Regional Learning Webinar April 15, 2015
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Regional Learning Webinar April 15, 2015
Webinar Notes • We are recording the webinar - will be available via our website later today
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If using computer and phone to access the webinar please turn on your computer speakers in order to hear video
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If using phone only, you will not be able to hear the video portion of today’s webinar
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We welcome your reflections and questions via Webinar chat feature or Text to 614-906-2440
www.hcgc.org
Providing More with Less: Primary Care Bright Spots Healthcare Collaborative of Greater Columbus April 15, 2015 Arnold Milstein, MD MPH Melora Simon MPH Stanford Clinical Excellence Research Center Š 2015 A. Milstein/Stanford Univ
America’s Most Valuable Primary Care
Video: From the patient’s perspective
Identifying Bright Spots: Assessing Performance Total cost of care •
Attribution and risk adjustment •
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Members attributed to group having maximum number of claims
• Member-level risk-adjustment using 3M’s Clinical Risk Group software (CRG) Cost basis •
Allowed amounts
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Standardized costs using a fee schedule
Quality • •
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Composite of > 40 HEDIS, NQF endorsed, or Medicare Star measures Balanced across process of care, prevention/wellness, and medication management domains and specific conditions Weighted to reflect a hybrid of clinical and empirical importance • Clinical - medication management, prevention-wellness, and diseases such as diabetes, asthma, CVD, etc. • Empirical - Determines measures, weighting to maximize discrimination between providers, identifies measures to remove as same in discriminating providers
Approach informed by consultation with diverse panel of experts in clinical performance assessment.
Rare But Powerful 10,000 scorable sites
• Risk-adjusted per capita total cost of care > 20% lower than average
• >10% higher on quality composite <5% In top quartile on both quality and cost
© 2015 A. Milstein/Stanford Univ
Bright Spots in high and low cost labor markets
Š 2015 A. Milstein/Stanford Univ
Bright Spot Sites are Diverse Independent, primary care only Fee-for-service (FFS) reimbursement
Independent, multispecialty
Part of a health system
Capitated
Fee-for-service
• Greater Tampa, FL
• Greater Minneapolis, MN • Greater Rochester, NY
• • • •
Capitated
Capitated
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• Orange County, CA
Greater Orlando, FL
Other
Phoenix, AZ Memphis, TN Greater Dayton, OH Greater Cincinnati, OH
• Workplace clinic: San Antonio, TX • Federally Qualified Health Center: Greater Boston, MA
© 2015 A. Milstein/Stanford Univ
Shared Features of Idol Sites
Deeper patient relationships
Wider scope of responsibility
Team-based practice organization
Deeper Patient Relationships • Always on • Conscientiousness and conservation
Adherence to guidelines Moderately adjustable care intensity Informal shared decision-making, advanced care planning, & other forms of choosing wisely • Complaints are gold
Wider scope of responsibility • Responsible in-sourcing • Staying close • Closing the loop
Team-Based Practice Organization • Upshifted staff roles • “Hived” workstations or rules-based decision making/standard work • Balanced compensation • Investments in people, not space & equipment
Next steps • Spread and scale – collaboration with the Peterson Center on Healthcare • Applying approach to other areas of health care delivery:
• Community Hospitals • 8 Specialties – Longitudinal Management and Episodic care
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Regional Learning Webinar April 15, 2015
Learning from your reflections and questions viaâ&#x20AC;Ś Webinar chat feature
Or Text to 614-906-2440
www.hcgc.org
http://petersonhealthcare.org/most-valuable-care
Thank you! We thank…. • Dr. Arnold Milstein & Melora Simon • Our public-private funding partners • Each of you for participating
We will send you a follow-up email asking for your feedback on the value of today’s webinar. Reminder: Recording of today’s webinar will be available via our website later this afternoon – please share with your colleagues! www.hcgc.org
Next Regional Learning Session… Regional In-Person Learning Session May 15, 2015 8:30-11:30a EST Nationwide & Ohio Farm Bureau 4-H Center 2201 Fred Taylor Dr. Columbus, 43210 Register via our website www.hcgc.org Learning Topic: Improving quality transparency in Greater Columbus
Objectives: • Explore lessons learned and best practices from recent national summit on healthcare price, cost, and quality transparency. • Collaborate with colleagues and competitors to help shape the design for a new regional quality transparency website – a good place to start in Greater Columbus. www.hcgc.org