Roundtable on Value & Science-Driven Health Care March 20, 2013 The National Academies of Sciences Building Lecture Room 2101 Constitution Avenue, NW Washington, DC 20418 ROUNDTABLE ON VALUE & SCIENCE-DRIVEN HEALTH CARE Table of Contents SECTION 1: AGENDA AND MEMBERSHIP • Agenda • Roundtable Roster SECTION 2: GENERAL BACKGROUND AND OVERVIEW • Fisher, E., et al. (2013) “The Real Promise of ‘Accountable Care’.” The Wall Street Journal, A17. • Christensen, C., et al. (2013) “Christensen, Flier and Vijayaraghavan: The Coming Failure of ‘Accountable Care’.” The Wall Street Journal, A15. • UC, Berkeley School of Public Health: A New Vision for California’s Healthcare System: Integrated Care with Aligned Financial Incentives – Executive Summary. 2013. SECTION 3: CORE METRICS FOR BETTER HEALTH AT LOWER COST • Consensus study on Core Metrics for Better Health at Lower Cost: Measuring progress toward better care, better health, and lower cost in the learning health system – 1-page description SECTION 4: HEALTH CARE INTEGRATION AND FOCUS: MILITARY HEALTH SYSTEM EXAMPLE • Military Health System Stakeholders’ Report. 2012. SECTION 5: EXPERIENCE AT THE CUTTING EDGES OF HIGH VALUE CARE: CASE STUDIES • Markovich, P. (2012). “A Global Budget Pilot Project Among Provider Partners and Blue Shield of California Led To Savings In First Two Years.” Health Affairs, 31(9):1969-1976. • Tomek, I. M., et al. (2012). “A Collaborative of Leading Health Systems Finds Wide Variations in Total Knee Replacement Delivery and Takes Steps to Improve Value.” Health Affairs, 31(6):1329-1338. SECTION 6: LESSONS AND INSIGHTS FROM WORK IN PATIENT AND FAMILY ENGAGEMENT • Workshop on Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement – 1-page description • James, J. (2013). “Health Policy Brief: Patient Engagement.” Health Affairs, 1-6. SECTION 7: BIOGRAPHIES AND MEETING LOGISTICS • Member Biographies • Other Participant Biographies • Location, Hotel, and Travel ----------------------------------Agenda and Membership Agenda and Membership IOM Roundtable on Value & Science-Driven Health Care MEMBERS MEETING MARCH 20, 2013 THE NATIONAL ACADEMY OF SCIENCES, LECTURE ROOM 2101 CONSTITUTION AVENUE NW, WASHINGTON, DC Meeting Goals 1. Generate suggestions on priorities and approaches in developing a core set of measures to assess progress toward better care, lower costs, and better health at national, state, local, institutional levels. 2. Consider current health and health care integration initiatives for high value care in the Defense Department, exploring relevant issues and lessons for broader national efforts with similar goals. 3. Identify dissemination priorities and strategies on emerging lessons in the creation of ACOs and the High Value Health Care Consortium. 4. Explore next steps in fostering patient-driven involvement in care decision-making, clinical research, and health care value. 8:30 am Coffee and light breakfast available 9:00 am Welcome and introductions Opening remarks Mark McClellan, The Brookings Institution and Roundtable Chair Michael McGinnis, Institute of Medicine 9:15 am Core metrics for better health at lower costs Panel to consider needs and approaches in developing core metrics for measuring overall progress in health, care quality, and lowering costs at national, state, community, and organizational levels. Perspectives on developing core measures Mark McClellan, The Brookings Institution Craig Jones, Vermont Blueprint for Health Kate Goodrich, Centers for Medicare & Medicaid Services Kevin Larsen, Office of the National Coordinator for HIT 10:30 am Break 10:45 am Health care integration and focus: Military Health System example This session will consider the Military Health System initiative to move the culture toward integration, coordination, and health orientation, and the implications for leadership. Discussion will lead off with observations on lessons for and from the civilian sector. Overview of Military Health System initiatives Jonathan Woodson, Department of Defense Health Affairs Michael Dinneen, Military Health System Strategy Management Brian Masterson, Office of the Surgeon General/U.S. Air Force Comments Gary Gottlieb, Partners HealthCare George Halvorson, Kaiser Permanente 12:00 pm Lessons and insights from work in patient and family engagement Conversation on new strategies for motivating patient and family leadership as advocates for a stronger focus on evidence, shared decision making, and care quality and value. Lyn Paget, Health Policy Partners Sally Okun, PatientsLikeMe 1:30pm Experience at the cutting edges of high value care: case studies Panel to reflect on new strategies for transforming the delivery of health care and moving to a focus on evidence, value, and health. The first