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Updates from the Lily Pad

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More than 170 large health care purchasers. More than 36 million Americans ... NQF-endorsed measures collected through the ORYX initiative or through Leapfrog ... – PowerPoint PPT presentation

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Title: Updates from the Lily Pad


1
Updates from the Lily Pad
2
Why Isnt Quality Better?
Health Plans Not Letting Provider Value Show
Through
Providers Not Seeing Case for Reengineering
Purchasers Not Buying Right, Toxic Payment System
Consumers Not In the Quality Game
Gridlock in the Health Care System Everyone
Responsible, No One Accountable New Thinking is
Needed to Leapfrog the Gridlock
3
Who we are-Populating the Pond
  • Leapfrog represents..
  • More than 170 large health care purchasers
  • More than 36 million Americans
  • More than 67 billion in health care expenditures

4
Leapfrogs Mission Statement
  • Trigger Giant Leaps Forward in the Safety,
    Quality
  • and Affordability of Healthcare By
  • Supporting Informed Health Care Decisions by
    Those Who Use and Pay for Health Care
  • Promoting High-Value Health Care Through
    Incentives and Rewards

5
Pillars for Improving Quality
Standard Measurements Practices
Reimbursement Incentives Rewards
Transparency
6
Standard Measurements Practices To achieve
transparency and improved quality, we must talk
the same language when asking hospitals
doctors to report
7
Initial Quality and Safety Leaps
  • An Rx for Rx
  • Computer Physician Order Entry (CPOE)
  • Sick People Need Special Care
  • ICU Staffing with CCM Trained M.D. live or via
    tele-monitoring, or risk-adjusted outcomes
    comparison
  • The Best of the Best
  • Evidence-based Hospital Referral (EHR) or
    risk-adjusted outcomes comparison
  • Leapfrog Quality Index
  • Rolled-up score of the remaining 27 of the 30
    NQF- endorsed Safe Practices

8
Transparency Make reporting results routine and
use results to make health care purchasing
decisions
9
Information for Consumers Purchasers on
Hospital Patient Safety Practices
10
Incentives RewardsEncourage better quality of
care through incentives and rewards
11
Growing Efforts to Buy Right
  • Leapfrog Group Compendium of Incentive and
    Reward Programs http//www.leapfroggroup.org/irc
    ompendium.htm
  • 90 programs nationwide 1 in 4 include
    Leapfrogs critieria
  • 9 target consumers
  • 18 target health plans
  • 32 target hospitals
  • 50 target physicians
  • 51 are financial
  • 87 are local
  • Good and Bad news lots of programs but no clear
    signal for health care providers

12
Leapfrogs Hospital Rewards Program (LHRP)
  • Easy way for payers to bring incentives rewards
    for hospital performance into specific markets-
    LHRP can be implemented by health plans,
    purchasers and coalitions
  • Adapts CMS-Premier demonstration program for the
    commercial sector
  • Focuses on performance improvement in both
    effectiveness and efficiency in 5 important
    clinical areas (see next slide)
  • Hospitals can participate with minimal additional
    reporting
  • Builds on reinforces participation in the
    Leapfrog survey performance on our survey is key
    to the program
  • Builds on reinforces hospital participation in
    another national initiative JCAHO
  • Rewards both top performers and improvers

13
Focused Clinical Areas Were Chosen to Maximize
Commercial Employer Impact
  • Each clinical area has NQF-endorsed measures
    collected through the ORYX initiative or through
    Leapfrog
  • Benchmarked against Medstats MarketScan, the 5
    represent 33 of admissions and 20 of a
    commercial payers I/P spend

14
Hospitals Arrayed in Four Performance Groups
Using Expert-reviewed Statistical Methodology
Cardiac Bypass Surgery
1.8
Good quality, But inefficient
1.6
1.4
1.2
Top Cohort
Cohort 2
Efficiency
Efficient, But poor quality
Cohort 3
Cohort 4
1
0.8
0.6
0.4
0.8
0.85
0.9
0.95
1
1.05
1.1
Effectiveness
15
The Leap over the Gridlock Has Begun
  • Rapid growth in purchasers signing on to
    Leapfrogs approach
  • Rapid growth in hospitals and physicians
    disclosing status to their communities
  • Active health plan support
  • Massive education of consumers through purchasers
  • Market reinforcement beginning through different
    channels
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