Gail R. Wilensky Project HOPE September 22, 2008 Comparative Effectiveness – A Key to Health Care Reform.

Slides:

Advertisements

Similar presentations

1 Gail R. Wilensky Project HOPE July 13, 2009 Scoring Savings: How Can Quality Improvement Reduce Health Care Costs?

Advertisements

THE COMMONWEALTH FUND Figure 1. Health Care Opinion Leaders Agree on the Need for a Public–Private Entity to Coordinate Quality Source: Commonwealth Fund.

THE COMMONWEALTH FUND Figure 1. Three of Five Health Care Opinion Leaders Feel that Mixed Private-Public Group Insurance Is an Effective Approach to Achieving.

Single Payer 101 Training Universal Health Care for Massachusetts.

Prepared for the Committee for Health Care for Massachusetts December 14, 2005 ACTION COSTS LESS The Health Care Amendment Standards and Options for Reform.

FIFTY YEARS IN MEDICINE, : WHERE ARE WE HEADED NOW? John P. Geyman, M.D. 50 th Reunion, Class of 1960 UCSF School of Medicine.

Shared Decision-making’s Place in Health Care Reform Peter V. Lee Executive Director National Health Care Policy, PBGH Co-Chair, Consumer-Purchaser Disclosure.

The EMR Puzzle – Putting the Pieces Together March 10, 2015.

2 The Use of Health Information Technology in Physician Practices.

Can Employers Drive Value Based Purchasing? Andrew Webber, President & CEO National Business Coalition on Health Leonard Davis Institute of Health Economics.

Chapter 4. Describe the history and evolution of health care information systems from the 1960s to the present. Identify the major advances in information.

Impact of Health Care Reform on Major Stakeholders Jeff Korsmo Executive Director, Mayo Clinic Health Policy Center 2010 Health Care Forecast Conference.

Growing Unaffordability of Health Care: Incremental vs. Real Health Care Reform John P. Geyman, MD Professor Emeritus- Family Medicine University of Washington,

Congressional Budget Office Presentation to The Tax Policy Center and the American Tax Policy Institute Taxes and Health Insurance February 29, 2008.

Setting the Context: The BC Health System Andrew Wray – April 8, 2013.

 Organized plan of Health Services  Combination of facilities, organizations and trained personnel  Publically Funded System  Largely funded by.

Maryland's New Demonstration Waiver Michael B. Robbins, Senior Vice President April 28, 2015.

Katherine Baicker Professor of Health Economics, Harvard School of Public Health Implementation of the ACA: Insurance Expansions and the Value of Care.

COMPARATIVE EFFECTIVENESS RESEARCH Public Policy Interest and Issues Jeanne Lambrew, PhD Associate Professor LBJ School of Public Affairs National Health.

CHCWG DRAFT March 2, 2006 Hearing from the American People: Preliminary Overview of Sources and Reports March 2006 Caution: Preliminary Data Do not cite.

History of Health IT Unit 3 Lesson 1

The Patient Protection and Affordable Care Act [PPACA = ACA] ASAP Meeting Austin, Texas July 22, 2010 Norman H. Chenven CEO & Founder Austin Regional Clinic.

Better Care, Lower Costs Value-Driven Health Care Carol Kelly Director, Office of Policy Centers for Medicare and Medicaid Services.

Stay Well Afford Care Secure Coverage. Our Broken Health Care System 6.5 Million Uninsured 20% of Population Source: California Health Interview Survey,

Comparative Effectiveness Research: Understanding What It Is and Helping to Shape the Future Course Debra Ness Co-Chair, Consumer-Purchaser Disclosure.

THE COMMONWEALTH FUND Developing Innovative Payment Approaches: Finding the Path to High Performance Stuart Guterman Assistant Vice President and Director,

1 Minnesota’s Efforts to Enhance the Quality of Health Care David K. Haugen Director, Center for Health Care Purchasing Improvement, MN Dept. of Employee.

Value Based Insurance Design Michael Chernew Oct 10, 2008 Portions of this research were funded by Pfizer and GSK.

