With this issue, Health Policy Corporation of Iowa launches HPCI News, a periodic electronic report of updates, news, insights and issues of concern to Iowa employers, other purchasers, consumers, health care providers and other stakeholders.
August 2003, In This Issue:
- Advancing LEAN Enterprise in Iowa's Health Industry.
- Creating Action Plans for Improving the Health Care
System in Iowa.
- Latest on HPCI Goals, Organization, and Priorities.
- Join HPCI.
- Health Insurance Rate Increases for Iowa Employers.
- Two New Hospital Facilities Proposed in Greater Des Moines.
- A Dozen Initiatives Are Under Way to Improve Accountability, Patient Safety, and Transparency of Health Information.
- Employees Consider Themselves Effective Health Care Consumers - May Not See a Need to Change.
- Leapfrog Group Makes Changes to the 2003 Survey.
- Becoming a Member of the Leapfrog Group.
The HPCI LEAN Enterprise Task Force recently expanded its membership and identified three work groups and their focus:
Work Group #1 / Conduct Process and Value Stream Mapping - Map the current process state between employers, health plan(s), health providers and patients.
Work Group #2 / Support Iowa Demonstrations - Develop pilot projects or demonstrations using LEAN in Iowa health provider settings. Also create networking and collaboration among and between demonstration sites and supportive organizations/ individuals.
Work Group #3 / Develop Communication and Education Strategy, i.e., LEAn 101 training and exchange, presentations, seminars, glossary of terms, communicate success stories and promotion of LEAN in healthcare.
The Value Stream Mapping or process map work group has begun identifying the current processes in health care which add cost to the system. The group's guiding philosophy:
Approach the issue very much like any other Lean or Sigma challenge. Start at the customer and work the complete process. Understand the problem before you jump to conclusions including quality and cost implications at each process step. By carefully understanding the problem, we will be much better prepared to articulate the "burning platform" as well as potential opportunities for each of the constituents along the way. The better everyone understands the process, what is in and out of scope as well as the potential returns for each of the constituents, the higher the potential for everyone to buy into the outcome.
A group of over 50 Iowa leaders have been working over the last several months to identify action steps to improve the health care system in Iowa.
Three suggested action steps have been identified based upon six themes that were articulated in April. The three action steps are:
Action Step 1. Educate and inform consumers/patients, health care providers and other stakeholders. This involves initiating a plan so all Iowa stakeholders have a better understanding and can speak a common language around health care, and developing a strategy for early age and continuous education on being healthy and using health care properly.
Action Step 2. Endorse and apply a set of quality measures and performance standards. This will use national measures and performance standards and linking them to Iowa. Focus also on the important role of educating consumers/patients and the general public on how to read and use the data and information generated. Several suggestions were made on how the HPCI task force should proceed.
Action Step 3: Activate consumerism in health care including choice of services and plans with good information (becoming a better health care consumer).
Attached is the latest information on HPCI goals, organization and priorities for 2003-2004.
HPCI works for quality, affordable health care in Iowa. Individual employers, other purchasers and consumers use many strategies for addressing health care costs on their own. HPCI adds value by helping focus attention and mobilize actions that are best done on a collective or coalition basis involving numerous employers and other purchasers across local Iowa markets. Join HPCI today!
- For membership information send a request to firstname.lastname@example.org
- Or, for a presentation about how HPCI membership can benefit your organization, contact the HPCI office.
Health insurance rates for Iowa employers of all sizes increased 18.7% in
2002 according to data published by David P. Lind and Associates, LP. Similar increases are expected this year. Iowa employers are responding to these large increases by: the employee and the company sharing in additional costs, reducing benefits to minimize or eliminate increases, the company absorbing the entire increase, changing insurance companies, passing on all increases to employees or no longer providing health insurance coverage.
Mercy Medical Center in Des Moines recently announced plans to add $165 million in hospital and clinic capital expenditures, while the Iowa Health System in Central Iowa plans to build a new $80+ million hospital in the West Des Moines area. Some see this as an investment in the future to the tune of more than $260 million. Others, especially employers and payors, see these capital expenditures as increases to health insurance premiums which are already rising at double-digit rates. All would probably agree that these plans represent the most ambitious expansion of health care facilities in Iowa in the last two decades. Stay tuned.
HPCI recently updated its description of initiatives under way to improve accountability, patient safety, and transparency of health information.
Twelve very significant efforts have been identified and described. The HPCI strategy is to leverage these national solutions and resources, such as the Business Roundtable founded Leapfrog Group, the National Consumer and Purchaser Disclosure Project, the eValue8 evaluation tool, the Centers for Medicare and Medicaid Services (CMS), the Agency for Health Care Research and Quality (AHRQ), and the National Quality Forum. More information is available through the HPCI office.
According to survey results recently published by Towers Perrin, employees consider themselves effective health care consumers and may not see a need to change.
- 86% agree or strongly agree that they take responsibility for their own health;
- 69% agree or strongly agree that they know what it means to be an effective healthcare consumer;
- 72% agree or strongly agree that they are effective healthcare
- 76% agree or strongly agree that they are accountable for using their health care plan effectively; and
- 78% agree or strongly agree that they understand how their health plan works.
The Leapfrog Group recently announced changes to the 2003 hospital survey which is now being completed by hospitals across the country. Changes include:
- A broadened definition of intensivist.
- Clinical process measures and risk adjusted outcome measures added to evidence-based hospital referral criteria.
- Expansion of the treatment category of coronary angioplasty.
- No longer focusing on carotid arterectomy, now highlighting
- Targeted implementation of the date for computerized order entry (CPOE) pushed back to 2005.
Leapfrog now has over 810 hospitals nationwide voluntarily participating in the Leapfrog Group's online survey to report their progress towards implementing Leapfrog's recommended practices. 70% of all U.S. healthcare consumers now have access to patient safety data for one or more hospitals in their area. Hospitals also have an opportunity to report other patient safety and quality initiatives through this website (www.leapfroggroup.org).
HPCI will be leading a drive to get numerous Iowa employers and purchasers to sign on as members of the Leapfrog Group. There is no additional membership fee or cost to become a member of the Leapfrog Group. The current plan is to have HPCI and all of its members who choose to do so to join as a group.
Leapfrog members agree to adhere to the following four purchasing principles in buying health care coverage for their enrollees:
- Educating and informing enrollees about patient safety and
importance of comparing health care providers' performance, with initial emphasis on the Leapfrog safety measures.
- Recognizing and rewarding health care providers for major advances in protecting patients from preventable medical errors;
- Holding health plans accountable for implementing the Leapfrog purchasing principles; and
- Building the support of benefits consultants and brokers to utilize and advance the Leapfrog purchasing principles with all of their clients Because the health industry needs time to meet these standards, Leapfrog purchasers are working with the provider community to arrive at aggressive but feasible target dates for application of the purchasing principles and the implementation of Leapfrog's recommended patient safety practices.
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