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Health Care

December 2010
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Recently, the National Academy of State Health Policy released State Strategies to Improve Quality and Efficiency: Making the Most of Opportunities in National Health Reform. This report examines specific Affordable Care Act provisions that support state system improvement goals and profiles efforts in 10 states including Colorado, and  Minnesota. The report highlights the opportunities and challenges that federal health care reform will bring and offers suggestions for how state and national leaders can streamline implementation.

 

The states were selected based on 2009 findings indicating that they were leaders in coordinating quality improvement strategies through public–private partnerships, in five key target areas states can use to improve quality and efficiency:  data collection and standardization, data transparency and public  reporting, payment reform, and both consumer and provider engagement.

 

Colorado’s Center for Improving Value in Health Care (CIVHC) was featured as driving consumer-centered care, improving population health, bending the cost curve and increasing transparency for the state. CIVHC has convened five advisory groups to identify strategies to reach its goals through data collection and transparency, consumer engagement, business engagement, delivery system redesign, and payment reform.

 

The Minnesota Statewide Standardized Quality Reporting and Measurement System supports increased quality, transparency and competition. In addition, Minnesota developed the Provider Peer Grouping, a composite measure that compares providers on overall value (including quality and cost); data collection began in July 2009. Also, Minnesota developed standard quality reporting measures for its baskets of care bundled payment initiative (see Payment Reform).

 

To access the full report: http://www.nashp.org/state-strategies-improve-quality-efficiency

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Nova Scotia Premier Darrell Dexter has announced in a speech earlier this month plans for a $16-million collaborative primary care clinic in Queens County. The overarching goal is to bring Better Care Sooner to Nova Scotia residents by reshaping how emergency care is delivered.

 

The collaborative care clinic will have space for five  family  physicians, a nurse practitioner, family practice nurses and  other  health professionals.The new plans also call for an upgraded 22-bed  inpatient unit.

 

Additionally the Better Care Sooner is poised to:

 

-improve access to primary care, especially in smaller communities.

-make emergency care more patient-centered and streamlined.

-provide care that is better tailored to those whose needs are more complex (i.e. seniors).

-increase public awareness of 911 and the healthlink nurse line 811.

-make changes to the way health care is funded (reward better, patient-centered care).

 

The government states that roughly 84 percent of ER visits at the hospital would be better addressed by primary care.

 

Dexter says the province is committing $2.5 million to the project while the Region of Queens Municipality has committed $1 million.

About $11 million comes from the Queens Foundation and private donors, and another $1.5 million still needs to be raised.

 

 

Check out the whole story at http://www.canadaviews.ca/2010/12/23/improvements-will-ease-er-overcrowding-access-to-care/

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Many people shared promising practices and pearls of wisdom from their work in their respective communities during the Reinventing Primary Care Project. Norma Battaglia let us know about how the Tucson Arizona Fire Department developed a promising practice, known as the Human Service Referral Program. The program significantly reduced non-emergency 911 calls among those who historically called most frequently for nonemergent reasons, contributing to a modest reduction in overall call volume and cost.

 

When a nonemergent call is placed, a secure, computer-based system is used to see if callers are already enrolled in a social service program.  The emergency responders either connect them to their community provider or the public health department, which conducts an intake visit and arranges for community services.  Between June 2007 and June 2009, the number of 911 calls fell by 57 percent, and these fewer calls helped to extend the life of emergency vehicles by 1 to 2 years, thus generating long-term cost savings for the fire department. With every 911 call billed at approximately $1000, stake holders such as the local taxpayers, insures, health plans, and patients are all winners as money is saved. Stakeholders such as the local taxpayers, insurers, health plans, and patients save money. Therefore, programs such as these that identify the most pressing need in the community can reap benefits shared by all in the community.

 

For more information, check out this project on their AHRQ Health Care Innovations Exchange Page: http://www.innovations.ahrq.gov/content.aspx?id=2809

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Biography

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Bob Kocher is a Principal at McKinsey and Company where he leads the McKinsey Center for Health Reform and a Non-Resident Senior Fellow at the Brookings Institution Engleberg Center for Health Reform.

