eValue8

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eValue8

• A Quality Improvement Process for Healthcare

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eValue8 So whats up today?

• An estimated 30 waste of healthcare resources
  costing over 600 Billion per year or an
  additional 2,000 PEPY
• Avoidable hospital deaths approaching 100,000 at
  an additional cost of up to 29 Billion
• Doctors provide appropriate care only about half
  of the time

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eValue8 So, Toyotas are good?

• If US Healthcare was an automobile, which one
  would it be?
• 2006 Lexus
• 1996 Honda
• 1976 Plymouth (for this exercise make believe
  that this car still exists)

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eValue8 So, why Toyota?

• W. E. Deming, Statistician,
• Quality equals Value to the customer
• Value Improvement is achieved through
• Process Evaluation
• Defect Prevention
• Measurement
• Improving suppliers
• Universal responsibility for process quality,
• Value Improvement leads to
• lower cost and higher customer outcomes.

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eValue8 So, what is it?

• eValue8 is
• A health plan evaluation process
• A measurement system by which all plans can be
  continually compared with an eye on continuous
  quality and value improvement
• A vehicle that enables many employers to join as
  one voice, leverage their collective influence
  and steer health plans toward these employers
  collectively desired outcomes

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eValue8 So, what is it, really?

• One monster of a questionnaire that asks
• How is the health plan improving quality of care?
• Prevention and Health Promotion?
• Consumer Engagement and Support?
• Health Information Technology?
• Disease Management Initiatives?
• Provider Management and Incentives?
• Pharmaceutical Management?
• Behavioral Care Management
• Administration, Operations and Accreditation

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eValue8 So, what about results?

• Results are used to
• rank each plan against the best in class,
• identify strengths and opportunities for
  continuous improvement, and
• increase the employers understanding of the
  health plans value proposition...
• beyond network discounts, low premiums

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eValue8 So, what?

• The cost of poor quality healthcare? We cant
  afford it!
• 380,000,000 X 30 114,000,000
• Annually!
• Employers have been disconnected from the actual
  purchase process and the care providers
• Traditionally health plans were concerned with
  expanding provider networks and increasing
  discounts not provider quality
• The eValue8 process connects employers to the
  quality process by holding the plans accountable
  for provider improvement and their own quality
  initiatives

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eValue8 So why trust it?

• Developed by NBCH
• for a group of 8 flagship companies
• with the help of CDC, CMS, SAMHSA, AHRQ, NCQA,
  JCAHO, URAC, Leap Frog and a some smart guys at
  PSU and GWU
• Now used by 15 Health Coalitions and more than 80
  large employers
• 130 Health Plans were evaluated in 2006

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eValue8 So how is it working?

• There are numerous and significant success
  stories across the nation in Minnesota, New York,
  Tennessee and other states
• Achievement include local and state initiatives
  in healthcare quality resulting directly form the
  eValue8 process
• Coalitions have adopted uniform RFIs
  incorporating the eValue8 tool

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eValue8 So, what do you get?

• A turn-key, validated, comprehensive and
  leveraged tool to influence health plans to
  improve the quality of their organizations and
  their contracted providers
• An enlarged, transparent and uniformly measured
  value proposition at RFP time
• A blue print to develop and measure impactful
  health plan performance guarantees
• A loudspeaker to our plans and healthcare
  providers that employers can shout in together.

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eValue8 So, whats up in VA?

• eValue8 was used to evaluate nine Health Plans in
  Virginia in 2006
• Anthem PPO and HMO
• Cigna HMO
• United HMO
• Optima HMO and PPO
• Care First
• Aetna Mid-Atlantic HMO
• Kaiser HMO

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eValue8 So, whats up in VA?

• The results were discussed with the participating
  plans this summer (except Anthem declined to
  meet)
• Sponsoring employers have reviewed the results
  and have begun identifying strengths (harder) and
  opportunities to improve (easier) for their plans
• The eValue8 committee and VBCH will coordinate
  submission of several opportunities to the plans
  for consideration
• One participating plan has already requested
  eValue8 results which they will use to plan
  future activities and priorities and get ready
  for eValue8 2007

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eValue8 So, hop on board?

• Not happy with todays healthcare situation?
• eValue8 is here and may be the best chance your
  company has to start making a difference
• The eValue8 train is on track and rolling towards
  2007 when we will evaluate the plans again to see
  how they have listened and improved
• So hop on board today!