Home >Health & Medicine >Healthcare X PRIZE - Executive Summary

Healthcare X PRIZE - Executive Summary

Date post:07-May-2015
Category:
View:646 times
Download:1 times
Share this document with a friend
Description:
This is the executive summary of the Initial Prize Design which was released for public comment on April 14, 2009. These draft provides an overview of what the Healthcare X PRIZE is, some of the detail of the competition, and how you can get involved in to help create a Prize that moves us toward a new health paradigm focused on individual vitality and increasing the health care value in communities.
Transcript:
  • 1.HealthcareXPRIZE InitialDesignandPrizeGuidelinesSummaryforPublicComment V1.0Published4/14/09Jointhediscussionat:www.xprize.org/wellpoint1 Initial prize designfor public comment: www.xprize.org/wellpoint

2. Introduction to effort 2 Initial prize designfor public comment: www.xprize.org/wellpoint 3. INTRODUCTIONTOXPRIZEAPPROACH Vision: Bringaboutradicalbreakthroughsforthebenefitofhumanitythroughthepowerofincentivisedcompetitionstostimulateinnovation Mission: WedesignandconductXPRIZEcompetitionstoaddressthegrandchallengesofourtimes. Attributes: Highlyleveragedinvestments,efficientbyonlypayingthewinner,andsparksanewindustryasabyproductofthecompetition- Targetmarketfailures;Definetheproblem,letteamscompetetocreatethesolution g;p,p- Clear,objective&simplerulesinahardbutattainablegrandchallenge(38yearhorizon)- Assurethatabackendbusinessisviableandanindustrycanbecreated- GlobalcompetitionthatyieldsatelegenicfinishGlobal competition that yields a telegenic finish Example: AnsariXPRIZE - $2.5Mstartup,$10Mprizepurse,$100Minvested,and$1Bindustrycreated - 26teams,7nations,andglobalinterestgenerating5Bmediaimpressions3 Initial prize designfor public comment: www.xprize.org/wellpoint 4. INTERVIEWSWITHEXPERTSHIGHLIGHTEDIMPLICATIONSFORAHEALTHPRIZE ProblemStatement: Problem Statement:ExpectedBreakthroughs: Expected Breakthroughs: Financialincentivesnotalignedwithdoing Paymentneedstorealigntodesired therightthingsoutcome Wedon'tknowholisticallywhatworks Outcometrackingneedstooccurholistically relative Solutionsneedtobeholisticandsteer tootherthings consumerstobestperformers Fragmented system with substandard Fragmentedsystemwithsubstandard Focusonengagement/behavior / distributionofbestpractice modification Needtomovetoquot;healthquot;systemvs.sick Needtofocusbothonpublichealthanda systemmoreefficientsystem Wehaveaveryshorttermfocusintermsof Consumerneedchoicesthatareengaging addressingfutureneeds (pull) Consumernotengagedincareevenifthey Providersaccountableforautonomous wanttobe want to beapproachesviatransparencyofoutcome approaches via transparency of outcome Bestprovidersnotrewardedforbetter performance4 Initial prize designfor public comment: www.xprize.org/wellpoint 5. WHEREWEAREINTHEEFFORTHealthcarePrizeDevelopmentTimeline Healthcare Prize Development Timeline IdeationPhase DesignPhasePlanningPhase Nov 08Dec Jan 09Feb MarApr MayJunJul Aug Sep InitialDesignAnnouncement April14th Next steps in the design phase:1. Announcement of initial prize design to engage interested parties and gain access to more experts/ ideas2. Public comment utilized to test and refine goals and initial design3. Experts engaged for deep dives in areas critical to prize development effort4. Validated prize design moves into planning phase 5Initial prize designfor public comment: www.xprize.org/wellpoint 6. The Initial Prize Design 6 Initial prize designfor public comment: