x x x x x x digital to analog converter module
- 98. ACCESSEXPRESS Q New Eligibility Response New Message (3) SMITH, MARY 8/15/1945 1234567890 MAMMOGRAPHY, CRC, CARDIO CARE, BLUE SHIELD OF CA DIABETES CARE, HYPERTENSION, GLAUCOMA, MED MONITOR, FLU VAC, PNEUMO VAC, DEXA, OSTEOPOROSIS, RHEUM, COPD CLICK HERE
- 99.
- 100.
- 101.
- 102. ACCESSEXPRESS Q New Eligibility Response New Message (3) ER SMITH, MARY 8/15/1945 G 1234567890 IG MAMMOGRAPHY, CRC, CARDIO CARE, BLUE SHIELD OF CA DIABETES CARE, HYPERTENSION, TR GLAUCOMA, MED MONITOR, FLU VAC, PNEUMO VAC, DEXA, OSTEOPOROSIS, RHEUM, COPD T O H
- 103. ACCESSEXPRESS Q New Eligibility Response New Message (3) ENABLING SMITH, MARY 8/15/1945 1234567890 FRONT OFFICE MAMMOGRAPHY, CRC, CARDIO CARE, BLUE SHIELD OF CA DIABETES CARE, HYPERTENSION, STAFF GLAUCOMA, MED MONITOR, FLU VAC, PNEUMO VAC, DEXA, OSTEOPOROSIS, RHEUM, COPD
- 104. ACCESSEXPRESS Q New Eligibility Response New Message (3) SMITH, MARY 8/15/1945 SIMPLE 1234567890 CARE PLAN MAMMOGRAPHY, CRC, CARDIO CARE, BLUE SHIELD OF CA DIABETES CARE, HYPERTENSION, GLAUCOMA, MED MONITOR, FLU VAC, PNEUMO VAC, DEXA, OSTEOPOROSIS, RHEUM, COPD
- 105. ACCESSEXPRESS Q New Eligibility Response New Message (3) SMITH, MARY 8/15/1945 1234567890 MAMMOGRAPHY, CRC, CARDIO CARE, BLUE SHIELD OF CA DIABETES CARE, HYPERTENSION, GLAUCOMA, MED MONITOR, FLU VAC, PNEUMO VAC, DEXA, OSTEOPOROSIS, RHEUM, COPD
- 106. ACCESSEXPRESS Q New Eligibility Response New Message (3)
- 107. ACCESSEXPRESS Q New Eligibility Response New Message (3)
- 108. ACCESSEXPRESS Q New Eligibility Response New Message (3) N O TI VA TI O M
- 109. ACCESSEXPRESS Q New Eligibility Response New Message (3)
- 110. ACCESSEXPRESS Q New Eligibility Response New Message (3)
- 111. ACCESSEXPRESS Q New Eligibility Response New Message (3)
- 112.
- 113.
- 114. Capability for physician office entry Y IT IL AB
- 116.
- 117. commercialadmits/1000 80 Milliman - Loosely-Managed 70 Milliman - Moderately-Managed 60 Milliman - Well-Managed 50 SCCIPA 40 11 10 1 1 0 1 0 0 R1 N1 L1 L1 R1 N1 CT CT JU JU AP JA AP JA O O
- 118. commercialbeddays/1000 275 Milliman ’11 Loosely-Managed Milliman - Loosely-Managed 250 225 Milliman -’11 Moderately-Managed Milliman Moderately-Managed 200 SCCIPA SCCIPA 175 Milliman ’11 Well-Managed Milliman - Well-Managed 150 11 10 1 1 0 1 0 0 R1 N1 L1 L1 R1 N1 CT CT JU JU AP JA AP JA O O
- 119. commercialalos 4.5 4.0 Milliman - Loosely-Managed 3.5 Milliman - Moderately-Managed SCCIPA 3.0 Milliman - Well-Managed 2.5 11 10 1 1 0 1 0 0 R1 N1 L1 L1 R1 N1 CT CT JU JU AP JA AP JA O O
- 120. medicareadmits/1000 400 Milliman - Loosely-Managed 350 Milliman - Moderately-Managed 300 SCCIPA Milliman - Well-Managed 250 200 11 10 1 1 0 1 0 0 R1 N1 L1 L1 R1 N1 CT CT JU JU AP JA AP JA O O
- 121. medicarebeddays/1000 2,200 2,000 Milliman - Loosely-Managed 1,800 1,600 Milliman - Moderately-Managed 1,400 SCCIPA 1,200 Milliman - Well-Managed 1,000 11 10 1 1 0 1 0 0 R1 N1 L1 L1 R1 N1 CT CT JU JU AP JA AP JA O O
- 122. medicarealos 6.0 5.5 Milliman - Loosely-Managed 5.0 Milliman - Moderately-Managed 4.5 SCCIPA Milliman - Well-Managed 4.0 11 10 1 1 0 1 0 0 R1 N1 L1 L1 R1 N1 CT CT JU JU AP JA AP JA O O
- 124. * * * * * increase/same scores in 21 of 26 measures
- 125. an essential aspect of creativity is notbeing afraid to fail - edwin land
- 126.
- 128.
- 129. When you improvea little bit each day, eventually big things occur. Don’t look for big, quick improvement. Instead, seek small improvement one day at a time. That’s the only way it happens - and when it happens, it lasts. John Wooden
- 130.
- 131. a journey ofa thousand miles, begins with a single step - Lao-Tzu
- 132. don’t be afraid to takethe plunge
- 133. Thank you! wpan@ppmsi.com slideshare.net/bonedoc97 WWW.SNOOPY.COM