Chartered Value Exchanges (CVEs)

1. Chartered Value Exchanges (CVEs) September 2008 CVEs may wish to tailor this slide deck for use with stakeholders in your community.

2. U.S. Department of Health and Human Services The Secretary Administration for Children and Families (ACF) Food and Drug Administration (FDA) Health Resources and Services Administration (HRSA) Administration on Aging (AoA) Centers for Medicare & Medicaid Services (CMS) Indian Health Service (IHS) Agency for Healthcare Research and Quality (AHRQ) National Institutes of Health (NIH) Centers for Disease Control and Prevention (CDC) Substance Abuse and Mental Health Services Administration (SAMHSA) Agency for Toxic Substances and Disease Registry (ATSDR) Program Support Center (PSC)

3. AHRQ’s Mission Improve the quality, safety, efficiency and effectiveness of health care for all Americans

4. Quality of care in US – Medical accidental deaths outnumber others Source: To Err is Human: Building a Safer Health System, Institute of Medicine, 1999.

5. 2001 IOM Report, Crossing the Quality Chasm • Scientific review documents the scale and gravity of quality problems • More than 70 publications cite quality problems …between the health care we have and the care we could have lies not just a gap, but a chasm.

6. Patients’ care often deficient, study says. Proper treatment given half the time. On average, doctors provide appropriate health care only half the time, a landmark study of adults in 12 U.S. metropolitan areas suggests. Medical errors corrode quality of healthcare system Medical Care Often Not Optimal Failure to Treat Patients Fully Spans Range of What Is Expected of Physicians and Nurses Study: U.S. Doctors are not following the guidelines for ordinary illnesses The American healthcare system, often touted as a cutting-edge leader in the world, suddenly finds itself mired in serious questions about the ability of its hospitals and doctors to deliver quality care to millions.

7. Alcohol dependence 11% 23% Hip fracture 33% Peptic ulcer 45% Diabetes 69% Low back pain 73% Prenatal care 76% Breast cancer 79% Cataracts RAND study – Doctors provide appropriate health care only about half the time Percentage of time E. McGlynn, S. Asch, J. Adams, et al., The Quality of Health Care Delivered to Adults in the United States, N Engl J Med, 2003.

8. Transformational Goal of CVEs: Improved Quality and Efficiency High Efficiency Low Low High Quality

9. What Will This Take? • Good measures and data • Strong local coalitions • Evidence-based reporting, payment strategies • Evidence, tools, strategies for improvement • Collaboration across sites

10. Focus of AHRQ Learning Network for CVEs • Technical assistance content spans contemplation, design and implementation decisions across the following activities identified by user/stakeholders as high priority: • Collaborative leadership & sustainability • Public at-large engagement • Quality & efficiency measurement • Public reporting • Provider incentives • Consumer incentives • Capacity for improving quality • HIT/HIE

11. AHRQ Learning Network Builds on Secretary’s Value-Driven Health Care Principles • All health care is “local” • Transparency – accurate meaningful information on quality and cost – is key to provider improvement and consumer engagement • Collaboratives involving key stakeholder groups – public and private payers, providers, plans and consumers* – hold promise to foster requisite reforms *and in some cases State data organizations, Quality Improvement Organizations, and health information exchanges

12. Improving Quality • The need for leadership has never been greater. • All public and private health care constituencies must commit to a shared agenda that can raise the quality of health care for all. -- 2001 IOM Report, Crossing the Quality Chasm