Directors Update Carolyn Clancy, MD National Advisory Council
July 13, 2012 July 13, 2012
Slide 2
Member Updates New Roles: Katherine Schneider, MD, MPhil
Medecision, Inc., Executive Vice President and Chief Medical
Officer Katherine Schneider, MD, MPhil Medecision, Inc., Executive
Vice President and Chief Medical Officer Ardis Dee Hoven, MD AMA,
President-Elect Ardis Dee Hoven, MD AMA, President-Elect Welton
ONeal, Jr., BS, RPh, PharmD Foundation for Managed Care Pharmacy,
Executive Director and Academy of Managed Care Pharmacy, Vice
President of Pharmacy Affairs Welton ONeal, Jr., BS, RPh, PharmD
Foundation for Managed Care Pharmacy, Executive Director and
Academy of Managed Care Pharmacy, Vice President of Pharmacy
Affairs
Slide 3
Overview The Big Picture The Big Picture FY 2012 FY 2013 Budget
Request Recent Accomplishments Recent Accomplishments In the News
Impact Case Studies AHRQ Program Updates AHRQ Program Updates
Todays Agenda Todays Agenda
Slide 4
FY 2012 Budget: $405M $16.6M for Patient-Centered Outcomes
Research (+$24M from the PCORTF) $16.6M for Patient-Centered
Outcomes Research (+$24M from the PCORTF) $15.9M for
Prevention/Care Management (+$12M from the Prevention and Public
Health Fund) $15.9M for Prevention/Care Management (+$12M from the
Prevention and Public Health Fund) $3.7M for Value Research $3.7M
for Value Research $25.6M for Health IT $25.6M for Health IT $65.6M
for Patient Safety ($34M HAI) $65.6M for Patient Safety ($34M HAI)
$108.4M for Cross-cutting ($15.9M in NEW grants) $108.4M for
Cross-cutting ($15.9M in NEW grants)
Slide 5
FY 2013 Request: $408.8M $10M for Patient-Centered Outcomes
Research (+$62.4M from the PCORTF) $10M for Patient-Centered
Outcomes Research (+$62.4M from the PCORTF) $15.9M for
Prevention/Care Management (+$12M from the Prevention and Public
Health Fund) $15.9M for Prevention/Care Management (+$12M from the
Prevention and Public Health Fund) $3.6M for Value Research $3.6M
for Value Research $25.6M for Health IT $25.6M for Health IT $62.6M
for Patient Safety ($34M HAI) $62.6M for Patient Safety ($34M HAI)
$88.9M for Cross-cutting ($2.7M in NEW grants) $88.9M for
Cross-cutting ($2.7M in NEW grants)
Slide 6
Overview The Big Picture The Big Picture FY 2012 FY 2013 Budget
Request Recent Accomplishments Recent Accomplishments In the News
Impact Case Studies AHRQ Program Updates AHRQ Program Updates
Todays Agenda Todays Agenda
Slide 7
2011 National Healthcare Quality and Disparities Reports
Released Key findings from annual reports: Key findings from annual
reports: Quality of care improving slowly overall Heart care
improving greatly: Reduced hospital admissions for congestive heart
failure Reduced hospital admissions for congestive heart failure
Fewer heart attack deaths in hospitals Fewer heart attack deaths in
hospitals Access not improving for most minority groups New data
on: New data on: Musculoskeletal diseases Childrens health EHR
adoption www.ahrq.gov/qual/qrdr11.htm
Slide 8
Quality is Improving Slowly Nearly 60 percent of health care
quality measures tracked showed improvement Nearly 60 percent of
health care quality measures tracked showed improvement However,
the median rate of change was 2.5 percent per year However, the
median rate of change was 2.5 percent per year AHRQ 2011 National
Healthcare Quality and Disparities Reports Quality measures that
are improving, not changing or worsening, overall and for select
populations
Slide 9
Few Disparities in Quality of Care Are Getting Smaller Few
disparities in quality showed significant improvement Few
disparities in quality showed significant improvement The number of
disparities that were getting smaller exceeded the number that were
getting larger The number of disparities that were getting smaller
exceeded the number that were getting larger AHRQ 2011 National
Healthcare Quality and Disparities Reports Quality measures for
which disparities related to age, race, ethnicity and income are
improving, not changing or worsening
Slide 10
National Quality Strategy First Annual Progress Report Released
April 30, 2012 www.workingforquality.ahrq.gov Released April 30,
2012 www.workingforquality.ahrq.gov NQS Aims 1) Improve overall
quality by making health care more patient-centered, reliable,
accessible and safe 2) Improve population health by supporting
proven interventions to address behavioral, social and
environmental determinants of health, in addition to delivering
higher-quality care. 3) Reduce the cost of quality health care for