www.xprize.org/wellpoint 7. HEALTHCAREXPRIZEDEVELOPMENTOBJECTIVES Weseektoimprovethevalueofthecurrenthealthsystemby:W kt i thlf tht h lth t b Rewardingentitieswhooptimizehealthvalue Reinvesting resources to enhance individual vitality by encouraging activation andReinvestingresourcestoenhanceindividualvitalitybyencouragingactivationandpersonalresponsibilityforhealth Byincreasingthevitalityofindividuals,weseektoadvancethehealthofcommunityoverall ll 7 Initial prize designfor public comment: www.xprize.org/wellpoint 8. GOALOFHEALTHCAREXPRIZE: Tocreateanoptimalhealthparadigmthat To create an optimal health paradigm thatempowersandengagesindividualsandcommunitiesinawaythatwilldramaticallyimprovehealthvalueimprove health value 8 Initial prize designfor public comment: www.xprize.org/wellpoint 9. PROPOSEDCOMPETITION: Goal:Communityhealth 50%in TotalcostDraftGuidelines: Healthvalue=ImprovementsinCommunityHealthIndexandTotalCost Teamscreatemechanismstoengage,coordinate,advise,evaluate,andinfluenceindividualsand relevantcareprovidersintheirassignedtestcommunityinwaysthatgeneratehealthvalue Eachfinalistcompetesinapreselectedcommunity/employertestcommunityof~10Kindividuals; resultscomparedagainstanequivalentcontrolgroupinasimilar/adjacentcommunity results compared against an equivalent control group in a similar/adjacent community Aggregateresultsover3yearcontestdeterminewinner.50%thresholdrequiredtowinpurse. Competitionandresultsauditedbyindependentpanelofjudges 9 Initial prize designfor public comment: www.xprize.org/wellpoint 10. DIFFERENCEFROMOTHEREFFORTS:1. Focusonhealthoutcomesandvalueatcommunitylevel: 1 Focus on health outcomes and value at community level: CommunityHealthIndextracksoutcomesacrossacommunity;TotalCosttracksexpenditure acrossallparties 2. ConsumerEngagement: 2 Consumer Engagement: Consumerengagementrequiredtogenerateresults 3. PaymentIncentives: Teamsmaycreatepaymentinnovationstoimproveincentivesforconsumers,providers, vendorstodemonstratedesirablebehaviors/outcomes 4. ComprehensiveandProactiveOutlook: p Teamsresponsibleforhealthacrossallcaresettingsandmultiyeartimehorizon.Increased focusandinvestmentinproactive,longertermhealthimprovementprograms 5. Localpartnerships: Teamsmustdeveloprelationshipswithatleastsomelocalhealthcareprovidersand/or communityorganizations10Initial prize designfor public comment: www.xprize.org/wellpoint 11. IMPACTPOTENTIAL SuccessfulimplementationoftheHealthcareXPRIZEcouldcreatewithin10yrs:1. Anewmodelandsystemofhealththatdemonstratesa>50%improvementinhealthcarevalue ( (HCV). )2. Ameasurableandgloballyacceptedpopulationhealthmetric,tentativelycalledtheCommunity HealthIndex(CHI),whichbecomesabenchmarkformeasuringfutureimprovementsinhealthata pp populationlevel3. Anindividualhealthmetric,tentativelycalledtheIndividualVitalityScore,whichcanhelps individuals(andprovidershelpingthem)understandandbenchmarktheircurrenthealthstatusand potentialforimprovement4. ApersonalizedVitalityDashboardwhereconsumerswillbeabletounderstandcurrenthealth status,portfolioofimprovementoptions,projectedreturnfromhealthimprovementefforts5. AnewOptimalHealthparadigmthathelpsconsumersoptimizetheirhealthandrewardsproviders5 A new Optimal Health paradigm that helps consumers optimize their health and rewards providers thatcandemonstrablycreateimprovedhealthvalue 11Initial prize designfor public comment: www.xprize.org/wellpoint 12. WELOOKFORWARDTOYOURINPUTANDPARTICIPATION Visitourwebsite:www.xprize.org/wellpoint Addyourcommentstotheproposedapproach/guidelines