State of Reform Conference, January 8, 2015 Health Care Transparency and the Value Equation

Understanding VALUE in Health Care - Six Key Variables 2 VARIABLEIs the Health Care Service... AppropriatenessReally Needed? Process Quality Provided in the most effective and safe manner? PriceProduced at a fair price for the buyer? Outcomes Producing the best possible results for the patient? IntensityProvided in the most efficient manner? ExperienceProvided in a patient-centered way? © 2015 Washington Health Alliance. All rights reserved. This material may not be reproduced or modified without the prior permission of the Alliance.

Washington Health Alliance Current Transparency Initiatives Community Checkup  Quality, Patient Experience – Medical Groups, Hospitals, Counties Value Portfolio  Quality, Intensity, Experience, Price – High volume, high cost hospitalizations Disparities in Care Rates of Procedure Use and Diagnostic Testing Choosing Wisely ® Potentially Avoidable ER Visits 30-day All Cause Hospital Readmissions Washington State legislation: FULL price transparency 3 By Hospital and Medical Group © 2015 Washington Health Alliance. All rights reserved. This material may not be reproduced or modified without the prior permission of the Alliance.

Washington One of Only Two States with an ‘A’ 4 This report grades states on the percentage of clinicians with publicly available quality information, the type of measurement reported, and how accessible and useful the information is to consumers. Fifteen years after the publication of ‘To Err Is Human’ by the Institute of Medicine, there is still little, if any, useful and meaningful information on the quality of health care across the country. HCI3 State Report Card on Transparency of Physician Quality Information Released December 16, 2014

Washington’s New Common Measure Set for Health Care Quality and Cost 5 © 2015 Washington Health Alliance. All rights reserved. This material may not be reproduced or modified without the prior permission of the Alliance.

Unlike in quality, Washington is not differentiating itself as a leader in health care price transparency 6 CPR Report Released March 2014 F Catalyst for Payment Reform 2014 Report Card on State Price Transparency Laws F

Health Care Performance, Transparency, Improvement 1.Focus on all variables of health care value 2.Harmonization of measures – converge around common signals 3.Transparency for: – Purchasers – Consumers – Providers with continuous feedback loop 4.Support for performance improvement, especially for smaller provider organizations 5.Strongly link incentives to performance (not volume) 7

Bottom Line Transparency is a key tool for identifying, understanding, and ultimately reducing, unwarranted variation in health care quality, utilization and price. 8