03/17/10 – Colorado's Center for Improving Value in Health Care Sets Goals
by Phil KalinExecutive Director, Center for Improving Value in Health Care
Challenges to be addressed through health reform are numerous and complex: from inefficient health care delivery systems and a lack of data transparency to spiraling costs that are unsustainable. And in the last two years, Colorado has been moving in the wrong direction – in 2007, The Commonwealth Fund ranked our state 23rd in overall health system performance. Last year, we moved down a notch to 24th place.
The Center for Improving Value in Health Care (CIVHC) is working to identify and implement strategies that contain health care costs and ensure that safe, quality health care services are available to all Coloradans. Over the next few years, this public-private coalition of health providers, payers, state agencies, businesses, consumers and policymakers has set out to improve the quality and timeliness of patient care and overall population health, bend the cost curve, and make health costs and quality data more transparent.
One of the reasons why our health care market doesn't function well is a lack of data that would provide businesses and health care consumers information on what things cost – not just what's being charged for health services. CIVHC is working to advance HB 10-1330 to create a statewide payer health claims database to provide transparent public reporting of health care cost and quality information.
Seven states have already implemented all-payer claims databases with meaningful results. In New Hampshire, consumers can go on the Web and input information about their geographic location, the procedure they require and their insurance plan. Instantaneously, they are provided with a list of hospitals or other facilities in their area, along with estimated out-of-pocket costs and overall costs. Additionally, the New Hampshire data has been used to compare differences in child health between participants in the Children's Health Insurance Program (CHIP) and commercial insurance members in the areas of access, prevention, care management, utilization and payments.
Another CIVHC workgroup is coming together on payment reform, exploring best practices that move us away from fee-for-service, volume-based reimbursements toward outcome-based provider payments. We're exploring state and national models that include bundled payment and global capitation models. Our intent is to identify a couple of methodologies that seem to address Colorado's needs, and bring payers and providers together for implementing demonstration pilots to test these models.
We're also working to support the redesign of Colorado's health delivery system by expanding access to palliative care, reducing unnecessary readmissions, and supporting models of care that reward integration and collaboration, for example Colorado's patient-centered medical home pilot.
We believe that payment reforms that provide incentives for improved quality at lower costs will lead to investment into delivery system redesign, likely bringing groups of doctors, nurses, specialists and hospital systems into organizational structures like Accountable Care Organizations where doctors and hospitals are paid to keep you well – not just treat you when you're sick.
As part of all its efforts, CIVHC is also working to engage and activate businesses and consumers in ways that will lead everyone to take more responsibility for their health and health care. It's our belief that everyone has to own the problem if we are going to fix it.
For more information about CIVHC, visit www.civhc.org or write us at info@civhc.org.
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