Addyourselftothemailinglistforupdates Followtheconversationonourblog,twitter,facebook,etc. Letusknowifyou dbeinterestedincreatingateamastheeffortmovesforward Let us know if youd be interested in creating a team as the effort moves forward 12 Initial prize designfor public comment: www.xprize.org/wellpoint 13. Details in development 13 Initial prize designfor public comment: www.xprize.org/wellpoint 14. PHILOSOPHY FOR MEASUREMENTMeasureswillcontaindesiredoutcomesonly(nointermediateorprocessmetrics) Statusimprovementswewanttohappen Clinicaleventsthatwewanttoremovefromthehumanexperience Wherepossible,measurestrackedwillbeobjectiveandcomefromestablishedcollectiontools Measureswillbeatthecommunity/populationlevel Measureswillbeactionable.Therearecaseexamplesavailablethatsuggestteamscaninfluenceoutcomes inasignificantwayCostswillbecapturedacrossasmanypaymentalternativesaspossibleandreflectthepaymentowedat timeservicesrenderedTestgroupcommunitieswillbeactuariallyequivalentacrossdemographics,socioeconomics,andhealth status.Wewilldividesimilaroradjacentcommunitiesinto2equivalentgroups,withtheteamselectingstatus We will divide similar or adjacent communities into 2 equivalent groups with the team selectingcontrolvs riskgroupsDatawillnotbeprojected.Specificsubpopulationsmaybeoversampledtomakeabsoluteresults comparableWeightingwillplacefunctionalimprovementatequalstaturewithsickcare Initial prize designfor public comment: www.xprize.org/wellpoint 15. COMMUNITYHEALTHINDEX DEFINITIONDraftcategory Draft categoryDraftmetric Draft metric Hospitalization/Rehospitalization Dayshospitalized ERvisits NumberERvisitsEliminateacute Communicabledisease CDCsurveillancereportofprevalence exacerbation Majormorbidity Incidence Prevent Disability(LongTerm) PrevalenceofLTDisabilitylongterm Longtermcare PrevalenceLTCusage impairmentp Mortality Incidence by age Incidencebyage Sickdays Totaldaysunplannedabsence(school,work)Reduce Disability(ShortTerm) TotaldaysSTDisabilityshortterm impairmentp FunctionalFitness TBD Optimize SelfReported SF12IndividualVitality 15 Initial prize designfor public comment: www.xprize.org/wellpoint 16. TOTALCOST DEFINITION$ h $throughexistingclaimsystem,orotherwiseprocessedbyclaimsh l hdb lDirect $assignedtomedicalcare(HSAcodes)goingthroughdebitcard $submittedforreimbursementonotherOOPspend $spentoncommunication/coordinationwithindividuals $spentonconsumerorprovideractivation(e.g.,lottery,rewards,incentives) Sickanddisabilitypayaddedtototalcost Notcountedincost,manyimprovementsincludedinvitalityindex,ypyIndirectNo CostsarealldirectandaccountedforpjprojectionsPhasein/out Teamgetsoperatingbudgetforfirst6monthsdryrunwhichdoesn'tcountagainsttotalcost16Initial prize designfor public comment: www.xprize.org/wellpoint 17. INDIVIDUALVITALITYSCORE DEFINITION Scoringsystemtohelpconsumersummarizecurrenthealthstatus Approachdevelopedbyeachteamtobestengageconsumers;team pppy gg;innovation Individualvitalityscoreusedtoengageindividualsintheirhealthandhealthactions 17 Initial prize designfor public comment: www.xprize.org/wellpoint 18. WHATISTHEPHILOSOPHYBEHINDTHEPRIZEDESIGNGUIDELINES? TrackingofCommunityHealthIndexandTotalCostauditedbytrustedthirdparty Opensharingofresultsandimplementationexperiencesbysponsor Transparent Regularanddetailedpublicupdatesonteamprogress andObjectivej Independentjudgesoverseeteamdownselectiontofinalists ddd dlfl Teamsmayenterfromanywhereaslongasabletocompeteintestbeds Allfundingsourcesareokfordevelopmentofteamplatform gp

Click here to load reader

Embed Size (px)
Recommended