Gaining Traction with PEBB’s Vision Through the eValue8™ RFI PEBB Board Meeting July 17, 2007

2 What is eValue8™?  Evidence-based request for information  Uses standard annual survey to gather hundreds of benchmarks in critical areas  Offered through National Business Coalition on Health (NBCH)  Offered in Oregon in 2007 through the Oregon Coalition of Health Care Purchasers (OCHCP)

3 eValue8™ Objectives  Implement standardized performance expectations that Are evidence-based, defendable in the Board Room Increase the “signal strength” for multiple purchasers Align with major stakeholders: HHS/CMS, OPM  Reduce redundancy by consolidating purchaser requests  Promote health plan accountability  Differentiate plan performance  Encourage health plans to evaluate the delivery systems that compromise the network  Promote consumer engagement and informed decision making  Provide a community-based forum for communication between purchasers and plans

4 eValue8™ Collaborators  Centers for Disease Control (CDC)  Centers for Medicare and Medicaid Services (CMS)  Substance Abuse and Mental Health Services Administration (SAMHSA)  Agency for Healthcare Research and Quality (AHRQ)  National Committee on Quality Assurance (NCQA)  Joint Commission for the Accreditation of Health Care Organizations (JCAHO)  URAC  American Board of Internal Medicine (ABIM)  eHealthInitiative (eHI)  The Leapfrog Group  Pennsylvania State University  George Washington University

5 Participating Coalitions in 2007  Memphis Business Group on Health  HealthCare 21 (TN)  Buyers Health Care Action Group (MN)  Colorado Business Group on Health  Greater Detroit Area Health Council  Michigan Purchasers Health Alliance  Midwest Business Group on Health  Indiana Employers Health Alliance  New York Business Group on Health  Mid-Atlantic Business Group on Health  Oregon Coalition of Health Care Purchasers  South Carolina Business Coalition on Health  Pacific Business Group on Health  Alliance for Health (MI)  Health Action Council of NE Ohio  Hawaii Business Health Council  Virginia Business Group on Health

6 Participating Oregon Plans in 2007  HMOs Kaiser  PPOs CIGNA HealthNet LifeWise ODS Providence Regence BCBS United

7 Participating Oregon Purchasers  A-dec, Inc.  Benton County  Bethel School District  Blount International  City of Corvallis  City of Eugene  City of Springfield  Eugene School District 4J  Evraz Oregon Steel Mills  Harry & David Operations Corporation  Intel Corporation  Lane County  Lane Transit District  Oregon Educators Benefit Board  Oregon School Boards Association  Portland General Electric  Public Employees’ Benefit Board  SAIF Corporation  SEIU Local-49  Seneca Sawmill  Tektronix, Inc.  TOC Management Services  United Metal Trade Association Trust

Evaluation Areas  President’sExecutive Order: 18 Questions in 3 Modules  Profile  Consumer Engagement  Provider Measurement  Prevention & Health Promotion  Pharmaceutical Management  Chronic Disease Management  Behavioral Health

9 Executive Order  Significance Alignment with federal agencies, including CMS Private sector Value-driven health care partnership  Purchaser Guide  Follow up on progress  Four Cornerstones HIT Quality measurement & transparency Price transparency Incentives for quality and efficiency  18 Questions in 3 Sections Profile: HIT Consumer: HIT support, price transparency Provider: HIT support, quality transparency, incentives

10 Plan Profile  Basic Information (Contacts, Structure, Enrollment, Scope)  Accreditation  Plan Design/Admin/Purchaser Reports  Provider Contracting  Health Information Technology  High Deductible Health Plan (Considered Separately)

11 Consumer Engagement  Provider Performance Transparency Practitioners and/or Groups Hospitals  Shared Decision Making Support  Electronic Personal Health Record  Price Transparency  Pharmaceutical Management  Racial and Cultural Competency  CAHPS Ratings

12 Provider Measurement  Community Collaboration  Physician Support  Practitioner Performance Measurement What is measured (very granular list)? How is it used (feedback, transparency, incentives)?  Practitioner Differentiation/Incentives Types of measures used Types of incentives  Facility Performance Measurement  Facility Differentiation/Incentives  Centers of Excellence and High Performance Network

13 Prescription Drug Management  Organization and Formulary Management  Efficiency Generic dispensing Utilization mgmt (prior auth, step therapy, etc.) Specialty pharmacy  Quality and Safety Antibiotic use Drug conflict measurement and initiatives Pharmacy audits & ISMP survey use

14 Prevention & Health Promotion  Worksite Health Promotion  Risk Factor Education for children/parents HRA content, use, promotion & incentives  Screening: Immunizations, Cancer, Other  Tobacco Use  Obesity  Obstetrics & Maternity

15 Chronic Disease Management  Program Scope and Coordination  Member Identification  Member Support Medication compliance monitoring Interventions, especially outreach  Practitioner Support Member-specific reminders Comparative reports  Performance Measurement  HEDIS  Non-HEDIS

16 Behavioral Health Screening & Mgmt  Program Organization & Member Access  Member Identification and Screening Alcohol Depression  Member Support (Depression only) Rx compliance monitoring Interventions, especially outreach Coordination of Co-morbidities  Practitioner Support: Non-BH and BH Clinical guidelines Member-specific reminders Comparative reports Tracking appropriate anti-depressant prescribing  Performance Measurement

17 Use of eValue8™ in Oregon  Used to identify plan performance against other plans in Oregon and against national benchmarks  In 1 st year, use is for quality improvement (no public sharing of results)  OCHCP uses to establish priorities for plan action (site visits)

18 Use of eValue8™ Results by PEBB  Reinforce PEBB priorities  Assist in identifying areas for improvement  May wish to eventually use in plan selection and/or contracting