CCA Featured Member: April 2013

Enrollment in HealthSciences Institute’s CCP Health Coach Learning and Certification Program continues to expand nationally and the organization is making inroads in Asia and the Middle East as well. HealthSciences is the largest chronic care and evidence-based health coaching training and performance improvement organization. Our fifth edition of the CCP program was released in February.

Our faculty includes NIH-funded specialists in health behavior change and engagement who have quadrupled engagement rates for employer purchasers in joint projects with Mercer, and assisted others in delivering measurable gains in patient-level outcomes by improving the proficiency of health care professionals to deliver evidence-based health behavior change solutions.

HealthSciences values the CCA partnership and continues to promote CCA membership as an avenue for a 25% reduction on the CCP Health Coach Learning and Certification Program tuition.

National Population Health Improvement Learning Collaborative

Since 2010 with the not-for-profit Partners In Improvement Alliance we have built a community of over 15,000 health care professionals from health plans, providers, federal and state units of health, among others. Each month our free learning collaborative webinar sessions are attended by 800 to 1,000 individuals. Learn more.

Health Coaching Performance Assessment (HCPA): Assessing the Proficiency of Health Coaches and the Quality of Population Health Services 

The first externally validated, standardized tool for measuring the quality of health coaching services delivered in wellness, disease management and care management programs. The HCPA is being used widely by BCBS affiliates, and other population health programs at Mayo Clinic, Marshfield Clinic, Stanford University Health System and the VA to benchmark and improve individual and program adherence to the evidence-based health coaching interventions demonstrated in hundreds of peer-reviewed publications to improve patient-level change. Learn more.

In an independently evaluated study by Ariel Linden, HealthSciences was the first to demonstrate a link between evidence-based health coaching proficiency (based on motivational interviewing health coaching) and member enrollment.

Registered Health Coach Program 

As you know, with lay people developing health coach training and certification programs, or wellness organizations WELLCOA offering theirs, we are proud to offer the only learning and certification programs in health coaching backed by outcomes and developed by specialists in behavioral medicine, motivational interviewing, medical psychology and health psychology. The Registered Health Coach credentials build on CCP, by offering proficiency-based training in MI health coaching. CCPs and RHCs are eligible for membership in the National Health Coach Registry http://registeredhealthcoach.org/.

CCA New Members Roll Call: April 2013

 

Accordant Health Services, a CVS Caremark company, is a recognized leader in delivering disease management and case management services for people with rare chronic conditions. We have been providing value-added services on behalf of our contracted clients such as health plans, employers, and third party administrators (TPAs) for more than 14 years.

 

Members eligible for our programs are offered our services at no cost to them through their health plan or benefit provider. This is a specialized program to help them manage their rare chronic illness. These conditions and their associated complications are managed by our registered nurses. Our programs improve the quality of life for those who are ill, their families and their caregivers, while significantly reducing overall health care costs for our clients.

 

News from CCA Quality and Research

CCA Forum Program Committee

With more than 90 proposal submissions received last month, the Program Committee has a multitude of high quality presentations from which to choose for CCA Forum 2013 in Scottsdale, AZ, on October 23-25, 2013. Through a process of online review and scoring along with an in-person meeting and conference call, the Committee is making final selections for the educational program. Themes for 2013 will include collaborative strategies for practice transformation, Big Data, and employer strategies for employee health, to name a few. And the traditional session format of the past will be transformed into more engaged presentations, working sessions, and workshops.

Walking Learning Labs and a pre-conference workshop on program evaluation are new offerings for 2013, providing additional opportunities for attendees to gain hands-on learning. The walking learning labs will guide attendees through a mini-tour of The Solutions Zone exhibit hall and demonstrate how, for example, a health care provider might use population health management strategies to better care for his patients. The half-day program evaluation workshop, on Wednesday afternoon (Oct. 23), will interest employers (HR and benefit managers) who want to better understand their wellness programs and what they should measure, resulting in “take back to the office” information. Forum attendees will need to register separately for these opportunities.

For the third year, the International Symposium on Wellness & Chronic Care will demonstrate the application and success of a variety of population health management strategies around the globe. This half-day conference will take place on Friday afternoon (Oct. 25) and will bring new perspectives from countries/regions that have not been represented at past conferences.

Our sincere appreciation goes to the Program Committee, reviewers, and their associated organizations for the commitment of time and resources: Greg Berg (McKesson Health Solutions), Suzanne Duda (Healthways), Neil Gordon (INTERVENT International), Cynthia Hallam (Blue Cross Blue Shield Louisiana), Nancy Hedstrom Wigley (Cigna), Natalie Heidrich (Ethicon), Iver Juster (ActiveHealth Management), Craig Keyes (Alere), Rose Maljanian (HealthCAWS), Michael Taylor (Accenture), and Mike Van Den Eynde (Deloitte).