Health Care Costs. How we pay for health care: Private pay Private pay Group health insurance Group health insurance Government sponsored plans Government.

1 Elements Transforming the Delivery System Accountable Health Networks Receive payment for value not volume Drive quality and efficiency by providing.

The Patient Protection and Affordable Care Act Our Healthcare Reform Law Why do we need it? What does it do for us?

The Heritage Foundation May 19, 2011 “How Should Washington Control Medicare Spending?” James C. Capretta Visiting Fellow

Texas Health Care Reform Coverage Institute September 26, 2007.

National Leader The state of Maryland, hospitals, and insurance companies partnered Applied to the federal government for a 5 year “demonstration project”

Medical Care Independent Living Consumer Rights & Responsibilities.

1 Comparative Effectiveness Research: Key Issues and Controversies Consumer-Purchaser Disclosure Project Discussion Forum May 5, 2009 Steven D. Pearson,

THE COMMONWEALTH FUND Figure 1. Medicare’s Success in Achieving Major Goals “How successful has Medicare been in accomplishing each of the following specific.

Health Reform 2014 Bill Graham VP, Policy & Government Affairs August 17, 2010.

1 Responding to the Challenge of Rising Health Care Costs: Employer and Health Plan Strategies Health Policy Audio Conference Robert S. Galvin, MD July.

1- 1 Introduction to US Health Care UUnit 1: The US Health Care System HS230 Health Care Administration Kaplan University Live Seminar Presentation Kathy.

Up at Night What Keeps a CFO. Recession Impact on Operations Cash and Investments Capital Access Competitor and Market Responses State Budgets and Medicaid.

1 Comprehensive Health Care Reform in Vermont: The Policy and Politics Jim Maxwell, PhDHerb Olson, JD JSI Research & Training Institute, Inc. Vermont Department.

J. James Rohack, MD, FACC President, AMA Director, Scott & White Center for Healthcare Policy Professor of Medicine and Humanities, TAMHSC Information.

A Journey Together: New Maryland Healthcare Landscape Health Montgomery Maryland Health Services Cost Review Commission March 2015.

Gail R. Wilensky Project HOPE April 9, 2008 “Paying for Performance” Starting with MA.

Better Care, Lower Costs Value-Driven Health Care Gordon Woodrow Regional Director U.S. Department of Health and Human Services.

MichPHA Fall Forum A Health System Perspective Rob Casalou, President & CEO, St. Joseph Mercy Hospitals, A Member of Trinity Health.

AHIA ANNUAL CONFERENCE 2006 INDUSTRY VIEWS ON THE IMPLEMENTATION OF BROADER HEALTH COVER : A PRIVATE HOSPITAL VIEW CHRISTINE A GEE NATIONAL PRESIDENT AUSTRALIAN.

Figure ES-1. Features of Leading Candidates’ Approaches to Health Care Reform ClintonEdwardsObamaGiulianiHuckabeeMcCainRomney Individual Mandate Yes Children.

1 Developing Partnerships Between Healthcare and Business Together we can make a difference The Lowndes County Partnership for Health.

Challenges of Health Care Reform New England Society of Healthcare Materials Management September 12, 2008.

Thomas B. Valuck, MD, JD Medical Officer & Senior Adviser Center for Medicare Management Centers for Medicare & Medicaid Services CMS’ Progress Toward.

Rewarding Provider Performance: Aligning Incentives in Medicare Implications for Private Payers Robert Galvin October 16, 2006.

Justine Strand de Oliveira, DrPH, PA-C. Objective: Describe the major features of the Patient Protection and Affordable Care Act (PPACA) that will impact.

State of the State’s Health Care Seventh Annual Leadership Forum Measuring Cost and Quality: Is There a Benefit? October 26, 2006.

Comparative Effectiveness Research: Key Issues and Controversies

Understanding Health Systems: The Organization of

Reforming Healthcare Reform

An Introduction to Health Care and Health Policy in the United States

Catamount Health Senator James Leddy, Chair

The Elements of Health Care Quality and Current Improvement Efforts

Making Healthcare Affordable

Peter Lee 11/28/2018 Comparative Effectiveness Research: Understanding What It Is and Helping to Shape the Future Course Debra Ness Co-Chair, Consumer-Purchaser.

