Public Reporting of Cost and Resource Use
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- Tracey Harper
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1 Public Reporting of Cost and Resource Use Cindy Schlough Director of Strategic Partnerships Wisconsin Collaborative for Healthcare Quality (608) Aligning Forces for Quality National Meeting in Denver May 19, 2011
2 Goals for Today Share examples of reporting cost and resource use Introduce consumer feedback on a potential display Foster dialogue and new ideas Wisconsin Collaborative for Healthcare Quality 2
3 Different Audiences, Different Needs Health care providers, purchasers/employers, payers/health plans, patients, and consumers Varying degrees of interest, varying degrees of understanding, varying degrees of action Using information for accountability, using information for improvement, using information for decision making Cost and resource use have different meanings, require different types or sources of data, and aren t interchangeable Wisconsin Collaborative for Healthcare Quality 3
4 WCHQ Quality and Cost Quadrant Displays a comparison of quality of care data and hospital charge data for heart attack (acute myocardial infarction/ami), heart failure, and pneumonia care. When computer mouse is moved over one of the letters, a pink box appears with details on quality data and hospital charge data. Wisconsin Collaborative for Healthcare Quality 4
5 Resource Use: Diagram of a Diabetes Episode Episode Start Antibiotic UTI Bronchitis Episode End: 1 year Episode Clusters: Contain diabetes related services Office Visit (Anchor Record) Lab Services (Ancillary Record) Radiology (Ancillary) Pharmacy Records (Ancillary)
6 WCHQ Resource Use Display Option A Wisconsin Collaborative for Healthcare Quality 6
7 WCHQ Resource Use Display Option B Diabetes Cost per Episode WCHQ Family Medicine Providers by Clinic Clinic Number of Episodes Peer Diabetes Cost per Episode Diabetes Cost per Episode Std Cost Index 1 $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $1, $ $1, $1, $1, $2, $1, Wisconsin Collaborative for Healthcare Quality 7
8 Information for Consumers Wisconsin Collaborative for Healthcare Quality 8
9 Physician Office Visit Cost Members are able to view costs of 35 common conditions representing 50% of outpatient physician spend. Cost estimate includes office visit, lab tests, and pharmacy costs compared to other doctors in their city. Why is this important: Able to anticipate cost when going to the doctor s office for common conditions along with receiving guidance on what questions to ask, what to expect as well as links to hospital cost information. 9
10 Prescription Costs Members can find the cost of prescription medications by condition and explore the cost of possible alternative drugs as well as compare costs across pharmacies by zip code. Why is this important: Teaches how to save money on medications by exploring less expensive alternatives by drug and by pharmacy. Can request doctor to prescribe cost-effective medication at the pharmacy of their preference. Able to see photo and detailed description of medication to ensure it matches the filled prescription along with understanding the possible side effects. 10
11 Hospital Cost and Quality Members are able to compare hospitals based on both cost and quality in a sideby-side format for inpatient procedures representing about 75% of inpatient spend. Also includes guidance for 50 outpatient surgery and diagnostic procedures. 11
12 Consumer Testing of Potential Display AIR research team conducted usability interviews in April 2011 with 12 women (1 aged 18-39, 12 aged 40-65, across range of incomes and education levels) with employer-based health insurance in Milwaukee, Wisconsin. Tested three different mock-ups (one is seen to the left) with a different frame for the information. 1.Gives the Right Diabetes Care at the Right Time 2.Uses Resources Wisely to Care for Diabetes 3.Uses Your Health Care Dollars Wisely to Care for Diabetes Wisconsin Collaborative for Healthcare Quality 12
13 Frames Title What is this? Why is this important? Gives the Right Diabetes Care at the Right Time Uses Resources Wisely to Care for Diabetes The information in this chart helps you compare local doctors on how well they care for diabetes. This includes how well they take care of patients with diabetes. It also includes how well they do at giving the right amount of care for diabetes at the right time. The information in this chart helps you compare local doctors on things that matter a lot. This includes how well they take care of patients with diabetes. It also includes how well they do at giving care for diabetes that makes wise use of resources. Getting quality care means getting the right care at the right time. By getting the right care at the right time, you may prevent harms that can happen to you when you get care you do not need. The cost of care in the United States is too high. This is because people are getting more care than they need in order to feel better. Doctors who use resources wisely make sure they give you only the care you really need to feel better. By using resources only when they are needed, doctors can bring down the cost of care. Uses Your Health Care Dollars Wisely to Care for Diabetes The information in this chart helps you compare local doctors on things that matter a lot. This chart includes how well they take care of patients with diabetes, and how well they do at giving care for diabetes that makes wise use of your health care dollars. The cost of care in the United States is too high. This is because people are getting more care they need in order to feel better. Doctors who make wise use of your health care dollars make sure they give you only the care you really need to feel better. By using your health care dollars wisely, doctors can pass on savings to you. Wisconsin Collaborative for Healthcare Quality 13
14 Findings Everyone stated it was important to have a doctor that used their healthcare dollars wisely and was a top performer. No one realized the three frames attempted to address the same idea and saw three distinct issues; some interviewees asked how all three issues could be combined. Resources was defined inconsistently: tests, products (free samples, medications, equipment), staff (nurse, health educator), knowledge and information, hospital stays, and dollars. Half preferred Gives the Right Diabetes Care at the Right Time while the others reacted negatively to this frame and felt it might limit a doctor from doing additional but necessary tests, cost shouldn t matter when it comes to your health, it was too vague to understand what was the right care, and it was unclear who defines what right care is. Wisconsin Collaborative for Healthcare Quality 14
15 Closing Thoughts A pioneer is never lost but occasionally bewildered. Daniel Boone Wisconsin Collaborative for Healthcare Quality 15
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