Transcript Bringing Transparency to Quality Outcomes

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
Health Care Transparency
and the Value Equation
State of Reform Conference, January 8, 2015
Understanding VALUE in Health Care - Six Key Variables
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.
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Washington Health Alliance Current
Transparency 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
By Hospital and
Medical Group
• Washington State legislation: FULL price transparency
© 2015 Washington Health Alliance. All rights reserved.
This material may not be reproduced or modified without the prior permission of the Alliance.
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Washington One of Only Two States with an ‘A’
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 Information
Released December 16, 2014
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Washington’s New Common Measure Set
for Health Care Quality and Cost
© 2015 Washington Health Alliance. All rights reserved.
This material may not be reproduced or modified without the prior permission of the Alliance.
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Unlike in quality, Washington is not differentiating
itself as a leader in health care price transparency
F
F
HCI3 and Catalyst for Payment Reform
2014 Report Card on
State Price Transparency Laws
HCI3/CPR Report Released March 2014 8
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 Collaborative
Using Transparency to
Improve Quality
Background
QI
Employers
Hospitals
Organizations
House Bill 1311
Others
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Stakeholders
Public
Purchasers
Health
Plans
Identify health
care services with
high:
• Variation
• Utilization
Without producing
better outcomes
Slide 12
Process
Evidence-Based Guidelines
Provider Feedback Reports
Public Comment
Shared Decision Aids
Financial Incentives
Data Transparency
Centers of Excellence
Clinical Committee
Recommendations to
improve health care
quality,
outcomes, and
affordability in Washington
State
Public Reporting
Slide 13
Our Topics
Obstetrics
Low Back Pain and Spine
SCOAP
Cardiology
Hospital Readmissions
Elective Total Knee and Total Hip
Replacement Bundle and Warranty
End-of-Life Care
Elective Lumbar Fusion Bundle and
Warranty
Addiction and Dependence
Treatment
Slide 14
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 procedures
Variation in way procedures are done
Readmission Rates by hospital on website:
www.breecollaborative.org/topic-areas/apm/
Source: Readmission Rates for TKR/THR Procedures in
Washington State:
Summary of Findings from 2011 CHARS Data
Bree Collaborative – Accountable Payment Model Subgroup
October 2013. Available:
http://www.breecollaborative.org/wpcontent/uploads/bree_summary_CHARS_Analysis.pdf
Slide 18
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 Director
[email protected]
(206) 204-7377
www.breecollaborative.org
Recommendations available here:
www.breecollaborative.org/about/reports
Slide 20
Quality and Transparency
The Provider Commitment
Carol Wagner
Senior Vice President Patient Safety
[email protected]
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January 8, 2015
Washington Hospital Quality
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www.WAHospitalQuality.org
Collaborative Learning
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www.WAHospitalQuality.org
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
Data For Patient Engagement
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www.WAHospitalQuality.org
Improving Care
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.
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Improving Care
Partnership for Patients
Better Quality
2010: 145 harms/1000 discharges
2011: 142 harms/1000 discharges
2012: 132 harms/1000 discharges
2013: 121/1000 discharges preliminary results
2013 fewest harm ever!
ever!
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Making a Difference for Washingtonians
Partnership for Patients
Better Quality
• 23,000 fewer patients harmed.
Lower Cost
• $235 million reduction in costs.
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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
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C-CDA
IoT
No
Control
Influence
Control
Question &
Answer