Market Scan and Sustainability Recommendations

This is the text version of the Market Scan and Sustainability Working Group, September 17, 2008, slide presentation.

Slides

Slide 1: Market Scan and Sustainability Working Group

Slide 1. Market Scan and Sustainability Working Group

OR Health Care Quality Corporation Board Discussion

September 17, 2008

Note: This and all following slides have the logo of the Learning Network for Chartered Value Exchanges, a puzzle with three pieces in place and a fourth falling into place.

Slide 2: Objectives for Today

Slide 2: Objectives for Today

  • Review Inputs: Recap of Three Perspectives: Business Model Insights from Case Studies; Results of Market Scan; and Results of Stakeholder Priority Survey.
  • Present Committee Recommendations: program recommendations, based on inputs and staff evaluation of effort (weighting).
  • Board Action: discuss & finalize recommendations.

Slide 3: Sustainability Plan Criteria

Slide 3: Sustainability Plan Criteria

  • Advances the Mission: Leads to real solutions for improving health care quality through better information and increased community-wide collaboration.
  • Acknowledges and responds to compelling circumstances.
  • Leverages the unique value of the Quality Corporation.
  • Delivers tangible value to stakeholders within a timeframe that will keep their attention.
  • Meets the expectations of funders.
  • Attracts the attention of potential new funders.
  • Builds a sustainable position for the Quality Corporation mission and organization.

Slide 4: Part I: Business Model Insights—Linking Value with Funding

Slide 4: Part I: Business Model Insights-Linking Value with Funding

Total funding and largest contributor group

  • CQC: health plans: largest contributor—$0.5, others—$0.5, Clinical Quality Improvements.
  • Puget Sound: purchasers: largest contributor— $0.9 others—$1.2, Public Reporting.
  • PRHI: foundation: largest contributor—$1.5, others—$1.0, Clinical QI; training program.
  • CCHRI: govt/CMS: largest contributor—$2.2 others—$4.0, Performance Measurement.

Slide 5: How are Collaboratives Funded? Consolidated View of Six Organizations Studied

Slide 5: How are Collaboratives Funded? Consolidated View of Six Organizations Studied

Pie chart showing the distribution collaboratives funding as follows:

  • Government 26%;
  • Health plans 25%;
  • Foundations 22%;
  • Purchasers 10%;
  • Providers 8%;
  • Other 5%; and
  • Pharma 4%..

Slide 6: Puget Sound Health Alliance

Slide 6: Puget Sound Health Alliance

Two pie charts showing sources of funds and uses of funds as follows:

Sources of Funds

  • Purchasers 43%;
  • Providers 4%;
  • Plans 15%;
  • TPAs, Health Net, dental plans 3%;
  • Other health related organizations 2%;
  • Pharmaceutical companies 3%;
  • Grants 22%;
  • Interest 2%;
  • Awards and gifts 5%; and
  • Other 1%.

Uses of Funds

  • Performance, measurement and public reporting 60%;
  • Aligning incentives to achieve desired outcomes 11%;
  • Quality improvement and consumer engagement 20%; and
  • Development and sustainability of the alliance 9%.

Slide 7: California Quality Collaborative

 Slide 7: California Quality Collaborative

Two pie charts showing sources of funds and uses of funds as follows:

Sources of Funds

  • Health plans 50%;
  • Pharmaceutical grants 17%;
  • Foundation grants 15%;
  • PBGH 6%; and
  • Physician group fees 12%.

Uses of Funds

  • Core support 26%;
  • Patient experience 25%;
  • Efficiency 21%;
  • Building capacity 19%;
  • Regional networks: Inland, LA., and Orange 5%; and
  • Disease management 4%.

Slide 8: California Cooperative Healthcare Reporting Initiative

Slide 8: California Cooperative Healthcare Reporting Initiative

Two pie charts showing sources of funds and uses of funds as follows:

Sources of Funds

  • Plans 24%;
  • Foundations7%;
  • Physician groups 30%;
  • PBGH 3%;
  • Pharmaceutical companies 1%; and
  • Government (CMS) 35%.

Uses of Funds

  • PAS 39%;
  • HEDIS 9%;
  • CPPI/BQI 51%; and
  • Other: after hours/CAHPS 1%.

Slide 9: Pittsburgh Regional Health Initiative

Slide 9: Pittsburgh Regional Health Initiative

Two pie charts showing sources of funds and uses of funds as follows:

Sources of Funds

  • Foundations 62%;
  • Program fees 10%;
  • Government 20%; and
  • Health plans 8%.

Uses of Funds

  • Online education and social networking 39%;
  • Training and technical assistance 10%;
  • Disease management 24%;
  • Payment reform 18%; and
  • Capacity for improving quality 9%.

Slide 10: Part II: Market Scan: Summary Points

Slide 10: Part II: Market Scan: Summary Points

  • Quality Corporation Niche: Recognition and respect for multi-stakeholder approach; not aware of “competitors” having that qualification.
  • Hoping that Quality Corporation doesn't think “too small.”
  • Several cautions against taking on too much.
  • Frequent perception that “nobody” is leading or innovating across stakeholder groups in key areas; innovations may be viewed as internally focused.
  • Increasing interest in access, value, and affordability out of necessity.
  • “Good ideas have come out of Oregon, but collaborative execution has been a challenge.”

