In Pursuit of Value. Physician Price and Quality Transparency. Christopher Queram. President / CEO WCHQ. December 3, 2013
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1 In Pursuit of Value Physician Price and Quality Transparency Christopher Queram President / CEO WCHQ December 3, 2013 Wisconsin Collaborative for Healthcare Quality 1
2 Presentation Objectives Describe the inherent tension between national and state quality eco-systems Introduce the Wisconsin Measures Alignment Project Identify the barriers to achieving success Wisconsin Collaborative for Healthcare Quality 2
3 National Quality Ecosystem in 2013 Pharmacy Quality Alliance AMA PCPI AHIP MAP IHI Surgical Quality Alliance Joint Commission NCQA PQRS Choosing Wisely QASC NQF CVEs 1M AHRQ Public Private Multi-Stakeholder Nursing Quality Alliance AQA HHS Partnership for Patients IHI Meaningful Use NPP CMMI RWJ Professional Societies / Boards Wisconsin Collaborative for Healthcare Quality 3
4 Wisconsin Quality Ecosystem in 2013 WCHQ WHIO WI Health Insurance Interchange RWHC WITECH Quality Counts Wisconsin Health Reports WISHIN WPHCA WHA PricePoint PHPR WHA ETF Public Private Multi-Stakeholder DHS AF4Q Wisconsin Medical Society Wisconsin Collaborative for Healthcare Quality 5
5 Dynamic Federalism: Balancing National & Local Quality Ecosystems CMS Partnership for Patients WCHQ WISHIN Leapfrog HHS Local WHA MU WHIO WMS PQRS National PHPR SVC 1M WIMAP 3
6 Leveraging Wisconsin s Assets... Robust multi-stakeholder quality ecosystem with long track record of accomplishment Healthcare market oriented toward multi-specialty group practice and integrated systems Engaged and motivated clinical leaders Culture of collaboration and innovation Wisconsin Collaborative for Healthcare Quality 6
7 Wisconsin Measures Alignment Project Over-arching goal: To identify a common measure set to accelerate progress in achieving a highreliability, high-value healthcare system in Wisconsin Consensus-driven process Multi-stakeholder composition 17 initial performance measures Wisconsin Collaborative for Healthcare Quality 7
8 Selected State Initiatives WCHQ - Wisconsin Collaborative for Healthcare Quality WHIO - Wisconsin Health Information Organization Wisconsin Collaborative for Healthcare Quality 8
9 The WCHQ Mission Wisconsin Collaborative for Healthcare Quality We publicly report and bring meaning to performance measurement information that improves the quality and affordability of healthcare in Wisconsin, in turn improving the health of individuals and communities. Wisconsin Collaborative for Healthcare Quality 9
10 WCHQ Member Organizations Wisconsin health systems, physician groups, and hospitals Representing approximately 65% of Wisconsin primary care physicians Agnesian HealthCare Associated Physicians Aspirus Aurora Health Care Bellin Health Columbia St. Mary s Dean Clinic / St. Mary s Hospital Fort HealthCare Froedtert Health Group Health Cooperative of South Central Wisconsin Gundersen Health System Holy Family Memorial Integrity Health Network Marshfield Clinic Mayo Clinic Health System: Eau Claire & La Crosse Medical College of Wisconsin Mercy Health System Meriter Health Services Ministry Saint Joseph s Hospital Monroe Clinic Physicians Health Network Prairie Clinic Prevea Health ProHealth Care QuadMed Richland Medical Center Sacred Heart Hospital Sauk Prairie Memorial Hospital & Clinics Sixteenth Street Community Health Centers ThedaCare UW Health Wheaton Franciscan Healthcare Wildwood Family Clinic Wisconsin Collaborative for Healthcare Quality 10
11 WCHQ Stakeholders These healthcare purchasers and organizations collaborate with WCHQ: AARP Wisconsin American Cancer Society Business Health Care Group Coalition of Wisconsin Aging Groups GE Healthcare Greater Milwaukee Business Foundation on Health HOPE of Wisconsin MetaStar Robert Wood Johnson Foundation Survey of the Health of Wisconsin The Alliance The Center for Patient Partnerships The Commonwealth Fund ThedaCare Center for Healthcare Value UW Center for Nonprofits UW Health Innovation Program UW Population Health Institute WEA Trust Webcrafters, Inc. Wisconsin Dept. of Employee Trust Funds Wisconsin Department of Health Services Wisconsin Health Information Organization Wisconsin Hospital Association Wisconsin Manufacturers & Commerce Wisconsin Medical Society Wisconsin Primary Health Care Association Wisconsin Collaborative for Healthcare Quality 11
12 WHIO: Wisconsin Health Information Organization Mission WHIO is a voluntary initiative supported by visionary leaders from insurance companies, health care providers, major employers and public agencies who share a commitment to the future of health care. Health Analytics Exchange Contains more than 247 million claims totaling $67.5 billion for care provided to 3.4 million Wisconsin residents Updated semiannually, holds a rolling 27 months of claims data and a total of 23.9 million episodes of care Wisconsin Collaborative for Healthcare Quality 12
13 WHIO Membership Anthem Blue Cross Blue Shield of WI Humana United Healthcare of WI WEA Trust WPS Health Insurance The Alliance Greater Milwaukee Business Foundation on Health Wisconsin Collaborative for Healthcare Quality Wisconsin Dept. of Health Services Wisconsin Dept. of Employee Trust Funds Wisconsin Hospital Association Wisconsin Medical Society Dean Health Plan Group Health Cooperative of South Central Wisconsin Gundersen Lutheran Health Plan Health Tradition Health Plan MercyCare Insurance Co. Network Health Plan Physicians Plus Insurance Corp. Security Health Plan Unity Health Plan Wisconsin Collaborative for Healthcare Quality 13
14 The Holy Grail Pneumonia Care Charges and Quality Comparison 14
15 Potholes on the Road to Value Fundamentally different databases Missing data elements Competition for bandwidth Political will Wisconsin Collaborative for Healthcare Quality 15
16 Chris Queram President/CEO Wisconsin Collaborative for Healthcare Quality Wisconsin Collaborative for Healthcare Quality 16
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