Partnering with Affordable Care Organizations

Vernice Davis AnthonyGreater Detroit Area Health Council

President and CEOOctober 13, 2011

Vision for southeast Michigan•Healthy people, healthy economy

GDAHC Mission•Uniting and leveraging stakeholders to drive collaborative improvements in healthcare quality, cost effectiveness and access to care across southeast Michigan

GDAHC Accomplishments• myCareCompare.org, publicly reports the quality of care provided by area

hospitals more than 80 percent of the area’s general practitioners—in areas like diabetes care, cancer screenings, pediatric care, asthma care and use of generic medications.

• significant improvements in the areas of diabetes management, cancer screenings and appropriate use of antibiotics in children have resulted.

• Early results from our Emergency Department Utilization pilot show reduced emergency room visits for patients who could be treated in a primary care setting.

• Early results from our worksite diabetes self-management program show success in blood sugar control, weight management and lifestyle changes.

• Our Cardiac Initiatives Team is working to reduce hospital readmissions and emergency department use related to heart disease, reducing the risk of inappropriate or unnecessary services and prevention of heart disease.

Detroit at a Glimpse• 1,7 million Michigan residents lack access to primary

care• 1.2 million (12.3%) Michigan residents are age 65 or

older • 8.7% are near seniors (age 55-64)• By 2014, health reform will add almost 4 million

physician office visits, 800,000 new medical enrollee and 635,000 newly insured in Michigan

Network for Regional Healthcare Improvement (NHRI)

• National membership organization for Regional Health Improvement Collaboratives

• Many NHRI members are also Chartered Value Exchanges designated by HHS and AHRQ

Prime Time for Collaboration

CMS

RHICACO

NHRI

Partnerships with Community Stakeholders

• Endorse requiring partnerships with community stakeholders to advance triple aim• RHICs are already engaged in• Performance Measurement• Payment & Delivery System Reform• Training & Assistance in Performance

Measurement• Consumer Engagement & Education

NHRI Recommendations to CMS(highlights)

• Require collaboration with RHICs• Fund RHICs to educate Medicare

beneficiaries • Encourage community-wide patient

experiences surveys conducted by RHICs

NHRI Recommendations to CMS(highlights)

• Draw on expertise of RHICs in collecting and reporting patient experience• Expand quality measures to include all

patients• Provide Medicare claims data for

beneficiaries within the community

Don’t re-invent the wheel….Don’t re-invent the wheel…

enhance what already exists!