State of Reform Conference, January 8, 2015

Health Care Transparencyand the Value Equation

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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 Provided in the most efficient manner?

Experience Provided in a patient-centered way?

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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

By Hospital and Medical Group

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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 InformationReleased December 16, 2014

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Washington’s New Common Measure Set for Health Care Quality and Cost

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Unlike in quality, Washington is not differentiating itself as a leader in health care price transparency

CPR Report Released March 2014

F

Catalyst for Payment Reform2014 Report Card on

State Price Transparency Laws

F

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Health Care Performance, Transparency, Improvement

1. Focus on all 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.