CORE METRICS FOR BETTER CARE, BETTER HEALTH, AND LOWER COSTS
An Institute of Medicine Workshop
Sponsored by Blue Shield of California Foundation
A Learning Health System Activity
IOM Roundtable on Value & Science-Driven Health Care
December 5–6, 2012
The Beckman Center of The National Academies
100 Academy Way
Irvine, CA 92617
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Appendix B Workshop Agenda Core Metrics for Better Care, Better Health, and Lower Costs An Institute of Medicine Workshop Sponsored by Blue Shield of California Foundation v A Learning Health System Activity IOM Roundtable on Value & Science-Driven Health Care December 5–6, 2012 The Beckman Center of The National Academies 100 Academy Way Irvine, CA 92617 Meeting Goals 1. Discuss the vision for the nature, use, and impact of core health metrics. 2. Identify the important principles, targets, infrastructure, processes, strategies, and policies. 3. Describe lessons from efforts at national, state, community, and organization levels. 4. Specify core needs and requirements and propose priority metric categories that will most reliably measure care outcomes, care costs, and health improvement. 5. Consider specific examples of metric options within categories. 6. Describe the implementation strategies—national, state, commu- nity, organizational. 117
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118 CORE MEASUREMENT NEEDS Wednesday, December 5 8:00 a.m. Coffee and light breakfast available 8:30 a.m. Welcome, introductions, and overview Welcome from the IOM Michael McGinnis, Institute of Medicine Welcoming remarks Peter Long, Blue Shield of California Foundation Opening remarks and meeting overview Jones, Vermont Blueprint for Health (Planning Craig Committee Chair) 9:00 a.m. Core metrics and health progress: Vision, principles, uses, requirements Discuss the purpose of core metrics, review examples of their usefulness, consider their development and use at national, state, community, organizational, and individual levels, and preview some of development and implementation challenges. Vision and importance of measuring the three-part aim Maureen Bisognano, Institute for Healthcare Improvement Vision for a systems approach to achieve the three-part aim George Isham, HealthPartners Q&A and Open Discussion Session Chair: Craig Jones, Vermont Blueprint for Health 10:15 a.m. Break 10:30 a.m. Current state of measurement Discuss the inventory of current primary efforts, their relationships to each other, the categories of issues they cover, and the key discrepancies between the measurement vision and the current state of assessment on the three dimensions at the various levels. Illustrate issues with case studies.
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APPENDIX B 119 The role of measurement in the National Quality Strategy Carolyn Clancy, Agency for Healthcare Research and Quality Key challenges and opportunities for current measurement capabilities Helen Burstin, National Quality Forum Consistent and timely measure implementation Barbara Gage, The Brookings Institution Q&A and Open Discussion Session Chair: Ed Sondik, Centers for Disease Control and Prevention 12:00 p.m. Lunch 12:30 p.m. Priority requirements and needs in measuring health, care, and cost Consider the principles for choosing the core metrics— priorities for improving care, lowering costs, improving health; regulatory and program requirements; available capacity. Accountable care and measuring the three-part aim Eugene Nelson, The Dartmouth Institute for Health Policy and Clinical Practice General themes for implementation Matt Stiefel, Kaiser Permanente Case studies of current initiatives for measuring the three-part aim Craig Jones, Vermont Blueprint for Health Q&A and Open Discussion Session Chair: Anne Weiss, Robert Wood Johnson Foundation
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120 CORE MEASUREMENT NEEDS 2:00 p.m. Breakout groups: Proposed options for measuring health, care, and cost Identify potential sets of core metrics to track progress toward better care, better health, and lower costs at national, state, community, organizational, and individual levels. Outline the primary challenges, opportunities, and measurement needs. Health Leader: Patrick Remington, University of Wisconsin Opening Context: Steven Teutsch, Los Angeles County Department of Public Health Health care Leader: David Stevens, National Association of Community Health Centers Opening Context: Mary Barton, National Committee for Quality Assurance Cost Leader: Kate Goodrich, Centers for Medicare and Medicaid Services Opening Context: Dennis Scanlon, Pennsylvania State University 4:00 p.m. Report back from breakout groups 5:00 p.m. Wrap up of the day’s discussions Summarize common themes heard in Day 1. 5:30 p.m. Recess to Reception Thursday, December 6 8:00 a.m. Coffee and light breakfast available 8:30 a.m. Summary of Day 1 9:00 a.m. Getting there from here: Panel discussion on implementation Examine strategies for successfully advancing measurement of the three-part aim using case studies of individual initiatives.
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APPENDIX B 121 Analyzing health status in all counties Patrick Remington, University of Wisconsin Implementing statewide measures on access, cost, quality Stefan Gildemeister, Minnesota Department of Health Measurement framework for coordinated care in Medicaid Carole Romm, Oregon Health Authority Q&A and Open Discussion Session Chair: Diana Dooley, California Health and Human Services 10:15 a.m. Break 10:30 a.m. Requirements for building the infrastructure Explore the common themes around the data, technical, and social infrastructure necessary to advance measurement. This will especially consider the challenges and opportunities for making measurement a routine component of the health care and health systems. Data infrastructure needs for measurement Larsen, Office of the National Coordinator for Kevin Health Information Technology Case examples of building the infrastructure Chris Queram, Wisconsin Collaborative for Healthcare Quality Building the data infrastructure in a health care environment Bruce Ferguson, East Carolina University Q&A and Open Discussion Session Chair: David Stevens, National Association of Community Health Centers
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122 CORE MEASUREMENT NEEDS 12:00 p.m. Moving forward: Policy options and practical strategies workshop will conclude with a session that The summarizes the discussions and outlines the path for moving these metrics into practice. Comments from the Chair Craig Jones, Vermont Blueprint for Health Comments and thanks from the IOM Michael McGinnis, Institute of Medicine 1:00 p.m. Adjourn ********************************************* Planning Committee Craig Jones (Chair) Vermont Blueprint for Health David Atkins Veterans Health Administration Maureen Bisognano Institute for Healthcare Improvement Michael E. Chernew Harvard Medical School Diana S. Dooley California Health and Human Services Julie Gerberding Merck and Co, Inc. Marjorie Ginsburg Center for Healthcare Decisions Kate Goodrich Centers for Medicare & Medicaid Services George J. Isham HealthPartners, Inc. Peter Margolis Cincinnati Children’s Hospital Medical Center Leo S. Morales University of California, Los Angeles Judy Murphy Office of the National Coordinator for Health Information Technology Samuel R. Nussbaum WellPoint, Inc. Patrick Remington University of Wisconsin School of Medicine and Public Health Edward J. Sondik National Center for Health Statistics David M. Stevens National Association of Community Health Centers George Washington University School of Public Health and Health Services Thomas B. Valuck National Quality Forum Anne F. Weiss Robert Wood Johnson Foundation Nancy Wilson Agency for Healthcare Research and Quality Staff officer: Robert Saunders firstname.lastname@example.org 202.334.2747