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FLORIDA’STRANSPARENCY
INITIATIVES
FLORIDA’STRANSPARENCY
INITIATIVES
Lisa K. RawlinsDirector, Quality and Process ImprovementBroward Health
Lisa K. RawlinsDirector, Quality and Process ImprovementBroward Health
Page 2
Florida’s VisionFlorida’s Vision Governor Bush and Florida Legislature Leadership
Transparent health care delivery system
“The 2004 Affordable Health Care for Floridians Act” 2004 - HB 1629 2006 – HB 7073
Stakeholder Advisory Council
Consumer – focused websites
“Shopping” for quality health care
Governor Bush and Florida Legislature Leadership
Transparent health care delivery system
“The 2004 Affordable Health Care for Floridians Act” 2004 - HB 1629 2006 – HB 7073
Stakeholder Advisory Council
Consumer – focused websites
“Shopping” for quality health care
Page 3
Transparency Initiatives: Pieces of
the Puzzle
Transparency Initiatives: Pieces of
the Puzzle1. Prescription Drugs retail prices
www.MyFloridaRx.com (July 2005)
2. Health Care Facilitieswww.FloridaCompareCare.gov (November 2005)
Hospitals (includes pediatrics)
Ambulatory Surgery Centers (ASCs)
3. Health Planswww.FloridaCompareCare.gov (October 2006)
4. Physicianswww.FloridaCompareCare.gov (Summer 2007
release)
1. Prescription Drugs retail priceswww.MyFloridaRx.com (July 2005)
2. Health Care Facilitieswww.FloridaCompareCare.gov (November 2005)
Hospitals (includes pediatrics)
Ambulatory Surgery Centers (ASCs)
3. Health Planswww.FloridaCompareCare.gov (October 2006)
4. Physicianswww.FloridaCompareCare.gov (Summer 2007
release)
Page 4
Stakeholders:Building Consensus
Stakeholders:Building Consensus
Agency for Health Care Administration (AHCA)
State Consumer Health Information and Policy Advisory Council
(Formerly known as the Comprehensive Health Information System <CHIS> Advisory Council)
Technical Workgroups:
1. Health Plan2. Facilities/Ambulatory Surgical Center3. Hospital Acquired Infections4. Physicians5. Public Relations
Agency for Health Care Administration (AHCA)
State Consumer Health Information and Policy Advisory Council
(Formerly known as the Comprehensive Health Information System <CHIS> Advisory Council)
Technical Workgroups:
1. Health Plan2. Facilities/Ambulatory Surgical Center3. Hospital Acquired Infections4. Physicians5. Public Relations
Page 5
Stakeholders:Building Consensus
Stakeholders:Building Consensus
Each stakeholder brings unique ideas and perspectives. Experts include representatives
from:
HospitalsPhysicians
Health PlansConsumers
EmployersAcademic
State Agencies
Each stakeholder brings unique ideas and perspectives. Experts include representatives
from:
HospitalsPhysicians
Health PlansConsumers
EmployersAcademic
State Agencies
Page 6
www.FloridaHealthStat.comwww.FloridaHealthStat.com
Where Florida’s Health Data resides, including:
list of licensed health care facilities in Florida;
medical help resources;
detailed information on patient data from hospitals and ambulatory surgery centers;
information on insurance programs such as Medicare, Medicaid, and KidCare;
prescription drug programs;
concerns for seniors;
consumer publications;
statistical health reports, and much more.
Where Florida’s Health Data resides, including:
list of licensed health care facilities in Florida;
medical help resources;
detailed information on patient data from hospitals and ambulatory surgery centers;
information on insurance programs such as Medicare, Medicaid, and KidCare;
prescription drug programs;
concerns for seniors;
consumer publications;
statistical health reports, and much more.
