CBGH Monthly Strategy Session Agenda

215 S. Wadsworth Blvd, Suite 250 Lakewood, CO 80226

303.922.0939

NOVEMBER STRATEGY SESSION Quality, Affordability, and Hospital Safety – An Update for Employers

Thursday, November 8, 2018 Lunch & Networking 11:30 am to 12:00 pm — Meeting 12:00 pm to 3:00 pm

Kaiser Permanente Lone Tree, 10240 Park Meadows Drive, Lone Tree, CO Room: Bluffs Room, 5th Floor

CBGH Conference Line: 712-770-8001, Code: 227407

To Register: Eventbrite

AGENDA

Meeting Purpose: Hear how various non-profit organizations are aiding Colorado employers and consumers in achieving healthcare affordability, transparency in pricing and hospital safety. The session will start with an employer roundtable discussion of the top 3 healthcare priorities for 2019.

Topic/Description Speaker Time Lunch & Networking All 11:30 am -

12:00 pm

Welcome/Introductions Welcome to our speakers and guests

Jeanne Thrower Aguilar President, CBGH Board

12:00 pm

Review of Meeting Purpose and Agenda A summary of the meeting purpose

Bob Smith Exec. Director, CBGH

12:05 pm

Employer Roundtable Discussion

“Employers, what are your 3 top healthcare priorities for 2019?”

All Moderated by Bob Smith

12:15 pm

Connect for Health Colorado

An update on Colorado’s Health Insurance Marketplace

Kevin Patterson CEO, Connect for Health CO

12:55 pm

Break 1:30 pm

Colorado Consumer Health Initiative (CCHI)

CCHI Policy Priorities for 2019

Adela Flores Brennan Executive Director, CCHI

1:45 pm

Leapfrog Fall 2018 Hospital Safety Grades

Release of the Fall 2018 hospital safety grades in Colorado and how they reflect national consolidation trends

Lisa Slavinski, Program Manager, CBGH

2:25 pm

Q&A All 2:45 pm

Adjournment

Bob Smith 3:00 pm

CBGH Monthly Strategy Session Agenda

Meet the Speakers Adela Flores Brennan, Executive Director Colorado Consumer Health Initiative (CCHI) Adela came to CCHI from Connect for Health Colorado where she was director of community-based assistance programs, and managed two statewide networks of organizations to provide outreach, education and assistance with application and enrollment. Adela brings nearly 15 years of experience in law and public policy in Colorado, the past seven years in health care policy. Adela graduated from the University of Denver with a BA and MA in International Studies and from the University of Colorado with her JD. As CCHI’s executive director, she is responsible for advancing public policy, guiding strategic and operational planning, and providing leadership and management support. Outside of work, Adela enjoys running. She is also an avid gardener, although she admittedly ends up killing most of what she plants. Kevin Patterson, Executive Director Connect for Health Colorado Kevin Patterson was named Chief Executive Officer of Connect for Health Colorado in April of 2015. Kevin previously served as chief administrative officer to Gov. John Hickenlooper and has an extensive history of public service. He has served as the interim executive director of three state agencies during leadership transitions, the Governor’s Office of Information Technology, the Colorado Department of Local Affairs and the Governor’s Energy Office. He brings a strong understanding of state government and stakeholder engagement to this role. Kevin has held leadership roles for the city and county of Denver in the Budget Office, the Planning Department, the Department of Human Services, the Department of General Services and the Department of Parks and Recreation. As the governor’s chief administrative officer, he served as a member of the State Board of Equalization, the Capitol Building Advisory Committee, the State Internet Portal Authority, and supervised 10 gubernatorial appointed public trustees. He was elected to the Denver Board of Education in 2001 and 2005. Kevin graduated with a BA in Teaching from Sam Houston State University and holds both a Masters of Public Administration and Masters of Urban Regional Planning from the University of Colorado at Denver. Lisa Slavinski, Program Manager CBGH Lisa is responsible for the management and accountability of various programs related to healthcare quality and improving value for CBGH members. She helps to manage the day to day operations as well as helping set strategic directions for CBGH programs including the National Diabetes Prevention Program (NDPP) grant, CBGH annual conference and other educational programs, the Leapfrog Group program and eValue8. Prior to CBGH, Lisa was the Assistant Director of Education at the Academy of Managed Care Pharmacy (AMCP) in Alexandria, VA from 2003 – 2012. She was responsible for the management of educational programs for the organization’s two national conferences. Outside of work, Lisa is an avid runner and is a volunteer for the Wounded Warrior Project organization.