March 2006 Caution: Preliminary Data Do not cite or distribute

Speeding up Improvement in Chronic Care: What should be the Federal Role? Sandra M. Foote Senior Vice President, Capitol Health January 29, 2009.

State of health care in the US

Strengthen Medicare Rx drug coverage Reform Medicare payment

Overview of State Efforts Toward Health Reform

Figure 1. Three of Five Health Care Opinion Leaders Feel that Mixed Private-Public Group Insurance Is an Effective Approach to Achieving Universal Health.

Comparative Effectiveness – A Key to Health Care Reform

Presentation transcript:

Gail R. Wilensky Project HOPE September 22, 2008 Comparative Effectiveness – A Key to Health Care Reform

We All Agree on the Problems ♦Unsustainable spending growth ♦Lots of problems with patient safety ♦Lots of problems with quality/clinical appropriateness And, of course—the uninsured

Slowing Spending/Improving Value is Critical ♦ in spending is biggest driver of uninsured ♦Improved value/slower growth will facilitate coverage expansions ♦Rising health care costs putting huge pressures on: Employers, Employees, Federal Budget

What We Know ♦ Huge variations in care exist ♦ Spending more not the same as more quality ♦ Spending growth partly relates to technology growth, need to learn how to “spend smarter” ♦ Spending growth largely related to growth in chronic disease, need to learn how to “treat smarter”

To Change Where We Are… ♦ We need to measure better -- need a “score-card” -- quality, efficiency, “patient-centeredness” ♦ We need to change the incentives -- Medicare – 25 years getting it exactly wrong! -- Private Sector – not much better ♦ We need better information

Better Data is Starting to be Available ♦ “Hospital Compare” - public data ♦ New P4P measures being collected for docs Really P4R, started July 1, 2007 ♦ JCAHO “Quality Check” – Public reporting

Need More Data; Better Data “What works when, for whom, provided by…” Recognition that “technology” is rarely always effective or never effective That is … Information on… also… Means a major investment in Comparative Effectiveness information

CCE Needs the Right Focus Elemental building blocks to “spending smarter” ♦ Focus on conditions rather than interventions/therapeutics; procedures, not just Rx and devices ♦ Invest in what is not yet known; use what is known more effectively Dynamic Process…

Comparative Effectiveness Should Include Data from Many Sources ♦ “Gold Standard” - - double-blinded RCT ♦ “Real World” RCT (Sean Tunis) ♦ Epidemiological studies; medical record analyses ♦ Administrative data Need to understand: All data have limitations

How to Bring in Cost-Effectiveness ♦ Fund cost-effectiveness studies with same funding stream as CCE ♦ Strong preference to keeping activities separate -- at AHRQ or CMS or wherever ♦ CMS needs new authority to use C/E -- reimbursement vs. coverage ♦ Private payers can fund additional C/E studies -- universities; free standing centers

“Spending Smarter” Also Means Better Incentives ♦ Need to realign financial incentives ♦ Reward institutions/clinicians who provide high quality/efficiently produced care ♦ Reward healthy lifestyles by consumers ♦ Use “Value-based” insurance in private sector

Will Better Information, Better Information Systems and Better Incentives -- ♦ Improve Values? ♦ Moderate spending growth rates? Better than the Alternatives! Yes, should improve values Should – but don’t know for sure

♦ Some interest across the political parties ♦ Physician groups beginning to “declare themselves ♦ Industry support is mixed – Big pharma ok as long as transparent process, minimal extra delay Small pharma/biotech worried about delays; Device companies nervous about small incremental improvements Lots of Interest

What Next? ♦ Congressional interest continues… ♦ Presidential candidate’s recognize imp. of CCE - Part of CHAMP bill passed in August; superseded by Senate - Baucus/Conrad Bill introduced August should be the year!