bringing transparency to quality outcomes 2015 washington state of reform policy conference january...
TRANSCRIPT
Bringing Transparency to
Quality Outcomes 2015 Washington State of Reform Policy Conference
January 8, 2015
Presenters
• Susie Dade, Deputy Director, Washington Health Alliance • Ginny Weir, Program Director, Bree Collaborative,
Foundation for Health Care Quality• Carol Wagner, Senior Vice President for Patient
Safety, Washington State Hospital Association• Rick Rubin, CEO, OneHealthPort
State of Reform Conference, January 8, 2015
Health Care Transparencyand the Value Equation
Understanding VALUE in Health Care - Six Key Variables
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VARIABLE Is the Health Care Service. . .
Appropriateness Really Needed?
Process Quality Provided in the most effective and safe manner?
Price Produced at a fair price for the buyer?
Outcomes Producing the best possible results for the patient?
Intensity/Utilization Provided in the most efficient manner?
Experience Provided in a patient-centered way?
© 2015 Washington Health Alliance. All rights reserved. This material may not be reproduced or modified without the prior permission of the Alliance.
Washington Health Alliance CurrentTransparency Initiatives• Community Checkup Quality, Patient Experience
– Medical Groups, Hospitals, Counties
• Value Portfolio Quality, Intensity, Experience, Price– High volume, high cost hospitalizations
• Disparities in Care
• Rates of Procedure Use and Diagnostic Testing
• Choosing Wisely®
• Potentially Avoidable ER Visits
• 30-day All Cause Hospital Readmissions
• Washington State legislation: FULL price transparency
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By Hospital and Medical Group
© 2015 Washington Health Alliance. All rights reserved. This material may not be reproduced or modified without the prior permission of the Alliance.
Washington One of Only Two States with an ‘A’
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This report grades states on the percentage of clinicians with publicly available quality information, the type of measurement reported, and how accessible and useful the information is to consumers. Fifteen years after the publication of ‘To Err Is Human’ by the Institute of Medicine, there is still little, if any, useful and meaningful information on the quality of health care across the country.
HCI3 State Report Card on Transparency of Physician Quality InformationReleased December 16, 2014
Washington’s New Common Measure Set for Health Care Quality and Cost
7© 2015 Washington Health Alliance. All rights reserved. This material may not be reproduced or modified without the prior permission of the Alliance.
Unlike in quality, Washington is not differentiating itself as a leader in health care price transparency
8HCI3/CPR Report Released March 2014
F
HCI3 and Catalyst for Payment Reform2014 Report Card on
State Price Transparency Laws
F
Health Care Performance, Transparency, Improvement
1. Focus on all six variables of health care value
2. Harmonization of measures – converge around common signals
3. Transparency for:
– Purchasers
– Consumers
– Providers with continuous feedback loop
4. Support for performance improvement, especially for smaller provider organizations
5. Strongly link incentives to performance (not volume)
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Bottom Line
Transparency is a key tool for identifying, understanding, and
ultimately reducing, unwarranted variation in health care quality,
utilization and price.
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The Dr. Robert Bree CollaborativeUsing Transparency to Improve Quality
Background
Slide 12
House Bill 1311
Health PlansPublic
Purchasers
QI Organizations Hospitals
Employers
Others
Identify health care services with
high:• Variation• Utilization
Without producing better outcomes
22 Stakeholders
Process
Slide 13
Data Transparency
Provider Feedback Reports
Shared Decision Aids
Financial Incentives
Evidence-Based Guidelines
Centers of Excellence
Public Reporting
Public CommentRecommendations to improve health care
quality, outcomes, and
affordability in Washington StateClinical Committee
Our Topics
Slide 14
Obstetrics
Cardiology
Elective Total Knee and Total Hip Replacement Bundle and Warranty
Elective Lumbar Fusion Bundle and Warranty
Low Back Pain and Spine SCOAP
Hospital Readmissions
End-of-Life Care
Addiction and Dependence Treatment
Cardiology
Recommendation: COAP publicly disclose hospitals’ insufficient information reports and the appropriateness of PCI procedures
Slide 15
Insufficient Information for Determining Appropriateness in Non-Acute PCI – 2011-2013
Slide 16
Total Knee and Total Hip Replacement High volume of proceduresVariation in way procedures are doneReadmission Rates by hospital on website:
www.breecollaborative.org/topic-areas/apm/
Slide 18
Source: Readmission Rates for TKR/THR Procedures in Washington State:Summary of Findings from 2011 CHARS DataBree Collaborative – Accountable Payment Model SubgroupOctober 2013. Available: http://www.breecollaborative.org/wp-content/uploads/bree_summary_CHARS_Analysis.pdf
Transparent Quality Standards
Appropriateness
Evidence-based surgery
Rapid and durable return to function
Patient care experience
Patient safety and affordability
Slide 19
More Information
Ginny Weir, Program [email protected] (206) 204-7377www.breecollaborative.org
Recommendations available here: www.breecollaborative.org/about/reports
Slide 20
Quality and TransparencyThe Provider Commitment
Carol Wagner
Senior Vice President Patient Safety
[email protected] 8, 201521
www.WAHospitalQuality.org
Washington Hospital Quality
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www.WAHospitalQuality.org
Collaborative Learning
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Healthy Competition
“The Washington State Hospital Association has come out fully in favor of transparency. We’re finding that if you share results, you’re really allowing the patient, family and consumer to understand, ‘How good is this care, really?’
“By nature, we’re competitive. By nature, if you’re in health care, you want to improve. It’s motivating to find areas and say ‘Whoa, we aren't quite as good as we should be and in fact, most of our colleague institutions are doing better.’ It’s a very motivating thing within our membership.”
--Scott Bond, WSHA CEO
www.WAHospitalQuality.org 24
Data For Patient Engagement
www.WAHospitalQuality.org 25
Better Quality• 50,000 fewer deaths in hospitals.
• 1.3 million fewer patients harmed.
• 17 percent decline in harm.
Lower Cost• $12 billion reduction in costs.
• Healthcare price inflation was lower than the
GDP for the last four years.
Nationally
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Improving Care
Better Quality2010: 145 harms/1000 discharges2011: 142 harms/1000 discharges2012: 132 harms/1000 discharges2013: 121/1000 discharges preliminary results ever!
Partnership for Patients
Nationally
2013 fewest harm ever!
Improving Care
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Better Quality• 23,000 fewer patients harmed.
Lower Cost• $235 million reduction in costs.
Partnership for Patients
Washington
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Making a Difference for Washingtonians
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Improving Care for all Washingtonians
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Improving Care for all Washingtonians
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Improving Care for all Washingtonians
C-CDAIoT
No Control
Influence
Control
Question & Answer