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California CQI Initiative Heart and Diabetes

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California CQI Initiative Heart and Diabetes

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    1. California CQI Initiative Heart and Diabetes September 29, 2008 Donald J. Rebhun, M.D. Regional Medical Director HealthCare Partners Medical Group

    2. Multi-Pronged Approach to Obtain Measurable Improvement

    3. Preventable Diseases Through Lifestyle Changes 80% of Coronary Heart Disease 90% of Type 2 Diabetes >50% of Cancers

    5. Health Promotion and Preventative Care Consumers (Patients) Ignore Recommendations Employers (Payers) Do Not Incentivize it Physicians Do Not Profit from it

    6. INCENTIVE INDUCEMENT Impetus MOTIVATION Urge Bait Enticement Stimulus Inspiration Catalyst Persuasion Influence Encouragement

    7. Collaboration for Success Incentives and Payment Strategy

    8. Incentives Patient Quality and Duration of Life Goals and Rewards Attendance in classes Attendance in Programs Morning Stretching Morning walking CAWL

    9. Incentives Medical Organizations Public Reporting Pay for Performance (P4P) Health Plan (Based on Contract)

    10. Incentives Physician/ Staff Data Systems and Mining Lists of Target Population Diabetes (HgbA1C>8, LDL >100, Annual Urine microalbumin, retinopathy evaluation, monofilament test) CHF (ACE, Beta Blocker, Aspirin) Prescription Non-Compliance& refills linked w/visits & testing Coordinated Communication Follow up Blood work & routine f/u visits Health Education mailings Consequences of Disease Process DSM Goals Set Recognition and $$ Payout

    11. Incentives Employer (Purchaser) Incentives Health Plan Premium Discount for Wellness Partnership Documented control of weight, blood pressure, cholesterol (Quarterly) Documented attendance at Health Club Employee Health Programs Healthy Food Alternatives Weight Loss Contests Walking programs/contests Monthly Newsletter Discounts to Health Club based on frequency of use 25%- 2x/wk 50%- 3x/wk 100%- 5x/wk

    12. Coordinated, Integrated, Collaborative Health Plan Medical Organization Physicians Medical Support Staff

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