Pieces of the PuzzlePieces of the Puzzle
Page 7
Pieces of the PuzzlePieces of the Puzzle www.FloridaCompareCare.gov
Collaborative stakeholder approach
Consumer-friendly, dynamic database and verbiage
Helpful information for consumers’ health care decisions
Assists self-pay patients as well as those with insurance
Customer Satisfaction Survey
www.FloridaCompareCare.gov
Collaborative stakeholder approach
Consumer-friendly, dynamic database and verbiage
Helpful information for consumers’ health care decisions
Assists self-pay patients as well as those with insurance
Customer Satisfaction Survey
Page 8
www.FloridaCompareCare.gov(continued)
www.FloridaCompareCare.gov(continued)
Used 3M Health Information Systems Software for risk-adjustment for comparing facilities
Agency for Health Research and Quality (AHRQ) performance measures and quality indicators
Used 3M Health Information Systems Software for risk-adjustment for comparing facilities
Agency for Health Research and Quality (AHRQ) performance measures and quality indicators
Pieces of the PuzzlePieces of the Puzzle
Page 9
Public Reporting (in-patient hospitals)
Public Reporting (in-patient hospitals)
November 2005 November 2005 Total HospitalizationsTotal Hospitalizations Average Charges Risk Adjusted Average Charges Risk Adjusted Average Length of Stay Risk Adjusted Average Length of Stay Risk Adjusted Readmission Rates Risk Adjusted Readmission Rates Risk Adjusted Complication/Infection Rates Complication/Infection Rates (first in America)(first in America) Mortality Rates Mortality Rates Hospital Characteristics/ServicesHospital Characteristics/Services
July 2006July 2006 Pediatric specific conditions and procedures Pediatric specific conditions and procedures (first in America)(first in America) reported separately reported separately Improved search abilities including facilities descriptions and 200 mile search radius, Improved search abilities including facilities descriptions and 200 mile search radius,
including:including: Rural HospitalsRural Hospitals Critical Access HospitalsCritical Access Hospitals Primary Stroke Centers (designated by AHCA/JCAHO)Primary Stroke Centers (designated by AHCA/JCAHO) Organ transplant by typeOrgan transplant by type NCI Comprehensive Cancer CenterNCI Comprehensive Cancer Center
Cesarean and vaginal deliveries (all ages) and newborns (normal baby and baby with Cesarean and vaginal deliveries (all ages) and newborns (normal baby and baby with complications). complications).
November 2005 November 2005 Total HospitalizationsTotal Hospitalizations Average Charges Risk Adjusted Average Charges Risk Adjusted Average Length of Stay Risk Adjusted Average Length of Stay Risk Adjusted Readmission Rates Risk Adjusted Readmission Rates Risk Adjusted Complication/Infection Rates Complication/Infection Rates (first in America)(first in America) Mortality Rates Mortality Rates Hospital Characteristics/ServicesHospital Characteristics/Services
July 2006July 2006 Pediatric specific conditions and procedures Pediatric specific conditions and procedures (first in America)(first in America) reported separately reported separately Improved search abilities including facilities descriptions and 200 mile search radius, Improved search abilities including facilities descriptions and 200 mile search radius,
including:including: Rural HospitalsRural Hospitals Critical Access HospitalsCritical Access Hospitals Primary Stroke Centers (designated by AHCA/JCAHO)Primary Stroke Centers (designated by AHCA/JCAHO) Organ transplant by typeOrgan transplant by type NCI Comprehensive Cancer CenterNCI Comprehensive Cancer Center
Cesarean and vaginal deliveries (all ages) and newborns (normal baby and baby with Cesarean and vaginal deliveries (all ages) and newborns (normal baby and baby with complications). complications).
Page 10
FloridaCompar
eCarePortal
Page 11
Search by pediatrics
,adults, seniors,
and obstetrics
Page 12
FirstFirstin the in the
NationNation
Search by
pediatric
condition or
procedure
Page 13
Geographic Geographic SearchSearch
Page 14
Mortality Mortality RatesRates
Page 15
By condition or procedure, search for:
•Average Charges
•Average Length
of Stay
•Volume
Page 16
Facility Profiles include:Mortality Inpatient Rates for procedure
s and conditions
.
Page 17
Building a Better SiteBuilding a Better Site
1. Publishing CMS SIP data
2. Additional health care performance measurement standards:
Agency for Healthcare Research and Quality (AHRQ)
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
Leapfrog Group, physician information
1. Publishing CMS SIP data
2. Additional health care performance measurement standards:
Agency for Healthcare Research and Quality (AHRQ)
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
Leapfrog Group, physician information
Page 18
www.FloridaCompareCare.govwww.FloridaCompareCare.gov
Health Plan Consumer Website
Floridians have one-stop shopping, at their fingertips and can search for a health plan by county.
1. plan benefits;
2. costs; and
3. member satisfaction using national measures.
Released October 12, 2006
Health Plan Consumer Website
Floridians have one-stop shopping, at their fingertips and can search for a health plan by county.
1. plan benefits;
2. costs; and
3. member satisfaction using national measures.
Released October 12, 2006
Pieces of the PuzzlePieces of the Puzzle
Page 19
Welcome Page
Page 20
Geographic Search for Health Plan Information
Health Plan Consumer
Information Website
www.FloridaCompareCare.govwww.FloridaCompareCare.gov
Page 21
Types of informatio
n to compare health plans
www.FloridaCompareCare.govwww.FloridaCompareCare.gov
Page 22
www.MyFloridaRx.comwww.MyFloridaRx.com
Consumers may shop for the lowest price for top 100 prescription name-brand and generic drugs (>350 drugs)
Compare pharmacy store prices on a local and statewide level, 4,305 pharmacies reporting
Updated monthly
Data source: Usual and Customary Charges (retail prices) billed to Florida Medicaid
Collaborative effort of AHCA and the Office of Attorney General
Consumers may shop for the lowest price for top 100 prescription name-brand and generic drugs (>350 drugs)
Compare pharmacy store prices on a local and statewide level, 4,305 pharmacies reporting
Updated monthly
Data source: Usual and Customary Charges (retail prices) billed to Florida Medicaid
Collaborative effort of AHCA and the Office of Attorney General
Pieces of the PuzzlePieces of the Puzzle
Page 23
Top Five Sources of Health
Information Consumers Use 2004 Top Five Sources of Health
Information Consumers Use 2004
Page 24
The The internetinternet is the is the major sourcemajor source of of informationinformation for medical topics, for medical topics,
prescription drugs and other health-prescription drugs and other health-related information.related information.