Stay tuned as we begin to release more details on the CCA Forum program within the next month. Those who submitted proposals can expect to receive notification of the Committee’s decision by the end of May.

Population Health Management in Health Insurance Exchanges

A 2013 research initiative, the Population Health Management in Health Insurance Exchanges has kicked off with two work groups: HIX Assessment and Exchanges 101. We are conducting an environmental scan of the state exchanges to better understand the variety in structure, design decisions, measurement, etc. We are also using past CCA research to build the value proposition for population health management and communicate that value to the exchanges. If you have resources or expertise to share in these areas, please contact Karen Moseley, KMoseley@CareContinuumAlliance.org.

Membership Update – March 2013

March has been a busy month for the Care Continuum Alliance. We are excited by the record number of CCA Forum 2013 proposal submissions received. The Program Committee is now hard at work in the selection process. With more than 90 proposals from around the world we can be sure of two things: the selection process won’t be easy and the final program will be top notch! We want to thank the CCA members who volunteered their time to be part of the Program Committee. The selected proposals will be announced late June, so, please, standby!
CCA is preparing for the April 11th Capitol Caucus. Don’t miss it! Please, check the Agenda, and I’m sure you will realize you need to be there. 
Frequently, members and prospective members ask about the opportunities for engagement with CCA and I thought it might be helpful to list them as a reminder:
  • We Are SOCIAL! Communication vehicles for you to engage with CCA and the community at large:
    1. Follow us on Twitter @CCAVoice
    2. Become part of our very active LinkedIn group
    3. Submit a Guest Blog Post about what’s going on in your organization: CCA’ s blog guidelines 
  • SUBMIT member info to the  CCA Connect: Voice of Population Health! Catch up on the January and February  editions.
  • INVITE your Washington D.C. legislative team/reps or if you are in town, to:
    1. ATTEND the monthly Washington Representatives Meeting – The March 26th meeting features Dr. Linda T. Bilheimer, Assistant Director for Health, Retirement, and Long-Term Analysis-The Congressional Budget Office. Read about the January meeting with Representative Charles Boustany (R-LA).
    2. ATTEND the April 11th Capitol Caucus, Embassy Suites, Washington DC.
    3. ATTEND  the monthly Government Affairs or Innovations Committee meeting either in person or via dial in. Contact Victoria Ingenito-Shapiro, vingenito@carecontinuumalliance.org
    4. Hold a Congressional Briefing.
  • SIGN UP for the new HIX Committee and Workshops! Contact Karen Moseley, kmoseley@carecontinuumalliance.org 
I’m here to answer any questions and am always interested in feedback and suggestions on how to improve upon our offerings to you.
Lisa Gorski
Vice President, Membership & Development
Care Continuum Alliance   LinkedInFacebookTwitter
701 Pennsylvania Avenue, N.W., Suite 700
Washington, DC 20004
Tel: 202-737-5806
Cell: 650-222-3811

 

CCA New Members Roll Call: March 2013

BayCare Health System is a leading community-based health system in the Tampa Bay area.  Composed of a network of 10 not-for-profit hospitals, outpatient facilities and services such as imaging, lab, behavioral health and home health care, BayCare provides expert medical care throughout a patient’s lifetime.

With more than 200 locations throughout the Tampa Bay area, BayCare connects patients to a complete range of preventive, diagnostic and treatment services for any health care need.

SCAN Health Plan® is a Medicare Advantage plan serving the needs of more than 130,000 members in California and Arizona. The goal of the organization is to continue to find innovative ways to enhance members’ ability to manage their health and to continue to control where and how they live. Since its inception, SCAN has provided the care needed to keep more than 100,000 people out of nursing homes. Founded in 1977, SCAN is headquartered in Long Beach, California. Today SCAN is the second largest not-for-profit Medicare Advantage plan in California. We invite you to find out more about our unique health plan dedicated to helping our members stay healthy and independent.

CCA Quality & Research Update – Focus on Partnerships

Quality & Research March Update

Population Health Management in Health Insurance Exchanges

The Affordable Care Act requires health insurance exchanges (HIX) to be established and working by 2014 in every state. Currently, 17 states are pursuing a state-run marketplace, while the remaining 33 states will allow a federally facilitated marketplace or partner for a state-federal marketplace. These exchanges will function as a transparent and competitive marketplace where buyers of health insurance, mainly individuals and small businesses, can buy affordable and qualified health benefit plans.

