Cincinnati USA Regional Health Transformation Initiative

1. Cincinnati USA Regional Health Transformation Initiative South Carolina Business Coalition on Health May 2012 www.TransformCincyHealth.org

2. Play video Cincinnati USA Regional Health Transformation Initiatives

3. Cincinnati landscapeFertile ground for change • Extensive health systems • 30+ hospitals • 5,000 physicians • Active collaborations • Strong experience with innovative pilots • National healthcare IT leader • Engaged employer base (GE, P&G, Kroger, Fifth Third, etc.)    

4. Old Process Map Baseline QFD Pareto Defect Definition Target Variation Drivers Performance Objectives Key performance Indicators Critical to Process Factors Tools Incentives Funding Accelerators Enablers Vision Mission Scope Business Case Contract Language Payment Reform Measure Improve Control Define Analyze Greater Cincinnati Health Care Project 2010 • Community Guidance Team • Keep Project on Course GMT Immelt Chamber Presentation Health Leader Kickoff 3/26 Community Health Care Summit — May Steering Committee Existing Initiatives/ Venues • Call to Action • VOC • Host by Collaborative • GE Facilitate • Cross Industry Representation • Develop Strawman & Guiding Principles for Project • VOC • Verify Strawman • Revise Strawman • Broaden Audience • Cross Functional Membership • - Chamber • - Academy of Medicine • - Health Council • - Health Collaborative • - Health Bridge • Develop Strategy • Develop Plan • Conduit for Improvements/ Efforts • Specific Project Implementation Process: Inclusive, Open, Transparent

5. Cincinnati Regional Health Transformation Aims • Better health • Better care • Lower cost Estimated impact through 2014 (not all inclusive): • 20% improvement in diabetic outcomes • 10% fewer Emergency Department visits • Cost reduction = $500MM+ Cincinnati USA Regional Health Transformation Initiatives

6. How we operate… Regional Health Transformation Sustainability Model Cincinnati USA Regional Health Transformation Initiatives 6

7. Social Innovation meets Healthcare Innovation in Cincinnati: Collective Impact for Health Common Agenda Shared Measurement Mutually Reinforcing Activities Continuous Communication Backbone Support

8. Common Agenda: 3 Aims  5 Strategic Priorities 3 Aims Community Leaders Voice of Customer Strategic Priorities Foundational GoalsHealthymagination 1 • Primary Care – specifically Patient-Centered Medical Home • Health Information Exchange that is interoperable across the community and informs the Quality Improvement and Payment Innovations work. • Quality Improvement support for primary care and transitions in care. • Public Reporting that makes quality, price and patient satisfaction transparent and enables consumer engagement. • Payment Innovations that rewards value, using shared savings components. 2 Access Quality Cost Population Health 3 Experience of Care 4 Per Capita Cost 5 Cincinnati USA Regional Health Transformation Initiatives

9. Shared Measurement: Progress Report

10. Mutually Reinforcing Activities

11. Continuous Communication: TransformCincyHealth.org Cincinnati USA Regional Health Transformation Initiatives

12. Cincinnati USA Regional Health Transformation Initiatives

13. Resulting in better care… % high-risk pediatric asthma patients rated “well-controlled” by MD and parent • % diabetes patients meeting following goals: • A1C < 8 • BP < 140/90 • LDL < 100 • Tobacco free Cincinnati USA Regional Health Transformation Initiatives

14. Resulting in lower cost… 1,252,436* $200M saved vs. projected Actual ED visits in ‘10 were 185k less than projected; 100k less than ‘09 *Projected at historical trend of 7%; Estimated cost per ED visit = $1,100 Cincinnati USA Regional Health Transformation Initiatives