VIRGINIA HEALTH INNOVATION PLAN AND ITS FIT WITH BLUEPRINT VIRGINIA BETH A. BORTZ AUGUST 12, 2013

BLUEPRINT VIRGINIA and the Virginia Health Innovation Plan Review the VHIP Call to Action  Background on Funding from the Virginia General Assembly & the CMS SIM Grant Opportunity  Process of Seeking Input and Engagement  Vision: Virginia will transform health care through three strategic pathways: Activated Consumers & Communities Person-Centered, Clinically Integrated, Accountable Care Aligned Infrastructure, Workforce, & Quality Incentives

VHIP Strategic Objectives Activated & Engaged Consumers:  Virginians enjoy better overall health, experience high satisfaction with the healthcare they receive, and are engaged in and responsible for their own care within a patient-centered health care system;  Communities are activated to advance access and population health;  The value of prevention, wellness, and health care services is defined, measured, recognized, and rewarded by all stakeholders;

VHIP Strategic Objectives Person-Centered, Clinically Integrated, Accountable Care:  Care throughout the lifecycle is delivered and organized through patient-centered, multi-payer systems of care;  Physical health care and behavioral health care are integrated;  Care transitions for patients between providers and institutions are optimized;  Healthcare information, and parent support services are strengthened and integrated for children and their parents from pre-conception to pre-kindergarten;

VHIP Strategic Objectives Aligned Infrastructure, Workforce, and Quality Incentives:  Telehealth is used to improve access to and the quality of healthcare;  Smart health information technology connects providers, payers, consumers, and community/public health;  Measures, data, and analytics are aligned across stakeholders and support practice transformation;  Payment models reward improved outcomes and reduced costs;

VHIP Strategic Objectives Aligned Infrastructure, Workforce, and Quality Incentives (Cont.):  The health workforce is optimized and equipped to deliver excellent care in a team environment in every community in Virginia; and  The rise in the cost of health care has been slowed or arrested while quality is sustained and improved.

VHIP Strategic Objectives Do the VHIP strategic objectives accurately reflect the objectives of the employer community? Are there other objectives that are important to employers? If so, what are they? If we can agree on a set of shared objectives, then the next question is how do employers want to prioritize their action steps? Today’s presentations will provide some possibilities for consideration.

What is Choosing Wisely? Play video Choosing Wisely ® is an initiative of the ABIM Foundation to help physicians and patients engage in conversations to reduce overuse of tests and procedures, and support physician efforts to help patients make smart and effective care choices. Originally conceived and piloted by the National Physicians Alliance, leading medical specialty societies, along with Consumer Reports, have identified tests or procedures commonly used in their field, whose necessity should be questioned and discussed.

Who is Engaged? There are now 26 different medical specialty societies that have completed their lists of “Five Things Physicians and Patients Should Question.” While there is some overlap, there are now more than 100 identified tests or procedures that should be questioned. VCHI is proposing a statewide Choosing Wisely Campaign, a concept which is supported by the Medical Society of Virginia.

What would a Choosing Wisely Campaign Look Like? Educational campaign with resources for physicians, patients, and employers Baseline data could be obtained through a partnership with Milliman to use their “Waste Calculator” which uses claims data to assess the frequency and cost of some of the identified tests and procedures Progress could then be regularly assessed through utilization of the APCD

What Could Employers Do to Support A Choosing Wisely Campaign Form an employer collaborative with a commitment to sharing Choosing Wisely materials with employees. Encourage the Commonwealth of Virginia to participate in the campaign in its role as an employer. Encourage the Commonwealth of Virginia to seek federal funding when available to support a statewide Choosing Wisely Campaign. Ask the Virginia General Assembly to fund VCHI to conduct a statewide Choosing Wisely Campaign. Employers could offer to match the Commonwealth’s contribution. Ask the Virginia Department of Health to include Choosing Wisely information in its “public” data requests from the APCD.

Advance Care Planning Overview of recent activity Review Care Planning Act proposed by Senator Warner and consider making it a priority Ask JCHC to conduct a study of what needs to be done at the state level to facilitate more effective advance care planning