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Quality Colloquium Harvard University

Quality Colloquium Harvard University. August 19 - 22, 2006. HealthPartners at a glance. Founded in 1957 as a cooperative Integrated, providing Health plans Care delivery Medical education Research Health improvement. Seven step model. Patient/ Member/ Consumer.

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Quality Colloquium Harvard University

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  1. Quality Colloquium Harvard University August 19 - 22, 2006

  2. HealthPartners at a glance • Founded in 1957 as a cooperative • Integrated, providing Health plans Care delivery Medical education Research Health improvement

  3. Seven step model Patient/ Member/ Consumer

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

  5. Agree on best care • Collaborate with providers • Set targets • Reward quality care

  6. 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

  7. Aim high Composite measures supporting optimal care for: Diabetes Heart disease Preventive care

  8. 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)

  9. Aim high Optimal diabetes care 1. HbAlc < 7 2. LDL <100 3. Blood pressure <130/85 4. Documented tobacco free 5. Daily aspirin >age 40

  10. 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

  11. 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

  12. Align incentivesPay for quality improvement Pay-for-performance- Partners in Progress Reimbursement in provider contracts for: primary care specialists hospitals, pharmacies, physical therapy

  13. 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

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

  15. Align incentives • BMI • Fairview Clinics • Burnsville Family Physicians, PA • HealthPartners Clinic • Peds Prev Care UTD • Children’s Physician Network • Metropolitan Pediatric Specialists

  16. National Business Group on Health • Recipient of 2006 Excellence and Innovation in Value Purchasing Award • Recognizes efficiency, improved quality, affordability

  17. Support improvement • At risk registries • Behavioral health case management • Results: Outpatient behavioral health visits +26 % Emergency room visits -9% Hospital inpatient admissions - 9% ROI 5:1

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

  19. Saves 100 Hearts & 140 Legs & 740 Pairs of Eyes Each Year

  20. Summary Leading for Quality: • Establish goals • Collaborate • Measure • Reward • Report

  21. “Progress through collaboration”

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