www.CHCCnet.org + Committee on a National Surveillance System for Cardiovascular and Select Chronic Diseases Purchasers Use of Health Care Data Alfredo Czerwinski, MD Chief Medical Officer J. Glynn & Company (800) 975-7920 x 8 + Two points of view + Typical employer’s annual meeting + Average Health Insurance Premiums and Worker Contributions for Family Coverage, 1999-2009 $4,247 $9,860 $1,543 $3,515 1999 2009 Employer Contribution Worker Contribution Note: The average worker contribution and the average employer contribution may not add to the average total premium due to rounding. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2009. $5,791 128% Worker Contribution Increase 131% Premium Increase $13,375
Transcript
www.CHCCnet.org
+Committee on a National Surveillance System
for Cardiovascular and Select Chronic Diseases
Purchasers Use of
Health Care Data
Alfredo Czerwinski, MD
Chief Medical Officer
J. Glynn & Company
(800) 975-7920 x 8
+ Two points of view
+ Typical employer’s annual meeting +Average Health Insurance Premiums and
Worker Contributions for Family Coverage, 1999-2009
$4,247
$9,860
$1,543$3,515
1999 2009
Employer Contribution
Worker Contribution
Note: The average worker contribution and the average employer contribution may not add to the average total premium due to rounding.Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2009.
$5,791 128% Worker
Contribution Increase
131% Premium Increase
$13,375
www.CHCCnet.org
+The usual brief reaction
+
OK.
So, there is
nothing
we can do.
Now what?
+
Image: Peter Oresved / FreeDigitalPhotos.net
Problem solved,
until next year
+Purchasers promote poor quality care
through three distinct actions
n By making contracting decisions based on price,
without also examining plan and provider performance.
n By using transaction based (rather than outcomes based)
payment structures that discourage quality
improvement.
n By failing to engage the consumer (employees and
beneficiaries) on quality issues.
n British Medical Journal, v.324(7352); Jun 22, 2002
www.CHCCnet.org
+
A different kind of “purchaser”
+
The California Health Care Coalition
is a membership organization of
public and private sector employers,
unions and health and welfare trust
funds, currently representing
over 4 million Californians.
+Our Member Organizations: 12/2009
+
Our mission is to collaborate with all
health care stakeholders
in creating and implementing high
quality, optimal value health care for
all Californians.
www.CHCCnet.org
+
We educate and organize group purchasers to engage ... health plans,
hospitals and physician organizations ...in collaborative efforts to improve the safety, appropriateness, effectiveness
and price of health care services.
+Some key principles:
n Health care is local:
n Problems can be most quickly addressed when purchasers join
together with their commercial plans and providers at the
community level to improve performance
n Employer-led, multi-stakeholder coalitions can improve
quality and reduce costs:
n Constructive Engagement with Providers of Care
n Establishing Leadership Roles with Health Insurers
n Effective Communications on Quality with Enrollees
13
+CHCC Strategy:
Constructive Engagement & Teamwork
+What can this kind of purchaser do ?
n Support the collection and analysis of helpful data
n Differences by payer (insurer)
n Differences by provider
n Differences by patient occupation
n Create economic incentives
n Pay for participation in registries and surveillance programs
