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Lead Support Major Support Additional Support
100% Access HealthColumbus
Board & Staff
Individual & Corporate Donations
Webinar Learning Session National Scorecard and Compendium
on Payment Reform
May 9, 2013 Host: Jeff Biehl, president of Access HealthColumbus,
co-chair of Ohio Patient-Centered Primary Care Collaborative, member of Governor’s Advisory
Council on Health Care Payment Innovation
Welcome!
Access HealthColumbus is a public-private partnership supported by the following organizations and individuals!
www.accesshealthcolumbus.org
• April: Report of the National Commission
on Physician Payment Reform • May: The National Scorecard and
Compendium on Payment Reform, Catalyst for Payment Reform
• June 20: State Innovation Models Initiative (SIM) , Center for Medicare and Medicaid Innovation (CMMI)
• Webinar Purpose: to objectively explore recent studies and promising best practices on improving the value of health care
• 1st Webinar Series focused on payment reform.. an enabler of health care transformation
WHO?
• Catalyst for Payment Reform (CPR) is an independent, nonprofit corporation working on behalf of large employers and other health care purchasers to catalyze improvements in how we pay for health services and promote higher-value care in the U.S.
• Mission: CPR's mission is to accelerate reforms to payment that promote the Institute of Medicine's six aims. We have a national framework for payment reform along with tools that catalyze change in the marketplace and align public and private-sector strategies. To catalyze a better payment system, purchasers and other stakeholders need to work together.
"More than ever, all of us feel the urgency to contain costs and are acutely aware of the health system’s failings in safety and quality. Our approach to how we pay doctors and hospitals is a critical lever we can use to create better care and better value. CPR provides thought leadership to and coordination among large health care purchasers who want to shape a more sustainable health care system. Come work with us and chart the path forward.” --Suzanne Delbanco, Executive Director, CPR
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
WHO?
• Principles: Payments for the prevention, diagnosis and treatment of disease should be assessed based on the extent to which they meet the following patient-centered and societal goals: Promote and reward high-quality, patient-centered care that is cost-effective and
reduces disparities; Ensure patients receive the “right care, at the right time, from the right provider,”
incorporating the values and preferences of patients; Foster improvement and innovation; and, Effectively slow the growth of the costs of health care.
• Private & Public Members: 3M, Arizona Health Care Cost Containment System
(Arizona Medicaid),AT&T, Bloomin' Brands, Inc., The Boeing Company, CalPERS , Capital One, Carlson, Dow Chemical Company, eBay, Inc., Equity Healthcare LLC, GE, Group Health Insurance, Commonwealth of MA, The Home Depot, IBM, Ingersoll Rand, Marriott International, Inc., ODJFS/Office of Medical Assistance (Ohio Medicaid), OhioPERS, Pennsylvania Employee Benefit Trust Fund, Pitney Bowes, Safeway, Inc., South Carolina Department of Health and Human Services (South Carolina Medicaid) , TennCare (Tennessee Medicaid), Verizon, Inc. , Wal-Mart Stores, Inc., Wells Fargo Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
WHY?
PAYMENT FACTS
• The U.S. health care system needs CPR to save dollars and lives; we spend entirely too much on care that is wasteful or even dangerous and that amount keeps rising.
• Those who purchase health care are spending more and more; they need the status quo to change.
• Payment Reform has several flavors that have proven to reduce spending and improve care. Bundled payment
Global payment
Reference pricing, price transparency, consumer engagement
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
WHAT?
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
Please use
webinar chat
feature to share
questions and
reflections on
national scorecard
WHAT?
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
Please use webinar chat feature to
share questions and reflections on benchmarks
WHAT?
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
Levels of Price Transparency: • Pricing information reported to the State only • Pricing information available upon request by an individual consumer • Pricing information available in a public report • Pricing information available via a public website Scoring Criteria: • Scope of price: including charges, average charge, amount paid by the insurer and amount paid by the consumer (allowed amount) • Scope of services covered under the law including: all medical services, inpatient services only, outpatient services only or the most common inpatient and outpatient services • Scope of providers affected by the law including: hospitals, physicians, and surgical centers
Report Card on State Price Transparency Laws, March 18, 2013
WHAT?
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
Report Card on State Price Transparency Laws, March 18, 2013
WHAT?
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
Report Card on State Price Transparency Laws, March 18, 2013
Please use webinar chat feature to
share questions and reflections on price transparency
WHAT?
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
CPR urges plans, providers to add their payment reform programs to our National Compendium CPR's National Compendium on Payment Reform is a brand new searchable , sortable website, designed to catalogue payment reform efforts underway across the country. Those implementing payment reforms are encouraged to share a description of their efforts in the compendium, a resource for health care purchasers, payers, providers, policymakers, researchers, and journalists
WHAT?
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
CPR urges plans, providers to add their payment reform programs to our National Compendium CPR's National Compendium on Payment Reform is a brand new searchable , sortable website, designed to catalogue payment reform efforts underway across the country. Those implementing payment reforms are encouraged to share a description of their efforts in the compendium, a resource for health care purchasers, payers, providers, policymakers, researchers, and journalists
Please use webinar chat feature
to share questions and reflections on compendium
Public & Private: Payment Reform Framework
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
HOW?
WHAT are your questions of clarity on the information presented?
WHAT are your reflections on the potential opportunities and challenges of utilizing the National Scorecard
and Compendium on Payment Reform?
LEARNING FROM YOUR QUESTIONS AND REFLECTIONS