This move toward increased health care access for broader populations provides an opportunity to apply population health management (PHM) beyond Medicare and Medicaid populations to the commercial market. As employers shift the ways in which they provide health benefits, this work will be applicable to any population health model trying to gain access to broader populations through broader access models such as state and private exchanges.

CCA and its members have already laid the groundwork for population health management as the cornerstone for this broader access model. PHM strategies and tactics will be important to the success of the health insurance exchanges. As the voice of population health, CCA will develop tools and guidance to address three main objectives: 1) help PHM vendors to understand the health insurance exchanges and the opportunities that may exist in these new markets; 2) demonstrate the value of PHM to the health insurance exchanges; and 3) inform policy makers about the value of PHM for the HIX and differentiate the payment models used.

The Quality & Research Committee has formed two work groups for this effort. If you are interested in participating, please contact Karen Moseley, kmoseley@carecontinuumalliance.org.

  1. HIX Assessment. This work group will perform the environmental scan of HIX, including participating states, design decisions, product offerings, populations served, measurement, health information technology, and other exchanges such as private exchanges and state-federal marketplaces.
  2. Exchanges 101. This work group will develop guidance around the value proposition of HIX as a new business opportunity for PHM organizations as well as the value proposition of PHM for the success of HIX.

HERO-CCA Employer Dashboard

CCA’s collaborative effort with HERO is progressing and will be in the final stages of review within the next few months. The project leadership group plans to meet for a full-day working session in April to finalize the document for review by experts in the industry and stakeholder groups within HERO and CCA. If you have expertise in measures for employee health management programs—specifically the domains of health impact, satisfaction, participation, financial outcomes, productivity, organizational support, and value of investment—please contact Karen Moseley, kmoseley@carecontinuumalliance.org, if you would like to serve as a reviewer of the work prior to release. The final review will include public comment, so stay tuned.

Workplace Wellness

The CCA data aggregation buzz has been quiet for several months, but it is becoming louder as we await the release of RAND’s Report to Congress on the effectiveness of wellness programs in the workplace, including factors such as the incentives offered, the impact participation has on employee behavior, and programs’ ultimate impact on employees’ health. We expect to have the full report in April, and RAND has offered to brief the CCA data advisory board as well as the data contributors on the report findings post release.

On a similar note, CCA Quality & Research is collaborating with CCA Advocacy to develop a detailed, comprehensive, and evidence-based response to a recent article in Health Affairs titled, Wellness Incentives In The Workplace: Cost Savings Through Cost Shifting To Unhealthy. The authors draw several conclusions that merit a response, and CCA members are called to submit case studies to increase the evidence. Read the Call to Actionand act now!

 

CCA Featured Members: February 2013

Every month, CCA features the work and contributions to the population health industry of some of its members. This brief highlights are shared through the CCA Connect: Voice of Population Health monthly newsletter.

Using a Calendar Approach to Drive Clinical Outcomes

Over 100M Consumers on the Move. Are You Prepared?

Today’s clinical leaders are looking for ways to optimize consumer communications and drive results.

Personalized, targeted and relevant information is key to helping members make better health decisions. When communicating with individuals,  it is essential to deliver highly personalized, scalable, and dynamic interactions, in a caring and compelling manner, around topics that impact day-to-day health.

One of the strategies we recommend to meaningfully impact care is a calendar-based approach to communications. This type of planning allows clinical leaders to be a thoughtful partner in care with communications designed from the member’s point of view. A well-planned schedule of outreach maximizes the effectiveness of clinical messages and avoids overwhelming or overlapping requests for action sent to the member.

Sometimes it isn’t possible to avoid asking people to do more than one thing in the same time period. For example, when an individual has multiple gaps in care, they may be targeted by multiple communications in a short time frame. In these cases, we recommend taking extra care to identify the affected individuals and deliver highly personalized outreach with a high-touch approach.

The communications calendar typically includes a broad set of calendar-based campaigns and trigger-based outreach that occurs more frequently, such as to provide support when a new medication is first prescribed. It may also include specialized campaigns, such as a multi-channel campaign designed to support seniors across a range of Star topics.

For more on Silverlink’s approach to smarter health engagement, visit www.silverlink.com.

Long Time on the Road of Accountability

HealthPartners is among six organizations to receive a new accreditation as an Accountable Care Organization from the National Committee for Quality Assurance, a leading non-profit organization dedicated to improving health care quality.

“ACO accreditation demonstrates that HealthPartners model of care is achieving the three aims of improving health, delivering an excellent experience and lowering the cost of care,” said Beth Waterman, HealthPartners chief improvement officer.