presentation will focus on work to establish ACO’s and the second on the High Value Health Care Collaborative. New directions in accountable care organizations Bruce Bodaken, Blue Shield of California Kristen Miranda, Blue Shield of California The High Value Health Care Collaborative Brent James, Intermountain Healthcare 3:00 pm Summary and next steps Comments from the Chair Mark McClellan, The Brookings Institution and Roundtable Chair Comments and thanks from the IOM Michael McGinnis, Institute of Medicine 3:30 pm Adjourn Roundtable on Value & Science-Driven Health Care The Roundtable Chair Ralph I. Horwitz, MD Joe Selby, MD, MPH Mark B. McClellan, MD, PhD SVP, Clinical Evaluation Sciences Executive Director GlaxoSmithKline Director, Engelberg Center PCORI The Brookings Institution Brent C. James, MD, Mstat Mark D. Smith, MD, MBA Chief Quality Officer President & CEO Members Intermountain Healthcare California HealthCare Foundation David Blumenthal, MD, MPP Michael M.E. Johns, MD President Glenn D. Steele, MD, PhD Chancellor The Commonwealth Fund President & CEO Emory University Geisinger Health System Bruce G. Bodaken, MPhil Craig A. Jones, MD Chairman & CEO Reed V. Tuckson, MD Director Blue Shield of California Executive VP & Chief of Medical Affairs Vermont Blueprint for Health UnitedHealth Group Paul Chew, MD Gary Kaplan, MD Head, Global Medical Affairs & CMO Debra B. Whitman, PhD, MA Chairman and CEO Sanofi SA Executive VP, Policy and International Virgina Mason Health System AARP Helen Darling, MA President Darrell G. Kirch, MD Ex-Officio President and CEO National Business Group on Health Agency for Healthcare Research and Quality AAMC Susan DeVore Carolyn M. Clancy, MD, Director Richard C. Larson, PhD Chief Executive Officer Centers for Disease Control and Prevention Mitsui Professor Premier, Inc. Thomas Frieden, MD, MPH, Director Massachusetts Institute of Technology Senior Health Scientist, OPTH Judith Faulkner, MS Gail R. Janes, PHD, MS, James L. Madara, MD Founder and CEO Centers for Medicare & Medicaid Services Chief Executive Officer Epic Systems Marilyn Tavenner, MHA, RN, Administrator American Medical Association Patricia A. Gabow, MD Patrick Conway, MD, MS, Chief Medical Officer Mary D. Naylor, PhD, RN Chief Executive Officer Department of Defense (Health Affairs) Denver Health Director, NewCourtland Center University of Pennsylvania Jonathan Woodson, MD, Assistant Secretary Atul Gawande, MD, MPH Department of Veterans Affairs General and Endocrine Surgeon William D. Novelli, MA Robert A. Petzel, MD, Under Secretary (Health) Brigham and Women’s Hospital Former CEO, AARP Professor, Georgetown University Food and Drug Administration Gary L. Gottlieb, MD, MBA Margaret A. Hamburg, MD, Commissioner President & CEO Sam R. Nussbaum, MD Acting Associate Commissioner Partners HealthCare System Chief Medical Officer Peter Lurie, MD, MPH, WellPoint, Inc. Health Resources and Services Administration James A. Guest, JD President & CEO Jonathan B. Perlin, MD, PhD Mary Wakefield, PhD, RN, Administrator Chief Medical Officer Consumers Union National Institutes of Health HCA, Inc. George C. Halvorson Francis Collins, MD, PhD, Director Richard Platt, MD, MS Chairman & CEO Susan Shurin, MD, Director, NHLBI Chair, Population Medicine Kaiser Permanente Office of the National Coordinator for Health IT Harvard Medical School James Heywood Farzad Mostashari, MD, ScM, National Coordinator Chairman John W. Rowe, MD PatientsLikeMe Former Chairman & CEO, Aetna Professor, Columbia University ROUNDTABLE SPONSORS: AstraZeneca, Agency for Healthcare Research and Quality, Blue Shiled of Californis, Blue Shield of California Foundation, California HealthCare Foundation, Centers for Medicare and Medicaid, Charina Endowment Fund, Department of Veterans Affairs, Epic Systems, Inc., Food and Drug Administration, GlaxoSmithKline, Gordon and Betty Moore Foundation, HCA, Inc., Health Resources and Services Administration, Kaiser Permanente, National Institutes of Health, Office of the National Coordinator for Health IT, Partners HealthCare, Patient-Centered Outcomes Research Institute, Premier, Inc., Robert Wood Johnson Foudation, Sanofi US, UnitedHealth Foundation, WellPoint, Inc.. --------General-------------------------- Background and Overview General Background and Overview THE WALL STREET JOURNAL March 5, 2013 The Real Promise of 'Accountable Care' New ACOs reward health providers for outcomes, not for cost cutting. By ELLIOTT FISHER, MARK MCCLELLAN AND STEPHEN SHORTELL For decades, the inexorable rise in health-care costs has been accompanied by growing evidence of large variations in care and widespread gaps in quality and efficiency. Almost daily, new developments come along that in other industries would improve