Utah Partnership for Value. September 19, 2013 HealthInsight
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1 Utah Partnership for Value September 19, 2013 HealthInsight
2 Welcome and Introductions Slides available at:
3 Regional Collaboratives (22) Principles: 1. Local 2. Multi-stakeholder (4 Ps) Utah Partnership for Value Areas of Focus 1. Delivery System Reform 2. Transparency 3. Efficiency/Value
4 UPV Steering Committee ~100 members Meets quarterly, considers and directs topics/areas for focus/work Delivery System: Medical Home Standards (monthly) Delivery System: Medical Home HIE/Care Coordination (monthly) Transparency: Reporting Task Force (monthly-quarterly) 2008-present Efficiency: Choosing Wisely Utah (quarterly) Intermountain UDOH UAFP UAHC and UHPCO Iasis Healthcare Sanofi Aventis University of Utah AUCH Medicaid UHIN Arches St. Marks Family Med Coalville Health Center St. Mark's Family Medicine U of U/Inception Avalon Healthcare VA Smiths Pharmacy UofU Pediatrics UHIN ARUP Harmony Home Health UofU Internal Medicine UofU Social Work UHIN Wellness Policy Network AARP Altius Health Plans ARUP AUCH UofU DFPM HCA HQ Catalyst Intermountain Healthcare Intermountain Medical Center UDOH University of Utah Utah Department of Insurance Utah Medical Association Wasatch Pediatrics UofU Dept of Family Medicine Intermountain Cardiology Intermountain Quality Council Intermountain Radiology PEHP UAFP UMA Utah Emergency Medicine AARP
5 Choosing Wisely is an initiative of the ABIM Foundation to help physicians and patients engage in conversations about the overuse of tests and procedures and support physician efforts to help patients make smart and effective care choices.
6 Key Players ABIM RWJF Funding agencies Recommendation list and consumer material development Medical Societies Consumer Reports Regional Collaboratives (10) Choosing Wisely Utah Ground game: Local campaigns Advisory Board
7
8 Choosing Wisely in the Media
9 Choosing Wisely The Current Buzz: Utah Business article, July 2013 PEHP provider newsletter, September 2013 UMA Bulletin August/September 2013 PSAs to air in October For more information:
10 Chaos Behind a Veil of Secrecy Healthcare Price Transparency II Clare Tobin Lence, Kimberly Mueller, HealthInsight Wu Xu, Norm Thurston, Utah Department of Health Utah Partnership for Value September 19, 2013
11 Last time Time Magazine s Bitter Pill CMS hospital chargemaster data Charges, not amount paid Senate Finance Committee hearing S. 1180: Medicare Data Access for Transparency and Accountability Act Local press in the Salt Lake Tribune
12 New Public Discussion: In the News Hospital charges bear little relationship to the quality of the care, study says, The Washington Post and Castlight Health How to Charge $546 for Six Liters of Saltwater, The New York Times The Cure for the $1,000 Toothbrush, The New York Times blog Finding the Best Price for a Medical Procedure, KSL
13 New Public Discussion: Around Access to Claims Data CMS accepted comments on the possibility of releasing Medicare claims data for individual physicians Following a lawsuit by Dow Jones/The Wall Street Journal, a 1979 injunction was removed 1980 CMS policy against release is still in place Comment period ended Sept. 6 th
14 New Public Discussion: Among Physicians Views of US Physicians About Controlling Health Care Costs, Journal of the American Medical Association (JAMA) Will Physicians Lead on Controlling Health Care Costs? JAMA American College of Physician Executives sounding board
15 New Public Discussion: From Private Providers Surgery Center of Oklahoma Central Utah Clinic
16 What are other states doing? Transparency Report Card
17 What are other states doing? North Carolina August 2013, passed legislation to publish the prices of the most common hospital services Medicare, Medicaid and the five largest private insurers Will also publish hospital policies on charity care
18 What are other states doing? New Hampshire -
19 What are other states doing? New Hampshire -
20 What are other states doing? Massachusetts -
21 What are other states doing? Massachusetts -
22 What are other states doing? Massachusetts -
23 What are other APCDs doing? Maine HealthCost -
24 What are other APCDs doing? Maine HealthCost -
25 What are other APCDs doing? Colorado CIVHC -
26 What are other APCDs doing? Colorado CIVHC -
27 What are other APCDs doing? Colorado CIVHC -