HealthPartners has been on the road of accountability for a long time.

In 1995, HealthPartners developed the Total Cost of Care measure to bring awareness of health care costs to providers and patients, and to drive improved value for the health care dollar.

According to  the Agency for Healthcare Research and Quality (AHRQ), HealthPartners’ population-based Total Cost of Care and Total Resource Use measures provide valuable information to health plans and providers on how to make health care more affordable without sacrificing quality or experience. Health plans and providers can use cost and resource use data to identify areas where they can lower cost by improving resource use or shifting to less expensive, yet equally effective resources — for example, use of a surgery center instead of a hospital where it is medically appropriate, without negatively impacting quality. Evidence supports this idea as depicted in various studies on diabetes care, in academic medical centers, across metropolitan statistical areas and in group practices in Minnesota. These studies conclude that increased cost does not result in increased quality, while quality is not sacrificed when resource use is optimized.

A key benefit of HealthPartners’ population-based Total Cost of Care and Resource Use measures is the identification of potential overuse and underuse of health care services. For example, a primary care physician may be referring back pain patients to an orthopedic surgeon. Rather than managing the back pain in primary care, these patients may have increased specialist costs and potentially more back surgeries than would be expected for their population. Overuse of health care services has led to wide variation in health care cost and use across geographies. Studies suggest that Medicare spending would be decreased by almost 30 percent if medium and high spending geographies consumed health care services comparable to that of lower spending regions. Experts agree that reducing overuse can make care safer and more efficient.

The HealthPartners Total Cost of Care and Resource Use measures for identifying healthcare cost drivers and opportunities to address them were the first of their kind to be endorsed by the National Quality Forum (NQF).

As NQF-endorsed standards, the HealthPartners Total Cost of Care and Resource Use measures complement existing quality measures to provide a much-needed, common reference point supporting the development of accountable care organizations (ACOs) and payment reform models. Providers, insurers, government agencies, employers, consumers and other organizations can use the measures to manage costs, drive affordability and improve delivery of healthcare.

To learn more about their programs, visit www.healthpartners.com.

CCA Quality and Research Report

This time of year is always an exciting one for Quality & Research at CCA as we finalize our priorities for the year and look to our members for your support and expertise. A huge thank you goes to those of you who contributed through discussions and survey responses to help us determine areas of priority for the industry, and therefore priorities for CCA.

Starting in October 2012, several leaders with a keen interest in quality and research met at Forum 12 to brainstorm the issues facing the population health industry today. Following the brainstorming session, a survey and focus group provided additional insights that helped to identify the areas where CCA should focus its resources in 2013. The lead item on the following list reflects the top new priority for 2013, followed by three additional areas from previous years that continue to hold importance for the industry and CCA.

1. Role of Population Health Management (PHM) in Health Insurance Exchanges (HIEs). The new health insurance exchanges will need to be successful, and PHM strategies and tactics will be an important part of these exchanges. CCA will develop tools and educational materials to help the HIEs understand the role of PHM in their success. This work will be divided into three work streams.

  • HIE Assessment Work Group. This group will perform an environmental scan of HIEs, to include who is participating, what they look like, who is accountable, and what they offer.
  • Exchanges 101 Work Group. This group will develop guidance materials to explain HIEs and their value proposition, discuss how they differ from the current system, and how PHM can add value.
  • Exchange Options Work Group. This group will explain the different types of exchanges—public, private, state/federal—and the populations they serve.

2. HERO-CCA Measures and Standards Collaboration. This partnership will continue to move forward in 2013, building on the work of the past 18 months and culminating in the release of a core set of measures later this year. Volunteers from both HERO and CCA have combined their expertise toward recommending measures for employers in six domains: value of investment, financial outcomes, health impact, participation, satisfaction, and organizational support.

3. Data Aggregation. CCA’s vision to validate industry accomplishments and contribute to the advancement of future efforts for policy making, program development and evaluation has been realized in the creation of the first data repository of its kind. Very soon, we will have a release on the first study using data from the CCA database so stay tuned.

4. International Task Force. For the past few years, the international presence within CCA has become more prominent. In 2013, CCA will host the 3rd International Symposium on Wellness & Chronic Care on Oct. 23, in Scottsdale, AZ. Also, following the successful release of the first global population health report on Brazil, CCA will look to other regions as the focus for the second report.

These areas were presented at the first quarter Quality & Research Committee update on Feb. 27th. We are currently accepting volunteers for the three work groups focused on the health insurance exchanges. If you are interested in participating or have questions, please contact Karen Moseley, Director of Research, at kmoseley@carecontinuumalliance.org or 202.747.4956.

