Provider Feedback Reports Jeffery Thompson, MD MPH.

Slides:



Advertisements
Similar presentations
+ Angel-RX Free Discount Prescription Card Saving your congregation up to 75% on their prescription medications, while at the same time raising funds for.
Advertisements

To sign up for a free Facebook account Go to Facebook is about socializing and social networking Its about sharing.
Building Medicaid/Research Partnerships: Some Observations from the Ivory Tower Benjamin Druss MD, MPH June 27, 2005.
Giving Feedback. The right and the wrong. >> giving feedback
1) Information and Advice: having the information I need, when I need it “I can speak to people who know something about care and support and can make.
Looking for Best Practices? Look No Further One of the Nation’s Top Eight State Dental Medicaid Programs Division of Health Care Services Virginia Department.
Evidence-Based Medicaid: Health Care That Works Pay for Performance: Health Care That Adds Value Jeff Thompson MD MPH Chief Medical Officer Washington.
Donald Mack, M.D. Ohio State University Medical Center Gregg Warshaw, M.D. University of Cincinnati College of Medicine.
INTRODUCING KyHealth Choices A New Beginning For Kentucky Medicaid.
Presented by: Ted Shaw THA president/CEO 2015 – A Conservative Year September 23, 2014 Texas Association for Healthcare Financial Administrators Fort Worth,
Head CT Scans per 1,000 Children ( , age-sex-payer adj.) 14.7 to19.7 (13) 12.3 to
Patented Process for Beneficially Managing Mental Health (Psychotropic) Drug Usage by Plan Members HR Specialty Products & Services Catalogue Executive.
> > Healthy Pennsylvania Access – Affordability – Quality.
Health Plan Changes for Medicare-Eligible Retirees 1 Effective January 1, 2013.
Pharmacy Program Initiatives Threshold, Mandatory Generic, Maximum Allowable Cost (MAC) Javier Menendez, RPh Pharmacy Manager Department of Medical Assistance.
THE AIDS INSTITUTE The AIDS Institute HEALTH REFORM AND ADAP Emily McCloskey, Public Policy Associate Carl Schmid, Deputy Executive Director AIDS Drug.
Pharmaceutical Development and Regulation Name brands, generics and the FDA.
Introduction and Vision for the Future Rod Hochman M.D., President and Chief Executive Officer, Providence Health & Services.
© 2005 National Mental Health Association The Medicare Drug Benefit: What Is It and What Does it Mean for Mental Health? Get Educated, Get Enrolled An.
1 Medicare and Prescription Drugs Rescuing Medicare Step 1 in Saving U.S. Health Care Diane Archer Founder and Special Counsel Medicare.
Medicare Prescription Drug Coverage. What’s Different About Prescription Drug Information? One size does not fit all, more than ever before Distinct messages.
Networking Career Management Services Present ed by Delicia Lewis.
Updated | 5/9/2012 Retiree Choices New Choices Better Value New Coverage New Approach to Health Care Coverage.
08/02/2011. £89 million target by end of FY 14/15. System-led delivery. Influencing front-line prescribing patterns. Collaborative procurement Strong.
© 2005 National Mental Health Association The Medicare Drug Benefit: What Is It and What Does it Mean for Mental Health?
1 Benefits effective 2/1/ Lifetime maximum of up to $5 million RX Card Wide choice of plans Family Flex ® – Each family member can apply for a.
Maximizing your presence on LinkedIn for those who know the basics.
An Opportunity for Transformation in Puerto Rico Jessica Kahn, MPH Technical Director for Health IT Center for.
Keele University Innovation Projects Day 22 May 2003 Student profiling Peter G. Knight School of Earth Sciences and Geography.
How to Get More Reviews. If your Review Strategy is : Boy, I sure hope they go and give me a review. You will wait a very long time to get any benefit.
Incorporating Behavioral Health Into the Health Planning Process to Improve Value Jack Mahoney, MD, MPH
Member Mail Order Helpful Hints, Reminders and Tools.
Nursing in Contexts of Marginalized Health Conference 11 th Sept 2015 Linda O’Driscoll Drug Treatment Court Liaison Nurse.
E-prescribing is the computer based generation of filling medical prescriptions. The purpose of E-prescribing is to reduce the risks associated with traditional.
FINANCIAL ISSUES CHAPTER 14. CHAPTER OUTLINE Financial Issues Third-Party Programs – private health insurance – managed care programs – public health.
