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Florida's Transparency Initiatives

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Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Lisa Rawlins
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FLORIDA’S TRANSPARENCY INITIATIVES Lisa K. Rawlins Director, Quality and Process Improvement Broward Health [email protected]
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Page 1: Florida's Transparency Initiatives

FLORIDA’STRANSPARENCY

INITIATIVES

FLORIDA’STRANSPARENCY

INITIATIVES

Lisa K. RawlinsDirector, Quality and Process ImprovementBroward Health

[email protected]

Lisa K. RawlinsDirector, Quality and Process ImprovementBroward Health

[email protected]

Page 2: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

Page 10

FloridaCompar

eCarePortal

Page 11: Florida's Transparency Initiatives

Page 11

Search by pediatrics

,adults, seniors,

and obstetrics

Page 12: Florida's Transparency Initiatives

Page 12

FirstFirstin the in the

NationNation

Search by

pediatric

condition or

procedure

Page 13: Florida's Transparency Initiatives

Page 13

Geographic Geographic SearchSearch

Page 14: Florida's Transparency Initiatives

Page 14

Mortality Mortality RatesRates

Page 15: Florida's Transparency Initiatives

Page 15

By condition or procedure, search for:

•Average Charges

•Average Length

of Stay

•Volume

Page 16: Florida's Transparency Initiatives

Page 16

Facility Profiles include:Mortality Inpatient Rates for procedure

s and conditions

.

Page 17: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

Page 19

Welcome Page

Page 20: Florida's Transparency Initiatives

Page 20

Geographic Search for Health Plan Information

Health Plan Consumer

Information Website

www.FloridaCompareCare.govwww.FloridaCompareCare.gov

Page 21: Florida's Transparency Initiatives

Page 21

Types of informatio

n to compare health plans

www.FloridaCompareCare.govwww.FloridaCompareCare.gov

Page 22: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

Page 23

Top Five Sources of Health

Information Consumers Use 2004 Top Five Sources of Health

Information Consumers Use 2004

Page 24: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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 Transparency Initiatives

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: Florida's Transparency Initiatives

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: Florida's Transparency Initiatives

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


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