Ohio Health Quality Improvement Plan
Ohio Health Quality Improvement Plan Ohio Health Quality Improvement Plan
In f o r m e d a n d ActivatedPa t ie n t s a n d In d iv id u a l sTacticsPatient and Public Involvement Task ForceThe Health Care Coverage and Quality Council “HCCQC” should appoint a Patient and Public Involvement “PPI” TaskForce. The PPI would be charged with identifying methods of activating individuals and patients to take a proactive rolein making health and health care decisionsAction Steps• Task Force should include experts in patient outreach, engagement, and self-management support. In addition, theseexperts teamed with broad stakeholder representation would draw attention to the importance of patient activation andenhance the credibility of the Task Force across disciplines and beyond the medical sector.• Adopt a common measure to assess patient activation and seek adoption by health providers and delivery systems.• Adopt a method to hold providers and delivery systems accountable for supporting and increasing patient activation.Healthy Lifestyle ChoicesAddressing health status improvement is an opportunity and a challenge. It requires a concerted, multi-pronged approachthat combines a synergistic combination of marketing and public policy. Yet behavioral and environmental changespresent the greatest opportunities to save lives and reduce costs. All stakeholders share responsibility for change.• Leverage implementation of Healthy Ohio’s goals and objectives related to Supporting Individuals and Families asdelineated in the Ohio Obesity Prevention Plan, which aggressively targets the primary causes of obesity in Ohio.• Make information and tools related to health promotion and disease prevention widely available.Action Steps◦◦ Integrate a mix of effective communications, community- and school-based approaches, and workplace wellnessprograms to educate and motivate individuals to engage in healthy behaviors.◦◦ Create and distribute materials to persuade individuals of the need to continue the lifelong continuum ofunderstanding health information.• Support financing proposals that give state and local public health agencies adequate and sustainable funding. Publicpolicies should facilitate and provide incentives for healthy living, with a dedicated revenue stream to support publichealth activities at the federal, state, and local level. This funding could support community-based programs to fosterhealthy behaviors, such as nutrition, exercise, and smoking cessation counseling.Action Step◦◦ Collaborate with ODH, OPHA and the Administration to develop a business case for increased funding for stateand local public health.Health Care Coverage Decisions• Develop a model for an Ohio health insurance exchange “connector” through which consumers can easily comparehealth plans and prices to enable them to select the health care plan that best fits their health care and budget.Action Step◦◦ Identify best practices used in developing tools which help individuals:▪▪ Compare coverage options, match to their own values, needs and preferences and select affordable, qualitycoverage (if private insurance through self or employer is applicable)▪▪ Gather and submit relevant eligibility documentation if applying for or seeking to maintain public insurance(e.g., Medicaid, Medicare, SCHIP), compare coverage options if applicable, match to their own values, needsand preferences, and select affordable, quality coverage.▪▪ Use all available comparative performance information (including cost data) to identify prospective providersand facilities.18
In f o r m e d a n d ActivatedPa t ie n t s a n d In d iv id u a l s▪▪Ascertain benefit coverage restrictions or incentives such as mental health benefits limitations, precertificationrequirements, access restrictions to specialists or adjunct health providers, variables in co-paysfor specific types of care or providers before seeking treatment.• Promote broad public access to and use of webCHAT Choosing Healthplans All Together, an abbreviated internetversion of the research and educational tool used by the Ohio Department of Insurance to determine what uninsuredOhioans think a “basic” health plan must offer. 15Health Care Treatment DecisionsTo be effective, information and decision supports related to health care treatment should be offered in understandableformats and take into account the range of health literacy levels and decision-making skills found in society.• Commission the development and testing of skill-building tools, which support health care treatment decision-making,patient activation, patient/provider care teams and self-management.Action Steps◦◦ Identify and facilitate access to culturally and linguistically appropriate tools and practices that have beendemonstrated to support patient engagement and self management.◦◦ Identify and facilitate use of proven, culturally and linguistically appropriate strategies and tools to enablepatients to understand all treatment options and to make decisions consistent with their values and preferences.◦◦ Develop and test culturally and linguistically appropriate tools, strategies or practices if they are not already inexistence.• Develop and implement a “shared decision-making” pilot in one or more of the state controlled medical plans (e.g.,Medicaid, state employee health plan), or in conjunction with early medical home initiatives with an initial focus ona few common expensive conditions where there are multiple treatment options. Key strategies supportive of patientself-management include identifying and disseminating evidence-based self management practices; recognizing thecentrality of self-management to good patient care and incorporating it into health care culture; developing programsand tools applicable to diverse populations; providing incentives for integrating the appropriate self managementsupports into the delivery of health care; and making better use of all members of the health care team.Action Steps◦◦ Identify and prioritize the high prevalence/high cost conditions to target.◦◦ Identify evidence-based self-management practices, disease-specific education programs and patient aids.◦◦ Establish a clearinghouse of patient education, self-management and decision-making tools.◦◦ Identify disease- and/or condition-specific tools that are evidence-based, age, culturally, and linguisticallyappropriate.