 

Bob joins McKinsey and Brookings after serving in the Obama Administration as Special Assistant to the President for Healthcare and Economic Policy and a member of the National Economic Council.  In the Obama Administration, Bob was one of the leading shapers of the healthcare reform legislation focusing on cost, quality, and delivery system reform.  In addition, he was a leader of the First Lady’s “Let’s Move” childhood obesity initiative and led the formation of the Partnership for a Healthier America and served on the Federal Advisory Panel charged with developing a national obesity strategy.  He was also co-leader of the Community Health Data initiative, a joint effort of HHS and the Institute of Medicine, to release healthcare data to spur private sector innovation to improve healthcare cost and quality.  In addition, he served as an active member of the Federal Food Safety Working Group and led economic policy related to the postal service and rural development and agriculture.

 

Prior to joining the Obama Administration, Bob served as a Partner at McKinsey & Company where he led McKinsey Global Institute’s healthcare economic research team, and served private and public sector healthcare clients.  He has worked extensively with hospitals, health systems, and policy makers in 18 countries including the US, Canada, UK, Middle East, India, and Asia.  In addition, he has led major research efforts to understand the economic incentives of the US health system, to look at why healthcare is so expensive, and to develop a framework for guiding health system reform around the world.

 

Bob is an active writer and public speaker on a range of healthcare topics including healthcare reform, healthcare economics, childhood obesity, improving clinical outcomes, and international healthcare policies and strategies.  He and his work have been widely published or quoted in Time, Washington Post, New York Times, Wall Street Journal, LA Times, New England Journal of Medicine, Health Affairs, Annals of Internal Medicine, McKinsey Quarterly, and on National Public Radio’s All Things Considered.  He is the lead author of “Accounting for the High Cost of US Healthcare” and a 2009 update.

 

Bob received undergraduate degrees from the University of Washington and a medical degree from George Washington University.  He completed a research fellowship with the Howard Hughes Medical Institute and the National Institutes of Health.  He went on to complete his internal residency training at the Beth Israel Deaconess Medical Center and the Harvard Medical School.  He is Board Certified and licensed in Virginia.

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Biography

 

http://www.alvarezandmarsal.com/images/professionals/Urbanowicz_PeterWEB.jpgPeter Urbanowicz is a Managing Director with Alvarez & Marsal Healthcare Industry Group in Washington, D.C. Mr. Urbanowicz brings more than 20 years of experience in solving challenging healthcare matters in government and private industry. He advises management, boards of directors, investors and lenders on healthcare compliance and regulatory issues, performance improvement, corporate governance and government and internal investigations.

 

Most recently serving as Executive Vice President, General Counsel and Secretary of Tenet Healthcare Corporation (NYSE: THC), Mr. Urbanowicz was responsible for successfully resolving all federal and state investigations and criminal and civil lawsuits facing Tenet by the United States Department of Justice, the Securities and Exchange Commission, the Office of Inspector General of the Department of Health and Human Services and several state attorneys general and United States Attorneys' Offices.

 

Prior to this, Mr. Urbanowicz served as Deputy General Counsel of the United States Department of Health and Human Services (HHS). Mr. Urbanowicz served as the Senior Legal Adviser to the Secretary of Health and Human Services on Medicare, Medicaid and other pressing healthcare policy issues and was also part of the team that drafted the historic Medicare Prescription Drug Act of 2003. As Deputy General Counsel he helped direct HHS's regulatory and legal positions in areas such as Medicare and Medicaid payment policy, fraud and abuse, as well as regulatory enforcement.

 

Prior to his service in government, Mr. Urbanowicz was a partner in the law firm of Locke, Lord, Bissell and Liddell, LLP. He served as the Treasurer and a member of the Board of Directors of the Federation of American Hospitals.

 

Mr. Urbanowicz earned a bachelor's degree and a juris doctor degree from Tulane University. He is member of the Bar of the District of Columbia, the United States Supreme Court, the Louisiana Supreme Court and is a member of the American Law Institute.

 

http://www.alvarezandmarsal.com/en/professionals/profile.aspx?ID=2729