individuals, families, employers and government. NQS Priorities 1)
Making care safer by reducing harm caused in the delivery of care
2) Ensuring that each person and family are engaged as partners in
their care 3) Promoting effective communication and coordination of
care 4) Promoting the most effective prevention and treatment
practices for the leading causes of mortality, starting with
cardiovascular disease 5) Working with communities to promote wide
use of best practices to enable healthy living 6) Making quality
care more affordable for individuals, families, employers, and
governments by developing and spreading new health care delivery
models
Slide 11
Next Steps for NQS Continue stakeholder engagement,
particularly around the strategic opportunities for improvement
identified by the National Quality Forum: Continue stakeholder
engagement, particularly around the strategic opportunities for
improvement identified by the National Quality Forum: Identify a
national strategy for data collection, measurement, and reporting
Develop organizational infrastructure at the community level that
assumes responsibility for improvement efforts Reform payment and
delivery systems Continue alignment and streamlining of measurement
across HHS programs Continue alignment and streamlining of
measurement across HHS programs Continue alignment of HHS
programmatic goals with NQS priorities Continue alignment of HHS
programmatic goals with NQS priorities
Slide 12
New: 2011 State Snapshots
http://statesnapshots.ahrq.gov/snaps11/dashboard.jsp?menuId=4&state=MD&level=0
= Most Recent Year = Baseline Year Performance Meter: All Measures
Very Weak Weak Average Strong Very Strong Maryland: Overall Care
Quality vs. All States State-specific health care quality
information, including strengths, weaknesses, and opportunities for
improvement Enables users to explore the quality of a State's
health care against national rates or best performing States
State-specific health care quality information, including
strengths, weaknesses, and opportunities for improvement Enables
users to explore the quality of a State's health care against
national rates or best performing States
Slide 13
Web Videonovela Helps Patients Compare Diabetes Treatments
Spanish-language videonovela Aprende a vivir (Learn to Live)
Spanish-language videonovela Aprende a vivir (Learn to Live) Three
episodes of family drama portray challenges of managing diabetes
Three episodes of family drama portray challenges of managing
diabetes Nearly 12 percent of Hispanic adults age 20 and older have
diabetes; Hispanics are twice as likely as whites to be
hospitalized for diabetes complications Nearly 12 percent of
Hispanic adults age 20 and older have diabetes; Hispanics are twice
as likely as whites to be hospitalized for diabetes complications
www.healthcare411.ahrq.gov/apre ndeavivir.aspx
Slide 14
Muscle Training Effective in Treating Urinary Incontinence in
Women Urinary incontinence (involuntary loss of urine) is extremely
common in adult women Urinary incontinence (involuntary loss of
urine) is extremely common in adult women Review of treatments for
urinary incontinence finds: Review of treatments for urinary
incontinence finds: Pelvic muscle floor training is effective
without side effects Drug-based treatments can work, but side
effects are common www.effectivehealthcare.ahrq.gov
Slide 15
Arizona Health Care Cost Containment System AHRQs Vaginal Birth
After Cesarean Section (VBAC): New Insights and Medicaid Medical
Directors Learning Network AHRQs Vaginal Birth After Cesarean
Section (VBAC): New Insights and Medicaid Medical Directors
Learning Network Evidence report suggests that VBAC may be safe in
large hospitals but research is mixed on outcomes in other
settings, such as rural hospitals Medicaid officials used findings
to identify settings where VBAC services could be performed safely
(KT-COE-100)
Slide 16
Highmark (PA, WV) AHRQs Health Literacy Universal Precautions
Toolkit and Questions Are The Answer public education campaign
AHRQs Health Literacy Universal Precautions Toolkit and Questions
Are The Answer public education campaign Used to educate physicians
about relationship between health literacy and outcomes Provider
Web site features AHRQs toolkit and a training module Downloadable
tools for patients include Questions Are The Answer campaign
resources (CP3-12-02)
Slide 17
Hospitals in NE, NM, and NY AHRQs Preventing Hospital- Acquired
Venous Thromboembolism (VTE): A Guide for Effective Quality
Improvement and QIO Learning Network AHRQs Preventing Hospital-
