All-Alliance Meeting: Monday, March 11 — Making Health Care More Affordable for Employers and Individuals
Reducing waste and making health care affordable—these are issues that engender more questions than answers. But I’m happy to report there is some encouraging news.
We are fortunate to have a speaker coming to our next all-Alliance meeting who has some provocative things to say on the subject. Chris Koller, President of the Milbank Memorial Fund, has been working on the question of waste and affordability since 1996, when he was CEO of Rhode Island’s Neighborhood Health Plan and continued in 2005, when he became Rhode Island’s Health Insurance Commissioner.
Known for taking progressive stands and leading the way with new ideas, Chris has witnessed first-hand efforts across the country to address waste and affordability. He will be speaking with us about what we here in Washington state might be able to use, given our unique circumstances, and what we should take a pass on. Take access to primary care, for example: Chris will discuss the innovative Multi-State Collaborative, a voluntary group looking at ways to make primary care more accessible and effective.
Members of the Multi-State Collaborative participated in the Comprehensive Primary Care Initiative (CPC), a program of the Center for Medicare and Medicaid Services Innovation Center between 2012 and 2016. Overall, CPC included a collaboration with 38 private and public payers and over 440 primary care practices in seven geographic regions. Despite less than stellar initial results, more recent reporting suggests it worked.
The Health Collaborative (THC), a multi-stakeholder organization based in the greater Cincinnati, Ohio area, participated in the CPC program. THC analyzed the claims data for all participating CPC payers, Medicare, and 75 primary care practices for approximately 450,000 covered lives. It reported significant reductions in treatments at primary care practices from 2013 to 2016. Overall, specialist visits decreased by 24%, hospital admissions decreased 33%, and ambulatory care sensitive admissions decreased 45%. And there was an incredible 37% decrease in overall costs and utilization for Medicare Advantage patients.
But what is really remarkable is that the cause of those reductions was actually pretty simple—individual case management and high levels of post hospital discharge follow-up. Of hospital patients discharged, 94% received a follow-up call within 72 hours and 82% of patients seen in the ED were called to be reminded of scheduling a primary care visit. It’s exciting and encouraging to see such simple changes have such a big impact on health care affordability.
And it’s just that kind of impact on affordability that the Alliance and our partner Milliman MedInsight were recognized for Achievement in Digital Health at Seattle Business Magazine’s 2019 Leaders in Health Care Awards gala last week. In discussing our First, Do No Harm report, Seattle Business magazine Editor in Chief Rob Smith said, “The groundbreaking work done by the Washington Health Alliance and Milliman MedInsight is proof that unnecessary medical care is more common than most people think.” We were delighted to be recognized by Smith as a “hero in health care” at the event and for being recognized as among Washington’s most accomplished health care innovators, “literally transforming health care as we know it.”
We couldn’t agree more, but wait—there is more!
Next week, the Alliance will be releasing two new reports. For the first time, the Alliance will publicly present prices attached to select inpatient treatments so purchasers, payers and consumers can see not only the wide variation of prices across the state, but within individual facilities. And we also report on statewide spending and break it down to see exactly how different factors contributed to the change. We look at how the number of insured, frequency and intensity of treatment, and price change all played a role in what Washington state spent on inpatient care in 2015 and 2016.
It’s a very exciting time at the Alliance and I thank you for being a part of it.
A friendly reminder–if you haven’t already registered for the All-Alliance meeting, please do so soon, seats are going fast. Email Adria to secure your space.
Published: March 7, 2019