◦◦ Make tools readily available to patients through marketing campaigns, Web sites, distribution through PCMHsand community organizations.◦◦ Propose incentives for integrating the appropriate use of self management supports into the delivery of healthcare.16• Develop and implement a pilot “academic pharmaceutical detailing” program in one or more of the state controlledmedical plans (e.g., Medicaid, state employee health plan), to provide independent information and support to15 CHAT TM is a computer simulation game, which was developed by physician ethicists at the National Institutes of Health and the University of Michigan.CHAT simulates the challenges in making decisions about health plan benefits packages when there are more choices than resources.16 Academic detailing is “university-based educational outreach.” The process involves face-to-face education of prescribers by trainedhealth care professionals, typically pharmacists, physicians, or nurses. The goal of academic detailing is to change prescribing of targeteddrugs to be consistent with medical evidence, support patient safety, and to be cost-effective medication choices. A key component ofuniversity-based academic detailing programs is that they (academic detailers, management, staff, program developers, etc.) do not haveany financial links to the pharmaceutical industry. For more information on academic detailing visit:http://www.prescriptionproject.org/tools/fact_sheets/files/0007.pdfSee also A Template For Establishing And Administering Prescriber Support And Education: A collaborative, service-based approach forachieving maximum impact. A report by Prescription Policy Choice’s Academic Detailing Planning Initiative. July 2008.19
- Page 1 and 2: Ohio Health QualityImprovement Plan
- Page 3 and 4: Introduc tionIn November 2008, more
- Page 5 and 6: In t r o d u c t io nimplementation
- Page 7 and 8: Oh io He a l t h Qu a l it y Im p r
- Page 9 and 10: Pa t ie n t Centered Me d ic a l Ho
- Page 11 and 12: Pa t ie n t Centered Me d ic a l Ho
- Page 13 and 14: He a l t h In f o r m a t io n Te c
- Page 15 and 16: Pa y m e n t Re f o r m◦◦◦◦
- Page 17: In f o r m e d a n d ActivatedPa t
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- Page 23 and 24: Me a s u r in g Su c c e s sPropose
- Page 25 and 26: Ne x t StepsOhio Health Care Covera
- Page 27 and 28: Appendix II — Response to Questio
- Page 29 and 30: Appendix III — Su r v e y Results
- Page 31 and 32: Appendix IV — Co m m e n t s f r
- Page 33 and 34: Appendix IV — Co m m e n t s f r
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- Page 45: CORE PLANNING TEAMAmy Rohling McGee
In f o r m e d a n d ActivatedPa t ie n t s a n d In d iv id u a l sTacticsPatient and Public Involvement Task ForceThe <strong>Health</strong> Care Coverage and <strong>Quality</strong> Council “HCCQC” should appoint a Patient and Public Involvement “PPI” TaskForce. The PPI would be charged with identifying methods of activating individuals and patients to take a proactive rolein making health and health care decisionsAction Steps• Task Force should include experts in patient outreach, engagement, and self-management support. In addition, theseexperts teamed with broad stakeholder representation would draw attention to the importance of patient activation andenhance the credibility of the Task Force across disciplines and beyond the medical sector.• Adopt a common measure to assess patient activation and seek adoption by health providers and delivery systems.• Adopt a method to hold providers and delivery systems accountable for supporting and increasing patient activation.<strong>Health</strong>y Lifestyle ChoicesAddressing health status improvement is an opportunity and a challenge. It requires a concerted, multi-pronged approachthat combines a synergistic combination of marketing and public policy. Yet behavioral and environmental changespresent the greatest opportunities to save lives and reduce costs. All stakeholders share responsibility for change.• Leverage implementation of <strong>Health</strong>y <strong>Ohio</strong>’s goals and objectives related to Supporting Individuals and Families asdelineated in the <strong>Ohio</strong> Obesity Prevention <strong>Plan</strong>, which aggressively targets the primary causes of obesity in <strong>Ohio</strong>.• Make information and tools related to health promotion and disease prevention widely available.Action Steps◦◦ Integrate a mix of effective communications, community- and school-based approaches, and workplace wellnessprograms to educate and motivate individuals to engage in healthy behaviors.◦◦ Create and distribute materials to persuade individuals of the need to continue the lifelong continuum ofunderstanding health information.• Support financing proposals that give state and local public health agencies adequate and sustainable funding. Publicpolicies should facilitate and provide incentives for healthy living, with a dedicated revenue stream to support publichealth activities at the federal, state, and local level. This funding could support community-based programs to fosterhealthy behaviors, such as nutrition, exercise, and smoking cessation counseling.Action Step◦◦ Collaborate with ODH, OPHA and the Administration to develop a business case for increased funding for stateand local public health.<strong>Health</strong> Care Coverage Decisions• Develop a model for an <strong>Ohio</strong> health insurance exchange “connector” through which consumers can easily comparehealth plans and prices to enable them to select the health care plan that best fits their health care and budget.Action Step◦◦ Identify best practices used in developing tools which help individuals:▪▪ Compare coverage options, match to their own values, needs and preferences and select affordable, qualitycoverage (if private insurance through self or employer is applicable)▪▪ Gather and submit relevant eligibility documentation if applying for or seeking to maintain public insurance(e.g., Medicaid, Medicare, SCHIP), compare coverage options if applicable, match to their own values, needsand preferences, and select affordable, quality coverage.▪▪ Use all available comparative performance information (including cost data) to identify prospective providersand facilities.18
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