Health Plan User Groups Leapfrog Town Hall Call January 13 & 15, 2004 Founded By The Business Roundtable with Support From the Robert Wood Johnson Foundation

Background Leapfrog conducted survey with 70+ members Assessed progress on implementing purchasing principles Solicited feedback on how Leapfrog can help members implement purchasing principles and safety leaps Assessed interest in moving beyond current limited focus on hospital safety measures

Background 71% said it was important for Leapfrog to move beyond hospital safety to a broader set of measures The most common barriers to implementing Leapfrog Purchasing Principles were: –Lack of internal resources –Lack of more comprehensive performance measures –Lack of buy-in from consultants –Need for health plans to offer easy to implement “off the shelf” solutions Health Plan User Groups being formed by Leapfrog to respond to member needs for standard solutions

Overview of High Level User Group Strategic Priorities Shared commitment to use national standard publicly reported performance measures linked to substantial consumer and provider incentives Collect and publish data using standard performance measures including NQF, Leaps, Bridges to Excellence, and JCAHO with agreement to expand measures to include future NQF-endorsed measurement sets Substantial incentives linked to standard performance measures through provider payment, benefit design, network development (e.g. benefit design) and public recognition High profile public support of shared strategic priorities

Health Plan User Groups Up to 4 – 6 user groups based on member interest Minimum of one successful group to put pressure on other plans Focus on major national carriers –UHC, Cigna, Aetna, Humana One or two large regional carriers possible –Kaiser, Anthem BCBS, Other?

Health Plan User Group Goals Identify enhancements for the 2005 plan year by April 15 Develop a multi-year strategy by end of 2004 Ongoing dialogue and monitoring of progress beyond 2005 Expanded number of user groups after 2004 based on results

Template for Setting User Group Priorities Available Tools 2005 Goal Multi-year Goal Inform and Educate Employees Use of Comparative Rating Use of Substantial Incentives - Patient Volume - Price - Public Recognition Focus on Discrete Leaps - CPOE - EHR - IPS - NQF Safe Practices Encourage support of consultants and brokers

Structure Members invited to participate in user groups Plenary member-only user group to assess options and share progress Separate user groups set up with each health plan and employers with existing contractual relationships Employers will agree to shared objectives to pursue with each health plan Employers will invite the plan to work with them to advance goals Focus on major national carriers and one or two large regional carriers

Structure Results will be shared with Leapfrog members Members will be encouraged to adopt new off-the- shelf solutions Leapfrog may also make announcement this fall based to acknowledge progress and promote adoption of enhanced plan products by purchasers

Timeline December 2, 2003Contact all Leapfrog members January 23, 2004 Finalize Leapfrog members user group participants Contact target health plans March 31, 2004 Employers reach consensus on goals for each respective User Group April 15, 2004 Convene User Groups and agree to 2005 enhancements October 1, 2004Multi-year strategy complete October 31, 2004Announce three year strategy January 1, 2005Implement 2005 enhancements