HealthMart 2005 Conference - Session 2 Description
"Paying for Quality: Does it add up?"
Friday, September 30, 2005 - 8:00am-4:00pm
Marriott Hotel, Rt 128 & 3A (One Mall Road), Burlington, MA |
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Session 2 Description:
Current Programs in Quality Performance
Panelists to Report on Array of Quality Performance Programs |
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Pay-for-performance programs take many forms, and those playing leadership roles on the state and national levels will describe various incentive programs during the "Current Programs in Quality Performance" session at the Consortium's HealthMart 2005 conference, "Paying for Quality: Does it add up?"
R.S. Johannes, MD, MS, Vice President of Medical Affairs for Cardinal Health-MediQual, will moderate the panel. He will discuss Cardinal Health analysis of hospital discharge data collected over 20 years in Pennsylvania -- including administrative data, vital signs and lab data -- and how it fits into the pay-for-performance movement.
He will be joined on the panel by Jeff East, President and CEO of MassPRO; Peter Goldbach, MD, Medical Director, Office of the Chief Physician Executive, Blue Cross Blue Shield of Massachusetts; and Dolores Mitchell, Executive Director of the Group Insurance Commission.
The Group Insurance Commission, which provides health care coverage for employees and retirees of the Commonwealth of Massachusetts, is engaged in a three-year program that attempts both to measure cost effectiveness and provide incentives for both patients and providers, according to Mitchell.
"The ongoing program emphasizes measuring resource utilization and quality of patient care and using the data to build tiered networks," said Mitchell.
The program started with limited hospital tiering, with the goal of adding physicians next year. The GIC, working with Mercer Human Resource Consulting, has analyzed three years of data for 2 million lives through the program, based on the books of business for each of the six health plans it works with, said Mitchell, who will discuss what has been learned through the ongoing program during her presentation.
As the federally designated Quality Improvement Organization (QIO) for Massachusetts, MassPRO has been a key player in health care quality improvement through its involvement with pay-for-performance (P4P) initiatives, promotion of health information technology (HIT), and collaboration with national and local stakeholders.
MassPRO's involvement with P4P programs includes partnerships with the Centers for Medicare & Medicaid Services, Bridges to Excellence program, and the American Heart Association. Specifically, it is seeking to streamline clinical measures across initiatives to avoid spreading incentives across too many measures, which could be confusing and challenging for participants. Looking toward the future, East sees the potential for P4P to spread into other clinical settings such as the nursing home arena.
In addition to its direct involvement in P4P initiatives, MassPRO also is promoting the adoption of HIT, which is closely linked to such initiatives.
"At the local level, we're one of only four pilot sites for the Doctors' Office Quality-Information Technology project," East said.
Involvement in this project is significant, because it promotes the utilization of electronic health records (EHR) in small-to-medium-size physician practices, which provide the majority of office-based medical care. Through the project, MassPRO is teaching physicians to utilize EHRs and other HIT to improve patient care and safety, qualify for P4P programs and increase office efficiency. It is expected that P4P financial incentives will become available early in 2006 and that Massachusetts will be eligible as a pilot state.
Dr. Goldbach will discuss Blue Cross-Blue Shield's strong pay-for-performance programs in the provider community, with both physicians and hospitals.
Blue Cross-Blue Shield is partnering with the Institute for Healthcare Improvement in its pay-for-performance efforts, adopting some of IHI's measures and incorporating feedback from the community.
HealthMart 2005 will be held on Friday, Sept., 30, at the Marriott Hotel in Burlington.
For further information on any of our conferences and events, please contact Ellen Kreopolides, Event Planner, via e-mail or by phone (781)768-2519. If you would like information on exhibiting opportunities for this or other events, please contact Arleen Coletti, Director of Member & Exhibiting Services via e-mail or by phone (781)768-2512.
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