CCA New Members Roll Call: February 2013

The Care Continuum Alliance welcomes three new members:

 Presbyterian Health Plan, Inc. and Presbyterian Insurance Company, Inc. are owned by Presbyterian Healthcare Services, the  state’s largest locally owned, New Mexico-based healthcare system. Presbyterian Health Plan offers a statewide healthcare delivery system and 25 years of experience in managed care.

Commitment to New Mexico

Presbyterian Health Plan is New Mexico’s largest locally owned health plan and offers a full spectrum of health insurance choices to meet the diverse needs of New Mexicans.  The National Committee for Quality Assurance (NCQA), which evaluates health plans across the country, has awarded “Excellent” accreditations for our Medicare HMO health plans and “Commendable” for our Commerical HMO/POS and Medicaid HMO plans.

More importantly, our quality is reflected in the health and wellness of our members and the ease with which they and network providers access health information and services. Putting the customer first, we have in recent years completely re-engineered our customer service processes and are now emerging as a leader in online services, offering an abundance of web-based tools and information for our members and network providers.

Investment in improving health

Presbyterian Health Plan has also invested in healthcare technologies and strategies that help more New Mexicans maintain or improve health through prevention and management of diseases and illnesses. We can now predict whether individuals are likely to face catastrophic health problems and can advise these members to follow healthcare and wellness strategies that are best suited to prevent such an event from happening. Plus, Presbyterian Health Plan is continuously working to improve breast cancer screening rates, immunization rates, and the care of members with asthma, diabetes and depression.

Learn more: http://www.phs.org/PHS/

CCA Featured Members: January 2013

Every month, CCA features the work and contributions to the population health industry of some of its members. This brief highlights are shared through the CCA Connect: Voice of Population Health monthly newsletter.

Viridian Health Management

Understand. Engage. Impact.

Viridian Health Management’s (Viridian) corporate office is based in Phoenix, Arizona, and the company has a national health coaching network in over 31 states. It serves clients in the worksite health, healthcare and public health sectors through its pioneering HealthImpact™ System, a comprehensive health coaching system; an integrative approach to wellness and Maestro™ care management technology solution.

Viridian’s programs combine evidence-based best practices with a “learning from doing” approach that results in health and financial outcomes for its clients. Its employees embody a spirit for service, passion for promoting well-being and a collaborative attitude. Central to Viridian’s work is the ability to scale programs to impact the health of entire communities in places where people spend their time and receive healthcare services – worksites, schools, community centers, places of worship, retail pharmacies in the community and healthcare provider offices.

2013 will be an exciting year for Viridian with several innovative project and partnerships underway:

  • Continued work on the Centers for Disease Control and Prevention’s (CDC) National Healthy Worksite Program. In 2011, as a result of Viridian’s unique industry model, it was selected by the CDC and awarded $8 million dollars to implement the CDC National Healthy Worksite Program to develop and define a national model for worksite health programs.
  • Launch of the Viridian My Weigh 2 Prevent Diabetes™ program as part of Viridian’s work as a recognized CDC Diabetes Prevention Program partner.
  • Fulfillment of its commitment to the Clinton Global Initiative to develop and implement interactive web-based tools for small employers to build worksite health plans and create learning communities to support program implementation and sustainability.
  • Launch of the Viridian Institute for Applied Health Improvement, which leverages Viridian’s health coaching expertise and provides a model for supporting prevention and disease management through training health coaches to reach people at the community level.
  • Delivering services to Viridian worksite health clients nationwide that provide best-in-class programming with industry exceeding participation rates of 85 percent.
  • Partnerships in value-based healthcare delivery environments that require new models for success such as integration of health coaching, health behavior change programs and care management technology.

To learn more about Viridian, visit its website at www.viridianhealth.com.

***

Inovalon

Inovalon, Inc. is a leading technology-enabled healthcare solutions provider focused on the importance of healthcare data and its ability to drive dramatic, objective improvement in clinical and quality outcomes, care management and financial performance throughout the healthcare community. Proprietary healthcare datasets, aggregation and analysis capabilities, combined with a national infrastructure of leading-edge technology, clinical prowess and deep human resources, empower Inovalon’s advanced generation of healthcare assessment and improvement through highly informed solutions. Driven by data, Inovalon uniquely identifies gaps in care, quality, data integrity, and financial performance ­– while also bringing to bear the resources to resolve them. This differentiating combination provides a powerful capability suite, touching more than 540,000 physicians, 220,000 clinical facilities, and more than 120 million Americans, driving high‐value impact, improving the quality and economics for health plans, hospitals, physicians, patients, and researchers. Please visit www.inovalon.com for more information.

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