Alliance Resources Help Increase Value-Based Care

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Alliance Resources Help Increase Value-Based Care

The Washington Health Alliance (Alliance) and Bree Collaborative (Bree) at the Foundation for Health Care Quality are teaming up to encourage everyone involved in the Washington state health care system to act to improve health and health care for all Washingtonians. Bree Chair Dr. Hugh Straley and I asked participants at the close of our recent Value-Based Care Summit (recording available here) to join this effort and make it a priority.

At the Summit, we heard Washington State Health Care Authority (HCA) Director Sue Birch and Chief Medical Officer, Dr. Judy Zerzan-Thul discuss the ways in which HCA is advancing the adoption of value-based payments on behalf of the Washingtonians it represents, which includes all public, and many school district employees, along with those who access care through the state’s Medicaid plan, Apple Health. The HCA has made steady progress towards the goal of driving 90% of state-financed health care to value-based payment by 2021, but to help realize the changes required to fundamentally shift the way care is delivered in the state, all stakeholders need to act.

We are delighted to be partnering with the Bree on this important initiative. Watch your inbox for a special joint communication that will give you the opportunity to make public your commitment to change as we prepare the ways we will support your efforts. In the meantime, I hope you will consider some of the Alliance’s many resources that can help you achieve your organizational goals to increase value-based care.

If you are a purchaser:

  • Make the commitment to purchase for value and educate employees why this is important to their health and well-being. Compare how medical groups and clinics rank across the state with the Quality Composite Score and see the 10 services that accounted for 94% of the low-value care analyzed over four years in the latest First, Do No Harm report, and incorporate these findings into benefit plan design.
  • Ask health plan partners, brokers and consultants about the contracts health plans have in place with providers to reward high value performance and how that high value care is best accessed by your employees.

If you are a provider:

  • Review the Alliance’s Quality Composite Score to see where you are doing well and which areas could use some attention across 29 measures considered strong indicators of primary care quality. Have you incorporated these findings into your quality improvement priorities for 2021?
  • Evaluate how much low value, non-evidenced based care you are providing. The Alliance’s First, Do No Harm report identifies 47 measures of common treatments, test, and procedures identified by Choosing Wisely® and the medical community to be overused. Compare these results to your internal data and identify opportunities for improvement.
  • Recognize that there is tremendous variation in practice patterns in our state. What operational steps are you taking to raise the practice level of all practitioners within your group to as close to the 90th percentile of national performance metrics as possible?

If you are a plan:

  • Consider whether your value-based plan offerings balance quality and cost performance of providers, or are they more heavily weighted toward cost savings? Increasing high value cost-effective preventive care, particularly for people with chronic diseases, for example, can result in better outcomes, and significant long-term cost savings.
  • Can we work collaboratively to develop a common set of quality performance measures to really move the needle on improving the quality of care in Washington, while minimizing administrative burdens for providers that have a different set of measures for each health plan they work with?

It’s true that no one stakeholder group can move the market to value alone. By working collectively, I know we can make this happen.

All the best,

Nancy

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