COLORADO STATE EXCHANGE PRESENTATION TO THE COLORADO BUSINESS GROUP ON HEALTH

Kevin Patterson

CEO, Connect for Health Colorado

2

Overview

• Historical Context

• Current State

• Our Value to Customers – Open Enrollment

• Future Possibilities

3

Historical Context

• Started from a bipartisan report issued in 2008

• Stated 32 principles of health reform for CO

No one size fits all approach

• C4HCO came from an idea of a connector

• Not a state agency, but a separate nonprofit

• Affordable Care Act became federal policy

4

Current State

• Finished a strategic plan

• Reduced CO uninsured rate from 15% to 6.7%

• Great for those who qualified for tax credit, and tough for those above 400% FPL

• Lots of time and attention on individual market, but not enough on small group

• Federal political context is a consistent challenge

5

Our Value to Customers

Financial help – The only place to receive tax credits that help lower the monthly cost of health insurance.

Transparency - Compare plans and prices from multiple health insurance companies.

Quality coverage - Includes essential health benefits and cover preventive services at no charge.

Expert in-person help in your area.

6

Our Value to Customers-Next Chance to Buy

The next Open Enrollment Period:

November 1, 2018 - January 15, 2019 Special Enrollment Periods Available for any of the following:

Lost employer coverage

Lost Medicaid coverage

Gotten married

Moved to Colorado

Turned 26

Had a baby

7

Our Value to Customers-Financial Help

Financial help available to lower the cost of health insurance, only through Connect for Health Colorado.

Premium Tax Credit • Lowers your monthly payment (premium).

• You can also take it at the end of the year.

Cost-Sharing Reductions • Makes your copayments, deductible, prescriptions and out-of-

pocket maximum lower.

8

Our Value to Customers-Explore plans & prices

Planfinder.ConnectforHealthCO.com/

9

Our Value to Customers-We’re Here to Help

10

Future Possibilities

• Shift focus from coverage to access

• Leverage carrier relationships

• Transparency role for exchanges as neutral party

• Better use our new public benefits corporation

• High Risk Pool v Reinsurance (waivers)

• Western Regional Exchange/best practices among exchanges

11

Thanks for your attention. Questions?

www.ConnectforHealthCO.com

CCHI: Who we are, what we do Colorado Business Group on Health

November 2018

2

Advancing the consumer perspective to improve health care

Colorado Consumer Health Initiative

VISION:

EQUITABLE ACCESS TO AFFORDABLE, QUALITY HEALTH CARE FOR ALL COLORADANS

The Colorado Consumer Health Initiative

(CCHI) is a statewide, non-partisan, non-

profit membership organization working so all

Coloradans can get affordable, high-quality

and equitable health care.

CCHI was created in 2000 to be a

counterweight to powerful health care

interests by building a cohesive consumer

voice among health advocacy organizations

and their constituents.

3

Advocate, engage, collaborate and educate

What we do

Advocacy for change by working with decision-makers at the

capitol and regulatory agencies and directly for clients

Consumer engagement through listening and sharing consumer

stories and advocacy training

Public Education through presentations, websites and

campaigns

Build alliances among community members and organizations

4

Consumer Assistance Program

New this year

• Client support navigating billing and claims issues. • Negotiation with providers and collections on payment

plans. • Identification of financial assistance programs. • Support with eligibility and enrollment. • Referrals.

