Ohio Health Quality Improvement Plan
Ohio Health Quality Improvement Plan Ohio Health Quality Improvement Plan
Me a s u r in g Su c c e s sIn addition to the strategy-specific milestones and measures proposed above, the core team recommends system-leveloutcome measures to help focus attention on the goal of creating a high-quality, cost-effective, high-performing healthsystem in Ohio by 2013. As the strategy-specific measures focus on assuring progress is taking place to implement theidentified tactics, system-level measures will help assess if the strategies and tactics together are producing the desiredtransformation of Ohio’s health care system.In developing the system measures, the team recommends using a balanced scorecard approach, with measures in fivedifferent areas to determine success. The proposed areas are: quality; access; wellness; health spending; and satisfaction(provider and individual). In addition, any metrics identified would be designed to ensure geographic, racial and otherdisparities are being addressed.All of the proposed measures are draft and under development. They require input from participants in the health caresystem to assure that they best assess the tactics selected, progress made, and outcomes desired.Proposed Collaborative Transformational Strategy MeasuresAs discussed within each collaborative strategy description, the CTS workgroups developed a set of proposed short, mid,and long term process milestones/metrics for their tactics. The milestones/metrics typically result in achievement of adesired process end, such as greater adoption of health information technology or a higher percentage of people having apatient-centered medical home. The proposed milestones/metrics and a potential time line are summarized in Figure 4.Fig. 4Proposed Milestones/MetricsPartnership designatedEMR service strategy finalizedLoan program strategy finalizedCenter for excellence service provider certification program completedHIE RFP awardedEstablish realistic adoption targets for EMR and HIE usageProposed OHQIS Process Metric Implementation TimelineCreate a PCMH task force under the HCCQCDevelop PCMH implementation planDevelop plan/ create incentives to expand/enhance primary care workforce to support PCMHImplement primary care workforce plan and incentivesPayment reform stakeholder group(s) appointedExisting medical claims data utilization reviewed to find overuse, underuse, misusePayment policies that discourage underuse, misuse and overuse identifiedPrinciples regarding avoidable adverse events establishedMedicaid and private payer incentives identifiedFinancial incentives for e-prescribing, e-billing, e-health records and electronic eligibility verification identifiedEstablish payment models to support PCMH implementationImplement PCMH plan and payment modelsPatient- and public-involved task force establishedA health insurance exchange model is developedHealth information delivery methods are developed and testedA “shared decision-making” pilot is developed and implementedA pilot “academic detailing” program is developed and implementedOne or more pilot self-management programs developed, implemented in conjunction with early PCMH initiativesA social marketing campaign promoting the execution of advance directives developed, testedQ2 2009 Q3 2009 Q4 2009 Q1 2010 Q2 2010 Q3 2010 Q4 2010 Q1 2011 Q2 2011Health Information TechnologyActivated Patient= milestone achievedPatient Centered Medical Home (PCMH)Payment Reform22
Me a s u r in g Su c c e s sProposed System LevelMeasuresThe four collaborative strategies aswell as other state-level efforts areaimed at creating the building blocksand infrastructure necessary to fostera transformed health system for allOhioans. Such a transformation requiresboth an enhanced emphasis on wellnessand health rather than the treatment ofillness, and the adoption of an affordableand sustainable health care financing anddelivery system.Fig. 5Potential system level outcome dashboardThe core team decided that the goals ofsuch a transformation would be reflectedin positive outcomes in five areas:improved and optimal health for allOhioans; available and affordable accessto quality care; more efficient delivery of health care services; sustainable health financing and economic performance;and demonstrated satisfaction among both consumers and providers of health care.These five areas identify the reality that a successfully transformed health system must produce clear, positive results inmultiple dimensions at the same time. Having measures in all five of these areas ensures that one set of outcome goalsdoes not come at the expense of desired goals in other areas. Figure 5 is an example of what a potential system-leveloutcome dashboard might look like.Potential measures for each of these five areas are listed below. The final determination of system-level measures willrequire additional discussion and shared commitment, as well as the identification of data sources, baseline measures,and attainable yet aggressive performance targets and time frames. As part of this discussion, each measure must includethe capacity to examine outcomes (and thereby the impact on health disparities) by race/ethnicity, geographic area withinOhio, gender, and income level.Improved and optimal health for all Ohioans (examples of measures)• Prevalence rates for the five leading chronic health conditions• Prevalence rate for intentional and unintentional injury• Immunization rates• Low birth weight and infant mortality ratesAvailable and affordable access to care (examples of measures)• Identification of a usual source of care (not the emergency department)• Uninsured rateEfficient delivery of health care services (examples of measures)• Rate of hospitalization for people with ambulatory sensitive conditions• Rate for 30-day readmission to hospitals• Mortality rate amenable to health care• Patient safety measure23
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- Page 45: CORE PLANNING TEAMAmy Rohling McGee
Me a s u r in g Su c c e s sProposed System LevelMeasuresThe four collaborative strategies aswell as other state-level efforts areaimed at creating the building blocksand infrastructure necessary to fostera transformed health system for all<strong>Ohio</strong>ans. Such a transformation requiresboth an enhanced emphasis on wellnessand health rather than the treatment ofillness, and the adoption of an affordableand sustainable health care financing anddelivery system.Fig. 5Potential system level outcome dashboardThe core team decided that the goals ofsuch a transformation would be reflectedin positive outcomes in five areas:improved and optimal health for all<strong>Ohio</strong>ans; available and affordable accessto quality care; more efficient delivery of health care services; sustainable health financing and economic performance;and demonstrated satisfaction among both consumers and providers of health care.These five areas identify the reality that a successfully transformed health system must produce clear, positive results inmultiple dimensions at the same time. Having measures in all five of these areas ensures that one set of outcome goalsdoes not come at the expense of desired goals in other areas. Figure 5 is an example of what a potential system-leveloutcome dashboard might look like.Potential measures for each of these five areas are listed below. The final determination of system-level measures willrequire additional discussion and shared commitment, as well as the identification of data sources, baseline measures,and attainable yet aggressive performance targets and time frames. As part of this discussion, each measure must includethe capacity to examine outcomes (and thereby the impact on health disparities) by race/ethnicity, geographic area within<strong>Ohio</strong>, gender, and income level.Improved and optimal health for all <strong>Ohio</strong>ans (examples of measures)• Prevalence rates for the five leading chronic health conditions• Prevalence rate for intentional and unintentional injury• Immunization rates• Low birth weight and infant mortality ratesAvailable and affordable access to care (examples of measures)• Identification of a usual source of care (not the emergency department)• Uninsured rateEfficient delivery of health care services (examples of measures)• Rate of hospitalization for people with ambulatory sensitive conditions• Rate for 30-day readmission to hospitals• Mortality rate amenable to health care• Patient safety measure23
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