Acquired Venous Thromboembolism (VTE): A Guide for Effective
Quality Improvement and QIO Learning Network Some hospitals
implemented new VTE protocols based on AHRQ Toolkit used by some
hospitals to revise existing point-based VTE assessment New
clinical approaches and protocols resulted in more appropriate VTE
prevention tactics (KT-CQuIPS-97-99)
Slide 18
Hospitals in ME, GA, IN, MD, MO, and MI AHRQ-funded toolkit,
Medications at Transition and Clinical Handoffs (MATCH) and QIO
Learning Network AHRQ-funded toolkit, Medications at Transition and
Clinical Handoffs (MATCH) and QIO Learning Network Identified need
for single medication history list Hospitals redesigned their
medication history lists based on toolkits One Source of Truth
Medication reconciliation compliance improved in participating
hospitals (KT-CQuIPS-89-94)
Slide 19
Arkansas Department of Health AHRQs MONAHRQ Learning Network
AHRQs MONAHRQ Learning Network Provided resources and tools to
enable State Health Department to launch public MONAHRQ Web site
States Hospital Discharge Health Data Site includes county maps
that compare potentially avoidable hospitalizations and patient
conditions and procedures (KT-CDOM-96)
Slide 20
Maine Health Data Organization (MDHO) AHRQs MONAHRQ Learning
Network AHRQs MONAHRQ Learning Network Learning Network provided
in-person meetings, Web conferences, and online discussions on
using MONAHRQ to publicly report data MDHOs MONAHRQ Web site
includes State- specific inpatient discharge data from all non-
specialty hospitals Policymakers and hospitals are primary users of
MDHOs MONAHRQ Web site (KT-CDOM-96)
Slide 21
Utah Department of Health MONAHRQ MONAHRQ Used to create Utah
Hospital Comparison Report Online report compares performance of
Utah hospitals on quality ratings and average hospital charges
Includes maps by county showing hospital rates of readmissions,
adherence to care guidelines, and patient satisfaction Using
MONAHRQ cut report production time in half (CDOM-12-03)
Slide 22
Ohio Medicaid AHRQs Maternal and Neonatal Outcomes of Elective
Induction of Labor and Medicaid Medical Directors Learning Network
AHRQs Maternal and Neonatal Outcomes of Elective Induction of Labor
and Medicaid Medical Directors Learning Network Found increase in
Cesarean deliveries when labor is induced vs. spontaneous Based on
AHRQ report, Medicaid program reduced labor inductions without
clear medical indications in near-term infants by 40% over 18
months Prevented nearly 200 neonatal intensive care unit admissions
(KT-COE-101)
Slide 23
Woodhull Medical and Mental Health Center (part of New York
City Health and Hospital Corp.) AHRQs Emergency Severity Index
(ESI) triage system AHRQs Emergency Severity Index (ESI) triage
system Annual ED visits increased from 65,000 in 1998 to 100,000 in
2011 Used ESI to handle the increase by improving emergency
departments (ED) patient flow, prevent care delays, and save costs
through greater efficiency Resulted in higher patient satisfaction
scores and decreased ED waiting room times (CQuIPS-12-07)
Slide 24
Overview The Big Picture The Big Picture FY 2012 FY 2013 Budget
Request Recent Accomplishments Recent Accomplishments In the News
Impact Case Studies AHRQ Program Updates AHRQ Program Updates
Todays Agenda Todays Agenda
Slide 25
Web Site Redesign AHRQs Web site is one of the primary
communications channels between AHRQ and its audiences In 2009,
AHRQ conducted a focus group on the Web site and found that the
design, technology, and information architecture needed to be
updated In 2009, AHRQ conducted a focus group on the Web site and
found that the design, technology, and information architecture
needed to be updated In 2010, AHRQ refreshed the Home Page of
AHRQ.gov based on the focus group findings In 2010, AHRQ refreshed
the Home Page of AHRQ.gov based on the focus group findings
Evaluated current Web needs to identify the best process to manage
content and enhance users Evaluated current Web needs to identify
the best process to manage content and enhance usersexperience
Slide 26
Primary Navigation Labels: Health Information For Patients
& Consumers For Professionals For Policymakers Research &
Data Funding & Grants Centers, Portfolios & Initiatives
News & Events Utility Navigation Labels: Home About AHRQ FAQs
Site Map Contact Us Text size adjuster Proposed New Primary
Navigation Hands-on user testing conducted in May 2012 shows
overall improvement in locating content as compared with August
2011 usability study in same tasks.
