The National Movement Towards Improved Disclosure

1
The National Movement Towards Improved
Disclosure Transparency

• Consumer-Purchaser Disclosure Project

United States Chamber of Commerce
2
Why Improved Disclosure is a High Priority

• Lives and economic vitality at stake
• Robust initial set of measures is key
• If you cant measure it, you cant improve it
• If you cant assess value, you cant reward it

3
Benefit Design Trends Demand Vastly Improved
Transparency

• 8 in 10 employers somewhat or extremely
  comfortable having employees take more
  responsibility in selecting
• Plans 81
• Coverage levels 81
• Providers 81
• Services/treatments 83
• Source Hewitt Associates Health Care
  Highlights, Feb. 2003

4
Leading Edge EffortsThe National Quality Forum

• Created in response to the Presidents Commission
  on Health Care Quality
• Multi-stakeholder, membership organization,
  consensus-based process
• Board plus 4 Councils
• Activities to date
• Never Events
• Hospitals (measures and safe practices)
• Nursing Homes
• Nursing Care

5
Leading Edge Efforts

• IOM
• JCAHO
• CMS
• AHA/FAH
• Premier
• HCAHPS
• Nursing homes
• Doctor Office Quality

6
Leading Edge Efforts

• NCQA
• States
• Local/regional business coalitions
• The Leapfrog Group

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The Leapfrog Group Safe Practices

• Three hospital leaps
• CPOE
• ICU staffing
• Volume-based referral
• What are they worth annually?
• 522,000 serious medication errors
• 58,300 preventable deaths
• 58,300 X disabilities
• 9.6 billion
• (If fully implemented in urban hospitals)

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Are We In Danger of Loving the Concept to Death
9
National Standards Essential

• Comparability across markets
• Credibility
• Reporting burden
• Economies of scale and leverage

10
Consumer-Purchaser Disclosure ProjectUniting the
Buy Side of the Market

• More than 60 consumer and purchasing
  organizations
• Change agent working through NQF and other bodies
  to act as a catalyst to speed up measurement
  development and implementation in various areas
• By January 1, 2007, Americans will be able to
  select hospitals, physicians, physician
  groups/delivery systems and treatments based on
  public reporting of nationally standardized
  measures for clinical quality, consumer
  experience, equity and efficiency.

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Consumer-Purchaser Disclosure Project

• RWJF and The Leapfrog Group Project Sponsors
• National Partnership for Women Families
  Project Host
• Participating Consumer, Purchaser and Labor
  Organizations
• 3M March of Dimes
• AARP Midwest Business Group on Health
• AFL-CIO Motorola
• American Benefits Council National Association
  of Manufacturers
• Buyers Health Care Action Group National Black
  Womens Health Project
• Carlson Companies National Business Coalition
  on Health
• California Healthcare Foundation National
  Citizens Coalition for Nursing Home Reform
• Consumer Coalition for Quality Healthcare National
  Partnership for Women and Families
• DuPont (invited) National Breast Cancer
  Coalition
• Employee Benefits Research Institute Niagara
  Health Care Quality Coalition
• Employer Health Care Alliance Coop. Pacific
  Business Group on Health
• ERISA Industry Committee The Robert Wood Johnson
  Foundation
• Ford Motor Company State Medicaid Directors
  Association
• Foundation for Accountability (invited) Union
  Pacific Railroad
• General Motors U.S. Chamber of Commerce
• The Leapfrog Group Washington Business Group on
  Health

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Full Dashboard for Chasm Crossing
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Our Approach to Measure Development
Implementation

• Collaborate with measure developers
• CMS, AHA, AHRQ, NCQA, JCAHO, others
• Seek consensus on breadth and content of
  measurement set
• Advance measures through NQF for consensus
  approval
• Develop rapid implementation strategy with key
  partners

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Meaningful Progress

• QuIC
• Comprehensive
• measure matrix

• NCQA
• HEDIS

• CMS/AHA/FAH JCAHO Demo
• 10 ORYX
• measures
• 3 sites

• Leapfrog
• 3 leaps
• Additional under
• development

• NQF Measurement Sets
• Hospital Measures
• Safe Practices
• Nursing Home Measures
• Cancer (beginning)

• CMS
• Nursing homes

• CMS/AHRQ
• HCAHPS

• CMS/NCQA/
• AHRQ
• Doctor Office
• Quality

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Implementation Two Related Tracks

• Voluntary track
• Leverage National Quality Forum and other related
  efforts to facilitate consensus-based adoption
  and implementation of national standards for
  performance reporting
• Regulatory track
• Explore regulatory approaches through work with
  government agencies and accreditation bodies,
  e.g. Medicare Conditions of Participation
  licensing and accreditation CMS Nursing Home
  Initiative
• Complementary approaches

16
Employers Expressing Growing Support for
Government Role

• 83 support mandated quality reporting
• 62 support requiring providers to publicly
  disclose price
• 61 support mandating uniform provider data and
  payment reporting procedures
• Source Hewitt Associates

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Ideas for Dissemination and Implementation

• Benefit design/tiered networks
• Report cards for consumers
• Provider mandates to report
• Measures set a regulatory floor for
  participation in public programs
• Data sharing a condition for network
  participation
• Use the bully pulpit

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Consumer-Purchaser Disclosure Project
Priorities for 2003

• Hospital measures
• Physician measures
• Cross-Cutting Support for the Disclosure Goal
• Shared vision and measurement matrix
• Make disclosure core to Medicare debate

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For More Information

• Consumer/Purchaser Disclosure Project
• Steve Wetzell, Strategic Director
• [phone]
• Email swetzell_at_msn.com
• The Leapfrog Group
• Suzanne Delbanco, Executive Director
• Web site leapfroggroup.org
• [phone]
• Email sdelbanco_at_leapfroggroup.org
• The National Quality Forum
• Web site qualityforum.org
• [phone]
• Email info_at_qualityforum.org