28 What s New about APCD? New Director for OHCS Dr. Norm Thurston New Data Management & Report Vendor Treo Solutions, Inc. (09/ /2018) New Possible Funding the CMS Insurance Rate Review Cycle III grant (10/ /2015) 9/19/ <#>
29 Treo s Year 1 Timeline No Future Distribution of this Slide Without OHCS Permission. 9/19/ <#>
30 Ten APCD Data Products (Extracts) Normalized Raw Data Enhanced Data UDI Risk Adjustment Data /19/2013 Total Cost of Care Aggregated Data Files Similar to CO APCD public website ( SQL Access & Access Treo BI Tools & Consumer Price/Cost Data Files To Be Designed 21 Five HEDIS claim-based measures De-identified Public Use Files Three CRGbased Episodes of Care Public Health Reporting Files <#>
31 How Can UPV-RTF Help? Bring all interested parties to the table Continuously recommend standardized quality and cost measures Prioritize the measures based on impact and resources 2013 Deliverables 9/19/2013 Finalize the list of HEDIS claim-based measures Define one episode of care measure for one chronic disease in #8 22 <#>
32 Proposed Utah Healthcare Data Center in the Cycle III Grant (State Funded) (Cycle III Funded) (Cycle III Funded) (Cycle III Funded) (State Funded) Processing Raw Data & Validation APCD Data Warehouse & Tools Quality Assurance HealthScape (Portal) Consumers o Public Providers o Internal New Analytic Data Elements IBIS-PH Editing, Linking, and Data Enhancement Data Transfer Audit Assign Master Person/Provider Indices Grouper Derived Elements Linkage to Other Data Sources: Hospital Discharge Database Emergency Department Database Ambulatory Surgery Database Validation/Review Communities o Geography Policy Makers Public Health Researchers OHCS Special Reports o Payers Researchers UID Standard Reporting Data/App Special Reports & Research Use Insurance Transparency Fee Schedule <#>
33 UPV s Role in Cycle III Bring all stakeholders together to plan and develop the uses of APCD Need a realistic analytic roadmap Data uses drive what to produce first Data suppliers active participation is the key success factor for Year 1 The quality of Treo s deliveries depend on the quality of payers data How can we make this win-win-win for payers, APCD and UPV? 24 9/19/2013 <#>
34 Expansion of Nurse Practitioner Services and Access to Care September 2013 Utah Action Coalition for Health Initiative
35 Medicaid Coverage and Reimbursement Barriers to NP Services Medicaid presently only covers Family and Pediatric NP services. Medicaid reimbursement policy requires NPs to bill through a supervising physician, which is not supported in Utah licensure rules.
36 Recommended New Policy for NPs Allow all NPs to bill Medicaid, including Psychiatric/Mental Health, Geriatric, and Women s Health NPs. Remove restrictive policy requirements, such as a collaborating physician for immediate referral of problem cases.
37 NPs AND ACCESS TO PRIMARY CARE IN UTAH There are already problems with access to primary care, particularly in Utah s rural areas. Health Professional Shortage Areas are particularly acute in the rural areas. Implementation of the Affordable Care Act, and the associated Medicaid expansion, would likely result in even greater primary care shortages. NPs are uniquely positioned to provide access to primary care for Utah s most vulnerable citizens.
38 NPs and Health Professional Shortage Areas According to data from the Utah Medical Education Council, expansion of the number of NPs in the rural areas, would reduce the health professional shortages, particularly in Carbon, Emery, Kane, Tooele, Rich, Morgan, Box Elder, Uintah, Daggett, and San Juan counties (less than 1 MD per 3,000 people). There are presently 632 Family and Pediatric NPs in the urban areas and 26 Family and Pediatric NPs in the rural areas. Expanding the pool to all NPs would increase the number of practitioners by 272 in the urban areas and 9 in the rural areas.
39 Utah Action Coalition for Health Project Coordinator Joan M. Gallegos, RN, CSW, HealthInsight Phone:
40 Text Polling How To Cell phone with SMS text Open your messaging feature Send to: Enter the answer to the poll Push send
41 A visual representation
42 Wrap up and Next Steps Governors Summit, September 26th Workgroup Meetings: Standards and Measures, Oct. 9 th 4-6pm HIE, Oct. 15 th 4-6pm Reporting Task Force, Oct. 15 th 1-2:30pm Choosing Wisely, Nov. 7 th 4-6pm Quarterly Meeting: December 19 th, 4-6pm
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