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Attendees

Name

Affiliation

Shane, Frank Opelka, John, Cary, Dhruv, Lee,

Agenda and Minutes

Document any tasks here, Document any decisions on group page

Agenda Item

Lead

Minutes

Updates

  • Connect a Thon, 1-5 March

    • Virtual session; IHE USA; IT arm of HIMSS

    • Reminder of four components

      • Jumpstart BPM+ Health

      • Advanced Consent Form

      • Bending Cost Curve (review)

    • Ask: please push/like/etc via social media

    • All to be offered as standing webinar going forward

    • Major impacts of this CAC for Connect a Thon

  • Objectives for 2021 to address after March; direction of this group; make ourselves available and good value-partner; August….real!

    • How to look towards, prep for August HIMSS

    • Make ourselves available; CAC is behind you, lets bring the key discussions to this group to help amp up the outcomes

  • March Meeting Prep

Value Based Care, ACS Equation (Frank)

  • Quality over cost, elevate quality to value of cost

  • Care in a value based direction, with cost in mind

  • Issue: fatigue around value based care concept…evolution in how it is perceived

  • To deliver at Enterprise level, some hurdles to overcome

  • Frank inputs:

    • Thrive Program with Harvard, episodes of care

    • Expressing through Value Expression

    • How to define Value Based Care and its subcomponents?

    • Viewing value as a judgement; we each apply different perception components; it is personnel; difficult then to express from a data perspective

    • Quality/Price; Costs required for this episode of care

    • How to represent patient’s judgement; experiences and sensitivities; are we meeting their expectations and goals?

    • Through: patient reported outcomes…get rid of pain, treated respectfully…respected end of life wishes…etc; series of plots like a radar plot/chart

    • Outcome: add all the pieces of and then map them out

    • Sensitivities: race, gender, background, etc….and how they overlay each other; expectations of health care system are very different; not sure what to expect vs. just want a good outcome vs other

    • Clinical success is not always equal to value

    • PROs as elements of the formula; PRO to be tailored to population being worked with; some are in place by researchers

  • Lee notes

    • Value based care equated to bundled payment

    • Quality of patient care for entire episode for least amt of $ being spent

    • Drives better patient outcomes and drive down cost for patient care; outcome is that more of these are being rolled out more broadly

    • National standard for bundles (Frank) in process, key for scaling; care is episodic once you get past transactions; did the outcome achieve the results?

    • Note on price: match to disease, not being done (for most part) today; must consider overall amortized price eg 1 yr of outcomes vs 10 yr of outcomes (cost in the end for bad care)

    • Corporation bundle model - required to be pitched to ind insurance companies, drives lack of standard for payment

    • Where bundles working well? Poorly?

      • Danville - profitable and high quality of care, seen as the gold standard

      • Simple, procedural bundles 600 and conditioned bundles 200; conditional level is really the opportunity for savings moving forward

      • CHF bundle this year as well

      • not necessarily same as “carve-outs”

  • Final thoughts

    • Frank: care model for each episode, resource model, come together with data models, all to inform, payment model, compensation model, competition, (value based); roles to play for several different aspects for implementation to be successful (ACTION: more discussion)

    • How CAC to help? focus on quantification…make it a reality

ONC

Broad discussion, how transition occurs, policy related, how best to structure;

  • Overview

    • Clear message through advocacy

    • papers etc to help drive the standardization

    • Also relates to brief/coordinate w FDA related to beneficial patterns (safety concern)

    • Frank leading the policy workgroup

    • How are we able to take CAC efforts to support Policy Group? How to make sure we don’t complicate?

  • Policy points

    • ONC, FDA, CDC, CMS

    • Looking to conversation with each agency, they each have public comment that will each hit WGs in different ways; how do they promote what we are doing; engage, be active, public comment both ways

    • New ONC leadership - may not be as BPM tuned; so how do we engage? Behind the scenes, policy papers, public comment;

FDA, CDC and CMS (both to add)

  • John FDA thoughts

    • Need to engage w FDA

    • Some processes are low risk, operational, procedural outside of FDA domain (eg scheduling)

    • FDA has clear rules re drug prescription, etc with high regulation;

    • Digital medicine is the group to engage with

    • Need to meet certain criteria;

    • Challenge with FDA - each drug or device requires separate submission, each taking two years to go through; that is big challenge for process automation

    • FDA will approve the company, but not necessarily each individually; narrow set of models will be approved, so many processes not being brought forward

    • Other issue is liability

Paper Criteria

Davide

AMIA, Causeway, call out for help, the ask

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