6

Support>Engagement>Advocacy

How we work

Consumer Assistance Program

Policy Outreach

and Engagement

7

CCHI Legislative Priorities

Legislation

1

2

3

New coverage options

Surprise medical billing

Prescription drug costs

4 Market stability; mental health; primary care

proactive

8

CCHI Priorities

Regulation

1

2

3

Short-term health plans

Network adequacy

Nondiscrimination

4 Noticing

9

Federal-level advocacy

Protect our Care Colorado

Prevent the repeal of the Affordable Care Act.

Prevent the dismantling of the Medicaid program through

block grants, per capita caps or defunding of specific

Medicaid populations.

Build a large and effective coalition that will continue to

advocate for health coverage and access in Colorado in

the coming months and years.

Advocate for improvements to the Affordable Care Act

that provide stability for the insurance market, broad

coverage and affordability.

10

Our voices are stronger together

Become a Member

Your voice can have an impact

Stay informed

Collaborate with other advocates

$50 individual

$150 - $300 for organizations

Facebook, Twitter, Membership

Connect with CCHI!

Twitter: @COHealthAccess or @CCHIPolicy Facebook: facebook.com/cohealthaccess Online: cohealthinitiative.org Adela Flores-Brennan Executive Director afbrennan@cohealthinitiative.org

2018 Fall Leapfrog Hospital Safety Grades

Lisa Slavinski Program Manager November 8, 2018

What We’ll Cover

• Who is The Leapfrog Group?

• Explanation of the Leapfrog Hospital Safety Grades

• Fall 2018 Leapfrog Colorado Hospital Safety Grades

• Grade Comparisons from Fall 2017 to Fall 2018

The Leapfrog Group

Founded in 2000 by large employers and other purchasers, the Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American health care. The Leapfrog Hospital Survey collects and transparently reports hospital performance, empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions. The Leapfrog Hospital Safety Grade, Leapfrog's other main initiative, assigns letter grades to hospitals based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents, and infections.

Explanation of the Hospital Safety Grades

• 41 Hospitals received grades of the 72 hospitals in the state.

• CO ranked 9th nationally for Fall 2018. Ranked 6th for Spring 2018.

• Leapfrog Top Hospital Award-Teaching: Saint Joseph Hospital.

• Leapfrog calculates a Safety Grade for general acute care hospitals for which there is sufficient publicly available data.

• Leapfrog Group is not able to calculate a Safety Grade for:

• Hospitals missing data for more than 7 process/structural measures or more than 5 outcomes measures. This is the reason a majority of CO rural hospitals do not receive a grade.

• Critical access hospitals; Specialty hospitals; Free-standing pediatric hospitals; Federal hospitals; US territory hospitals; MH, LTC & Rehab facilities.

12/14/17 4

Explanation of the Hospital Safety Grades

• 27 evidenced-based measures of patient safety collected & publicly reported by Leapfrog and the Centers for Medicare & Medicaid Services.

• Secondary data from the AHA’s Annual Survey & HIT Supplement.

