1. BHCAG Community Dialogue Lawrence Massa President & CEO Minnesota Hospital Association November 11, 2010 Health Care Quality & Public Reporting

2. What have we learned in first 10 years of Leapfrog?  Collaboration is essential MHAMN Dept. of HealthMMAStratis BHCAG Health Plans MAPS  Growing interest in quality measurement and reporting  Need for balance of burdens and costs of collection/measurement with impact to care and results for patients

3. Minnesota continues its national leadership in … Transparent communication with patients MN’s 2002 full disclosure model policy adopted by more than 90% of MN hospitals and sent to all 5,000 hospitals nationwide. Patient safety Health Grades ranked MN 1 st or 2 nd over the past several years. MN had more “distinguished hospitals” than any other state. Culture of safety MN hospitals advocated for public reporting of adverse health events, including by facility. MN hospitals’ adoption of best practices improved dramatically since AHE law. Decreased harm to patients Overall trend of decreased harm over 8 years. Pressure ulcers continue to decline. Decrease number of falls. Retained objects trending downward.

4. Level of accountability is continually increasing  Increased attention and resources 100+ hospitals addressing 4 most common AHEs through MHA’s calls to action Best practices up dramatically from 59% to 90%  Collaboration v. competition 87 hospitals (96% of discharges) voluntarily share patient safety information  Increased accountability Increased Accountability TransparencyPay for Reporting Pay for Performance Value Based Purchasing 2000200320052012 Leapfrog AHE law MHA/Stratis MHQP Hospital Compare MHA non-billing policy CMS HAC, POA and nonpayment policy VBP and Readmissions

5. Future of hospital quality & public reporting

6. Value of current reporting tools: Measuring what matters Patient/ Consumer Hospital Compare

7. Impact of 2008 legislation mandating hospital public reporting  Reliance exclusively on administrative data could be problematic Admin data alone are insufficient for quality and safety comparisons; potentially misleading MHA is leading research with the Agency for Healthcare Research and Quality (AHRQ) to improve admin data’s value by adding lab and pharmacy data  Provider peer grouping is ambitious, but unlikely to produce reliable results

8. Questions & Discussion