Health Datapalooza IV: June 3rd-4th, 2013 Employer Use of Health Care Data and Evidence to Improve Quality and Value: What Is Working and How Do We Facilitate It Moderator: E.J. “Ned” Holland, Jr., Assistant Secretary for Administration, US Department of Health and Human Services (HHS) Panelists: Cristie Upshaw Travis, Chief Executive Officer, Memphis Business Group on Health Lisa Wear-Ellington, President & Chief Executive Officer, South Carolina Business Coalition on Health William Freeman, Staff Service Fellow, Center for Delivery, Organization, and Markets, Agency for Healthcare Research & Quality (AHRQ) Keith T. Kanel, Chief Medical Officer (CMO), Pittsburgh Regional Health Initiative Discussants: Deborah Greene, Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services, Centers for Medicare and Medicaid Services (CMS) Niall Brennan, Director, Office of Information Products and Data Analytics, Centers for Medicare & Medicaid Services (CMS) Irene Fraser, Director, Center for Delivery, Organization, & Markets, Agency for Healthcare Research & Quality (AHRQ) New variations in health care quality and value are a huge priority for employers. Poor quality and unnecessary cost negatively affect the health of employees and their families, the firms’ bottom line, and firm productivity and competitiveness. The panel will review four strategies with existing examples that employers, employer coalitions, and multi-stakeholder groups are using to improve health care quality and value. Discussion will focus on several questions: How can data and tools for each strategy be strengthened? How can the power and utility of data and supporting evidence be increased? How can the alignment and combined power of public and private efforts be maximized?

1. Employer Use of Health Care Data and Evidence
What’s Working: eValue8
Cristie Upshaw Travis
CEO, Memphis Business Group on Health
June 4, 2013
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2. Memphis Business Group on Health
• Non-profit coalition of employers sharing solutions
and providing tools to manage the cost and quality of
health benefits in an ever-changing environment
• 12 members with 300,000+ covered lives in Memphis
and Tennessee
• Our work focuses on:
o Creating a culture of health at the worksite
o Aligning health benefit programs with overall goals for
employee and family health
o Setting strong purchaser expectations for safe, high quality,
cost effective, affordable health care services through the
leverage of employers as clients and purchasers
• Member of the National Business Coalition on Health
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3. What is eValue8?
• A vendor management/accountability resource
o Collection of plan responses as well as information from third party
sources on accreditation and HEDIS/CAHPS performance on key
measures
o Responses assigned scores/weighted based on evidence-based best
practices, percentile ranking; subset are verified
o National database provides ability to benchmark and understand
what is possible
o Catalyst for discussion on performance improvement
Developed by the National Business Coalition on Health to
translate data into meaningful information for employers and
coalitions
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4. What is eValue8?
• Collects information on how health plans use resources
and information to:
o Improve and maintain the health of
members/employees
o Improve health care delivery system
• Results used by Coalitions and Purchasers to partner with
plans to improve quality
eValue8 measures performance and motivates improvement
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5. What is eValue8?
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©2013 Memphis Business Group on
Health
5
• Standardized evaluation process that:
o Is evidence-based focused on the “drivers” of cost
and health status
• Significant input from CDC
o Uses results from recognized third parties (e.g.
NCQA, Leapfrog) to align strategies
o Puts plans face-to-face with Purchaser clients in a
market
o Serves as a foundation for continuous
improvement and value-based purchasing

6. Aligned with quality criteria
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7. Zeros in on underlying issues
Source: eValue8 2011
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8. Compares performance
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9. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Plan A PPO Plan B PPO Plan B HMO Plan C PPO Plan D PPO Plan E PPO Plan F PPO Possible Best
42% 38% 38% 42% 39% 35%
30%
47%
11%
7% 7%
8%
0%
0% 8%
13%5%
7% 7%
7%
0% 4%
5%
7%12%
6% 9%
12%
6%
0%
4%
12%12%
16%
16%
9%
0%
0%
3%
21%
80.8% 74.8% 77.9% 78.3%
45.6%
39.1%
50.8%
100.0%
PercentofPossiblePoints
eValue8 2012
Patient Safety
Series6
Payment Incentives -Other Patient Safety Measures (e.g.,Complications, Mortality, )
Readmissions (Performance and Payment)
Medication Safety
Admissions to hospitals reporting to Leapfrog and better performing hospitals
Tracks strategies that drive change
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10. Covers the country
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*
Full responses
Full & Partial Responses*
Partial Responses*
Aetna PPO
Cigna PPO
Regence PPO
UHC PPO
Group Health
HMO
Kaiser HMO
PacificSource HMO
PacificSource PPO
*Cigna PPO
*UHC PPO
Kaiser N Cal HMO
Kaiser S Cal HMO
HealthNet HMO
Cigna PPO
HealthNet PPO
UHC PPO
*Aetna PPO
HealthNet HMO
HealthNet PPO
*Cigna PPO
Cigna HMO
Kaiser HMO
Cigna PPO
UHC PPO
*Cigna PPO
Aetna PPO
Excellus PPO
CDPHP HMO
CDPHP PPO
Cigna PPO
MVP HMP
MVP PPO
UHC PPO
Aetna PPO
Capital BC HMO
Capital BC PPO
Cigna PPO
HealthAmerica
PPO
Highmark BS
PPO
UHC PPO
*Cigna
PPO
*UHC
PPO
Cigna
PPO
UHC PPO
*Aetna
PPO
Kaiser
HMO
*Cigna
PPO
*UHC
PPO
*Cigna
PPO
*Cigna
PPO
*UHC PPO
*Cigna PPO
Kaiser HMO
*Cigna PPO
BCBS PPO
Cigna PPO
*UHC PPO
BCBS
HMO
BCBS
PPO
Tufts
HMO
Tufts
PPO
*Cigna
PPO
Kaiser HMO
*Aetna PPO
MD /DC/VA
*Cigna PPO
*UHC PPO
Cigna PPO
*UHC PPO
*Partial response to ~ 80% RFI – consists of responses
that apply irrespective of market (e.g., consumer tools)
as well as market-specific HEDIS and CAHPS
Cigna PPO
*Cigna
PPO
Tufts HMO
Tufts PPO
*Cigna PPO
*UHC PPO
Sponsoring Coalitions
Colorado Business Group on Health
HealthCare 21
Lehigh Valley Business Coalition on Health
Care
Memphis Business Group on Health
Northeast Business Group on Health
Pacific Business Group on Health
Puget Sound Health Alliance
eValue8 2012 respondents

11. Used by many
Public/State Purchasers
• State of TN
• WA State Health Care
Authority, King and
Pierce Counties, City of
Seattle
• NYC Transit Authority
• Schools
 Large and Small Private
Purchasers
Multi-state/National
Carriers
• Aetna
• Cigna
• UHC
• Kaiser
Select regional plans
and Blues Plans
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12. Summary
• What gets measured gets improved - eValue8 is a “ready
made” evidence-based measurement tool based on what
matters to employers/purchasers
• eValue8 is a cost-effective way for employers to fulfill
their fiduciary responsibilities of plan selection and
performance evaluation.
• Standardization of measures that matter goes a long way
toward quality improvement - eValue8 provides a high-
leverage, collaborative mechanism to address the
underlying problems in health care that contribute to high
cost, waste and uneven quality.
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13. Thank You!
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For more information contact:
Cristie Upshaw Travis
CEO
Memphis Business Group on Health
ctravis@memphisbusinessgroup.org