Slide 27
Slide 28
Forthcoming Release of 2011 Employer Health Insurance Offerings
and Premiums AHRQs MEPS Insurance Component is an annual survey of
40,000 establishments providing national and State-level estimates
of employer sponsored health insurance coverage (ESI) AHRQs MEPS
Insurance Component is an annual survey of 40,000 establishments
providing national and State-level estimates of employer sponsored
health insurance coverage (ESI) Used to assess trends in health
insurance coverage, ESI, insurance take-up, eligibility for
subsidies Used to determine the small employer health insurance tax
credit (part of ACA) 2011 data release scheduled for this
month
Slide 29
Collaboration With the National Cancer Institute and CDC
Collaboration with AHRQ, NCI, CDC, American Cancer Society, and the
Livestrong Foundation Collaboration with AHRQ, NCI, CDC, American
Cancer Society, and the Livestrong Foundation Enhancing the Medical
Expenditure Panel Survey (MEPS) Content to Support Cancer
Survivorship Research Enhancing the Medical Expenditure Panel
Survey (MEPS) Content to Support Cancer Survivorship Research
Addition of questionnaire for households with cancer survivors to
address cancer treatment and quality of care measures for cancer
survivors and their families Addition of questionnaire for
households with cancer survivors to address cancer treatment and
quality of care measures for cancer survivors and their families
Enhanced sample of cancer survivors included in MEPS, 2011-2012
Enhanced sample of cancer survivors included in MEPS,
2011-2012
Slide 30
Patient Safety Organizations (PSOs) 75 current PSOs in the
United States and Washington, DC 75 current PSOs in the United
States and Washington, DC PSOs working with over 2000 U.S.
providers, including over 1,600 hospitals New PSOs include a
component of the American College of Physicians Common Formats (CF)
Update: Common Formats (CF) Update: Beta version of Readmissions CF
to be published Summer 2012 Coordinating Readmissions CF pilot test
in the Veterans Administration hospital system in July 2012 The
Office of the National Coordinator sponsoring Purple Button
Challenge Award The Office of the National Coordinator sponsoring
Purple Button Challenge Award Calls for development of an
application to enhance patient safety event reporting using Common
Formats
Slide 31
2012 TeamSTEPPS Collaborative Meeting 6 th Annual TeamSTEPPS
National Conference: From What? to How? 6 th Annual TeamSTEPPS
National Conference: From What? to How? June 2012, Nashville,TN
Unprecedented number of new attendees Many affiliated with a
Hospital Engagement Network Shared best practices to promote
executive leadership engagement for TeamSTEPPS Previewed upcoming
modules: Long-Term Care, Primary Care, Limited English
Proficiency
Slide 32
Healthcare-Associated Infections Agency Priority Goal (HAI-APG)
Collaborative, cross-departmental effort: AHRQ, CMS (lead), CDC,
and OASH Collaborative, cross-departmental effort: AHRQ, CMS
(lead), CDC, and OASH HAI-APG: 1 of 6 HHS APGs being tracked by HHS
and OMB Goals: Reduce hospital-acquired CLABSI and CAUTI by
September 30, 2013 (with respect to 2010 baseline levels) Goals:
Reduce hospital-acquired CLABSI and CAUTI by September 30, 2013
(with respect to 2010 baseline levels) CAUTI by 20% CLABSI by 25%
Final project results due in September 2012 Final project results
due in September 2012
Slide 33
Uniformed Services University of Health Sciences (USUHS) Pilot
graduate-level course titled Patient Safety & Quality in an
IT-driven World Pilot graduate-level course titled Patient Safety
& Quality in an IT-driven World Novel partnership for USUHS and
AHRQ Novel partnership for USUHS and AHRQ Content explored
theoretical underpinnings and applications of patient safety and
health IT legislation and initiatives Content explored theoretical
underpinnings and applications of patient safety and health IT
legislation and initiatives
Slide 34
Organisation for Economic Co-operation and Development (OECD)
OECD is using AHRQ Quality Indicators for its Health at a Glance
program tracks and compares health and health care across member
countries OECD is using AHRQ Quality Indicators for its Health at a
Glance program tracks and compares health and health care across
member countries Patient Safety Indicators Preventable Quality
Indicators for reporting on potentially preventable hospitalization
rates *AHRQs HCUP/NHQR teams provide the U.S. statistics to
OECD.
