Success Stories
See where the hard work is beginning to pay off with positive, real-world results.
Wisconsin Health Information Organization (WHIO)
WHIO is an innovative collaboration among providers, insurance companies, employers and public agencies to maintain a state-wide data mart of health claims. The database includes 3.4 million unique members, 207.1 million claims, 18.8 million episodes of care, 88,000 providers and $52 billion in billed charges…and growing.
Read the full case study here.
The Wisconsin Experiments:
Can you compare your organization’s performance to that of your peers? What does best practice look like? How much variation exists and where does your organization sit on the list? Comparative quality transparency in Wisconsin has resulted in real improvement in patient care. This is the outcome of a simple chain reaction: providers see how their care stacks up against the competition based on publicly shared measures and then throw resources into improving the lowest results. Read about the tangible impact of comparative performance public reporting in WI.
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At the Center we’re working to spread the benefits of a comparative performance environment as a way to accelerate the pace and impact of the lean journey for members of the Healthcare Value Network. Experiments are underway to populate a comparative Patient Safety Dashboard and a Hospital Value Performance dashboard.
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As part of its national healthcare transparency initiative the ThedaCare Center for Healthcare Value launched a series of incremental and sequential experiments to test the hypothesis that : 'Development of a more transparent, rational healthcare marketplace is the most effective way to achieve improvements in quality, affordability, safety and efficiency of care delivered across the nation'.
Built on the Wisconsin experience (www.wchq.org, www.wisconsinheathinfo.org, www.phpr.org ) these national experiments will entail selection of meaningful measures of health care organization performance, comparison of those results between and among participating healthcare organizations, and examination of the level and basis of variation reflected in the results. Observations and recommendations for scaling the project to support public reporting of an expanded set of performance metrics across the national healthcare community will be published in periodic reports based on findings of the pilot program participants.
There are two opportunities for Healthcare Value Network member organizations to participate:
- The Patient Safety Measures Dashboard will compare performance of key safety indicators across participating organizations. Participants selected the starter measure set and plans to populate the dashboard by 4th quarter 2012. Viewing of the dashboard will be restricted to participating members until the process and metrics are fully vetted. Once done, the information is intended for public display.
- The Hospital Performance Dashboard will compare quality, operational and financial indicators across participating organizations. The work group established the starter measure set in June and plans to populate the first dashboards in 4th quarter 2012. Viewing of this comparative performance information will be limited to participating organizations.
In addition to offering insights into best practice and supporting peer to peer learning, these experiments represent an opportunity to influence the scope and focus of national healthcare transparency efforts across the nation.
Sometimes you just have to have more data to build credible and actionable analytics. Quality is an important, but not the only, measure of healthcare value. Quality is inextricably linked with cost – but not in the way that most people think. Many assume higher healthcare quality equals higher cost — the ‘you get what you pay for’ perspective. However the opposite is often true. Higher costs frequently indicate poorly designed, inefficient systems. Measuring health care costs in aggregate - not just the copay, or the deductible; not just the doctor’s costs or the hospital bill; but the entire cost of an episode of care - allows us to see what we’re paying for and how much we’re buying.
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All Payer Claims Databases (APCDs) are an important and essential component to healthcare transformation. These statewide data sets allow for comprehensive reporting of entire episodes of care across the care continuum, across insurance plans and medical systems, over geographic regions and through time periods. At the Center, we support development of APCDs by sharing our experience in building the Wisconsin APCD and by connecting APCD developers in one area to healthcare providers in their community to build interest and garner support. We also support information sharing among APCDs to exchange specialty care or population based metrics across geographic and political boundaries in order to establish national best practice benchmarks.
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Parties interested in learning more about All Payer Claims Databases should also explore the APCD Council (APCDCouncil.org) and National Association of HealthCare Data Organizations (NAHDO) sites (NAHDO.org) sites.
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Let us know by emailing ncook@createvalue.org.