Purchaser Learning Group August 11, 2015
‌ catalyzing the spread of healthcare best practices
www.hcgc.org
Advisory Discussion
Advisory Discussion
What questions of clarity do you have regarding the collaborative activities coordinated by HCGC?
Advisory Discussion Regional quality information – Greater Columbus Hospital Safety Score - Columbus Region Hospital Safety Score - Individual Hospital Level
What questions of clarity do you have regarding the
Medicare Nursing Home Compare - Columbus Ohio ProPublica Hospital Compare
Advisory Discussion
Whatare questions of clarity and do you have regarding on thethe What your reflections recommendations collaborative activities coordinated by HCGC? emerging ourhealthcarequality.org website??
Co-Learning Discussion: Briefing on Transformation Activity
Shift to Value-based Health Care Rising Consumerism
Population Health
Value-based Healthcare
Quality-Cost Transparency www.hcgc.org
Payment Innovation
WHY: The need to transform healthcare in the U.S. Variations in COST: Recent study for Lower Back MRI
Columbus Ohio Average: $1,711 Price Range: $1,335 - $2,749
Nashville TN Average: $1,066 Price Range: $531 - $1,975
Co-Learning Discussion
2014 Aon Health Care Survey
Co-Learning Discussion
What are we learning about what is emerging in valueReference-Based Benefit/Pricing: based payment innovation? Contribution toward payment for each product or service, leaving the consumer to pay the difference between this contribution and the actual price charged by the provider.
Health Affairs: Reference-Based Benefit Design Changes Consumers’ Choices and Employers' Payments For Ambulatory Surgery, March 2015
Co-Learning Discussion Initial Reference-Based Benefit (RBB) Design Example: • California Public Employees Retirement System (CalPers) • Implemented RBB for knee and hip replacement – variation in price from $20,000 to $120,000, without evidence of quality differences What are we learning about what is emerging in value• RBB limit of $30,000 and Initiated communication program for based payment innovation? enrollees • Result: Increase in low-price hospitals, high price hospitals reduced prices, and $2.8 M in cost savings Extended RBB to ambulatory surgery centers • Wide variation in prices • RBB reimbursement of allowed charge for select ambulatory center with no consumer cost sharing. Consumers pay the difference between allowed amount for surgery center and hospital outpatient cost
Co-Learning Discussion
What are we learning about what is emerging in valuebased payment innovation?
Co-Learning Discussion
What we learning about what is emerging in valueWhatare questions of clarity about reference-based benefit based designpayment are you innovation? sitting with?
Co-Learning Discussion
What we learningand about what is emerging in valueWhatare opportunities challenges are we learning in basedreference-based payment innovation? implementing benefit design?
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
Purchaser Learning Group Next Meeting October 13, 2015 Broad Street Presbyterian Church 8:30 a.m. – 10:00 a.m.