driving health system change at the regional level ahrq september 2007
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Driving Health System Change at the Regional
LevelAHRQ
September 2007
Margaret StanleyExecutive Director
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How the Health Alliance was Formed
Purchaser Leadership: King County Executive Ron Sims• Unsustainable cost growth in health care
Task Force Report completed in 2004Standardize care based on evidence Standardize how quality is measuredImprove quality, decrease waste, slow cost growthAlign incentives to recognize and reward quality
Recommended creation of public-private collaborative
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The Puget Sound Health Alliance Today
Private, non-partisan, non-profit 501(c)(3) Focus five counties in Western Washington, with
interest in statewide expansion eventually Funded by participating organizations, RWJF
grant and King County
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The Puget Sound Health Alliance Today
Public and public employers, physicians, hospitals, patients, health plans, unions, associations …
~160 organizations, representing more than 1.5M covered people, not counting health plan enrollment
Board is 50% +1 purchasers, 4 providers, 4 plans, 2 consumer representatives
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Alliance Major Initiatives
Community agreement on evidence-based treatment
Better information about health carePublic reports comparing quality and efficiency Useful information for decision-making
Encourage use of health information technology Aligned incentives to reward quality care
DiabetesLow Back Pain
DepressionHeart
Disease RX
Broad Participation in Committees & Teams
Quality Improvement
Committee
Health Information & Technology
Committee
Communication Committee
Board of DirectorsConsumer Advisory
Group
Affordability Work Group
Prevention Asthma
Clinician Advisory Panel
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Involvement by Many in the Community Over 200 people volunteer time and expertise• Committees include physicians and other medical
experts, purchasers, consumers and others Create ‘Ambassadors’ through participation
• Pride in the Alliance product• Builds credibility with peers• Local buy-in to the process
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Involvement by Many in the Community Building Community Agreement is a Core Competency• Inclusion, committee processes, coordination• Anyone can join & attend any meeting• All Alliance meetings are held quarterly
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Challenges and Strategies1. Medical Association / Regence Blue Shield lawsuit -
heightened sensitivity to physician concerns• Alliance open-book approach is designed to avoid
pitfalls2. Some major employers won’t join – “free rider” threat • Give employers additional value not available to the
public3. Future financial sustainability• Create a valuable community asset with the data base
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Challenges and Strategies4. “To do” list is too long for time, staff & money available• Focus
5. Finding the levers to turn information into action by participating organizations• Use the uniqueness of the organization to create
pressure for improvement
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Success Factors for the Alliance1. Charismatic leader: King County Executive Ron Sims
• Vision of what’s possible, rooted in common sense• Recruited major corporations to join
2. Involvement of purchasers, providers, plans, consumers3. Together we can do this better than any one organization
could do alone4. Produced good reports in clinical areas
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Success Factors for the Alliance5. Have respect in the community6. Public performance report will include 2.5 million lives, 14
data suppliers, 16 medical group and 21 measures7. Seeking the “sweet spot” of quality improvement & cost
containment
Useful Information Consistent Incentives
Improved Quality of Care
Creating the Tools and Motivation to Support Quality Improvement
Greater Value
Healthier People
• Agreement on effective treatments• Agreement on how to measure value• Public report on local health care• Useful resources and tools
• Recognition• Benefit design• Value-based purchasing• Pay for performance for providers• Technology adoption
Outcomes
Goal
Strategies
Methods
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Collaboration. Accountability. Action.
2003 Western Avenue, Suite 600Seattle, WA 98121
(206) 448-2570www.pugetsoundhealthalliance.org
Puget Sound Health Alliance
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