Healthcare Town Hall

Today’s Milwaukee Journal Sentinel reports that the community data pooling organization, Wisconsin Health Information Organization (WHIO), has launched a database that will now be available to large healthcare systems and, eventually, to consumers. The database will improve transparency and allow better understanding of healthcare quality and cost dynamics:

The database is drawn from the experiences of more than 1.6 million people and 72 million treatment services. In April, WHIO will add data from Dean HMO and Medicaid, which includes BadgerCare, the state health program for the working poor, adding the experiences of 1 million more insured people to the database.

“To us, the real opportunity is to look across all the claims aggregated here and get a picture of where we have cost-effective health care being delivered in Wisconsin, and where we have an opportunity to improve the cost-effectiveness of health care,” said Karen Timberlake, secretary of the state Department of Health Services and a WHIO board member.

“There isn’t a database like this that’s been available to providers to measure these sorts of things. And if you can’t measure it, you can’t improve it,” said Larry Rambo, chief executive of Humana’s Wisconsin, Michigan and Illinois markets.

Wisconsin is among a handful of states – including Minnesota, Massachusetts, Oregon and Washington – that have put infrastructures in place for pooling health data to improve quality and transparency, according to a briefing paper written this year by the consulting and actuarial company Milliman.

Click here for more information on these information exchanges.

Cost, Electronic Health Records, Quality of Care, Transparency chartered value exchanges, data pooling, Paul Leonardo, Rich Moyer

Michigan is pursuing stimulus funding to advance health IT:

The Recovery Act included more than $25 billion in grants aimed at improving the nation’s technology infrastructure and expanding adoption of electronic health records. The unprecedented amount of federal funding for health IT and broadband initiatives has provided some economic hope to states like Michigan, which boasts the highest unemployment rate in the country.

Faced with 15 percent unemployment, a $2.8 billion budget deficit and the struggling automotive industry, officials in Michigan are hoping the federal government’s IT investments provide a long-term windfall for the Midwestern state. With an eye toward enticing more technology firms to set up shop within the Michigan’s borders, state officials have teamed up with business groups and local universities to coordinate the state’s efforts on increasing adoption of both broadband and electronic health records.

Economy, Electronic Health Records chartered value exchanges, EHR

• Thomas D. Snook quoted in “Twelve elements of Baucus’ bill,” an article from the latest  Health Plan Week:

(6) “Young invincible” policy: A separate type of catastrophic-coverage option would be made available to people aged 25 years or younger and would be less expensive than the bronze-level coverage. Preventive benefits would be exempt from the deductible. [Kansas Insurance Commissioner Sandy] Praeger says this coverage option is a good idea if the coverage costs are low enough to attract this segment of the population. [Blue Cross Blue Shield Association President Scott] Serota said BCBSA strongly supports the provision and contended that age-rating provisions in other bills “would preclude these discounts and would result in major premium increases to young people causing many to forgo coverage.” But segregating some of the healthiest members from the risk pool could cause problems, suggests Thomas Snook, a consulting actuary in Milliman’s Phoenix office. “If you take, say, the healthiest 10% [of the population] and isolate them in their own pool, the cost for the remaining 90% will be higher,” he explains. Participation by these healthy individuals, if in the same risk pool, could help minimize the cost of the standard platinum, gold, silver, and bronze benefit options, he adds.

• U.S. lags in EHR, despite longstanding efforts
• Margaret Stanley, former executive director of the Puget Sound Health Alliance (for more on the PSHA, see this or this)
• “Why health care will never be equal”
• www.bendingthecostcurve.com … a new Web site by Aetna

Electronic Health Records, Exchanges, Reform chartered value exchanges, EHR, young invincibles

We have seen much attention paid to the adoption of electronic health records (EHR). Paying for EHR is notable as one aspect of healthcare reform that already has won funding thanks to billions set aside in the American Recovery and Reinvestment Act. Some stimulus makes sense given the low adoption of EHRs by providers nationwide and the inefficiencies of a paper-based system.

But one aspect of EHR adoption has been largely overlooked. A new healthcare reform briefing paper by Rich Moyer and Paul Leonardo examines how population-level analysis is key to unlocking the potential of electronic health records. Community data pooling allows analysis that makes healthcare quality more apparent and can help measure and improve the system on a regional basis. These information exchanges are currently operational in at least five states and are already yielding results (while hopefully preventing the formation of new information silos in the move toward EHR).

Electronic Health Records, Reform chartered value exchanges, EHR, Paul Leonardo, Rich Moyer