LOCKTON DUNNING BENEFITS UNIVERSITY OF ALASKA 2ND QTR FY13 UTILIZATION REVIEW 7/1/2012 TO 12/31/2012.
1 Anti-psychotic Medication in Children, Adolescents and Foster Care: Too Many, too Much, and too Young Medicaid Medical Directors Learning Network (MMDLN)
Presentation Skills Trainer. Make or Break Your Business in 30 Seconds.
Certification for Enterprise Account Services Class One.
Developing Dementia Friendly Businesses Phil Freeman, Partnerships Manager, Dementia Friendly Communities.
Scotstoun Primary School Learning journeys Pupil Learning Logs, Pupil Profiles, Targets, Learning Conversations.
Brought to you by UNITEDSCRIP Now More than ever, Spend Wisely And Make Every Purchase Count! we need to invest wisely,
Differentiation and challenge: Research and Development Group Cycle Meeting 1: selecting the issue.
EZRA STATISTICS & GCFA CHURCH USER GUIDE. LOGGING IN The first time you log in to the program, you will be led through initial steps to set up your account.
Access, Quality and Cost in Emergency Benefits Jeffery Thompson, MD MPH Chief Medical Officer Washington State Health Care Authority September 24, 2012.
To a Teacher:. April 1, 2014 Dear Mrs. Rivas, DATE AND GREETING:
Guide to: Checking community service hours. Step 1  Log onto your My Missouri State account.
شناخت مراجعه کننده و چگونگی گرفتن شرح حال باروری سالم.
Managing Pharmacy in the Post-PPACA World Michael A. Rashid President and Chief Executive Officer AmeriHealth Mercy Family of Companies July 13, 2010 “
Health Care Reform IT’S COMPLEX! Jeffery Thompson, MD MPH Chief Medical Officer Washington State Medicaid.
Warm Up, May 16 th In your journal, list out 1-2 expectations you have for this series of presentations. List out 1-2 questions you may have.
Medicaid Managed Care for Persons with Severe Mental Illness in New York: Challenges and Implications Michael Birnbaum Director of Policy, Medicaid Institute.
MGT 4543: Compensation Management Chapter 10 Part II Employer-Sponsored Health Insurance Programs.
Cluster Host Preparation Meeting Autumn Term 1a Overview and Action Planning Judith Carter Senior Adviser Complex Needs/Vulnerable Learners
Mental Health and Substance Abuse Prescription Drug Spending Trends: Medicaid and Privately Insured Populations American Public Health Association Annual.
Top 20 Ways To Achieve Your Purpose With LinkedIn
Medicaid Expansion.
Per Enrollee Growth in Medicare Spending and Private Health Insurance Premiums (for Common Benefits), NOTE: Per enrollee includes primary.
Mentoring Process Re-visited.
Building your business with referrals
PMP Advisory Committee
How data analytics can drive greater results
Assessment Piece – Evaluation Success Criteria
Improving participation: A Physician perspective
Using capital letters and full stops
Health Insurance Annual Update
Learning Intention I will learn about selection with multiple conditions.
Set targets for total spending growth
Benefits for Patients, Providers and Payers
Strategies to Improve Drug Use
Presentation transcript:

Provider Feedback Reports Jeffery Thompson, MD MPH

Evidence Meets Report Cards: Improving Generic Performance in State funded Drug Benefits SB 5892 (2009) -- Engaging the community to improve generic drug use State Medicaid has 80% of the Rx spend in brands and 20% in generics But state’s 63% generic utilization rate (rate of all generic options) is behind private plans (> 80%) 1,500 providers have generic fill rates under 80% State statute allows for feed back reports with sticks and carrots to improve generic use

Provider Feedback: The Data 824 prescribers are targeted using the criteria of DAW>25% or generic use under 80% or a statistical difference from their peers. The cohort represent ~$6.6 million in spend with ~36,000 clients. Only 6 prescribers had 100% brand use and no provider had 100% DAW use. 65% of the cost and 70% of the clients were in the 50-80% generic use. 59% of the prescribers in this cohort were primary care by cost and 63% by client counts. Of the six classes the more problematic classes for generic and DAW use were ADHD and antidepressants. The top 50 prescribers accounted for 22% of the total cost in the 824 prescriber cohort.

Dear Prescriber: See the letter

Comments to Date Top Comments from Feedback Reports Clients come in for brands Mine are sicker Wrong peer group Can you send me my profiles I always write for generics I am writing an Rx for a colleague