Slide 35
AHRQ Research Makes Health Affairs Top Ten List #2 New Federal
Policy Initiatives To Boost Health Literacy Can Help The Nation
Move Beyond The Cycle Of Costly Crisis Care (authors include AHRQs
Carolyn Clancy and Cindy Brach, January 2012) #9 An Experiment
Shows That A Well-Designed Report On Costs And Quality Can Help
Consumers Choose High-Value Health Care (Judith Hibbard, et al,
March 2012) Top 10 "Most-Read Articles January-June 2012
Slide 36
New Public Portal on Integration of Behavioral Health &
Primary Care integrationacademy.ahrq.gov
integrationacademy.ahrq.gov
Slide 37
New Self Management Support Resources
Slide 38
Update From the U.S. Preventive Services Task Force Five final
recommendations released since last NAC meeting Five final
recommendations released since last NAC meeting Counseling to
Prevent Skin Cancer (May 8) Screening for Prostate Cancer (May 22)
Interventions to Prevent Falls in Community-dwelling Older Adults
(May 29) Screening for and Management of Obesity in Adults (June
26) Behavioral Counseling to Promote a Healthful Diet and Physical
Activity for CVD Prevention in Adults (June 26) Five draft
recommendations posted for public comment since last NAC meeting
Five draft recommendations posted for public comment since last NAC
meeting
Slide 39
New Materials for Consumers
Slide 40
Additional indicators and health topics 4 additional AHRQ QIs,
including composite measures 4 additional AHRQ QIs, including
composite measures 12 additional Hospital Compare measures 12
additional Hospital Compare measures New health topic on nursing
sensitive care New health topic on nursing sensitive care New
customization options Updated coding changes and new technical
design features HCUP cost-to-charge ratios convert charges to costs
HCUP cost-to-charge ratios convert charges to costs MONAHRQ New
Version 3.0
Slide 41
New Materials for Clinicians
Slide 42
Guides independent pharmacies through the process of adopting
e-prescribing Guides independent pharmacies through the process of
adopting e-prescribing Illustrates how to assess pharmacy workflows
to determine whether changes or updates are needed to a pharmacy
software system Illustrates how to assess pharmacy workflows to
determine whether changes or updates are needed to a pharmacy
software system Discusses hurdles and problems that can arise when
implementing e-prescribing Discusses hurdles and problems that can
arise when implementing e-prescribing A Toolset for E-Prescribing
Implementation in Independent Pharmacies
Slide 43
A Toolset for E-Prescribing Implementation in Physician Offices
Designed for small, independent offices to large medical groups
Designed for small, independent offices to large medical groups
Supports implementation of e- prescribing, whether as a stand-
alone system or as a component of a full EHR Supports
implementation of e- prescribing, whether as a stand- alone system
or as a component of a full EHR Useful for providers who have not
achieved the full potential of their current e-prescribing system
Useful for providers who have not achieved the full potential of
their current e-prescribing system Both available at:
http://healthit.ahrq.gov/eprescribingtoolsets
Slide 44
Enabling Patient-Centered Care Through Health Information
Technology EPC Report While Health IT was shown to improve
outcomes, few studies demonstrated impact on patient-centered care
(as defined by the IOM) While Health IT was shown to improve
outcomes, few studies demonstrated impact on patient-centered care
(as defined by the IOM) 14 studies focused on improving
responsiveness to the needs and preferences of individual patients
25 studies focused on improving shared decisionmaking or related
measures of patient- clinician communication or access to
information Available at
http://www.ahrq.gov/clinic/tp/pcchittp.htm
Slide 45
Using Health IT in Workflow Redesign: Impact of Health IT on
Workflow Two ACTION II task orders awarded Two ACTION II task
orders awarded Study implementation of health IT to support
practice redesign in ambulatory care settings Further understand
causal relationships between health IT and workflow processes
Billings Clinic Billings Clinic Three practices from Billings
Clinic (Billings, MT) and Cabin Creek Health Systems (Dawes, WV),
each Time and motion studies, observations, software logs, and
