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Finding the Right Care for the Right Price, Cost and Quality (Geof Baker)
1. Finding the Right Care for the Right Price, Right Quality, Right Cost and Right Provider(s) Lessons From Health Plans Deploying Transparency for Consumers Geof Baker, Principal Venture Advisory Services
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4. Measurement Leads To Improvement Denotes measure specification change in 2006 Slide Source: J. Benjamin, NCQA Reporting Best Approaches & Best Practices
5. Public Reporting of Physician Performance Source: Med-Vantage – Leapfrog 2006-2007 National P4P Study Do you use PUBLIC REPORTING on physician performance as part of your P4P program? 2006 Percent (n=55) 2005 Percent (n=78) 2004 Percent (n=50) 2003 Percent (n=28) Yes, we send reports to consumers 5% N/A N/A N/A Yes, we send reports to our enrollees 7% N/A N/A N/A Yes, we send reports to employers 9% N/A N/A N/A Yes, we send reports to all physicians so they can compare their performance to their peers 31% N/A N/A N/A Yes, we publish information in local newspapers 4% N/A N/A N/A Yes, we post information in the provider directory on our Web site 27% N/A N/A N/A Yes 44% 32% 30% 29% No 45% 68% 70% 71% Other 11% N/A N/A N/A
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7. The Road to Transparency…Where Do We Go From Here? We are missing a significant opportunity to shape the consumer decision process before patients seek treatment
20. What do Purchasers Think So Far? “ Current Information is not up to the job of enabling consumers to compare provider costs and quality – particularly about physicians. There are signs of progress and room for improvement.” Source: “The CDH Implementation Experience with Larger Employers,” California Healthcare Foundation, RWJ, July 2007 Few Employers give high overall ratings for cost and quality comparison tools
21. What do Purchasers Think So Far? Source: “The CDH Implementation Experience with Larger Employers,” California Healthcare Foundation, RWJ, July 2007
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23. What is the Government Advocating? “ Every American should have access to a full range of information about the quality and cost of their health care options.” - Secretary Leavitt 2. Connectivity & Interoperability 1. Incentives (P4P) 4. Benchmarks, standards & reliable measurement 3. Transparency (Cost & Quality) Government Initiatives (4 Cornerstones) vs. HHS
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25. What the Public Thinks Peter D. Hart Research Associates Survey, October 2007 Do you have reliable information about how often your doctor provides the right treatment/right amount of care? I don’t have information I have some information, but could use more I have reliable information Not sure
26. Public Supports Consumer Information System About Doctors Support Oppose Definitely support 32% 82% 14% Peter D. Hart Research Associates Survey, October 2007
27. Source: Forrester Research, Q2 2007, survey of online survey of 3,403 nonelderly, commercially insured U.S. consumers who use online health care tools What On-Line Healthcare Tools are Members Using?
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