Benefit Consultant Learning Group July 30, 2015
... catalyzing the spread of healthcare best practices The Healthcare Collaborative of Greater Columbus is a non-profit, public-private partnership. We serve as a catalyst, convener, and coordinator of healthcare transformation & learning in Greater Columbus. Our Collaborative Approach The status of our healthcare situation is not acceptable in terms of its prevention, quality, safety, transparency, or cost. We strive for win-win solutions recognizing that change is required by all – consumers, providers, and purchasers. We believe the best solutions come from a collaborative approach – we seek no authority in our role as a catalyst/convener/coordinator We work together with our public-private partners to accelerate and scale innovation. www.hcgc.org
Benefit Consultant Learning Group July 30, 2015
‌ catalyzing the spread of healthcare best practices
www.hcgc.org
OHIO
Advisory Discussion
What is questions you have new regarding What the valueofofclarity HCGCdo evaluating publicthe tools collaborative coordinated HCGC? and resources toactivities share with you? Areby there specific tools and resources you would like for us to provide further demonstration??
Co-Learning Discussion: Briefing on Transformation Activity
NATIONAL
SUPREME COURT – HEALTHCARE SUBSIDIES
SUPREME COURT – HEALTHCARE SUBSIDIES
MERGERS & ACQUISITIONS
Shift to Value-based Health Care Rising Consumerism
Population Health
Value-based Healthcare
Quality-Cost Transparency www.hcgc.org
Payment Innovation
Report Card on State Price Transparency Laws, July 2015
Report Card on State Price Transparency Laws, July 2015
Report Card on State Price Transparency Laws, July 2015
Shift to Value-based Health Care Rising Consumerism
Population Health
Value-based Healthcare
Quality-Cost Transparency www.hcgc.org
Payment Innovation
Payment Innovation National Goals 50% of payments in alternative payment models by 2018
Mandate bundled payment model for joint replacement in 75 markets as of Jan 2016 2090% of FFS payments linked to quality by 2018
75% of business operating under value-based payment arrangements by 2020
OHIO
Co-Learning Discussion
Co-Learning Discussion Variation in QUALITY: Readmissions within 30 days medical discharge
Central Ohio region is one of 57 regions ranked with highest variation
OHIO: Public-Private Healthcare Innovation Plan (SIM grant)
OHIO: Public-Private Healthcare Innovation Plan (SIM grant)
Ohio’s Health Care Payment Innovation Partners:
OHIO: Public-Private Healthcare Innovation Plan (SIM grant)
Co-Learning Discussion
OHIO: Public-Private Healthcare Innovation Plan (SIM grant)
OHIO: Public-Private Healthcare Innovation Plan (SIM grant)
OHIO: Public-Private Healthcare Innovation Plan (SIM grant)
OHIO: Public-Private Healthcare Innovation Plan (SIM grant)
OHIO: Public-Private Healthcare Innovation Plan (SIM grant)
OHIO: Public-Private Healthcare Innovation Plan (SIM grant)
Co-Learning Discussion
OHIO: Contract services RFP for the implementation of PCMH RFP released end of May to be awarded in July Contract services include: a. Engage and coordinate work with stakeholders (e.g. providers, payers, patients, advocacy groups, state staff, and funding partners) b. Identify, communicate and adopt best practice approaches for PCMHs c. Ensure continuous improvement and accountability for the overall PCMH program through evidence-based analytical techniques and evaluation. d. Health care payments should encourage and reward patient-centered care that coordinates services across the spectrum of providers and care setting while tailoring health care services to the individual patient's needs. e. Payment policies should encourage alignment between public and private health care sectors to promote improvement, innovations and meeting Ohio’s priorities to improve population health. Source: Governor’s Office of Health Transformation