interviews to study pre, during, and post implementation RTI RTI
Six practices at different stages of implementing MyHealthTeam to
support care coordination Observations, interviews, software
tracking, and review of outcomes
Slide 46
Project ECHO Funded by AHRQ in 2004; subsequent funding from
RWJF and now CMMI Funded by AHRQ in 2004; subsequent funding from
RWJF and now CMMI Results published in NEJM last year: Results
published in NEJM last year: Reduced rural disparities in care
Improved provider satisfaction Adopted by the Veterans Health
Administration 7/11/12 Adopted by the Veterans Health
Administration 7/11/12
Slide 47
Electronic Data Methods (EDM) Forum ARRA grant to AcademyHealth
to convene PROSPECT, DRN, and enhanced registry (for QI and CER)
investigators and other stakeholders to: ARRA grant to
AcademyHealth to convene PROSPECT, DRN, and enhanced registry (for
QI and CER) investigators and other stakeholders to: Collect,
synthesize, and share lessons learned in building an electronic
data infrastructure for CER Advance methods to overcome common
barriers in CER analytics, informatics, and governance Disseminate
knowledge through electronic documents and Webinars posted at
www.edm- forum.org and articles in journal supplements Disseminate
knowledge through electronic documents and Webinars posted at
www.edm- forum.org and articles in journal supplementswww.edm-
forum.orgwww.edm- forum.org
Slide 48
First Journal Supplement 14 commissioned and invited papers 14
commissioned and invited papers Informed by ongoing ARRA-funded
work Informed by ongoing ARRA-funded work Three domains: Three
domains: Analytic Methods Clinical Informatics Governance Available
at www.edm-forum.org Available at www.edm-forum.org
www.edm-forum.org
Slide 49
Ongoing Activities Working on a JAMIA journal supplement
Working on a JAMIA journal supplement Symposia, Webinars, and issue
briefs Symposia, Webinars, and issue briefs eGEMS: electronic
publications Generating Evidence and Methods (to improve outcomes)
eGEMS: electronic publications Generating Evidence and Methods (to
improve outcomes) New publication avenue starting in August Diverse
products: original articles, protocols and best practices,
conceptual frameworks, data visualizations, white papers,
tutorials, continuing education tools Timely, useful, credible
content
Slide 50
EDM Forum Consultants Mike Stoto, Wade Aubry, Jonathan Nebeker,
Neil Sarkar Steering Committee Chair: Ned Calonge Subcommittees:
Analytic Methods, Clinical Informatics, Data Governance EDM Forum:
EDM Forum: Organizational Chart
Slide 51
Recently Released Translation Products ADHD in Children ADHD in
Children ANA and RF tests for Musculoskeletal Complaints in
Children ANA and RF tests for Musculoskeletal Complaints in
Children Chronic Pelvic Pain Chronic Pelvic Pain Mechanical
Thrombectomy Mechanical Thrombectomy Pain Management in Hip
Fracture Pain Management in Hip Fracture Preventing Fractures in
Low Bone Density Preventing Fractures in Low Bone Density Urinary
Incontinence in Women Urinary Incontinence in Women
Slide 52
2012 AHRQ Annual Conference September 9-11, 2012 September
9-11, 2012 Bethesda North Marriott Hotel and Conference Center
Bethesda North Marriott Hotel and Conference Center
Slide 53
2012 AHRQ Annual Conference General Schedule General Schedule
Sunday, September 9 closed meetings Monday, September 10 open
sessions all day and mAHRQet Place Caf with posters and AHRQ table
top exhibits Tuesday, September 11 open sessions 10:00 am 12:00 pm
Tuesday, September 11 open sessions 10:00 am 12:00 pm Two Plenary
Sessions Two Plenary Sessions September 9, 4:30 5:30 Carolyn Clancy
Unplugged: A Conversation about the Research September 9, 4:30 5:30
Carolyn Clancy Unplugged: A Conversation about the Research
September 11, 10:00 12:00 Engagement and Use: Making Health Care
More Patient-Centered, Reliable and Safe Carolyn Clancy, MD, MACP
Carolyn Clancy, MD, MACP Reed Tuckson, MD, FACP, Executive Vice
President and Chief of Medical Affairs, UnitedHealth Group Reed
Tuckson, MD, FACP, Executive Vice President and Chief of Medical
Affairs, UnitedHealth Group
Slide 54
Todays Agenda Directors Update Directors Update Health Care
Costs Health Care Costs Public Comment Public Comment Lunch Lunch
Executive Session Ambulatory Care Safety Ambulatory Care Safety
Public Comment Public Comment Chairmans Wrap-up Chairmans
Wrap-up