Slide 11: Market Scan Highlights: State Health Reform

Slide 11: Market Scan Highlights: State Health Reform

  • Considerable energy around reform recommendations; expecting some key components to move forward.
  • Expect nonprofits and public-private partnerships to have a significant role in executing on those recommendations.
  • Expect state to take “partner/buy” vs. “design/build” approach.
  • Differing opinions about the Quality Institute.
  • Suggested additional promotion of Quality Corporation to position for future opportunities.

Slide 12: Part III: Survey Results Feedback on Current Programs

Slide 12: Part III: Survey Results Feedback on Current Programs

  1. Aggregate data for primary care—number of raters rating as high or moderate: 26, number of raters rating as high value: 16.
  2. Provide tools to partners to help consumers understand quality—number of raters rating as high or moderate: 25, number of raters rating as high value: 18.
  3. Publish quality information: Trusted link—number of raters rating as high or moderate: 25, number of raters rating as high value:13.
  4. Shaping of health policy: Advisory role—number of raters rating as high or moderate 24, number of raters rating as high value: 13.
  5. Facilitate partnership to report on disparities—number of raters rating as high or moderate: 23, number of raters rating as high value: 9.
  6. Facilitate hospital partnership in National Q1—number of raters rating as high or moderate: 22, number of raters rating as high value: 7.
  7. Assist clinics in using Q-Corp quality information—number of raters rating as high or moderate: 22, number of raters rating as high value: 7

Slide 13: Highest Value Current Programs by Type of Stakeholder

Slide 13: Highest Value Current Programs by Type of Stakeholder

This slide presents value assigned to seven current programs by seven types of stakeholders. Only the highest and lowest values are noted on the slide.

  1. Aggregate data for primary care: a) providers (8)—highest rating within that stakeholder group (may be tied), and noted by at least one respondent as “low/no value,” b) health plans (4)—highest rating within that stakeholder group (may be tied), c) purchasers (3)—blank, d) health services (4)—highest rating within that stakeholder group (may be tied), e) consumer advocates (4)—blank, f) public policy (3)—blank, g) all others (4)—highest rating within that stakeholder group (may be tied).
  2. Provide tools to partners to help consumers understand quality: a) providers (8)—noted by at least one respondent as “low/no value,” b) health plans (4)—noted by at least one respondent as “low/no value,” c) purchasers (3)—highest rating within that stakeholder group (may be tied), d) health services (4)—blank, e) consumer advocates (4)—highest rating within that stakeholder group (may be tied), f) public policy (3)—blank, g) all others (4)—highest rating within that stakeholder group (may be tied).
  3. Publish quality information: Trusted link: a) providers (8)—noted by at least one respondent as “low/no value,” b) health plans (4)—blank, c) purchasers (3)—blank, d) health services (4)—blank, e) consumer advocates (4)—blank, f) public policy (3)—blank, g) all others (4)—blank.
  4. Shaping of health policy: Advisory role: a) providers (8)—noted by at least one respondent as “low/no value,” b) health plans (4)—noted by at least one respondent as “low/no value,” c) purchasers (3)—blank, d) health services (4)—blank, e) consumer advocates (4)—blank, f) public policy (3)—blank, g) all others (4)—highest rating within that stakeholder group (may be tied).
  5. Facilitate partnership to report on disparities: a) providers (8)—noted by at least one respondent as “low/no value,” b) health plans (4)—noted by at least one respondent as “low/no value,” c) purchasers (3)—noted by at least one respondent as “low/no value,” d) health services (4)—noted by at least one respondent as “low/no value,” e) consumer advocates (4)—highest rating within that stakeholder group (may be tied), f) public policy (3)—highest rating within that stakeholder group (may be tied), g) all others (4)—blank.
  6. Facilitate hospital partnership in National Q1: a) providers (8)—noted by at least one respondent as “low/no value,” b) health plans (4)—blank, c) purchasers (3)—blank, d) health services (4)—noted by at least one respondent as “low/no value,” e) consumer advocates (4)—blank, f) public policy (3)—noted by at least one respondent as “low/no value,” g) all others (4)—blank.
  7. Assist clinics in using Q-Corp quality information: a) providers (8)—noted by at least one respondent as “low/no value,” b) health plans (4)—blank, c) purchasers (3)—blank, d) health services (4)—noted by at least one respondent as “low/no value,” e) consumer advocates (4)—noted by at least one respondent as “low/no value,” f) public policy (3)—noted by at least one respondent as “low/no value,” g) all others (4)—blank.

Caution: number of respondents in each category is small.

Slide 14: Survey Results: Value of Future Programs

Slide 14: Survey Results: Value of Future Programs

Horizontal bar graph showing the following data:

  1. Clinical quality improvement–ICSI Model: total ratings—12, rated number—4.
  2. Report on efficiency and value: total ratings—12, rated number—3.
  3. Provider incentives: total ratings—11, rated number—3.
  4. Report on specialty care: total ratings—9, rated number—4.
  5. Interoperability of electronic health records: total ratings—8, rated number—3.
  6. Consumer incentives: total ratings—7, rated number—4.
  7. Increase provider use and access to EMRs: total ratings—7, rated number—1
  8. Report on patient experience: total ratings—6, rated number—2.
  9. Monitor quality of care to publicly advocate: total ratings—3, rated number—2.
Page last reviewed September 2008
Internet Citation: Market Scan and Sustainability Recommendations. September 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/value/marketscan/index.html