cincinnati usa regional health transformation initiative south carolina business coalition on health...
TRANSCRIPT
Cincinnati USA Regional Health
Transformation Initiative
South Carolina Business Coalition on Health
May 2012
www.TransformCincyHealth.org
Play video
Cincinnati USA Regional Health Transformation Initiatives 2
Cincinnati landscapeFertile ground for change
Extensive health systems– 30+ hospitals
– 5,000 physicians
– Active collaborations Strong experience with
innovative pilots National healthcare IT leader Engaged employer base (GE, P&G, Kroger, Fifth Third, etc.)
Greater Cincinnati Health Care Project
Health LeaderKickoff 3/26
• Call to Action • VOC• Host by Collaborative• GE Facilitate• Cross Industry
Representation• Develop Strawman &
Guiding Principles for Project
• VOC• Verify Strawman• Revise Strawman• Broaden Audience
• Cross Functional Membership
- Chamber - Academy of
Medicine - Health Council - Health
Collaborative - Health Bridge• Develop Strategy• Develop Plan
• Conduit for Improvements/ Efforts
• Specific Project Implementation
ImmeltChamber
Presentation
CommunityHealth Care
Summit — May
SteeringCommittee
ExistingInitiatives/
Venues
GMT• Community
Guidance Team• Keep Project on
Course
VisionMissionScopeBusiness Case
Define
Old Process MapBaselineQFDParetoDefect DefinitionTarget
Measure
Variation DriversPerformance
ObjectivesKey performance
IndicatorsCritical to Process
Factors
Analyze
ToolsIncentivesFundingAcceleratorsEnablers
Improve
Contract Language
Payment Reform
Control
Process: Inclusive, Open, Transparent
2010
Cincinnati Regional Health Transformation Aims
1. Better health2. Better care3. Lower cost
Estimated impact through 2014 (not all inclusive): • 20% improvement in diabetic outcomes • 10% fewer Emergency Department visits• Cost reduction = $500MM+
Cincinnati USA Regional Health Transformation Initiatives 5
How we operate…Regional Health Transformation Sustainability Model
Cincinnati USA Regional Health Transformation Initiatives 6
Social Innovation meets Healthcare Innovation in Cincinnati: Collective Impact for Health
1. Common Agenda2. Shared Measurement3. Mutually Reinforcing Activities4. Continuous Communication5. Backbone Support
Cincinnati USA Regional Health Transformation Initiatives 8
Common Agenda:3 Aims 5 Strategic Priorities
Foundational Goals Healthymagination
3 AimsCommunity Leaders Voice of Customer
Population Health
Experience of Care
Per Capita Cost
Strategic Priorities
Primary Care – specifically Patient-Centered Medical Home
Health Information Exchange that is interoperable across the community and informs the Quality Improvement and Payment Innovations work.
Quality Improvement support for primary care and transitions in care.
Public Reporting that makes quality, price and patient satisfaction transparent and enables consumer engagement.
Payment Innovations that rewards value, using shared savings components.
1
5
4
3
2
Access
Quality
Cost
Shared Measurement: Progress ReportAim Focus Area Measure
Baseline Current Goal Timeline MeasureSteward
Better Care
Optimal Diabetes Care
Diabetes Composite Measure: percent of patients in control of their Diabetes
28% 29% 35% 05/2013
M. Kennedy
Optimal Asthma Care
Percent of “high-risk” pediatric asthma population rated “well-controlled” by physician and parent
28.6% 75.6% 80% 12/2012
K. Mandel
Patient Experience Patient rating of understanding post-hospital instructions (indicator of care coordination)
82% 82% TBD TBD
N. Strassel
Disparity in Care Percent of acute care CES hospitals submitting all three Race, Ethnicity and Language fields accurately and consistently
56% 94% 90% 6/2013 N. Strassel
Access to Primary Care
Percent of the community reporting that they have a usual source of medical care
84% 84% 95% 2020
United Way Bold Goal
Patient Safety Percent reduction in regional rate of Patient Falls (with Injury) and Pressure Ulcers in local hospitals.
.115 falls /1,000; 2.0 pressure ulcers/10,000
.13 falls /1,000; 2.8 pressure ulcers / 10,000
.07 falls /1,000; 1.2 pressure ulcers/10,000
12/2012 N. Strassel
Electronic Health Records Use
Percent of primary care providers that are “meaningful users” (M3) of electronic health record technology
M 1 – 0%M 2 – 0%M 3 – 0%
M1 – 75%M2 – 58%M3 – 0.4%
Meaningful Use (M3) - 60%
2013
D. Groves
Better
Health
Body Mass Index Percent of adults whose BMI is ≥ 30 (BMI is a healthy weight estimate based on height and weight)
30.9% 30.9% 30.6% 2020 J. Chubinski
Tobacco Current smokers29% 29% 12% 2020
J. Chubinski
Mental Health Percent of adults who report good mental health60% 60% N/A N/A
J. Chubinski
Self-reported Health Status
Percent of adults who report being in “excellent” or “very good” health 50% 50%
70% 2020 J. Chubinski
Percent of primary caregivers who report their child’s health status to be “excellent” or “very good”
87% 87% N/A N/A J. Chubinski
Colon Cancer Screen Percent of patients aged 50 – 75 who have received the appropriate colorectal cancer screening
TBD 05/2013 M. Kennedy
Infant MortalityNumber of infant deaths within the first year of life per 1,000 live births (14 county service area)
8.4 8.5 6.0 2020
Ted Folger
Number of infant deaths within the first year of life per 1,000 live births (Hamilton County)
11.1 10.4 6.7 12/2012
Ted Folger
Substance Abuse Percent of adults who report binge drinking in the last month (in a single sitting, 5+ drinks for men; 4+ drinks for women)
19% 19% 24% 2020
J. Chubinski
Lower Cost
Total Cost of CareTotal annual per capita cost of patients with diabetes TBD 05/2013
M. Kennedy
Total annual per capita cost (14 county service area) TBD 05/2013
M. Kennedy
30-day Readmissions Percent reduction in heart failure all-cause readmission rates. 23.63% 23.46% 21.27% 01/2012
N. Strassel
Emergency Department Visits ED visits per 1000 population TBD 05/2013 M. Kennedy
Mutually Reinforcing Activities
11
Continuous Communication: TransformCincyHealth.org
Cincinnati USA Regional Health Transformation Initiatives
Cincinnati USA Regional Health Transformation Initiatives 12
Resulting in better care…
Cincinnati USA Regional Health Transformation Initiatives 13
% high-risk pediatric asthma patients rated “well-controlled”
by MD and parent
2010 2011 2012 Goal0%
20%
40%
60%
80%
100%
Optimal Asthma Care
2009 201020%
25%
30%
35%
40%
Optimal Diabetes Care
Non-PCMH PCMH
% diabetes patients meeting following goals:
1) A1C < 8 2) BP < 140/903) LDL < 1004) Tobacco free
Resulting in lower cost…
Cincinnati USA Regional Health Transformation Initiatives 14
2007 2008 2009 2010600,000
800,000
1,000,000
1,200,000
1,400,000
999,448
1,092,435
1,169,703
1,068,459
Emergency Department Visits
Actual ED visits in ‘10 were 185k less than projected; 100k less than ‘09
*Projected at historical trend of 7%; Estimated cost per ED visit = $1,100
1,252,436*
$200M saved vs. projected