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Lucy Savitz , Ph.D., MBA Director of Research and Education

The High Value Healthcare Collaborative (HVHC) Model for Driving Innovation/Spread in Care & Payment Reform. Lucy Savitz , Ph.D., MBA Director of Research and Education Institute for Health Care Delivery Research Intermountain Healthcare. Sustainable H ealth S ystem, Provider-driven.

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Lucy Savitz , Ph.D., MBA Director of Research and Education

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  1. The High Value Healthcare Collaborative (HVHC) Model for Driving Innovation/Spread in Care & Payment Reform Lucy Savitz, Ph.D., MBA Director of Research and Education Institute for Health Care Delivery Research Intermountain Healthcare

  2. Sustainable Health System, Provider-driven The High Value Healthcare Collaborative (HVHC) is a collaborative of provider organizations who’s mission is to: • improve healthcare value – defined as quality and outcomes over costs, across time – for its service population in the U.S. • Serve as a model for national healthcare reform.

  3. Sustainable Health System, Provider-driven HVHC delivers on its mission by: • identifying best-practice care models • testing value-based payment models • accelerating adoption of these models through: • collaborative improvement efforts • a common information infrastructure • tools to support care delivery Resulting in: 1)Improved Population Health, 2)Value-Based Care, and 3)Reduced Costs.

  4. 20 Members and Growing 31 states; patients in every state

  5. Working together, we can really make a difference 70,000 PHYSICIANS 300,000 STAFF 31 STATES 20 MEMBERS 70,000,000 PATIENTS 200 HOSPITALS 30,000 BEDS

  6. Founding Partners • Mayo Clinic • Intermountain Healthcare • Dartmouth Hitchcock Medical Center • (The Dartmouth Institute (TDI) – data center, convener) • Denver Health

  7. Partners • Baylor Health Care System • Scott & White Healthcare • University of Iowa Health Care • Beaumont Health System • North Shore-Long Island Jewish Health System • MaineHealth • Providence Health & Services (affiliate) • UCLA Medical Center • Virginia Mason Medical Center • Beth Israel Deaconess Medical Center

  8. More Partners • Hawaii Pacific Health • Sinai Health System • NYU • Boston Children’s • Dept of Defense Tricare (MCA signed)

  9. All are integrated delivery systems • (+/- insurance – ownership vs. partnership) • Other systems showing active interest • Core funding: Annual member payments • supplemented by grants

  10. Core Activities • MCA – Master Collaborative Agreement: establishes principles by which we work together and share data • Criteria for Membership • “All in” collaborative projects – • Total knee (e.g., HA article) • Diabetes mellitus • Heart failure (just starting) • Episodic bundled payment (focus: total knee) • Medicare data base analysis

  11. Core Activities (continued) • Voluntary collaborative projects – • CMMI Innovation Challenge - ~$120 million • Shared Decision Making – hip, knee, spine, diabetes, HF • Sepsis • 3 QI projects in complex chronically ill patients • Other

  12. Shared Learning • 3 levels of deployment: • Directly participate in a project • Adopt a success from another subgroup • (direct access to front-line, hands-on expertise) • Transparently Publish

  13. HVHC Organization Structure HVHC Program

  14. HVHC Data Trust & Collaborative Tools

  15. HVHC TKR patients, every state

  16. Cost = cost per episode x # of episodes Variation in cost per episode: Cost of TKRs across HVHC sites Variation in # of episodes: # of TKRs across HVHC sites

  17. Sample: % TKR Patients Discharged to Self-care Site E higher due to lack of insurance Site G higher due to intentional process HVHC is now testing

  18. Sample: TKR Length of Stay (LOS) Improvement Early results of change Average Length of Stay (in days) Site C has reduced its Length of Stay for TKRs by almost a day

  19. CMMI Innovation Challenge Award The goals of this initiative are to: • Improve quality, outcomes, and cost of care by advancing best practice care models for patients considering hip, knee, or spine surgery and patients with diabetes, congestive heart failure, or sepsis • Improve patient experience and reduce utilization and total cost by implementing: • Shared decision making (SDM) interventions for preference-based decisions (hips, knees, spine surgery) • Patient engagement interventions (e.g., decision tools, motivational interviewing, patient management) for complex patients with diabetes or CHF

  20. Patient Data: identify best practices, assess impact of change, support research 35,000 Knee Patients 55,000 Knee Surgery Patient Data Cohorts 385,000 Diabetes Patients 39 Million CMS Beneficiaries 40,000 Sepsis

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