OHIO: SIM-PCMH DESIGN TEAM SELECTED • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Mary Applegate Ohio Department of Medicaid Brian Bachelder Akron General Medical Center Karen Bell Ohio Consumers for Health Coverage Angie Bergefurd Ohio Mental Health and Addiction Services Kenneth Bertka, Mercy Health Dee Bialecki‐Haase ProMedica Sarah Biehl Children's Defense Fund Jeff Biehl Healthcare Collaborative of Greater Columbus Larry Blosser COPC Sarah Bolton Health Collaborative of Greater Cincinnati Kevin Brinckerhoff Ohio Department of Administrative Services Nita Carter UHCAN Randall Cebul Better Health Greater Cleveland Mark Couch PriMed Physicians Robin Dawson Medical Mutual of Ohio Angela Dawson Ohio Commission on Minority Health Mary DiOrio Ohio Department of Health Sarah Durfee OPERS Chad Evans Mount Carmel Health Bob Falcone Ohio Hospital Association Sean Gleeson Nationwide Children's Hospital Rick Hodges Ohio Department of Health Rita Horowitz Better Health Greater Cleveland Karin Hoyt Ohio Department of Medicaid Mark Hurst Ohio Mental Health and Addiction Services Kristine Jessen UnitedHealthcare Monica Juenger Office of Health Transformation Lisa Kaiser Health Action Council Cathy Levine UHCAN
• • • • • • • • • • • • • • • • • • • • • • • • • • • •
Source: Governor’s Office of Health Transformation
Stephanie Loucka Ohio Department of Administrative Services Paul Martin Family Care Center ‐ Providence Medical Group Jeff Martin Paramount John McCarthy Ohio Department of Medicaid Amy Mechley Christ Hospital James Misak MetroHealth Greg Moody Office of Health Transformation Kristin Oaks independent Craig Osterhues GE Aviation Kelly Owen Anthem Sandy Oxley Voices for Ohio's Children Martin Portillo Molina Michael Rotherberg Cleveland Clinic Shelly Senders Senders Pediatrics Richard Shonk Health Collaborative of Greater Cincinnati Krista Stock Healthcare Collaborative of Greater Columbus Rebecca Sustersic Ohio Bureau of Worker's Compensation Barb Tobias UC Health Rick Tully Office of Health Transformation Steve Ulrich Perry County Family Practice Bruce Vanderhoff OhioHealth Bruce Wall Aetna Daniel Wendorff Mount Carmel Health Randy Wexler The Ohio State University Donald Wharton CareSource John Wiley Buckeye William Wulf Central Ohio Primary Care Ted Wymyslo Ohio Association of Community Health Centers
MONUMENTAL TRANSFORMATION
Co-Learning Discussion
What areare we we learning about what emerging in valueWhat learning about theisopportunities and paymentepisode-based innovation? payment and challenges of based implementing service delivery reforms?
2015 Regional Learning Sessions Topic
Date/Time
Population Health Management: Why It matters, How it’s done, What’s next?
August 21
Featured speaker: • Pamela Peele, PhD, Chief Analytics Officer, University of Pittsburgh Medical Center (UPMC) Health Plan Regional Panel: • David Applegate, MD, Chief, Primary Care Transformation, OhioHealth Physician Group • Rick Forrest, MD, Medical Director, Ambulatory Services, The Ohio State University Wexner Medical Center • Tricia Schmidt, Client Advocate, Willis of Ohio • Ben Shaker, Vice President and COO, Mount Carmel Health Partners • King Stumpp, President and CEO, Netcare Access • Bruce Wall, MD, Senior Medical Director, Aetna
8:30-11:30AM EST Nationwide & Ohio Farm Bureau 4-H Center 2201 Fred Taylor Dr. Columbus, 4321
National Quality Measures – Jeff Geppert, Research Leader in Battelle’s Advanced Analytics and Health Research Group
October 7 - Webinar 1:00 – 2:00 EST
Showcase Regional Healthcare Improvement Projects
December 4
www.hcgc.org
Next Meeting
Benefit Consultant Learning Group Next Meeting October 1, 2015 Broad Street Presbyterian Church 8:30 a.m. – 10:00 a.m.