The The internetinternet is the is the major sourcemajor source of of informationinformation for medical topics, for medical topics,
prescription drugs and other health-prescription drugs and other health-related information.related information.
Page 25
When asked how important a role various factors play in contributing to rising healthcare
costs, more than three fourths of business decision makers and the media
cited cost of prescription drugs as very important.
When asked how important a role various factors play in contributing to rising healthcare
costs, more than three fourths of business decision makers and the media
cited cost of prescription drugs as very important.
Page 26
More than More than 76% media76% media and and 85% business 85% business decision makersdecision makers cited cost of cited cost of
prescription drugs as very important prescription drugs as very important contributor to healthcare costs contributor to healthcare costs
Page 27
www.MyFloridaRx.cowww.MyFloridaRx.comm
www.MyFloridaRx.cowww.MyFloridaRx.comm
Consumers may shop for the lowest price for the top 100 prescription name-brand drugs and search by city or county
Searches automatically include generic alternatives and the site publishes prices for more than 650 prescriptions in the most frequently dispensed dosages
3,457 pharmacies authorized as a Medicaid providers
Data source: Usual and Customary Charges (retail prices) billed to Florida Medicaid, required in addition to negotiated rate
Updated monthly from billing statements
Collaborative effort of AHCA and the Office of Attorney General
Consumers may shop for the lowest price for the top 100 prescription name-brand drugs and search by city or county
Searches automatically include generic alternatives and the site publishes prices for more than 650 prescriptions in the most frequently dispensed dosages
3,457 pharmacies authorized as a Medicaid providers
Data source: Usual and Customary Charges (retail prices) billed to Florida Medicaid, required in addition to negotiated rate
Updated monthly from billing statements
Collaborative effort of AHCA and the Office of Attorney General
Page 28
MIAMI-DADEMIAMI-DADECountyCounty
Xanax 1 mg Xanax 1 mg TabletTablet
Usual and Usual and Customary (U & Customary (U &
C) pricesC) prices
February 1-28, February 1-28, 20072007
(Continued)(Continued)
www.MyFloridaRx.comwww.MyFloridaRx.com
Page 29
Highest:Highest:
$322.77$322.77Lowest:Lowest:
$5.50$5.50
5, 950%5, 950%differencedifference in in
prices within prices within 1212 miles miles
Page 30
Florida’s site essentially needed:Florida’s site essentially needed:
• Access to Medicaid Pharmacy Claims DataAccess to Medicaid Pharmacy Claims Data
• 160 hours to Design, Develop, Test, and “Go-Live”160 hours to Design, Develop, Test, and “Go-Live” (Two weeks time with a web designer and (Two weeks time with a web designer and programmer)programmer)
• Monthly data extraction Monthly data extraction (approximately 1 hour, once (approximately 1 hour, once report developed)report developed)
• Automated 14 hour process, per month, to clean Automated 14 hour process, per month, to clean the Medicaid datathe Medicaid data (approximately 1 hour staff time to (approximately 1 hour staff time to update the website each month)update the website each month)
Page 31
Future PlansFuture PlansFuture PlansFuture Plans
Strategic Planning Retreat: Florida’s 1-, 3-, and 5-year vision with State Consumer Health Information and Policy Advisory Council and Workgroups, June 19-20
Outreach and Education ConsumersConsumers Employers, payersEmployers, payers ProvidersProviders MediaMedia
Continue long term relationships Providers – Hospitals, Physicians Consumers – focus groups, surveys Employers
Strategic Planning Retreat: Florida’s 1-, 3-, and 5-year vision with State Consumer Health Information and Policy Advisory Council and Workgroups, June 19-20
Outreach and Education ConsumersConsumers Employers, payersEmployers, payers ProvidersProviders MediaMedia
Continue long term relationships Providers – Hospitals, Physicians Consumers – focus groups, surveys Employers
Page 32
Questions?Questions?Questions?Questions?
Lisa RawlinsLisa Rawlins
BrowardHealth.orgBrowardHealth.org
Floridacomparecare.govFloridacomparecare.gov
MyFloridaRx.comMyFloridaRx.com
Lisa RawlinsLisa Rawlins
BrowardHealth.orgBrowardHealth.org
Floridacomparecare.govFloridacomparecare.gov
MyFloridaRx.comMyFloridaRx.com