Quality Colloquium Harvard University

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Quality Colloquium Harvard University

• August 19 - 22, 2006

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HealthPartners at a glance

• Founded in 1957 as a cooperative
• Integrated, providing
• Health plans
• Care delivery
• Medical education
• Research
• Health improvement

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Seven step model
Patient/ Member/ Consumer
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Focus on goals

• Health goals 2010
• Engage experts, staff, community
• Create system improvement by
• embedding goals in work plans

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Agree on best care

• Collaborate with providers
• Set targets
• Reward quality care

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Define success

• Clinical Indicators Report
• Significant improvements in
• Optimal Diabetes Care
• BMI Assessment
• Pediatric Immunizations
• Generic Drug Use
• Cervical Cancer Screening
• Child Teen Check Ups
• Lead Screening

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Aim high

• Composite measures supporting optimal care for
• Diabetes
• Heart disease
• Preventive care

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Institute of Medicine Composite measurement

• The committee believes this concept
  represents a turning point, and a relatively new
  challenge, for performance measurement.
• Source Performance Measurement Accelerating
  Improvement (2006)

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Aim high

• Optimal diabetes care
• 1. HbAlc lt 7
• 2. LDL lt100
• 3. Blood pressure lt130/85
• 4. Documented tobacco free
• 5. Daily aspirin gtage 40

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Minnesota Community Measurement

• Performance data for 100 medical groups
• Comparative data for 13 conditions
• Search by city or county
• Ratings by
• below average
• average
• above average

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Align incentivesPay for quality improvement

• Pay-for-performance
• Partners in Excellence
• Stretch goals for
• Clinical quality (80)
• Patient experience (20)
• Payouts for superior, excellent performance

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Align incentivesPay for quality improvement

• Pay-for-performance-
• Partners in Progress
• Reimbursement in provider contracts for
• primary care specialists hospitals,
• pharmacies,
• physical therapy

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Align incentivesNever events

• 2003
• New MN law to report adverse health events
• 2005
• HealthPartners policy to not pay for never
  events
• 2006
• Centers for Medicare and Medicaid
• investigates ways to not pay for never events
  
• Leapfrog never events policy

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Align incentives

• Engage providers in design and implementation
• Metrics based on consensus of evidence based
  guidelines
• Provider round tables
• Public recognition

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Align incentives

• BMI
• Fairview Clinics
• Burnsville Family Physicians, PA
• HealthPartners Clinic
• Peds Prev Care UTD
• Childrens Physician Network
• Metropolitan Pediatric Specialists

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National Business Group on Health

• Recipient of 2006 Excellence and Innovation in
  Value Purchasing Award
• Recognizes efficiency, improved quality,
  affordability

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Support improvement

• At risk registries
• Behavioral health case management
• Results
• Outpatient behavioral health visits 26
• Emergency room visits
  -9
• Hospital inpatient admissions
  - 9
• ROI 51

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Evaluate

• Transparency in reporting
• Ongoing evaluation for
• trend impact
• improved performance
• improved patient outcomes
• provider satisfaction.

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Saves 100 Hearts 140 Legs 740 Pairs of Eyes
Each Year
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(No Transcript)
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Summary

• Leading for Quality
• Establish goals
• Collaborate
• Measure
• Reward
• Report

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Progress through collaboration