Ohio Health Quality Improvement Plan

Appendix IV — Co m m e n t s f r o mStatewide Or g a n iz a t io n svaluable learning experience as we each continue to striveto understand the challenges being faced by all stakeholdersin the health care system.OAHP hopes we are afforded an opportunity to continueour involvement with the newly formed Health careCost and Quality Council and the development of theimplementation details for the four core strategies. Wewould like to ensure there is a focus on achievable resultsand a process that captures work being done at the nationallevel in many of these areas. In fact, leaders from ourindustry are initiating efforts on consumer engagement,electronic technology, payment strategies and medicalhome pilots across the country. We look forward to briningour expertise on these issues.For the health insurance industry, we are particularlyinterested in the efforts concerning payment reform,engaging the consumer and the development of patientcentered medical homes. In looking for a top priority, Ithink the council will be confronted with a chicken andegg scenario. Do you fix the problems with the currenthealth care system and follow-up with payment reforms toreward the changes or do you reform the payment structurein hopes of achieving the changes needed to transform thehealth care system? I think this will be a major focus andpotential struggle for the Council.In reviewing the CORE strategies there are opportunitiesfor integration. For example, I believe payment reformcan have an impact on the patient centered medical homedevelopment which also references development ofpayment reforms. In all of these areas, it will be importantto avoid duplication of efforts.Finally I have comments on the draft report and area forfuture consideration. In the area of activated patientsand individuals, there appears to be lacking a tactic toprovide information to consumers on costs or outcomes ofmedical providers and facilities or to educate consumerson their rights and responsibilities as a patient and userof the health care system. I believe this would round outthe area of activated patients and individuals. In the areaof payment reform, it will be important for this groupto look at payments within the entire system and findways to address the subsidy that is being imposed in thecommercial insurance market by medical providers tocover the inadequate payments from government programs.36Additionally, I would caution against implementationof payment reforms by regulations. Any paymentmodels recommended by the council should be basedupon proven results from pilots or other efforts alreadyunderway in Ohio or other states. There should also beagreement that payment reform involves realigning thecurrent dollars available for medical services based uponoutcomes and “what we want to achieve” from the system.Acknowledgment of this will be needed to achieve successin any payment reform discussion.Ohio Business RoundtableThe Ohio Business Roundtable is thankful for theopportunity we were given to participate in Ohio’s HealthQuality Improvement initiative, and we commend the workof the core and implementation teams for their work indeveloping the Ohio Health Quality Improvement Plan.We share a sense of ownership with the plan’s other cocreators,and we believe the plan takes a comprehensiveand holistic approach to reforming our health care systemwhile also identifying four key and appropriate initialpriorities for focusing Ohio’s health reform efforts.Our attention – and, we hope, the attention of the plan’sother co-creators – now shifts from diagnosing andprioritizing health care reform priorities to the much harderwork of implementing solutions. The creation of the OhioHealth Care and Coverage Council is a good start forcoordinating implementation-focused reform efforts, andwe strongly urge lawmakers to invest the modest resourcesneeded to fund the Council and its staff that were requestedin the Governor’s proposed budget so that this muchneededwork can move forward.To maximize its potential for success, we urge the Councilto maintain a disciplined focus on the initial prioritiesidentified in the draft plan. These priorities align well withthose identified in our recently released Improving Ohio’sHealth System diagnostic report (see, for example, thepopulation health, chronic disease management, consumervalue consciousness, provider value consciousness,and technology-enabled clinical information sharingopportunities discussed on pages 9, 40-47, 53-58, 76-79,and 90-92 of the report) . There have been and will bemany temptations to take on everything when tacklinghealth care reform. Maintaining focus on the plan’spriorities will help combat these temptations – and, infact, the Council should consider even further focusing