• Two domains of measures: 1) 13 Process/Structural Measures

2) 15 Outcomes Measures

Process & Structural Measures

1. Computerized Physician Order (CPOE)

2. Bar Code Medication Administration (BCMA)

3. ICU Physician Staffing

4. NQF Safe Practice 1: Leadership Structure & Systems

5. NQF Safe Practice 2: Culture Measurement, Feedback & Intervention

6. NQF Safe Practice 4: Identification & Mitigation of Risks & Hazards

7. NQF Safe Practice 9: Nursing Workforce

8. NQF Safety Practice 19: Hand Hygiene

9. Hospital Consumer Assessment of Healthcare Providers & Systems (H CAHPS®)-1: Nurse Communication

10. H CAHPS®-2: Doctor Communication

11. H CAHPS®-3: Staff Responsiveness

12. H CAHPS®-5: Communication about Medicines

13. H CAHPS®-6: Discharge Information

Outcomes Measures 1. Foreign Object Retained

2. Air Embolism

3. Falls & Trauma

4. Central Line Associated Bloodstream Infections (CLABSI)

5. Catheter Associated Urinary Tract infection (CAUTI)

6. Surgical Site Infection: Colon

7. MRSA

8. C.Diff.

9. PSI 3: Pressure Ulcer Rate

10. PSI 4: Death rate among surgical inpatients with serious treatable conditions

11. PSI 6: Iatrogenic pneumothorax rate

12. PSI 11: Postoperative respiratory failure rate

13. PSI 12: Perioperative PE/DVT rate

14. PSI 14: Postoperative wound dehiscence rate

15. PSI 15: Unrecognized Abdominopelvic Accidental Puncture/Laceration Rate

Colorado 2018 Fall Hospital Grades Denver & Front Range Hospitals Grades “A” Grade: 1. Centura Health Penrose Hospital

(COS)

2. Centura Health St. Francis Medical Center (COS)

3. Denver Health

4. Lutheran Medical Center

5. McKee Medical Center (Loveland)

6. Medical Center of Aurora

7. North Suburban Medical Center

8. Presbyterian-St. Lukes Medical Center

9. Rose Medical Center

10. Saint Joseph Hospital

11. Sky Ridge Medical Center

12. Swedish Medical Center

13. Vail Health

12/14/17 8

Colorado 2018 Fall Hospital Grades Denver & Front Range Hospitals Grades

“B” Grade: 1. Centura Health Castle Rock

Adventist Hospital

2. Centura Health Littleton Adventist Hospital

3. Centura Health Porter Adventist Hospital

4. Good Samaritan Medical Center

5. Platte Valley Medical Center

6. Northern CO Medical Center

7. UC Poudre Valley Hospital

Colorado 2018 Fall Hospital Grades Denver & Front Range Hospitals Grades

“C” Grade: 1. Boulder Community Foothills

Hospital

2. Centura Health Parker Adventist Hospital

3. Centura Health St. Anthony Hospital

4. Centura Health St. Anthony North Hospital

5. Longmont United Hospital

6. UC Health Medical Center of the Rockies Hospital

7. UC Health Memorial Hospital Central (COS)

8. UC Health University of CO Hospital

Colorado 2018 Fall Hospital Grades

Pueblo

“C” Grade: Centura Health St. Mary’s Corwin Medical Center

“D” Grade: Parkview Medical Center

Western Slope

“A” Grade: 1. St. Mary’s Hospital & Medical

Center (Grand Junction)

2. Valley View Hospital (Glenwood Springs)

“D” Grade: Community Hospital (Grand Junction)

Colorado 2018 Fall Hospital Grades Rural Colorado “A” Grade: 1. Centura Health St. Thomas Moore Hospital (Canon City)

2. Sterling Regional Medical Center (Sterling)

“C” Grade: 1. Centura Health Avista Adventist Hospital (Louisville)

2. Delta County Memorial Hospital (Delta)

3. Mercy Regional Medical Center (Durango)

4. Montrose Memorial Hospital (Montrose)

5. Regional Medical Center (Alamosa)

6. UC Health Yampa Valley Hospital (Steamboat Springs)

Hospital Safety Grades Comparison

Fall 2017 to Spring 2018 Spring to Fall 2018 • Ranked 9th Nationally • 2 Grade “D” Hospitals • 3 hospitals from Grade “A” to “C” • 9 hospitals stayed a Grade “C” • 3 hospitals stayed a Grade “B” • 2 hospitals from Grade “C” to “A” • 12 hospitals stayed a Grade “A” • 1 hospital received its first Safety

Grade, an “A”

• Ranked 6th Nationally

• No Grade “D” hospitals

• 1 hospital from Grade “A” to “C”

• 8 hospitals stayed a Grade “C”

• 3 hospitals stayed a Grade “B”

• No hospitals from Grade “C to “A”

• 15 hospitals stayed a Grade “A”

Leapfrog Group Information

• The Leapfrog Group: www.leapfroggroup.org

• Leapfrog Hospital Safety Grades: www.hospitalsafetygrade.org