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Presentation by Mark Moyer on ASQ Discussion Groups on Dec 8, 2008

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ASQ Biomedical Discussion Groups Presented by: Mark Moyer

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Thank You … from the ASQ Biomedical Division

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Presentation by Dr. Dana Gelb Safran, CEO / President, National Quality Forum- Quest for Value in US Health Care: The Central Role of Performance Measurement. Economic Imperative in a Global Economy. Life Expectancy and Health Expenditure. Payment Reform Is a Key Lever . Improved Quality, Outcomes & Affordability: BCBSMA AQC Catalyzes US Payment Reform. Medicare Payment Reform Results: Evidence to Date. Value Based Payment Demands a Shift to “Big Dot” Measures. Essential Needs for Ultimate Success of Value-Based Payment. NATIONAL QUALITY FORUM www.qualityforum.org

Quest for Value in US Health Care: The Central Role of Performance Measuremen...

Levi Shapiro

Presentation by Dr. Frank Opelka, American College of Surgeons, for mHealth Israel , April, 2022 What do PATIENTS want? Value Based Health Care (VBHC): Patients want to know where to go to get the care they desire. When a condition arises, patients want help managing their condition and to know where to find Safe, Affordable, Good, Equitable care for their condition. They hope to trust their care team. (SAGE). Patients struggle in a convoluted unpredictable care journey - disaggregated, transactional, duplicative, inefficient business model. Patients would like to avoid preventable harms at all cost (Safety). What do Payers want? Value Based Health Care (VBHC): Payers want to optimize care to limit harm and reduce waste. Payers want to measure quality for payment incentives with limited effort. Payers seek to standardize care through practice guidelines and limit customization of care to fit each patient and in each delivery system. Realize payers’ business systems profit greatly from transactional, disaggregated models – to change would be costly. ACS Mission: dedicated to improving the care of the surgical patient and to safeguarding standards of care in an optimal and ethical practice environment. Value Based Health Care (VBHC): A framework for redesigning healthcare with an emphasis on patient goals, around the relationships between outcomes (Quality) and affordability (Price). V = Q / $ is an expression of the judgment a patient places on the relation of the quality of care for the price. (It is not a numeric expression). An episode of care (such as a surgical procedure or an acute/chronic medical condition) defines a care journey and applies a business model which sets a price for a bundled set of services. Price in S-VBHC Do patients want each transaction or a single episode which groups all the services into a meaningful package? Tools exist which can create risk adjusted price estimates. Policy Landscape: Extremely large federal bureaucracies with hundreds of divisions, not all of which are aligned. Medicare: Payment Quality – MIPS vs MVP Innovation Center (CMMI) Medicare Advantage (42%), ACOs (20%) APM – Episodes of care (Bundles)/Direct Contracting FFS/RVUs (38%) FDA: Safety Clinical Decision Support (Apps) as a medical device (ACS risk calculator, CoC Staging App) CDC: Care Delivery/Pop Health Digital Guidelines Care Pathway Process Maps/care tracking notation Policy Landscape Value Based Care/Episodes of Care: V=Q/$ Numerator = Quality (defined by ACS) Denominator = Price (defined by payment) Production cost (defined by TDABC). New payment models (Episodes of Care). echnology Interoperability Platforms/More than EHRs Standards & Data definitions Exchanges / Translators FHIR/CQL/HL7 Specialty Society Role in AI & Digital Healthcare Specialty as the content/context experts Clinical Decision Support (CDS) (Risk Calculator, Cancer Staging) CMS’ “MIPS THINK” Episodes of Care ACS Quality Model / Price PROs

Frank Opelka- Value Based Health Care

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Quest for Value in US Health Care: The Central Role of Performance Measuremen...

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Organisational success today depends on effective communication and collaboration with individuals from cultures with varying beliefs and practices. Indeed, with the workforce increasingly comprised of people of varying cultural backgrounds, leaders must now prioritise the significance of cultural competence in the workplace. Ensuring cultural competence at every level of your organisation cannot be understated. While cultural disparities can manifest in different ways, as a leader, you must build deep and nuanced cultural competence skills and education to accurately spot, address and alleviate the various scenarios that can arise. Failing to recognise the importance of cultural competence or not acting to improve it can lead to cultural negligence. There are a few things to consider to ensure your organisation is on the right track. In this deck, you'll understand the importance of building cultural competence in the workplace. You'll also learn • The three (3) dimensions of Cultural Competence in the workplace • Key strategies to build a culturally competent workforce • Major benefits you stand to gain by having a culturally competent team.

Cracking the Cultural Competence Code.pptx

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