HCQCC: Roadmap to Cost Containment Project Focus and Structure

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HCQCC Roadmap to Cost ContainmentProject Focus
and Structure

• January 21, 2009

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Project Focus

• Provide Council members with an in-depth
  understanding of health care cost trends and
  potential strategies to contain costs
• Establish baseline of state health care spending
  and likely trend without intervention
• Develop principles and criteria through which
  potential cost containment strategies should be
  reviewed
• Build consensus among Council members
• Be concrete about what the strategies are, and
  what they will mean in practice
• Explain the multiple levels of cost-containment
  strategies
• Narrow strategies for consideration only after
  robust discussion, including feedback from the
  stakeholder engagement process
• Clearly articulate advice or action needed from
  the Council
• Have a robust stakeholder engagement process,
  including ongoing meetings with
• Councils Advisory Group
• Stakeholder Groups

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Project Focus

• Deliverables
• Initial brief on Principles and Criteria through
  which cost containment strategies should be
  reviewed, for release by Council
• Draft and Final Roadmap Report
• Report will include
• Review of selected initiatives impact on health
  care system as whole and individual stakeholder
  groups steps towards implementation and how to
  address barriers to success
• Integrated cost containment strategy that
  combines a number of initiative, contain multiple
  levels of strategies and provides a cohesive
  strategy for staged implementation

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Project Structure

• Devote 90 minutes per Council meeting to Roadmap
  work
• Agenda items to focus on particular types of
  strategies (e.g., delivery system reform update
  from Payment Commission, etc.)
• As appropriate and feasible, bring local or
  national experts to Council meeting to make
  presentations
• Cost Containment Committee of Council will meet
  once per month (90 minutes per meeting)
• More detailed discussions of strategies than at
  Council meetings
• May further review topic brought to Council to
  obtain more detailed information or understanding
  of a potential strategy
• Bailit, and any interested Committee members,
  will meet with Advisory Groups and stakeholders
  throughout the process
• Educate regarding specific meaning of cost
  containment strategies
• Obtain clear feedback on key success factors and
  barriers to implementation

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Highlights of Detailed Work Plan

• Phase One a) Understand baseline health care
  spending and likely trend without intervention,
  b)Understand potential cost containment
  strategies, c) gain consensus from the Council on
  principles and criteria with which to consider
  strategies and what initiatives are most
  imperative to put forward, and d) begin to engage
  stakeholders in the process so that they can
  inform and influence the outcome.
• Phase Two Develop fuller understanding of the
  implications of preliminary recommended
  initiatives to identify implementation success
  factors. A particular focus in this phase will
  be discussions with stakeholders that can affect
  change in system and working with them to assess
  ability to implement particular strategies.
• Phase Three Bring recommendations together in a
  document that provides a Roadmap for the state to
  meet desired cost containment goals, including a
  timeline for implementation and recommendation of
  responsible actor(s) for successful
  implementation of each strategy.

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Defining the Problem

• The goal of the Roadmap, as originally conceived
  by the Council, is to develop a cohesive set of
  strategies to reduce health care cost growth to
  GDP by 2012.
• HCFP plans to do presentation of baseline trends
  at the 2/4/09 Cost Containment Committee meeting
• Discussion What are the barriers to meeting this
  goal?

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Principles for Cost Containment Strategies

• Next Step Discuss principles to be utilized in
  selecting strategies.
• High-level principles may require that selected
  strategies
• focus across the health care system
• are complementary
• Include a balance of shorter, mid and long-term
  initiatives
• taken together, have a strong probability of
  achieving targeted cost containment goals
• have success factors that are within control of
  the state or state players

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Criteria for Cost Containment Strategies

• Criteria are the metrics by which to evaluate
  whether selected strategies address the goals or
  principles of the Council.
• Potential criteria include requiring that
  selected strategies
• maintain or improve quality in the system
• maintain or reduce cost growth in the system
• maintain or improve access to care
• maintain or improve efforts to reduce racial and
  ethnic disparities

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Cost Containment Initiatives for Consideration

• Recommend starting with the RAND list
• Comprehensive grouping of strategies
• Discussion of additional strategies to consider