by Dianne Kiehl
From the Executive Director

In this edition of the Catalyst, I would like to focus on two initiatives in the state that the BHCG both supports and is actively involved with – the Statewide Value Committee and the Wisconsin Medical Society’s Honoring Choices Wisconsin pilot project. Both are excellent examples of the forward thinking and innovation that characterizes the movement to improve health care delivery in our state.

Defining value through collaboration
The Statewide Value Committee was formed last year to develop a consistent approach to measuring value and to determine the focus that will accelerate improvement in value. I serve on the Committee and I am involved in one of its key initiatives – the development of agreed upon measures of value across all stakeholders in the state of Wisconsin. It’s imperative that employers have a voice in this critical process to gain agreement with providers, administrators and other purchasers about what constitutes health care value.

The BHCG along with a number of other organizations such as the Wisconsin Collaborative for Healthcare Quality (WCHQ), the Wisconsin Hospital Association (WHA), the Partnership for Healthcare Payment Reform (PHPR), the Wisconsin Health Information Organization (WHIO), and the Wisconsin Health Information Network (WISHIN) all share the common goal of working to reduce costs and improve health care quality thereby improving value. However, as a group, we do not have a set of agreed upon measures for health care value. In addition, provider organizations must contend with ever-increasing requests for performance measurement data from a number of sources – the federal government, health plans and health care purchasers among others – that divide their focus and resources.

One of the Committee’s first efforts is the initiation of the Alignment Measures Project (led by WCHQ) designed to streamline the demand for data from providers and move the market forward in its quest to define health care value. Says Chris Queram, president and CEO of WCHQ, “We believe the goal of measurement alignment has the potential to offer sustainable benefits for providers and all stakeholders as we work together to increase the value of health care in our state.”

Initial plans for the project call for a work group made up of health plans, public agencies and private purchasers to identify all the different value measures currently collected by providers. From there, we will seek to develop a process to determine which ones are the best to move quality improvement and cost savings forward in the state.

Through collaboration, we hope to define a common set of data requirements that will meet the needs of all stakeholders, providers, purchasers and consumers alike. I believe this work is especially important and we plan to keep you apprised of our progress. The more agreement we can get on how to define value, the further ahead will we be in "moving the market."

End of life – starting the conversation
In the July edition of BHCG’s Monitor newsletter we wrote about the importance of advance care planning: Advance Care Planning - An Imperative Conversation. In that article we mentioned that the Wisconsin Medical Society was planning a major new initiative regarding advance care planning. Last month, the Medical Society launched Honoring Choices Wisconsin, an initiative designed to give physicians and other health care providers the knowledge and tools to make system improvements that will ensure patients make well-informed decisions about their wishes for the end of life.

Eight health systems in the state, including two in our area – ProHealth Care and Fort HealthCare – agreed to participate in the pilot program. We are very pleased that ProHealth and Fort HealthCare have joined this initiative and hope other provider systems in our area join over time.

The Honoring Choices Wisconsin is based on proven concepts, methodologies, training systems and materials developed by Respecting Choices®, a pioneering organization in advance care planning based in La Crosse. The eight pilot participants will offer facilitated advance care planning conversations to patients. Facilitator training within the pilot systems is already underway, with implementation scheduled to begin in March 2013.

The BHCG enthusiastically supports this initiative and plans to assist in several ways. We are planning to help member employers in communicating the importance of advance care to their work force. In addition, we will be organizing an educational event for employers about this very important topic. Finally, we are considering creating a pilot project in which an area employer and a participating health care system could work together in addressing advance care planning with the employer’s workforce.

I will leave you with a quote from Tim Bartholow, MD, the Medical Society’s chief medical officer. I think it sums up well the importance of advance care planning and the fact that it’s really about the process and starting the conversation. “Too often in our health care system, patients do not receive the care they wish for as they approach their last days,” said Bartholow. “Starting a conversation about the end of life is difficult for all of us, whether we are physicians, patients, family members, religious and community leaders or health care professionals. It is, however, imperative that these conversations happen. And once they occur, it is equally critical that patients’ choices are honored by those who care for them.”

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