Annual Ritual of Resolutions

Submitted by on Saturday, January 3, 2015 - 04:08

In the annual ritual of resolutions, individuals commit to bettering themselves. Our resolve, however, is to better everyone, for we commit ourselves and every resource we can muster to achieving more affordable and higher quality health care for all –

To help accomplish that goal, this year we commit to the following:

1. To permanently disrupt the sad status quo of health care market opacity – in December 2014, three of our original measures of potentially avoidable complications were conditionally endorsed to become part of the Medicare hospital reporting program. As our friend Dolores Mitchell said, these are all-cause harm measures, a leading indicator for consumers on whether or not they might be harmed by a provider when treated for a specific condition, illness or injury. We will build on that success this year and produce a number of these measures for public accountability of providers. In addition to these quality measures, and leveraging our open source episode definitions, we can calculate accurate measures of price. And here's the disruption potential: anyone with a large data set of claims can calculate them. And there will be no excuses left for any state with an APCD because we'll give them the formulas for free.

2. To provide employers and other payers, as well as providers, with actionable data on costs and quality of care by giving them insights on the causes of quality defects and cost of care variability. We call it "Discover Your Opportunity", and it's completely free. Anyone with a batch of claims data will get a custom report that indicates where they should focus their payment and benefit design reforms, what type of reform might be more useful, and the size of the opportunity to reduce cost of care variation and improve quality. We'll be working closely with our colleagues at NHRI and their new Collaborative Health Network to make this service available as widely as possible.

What this means to you – Our commitments should help you stick to yours, or decide to add to your list. We've collectively sat by for far too long as the opacity in health care has continued to harm our families, friends and neighbors. It's time to put a permanent stop to it, and while we can't do much in the states where lawmakers collude with special interests to keep their citizens in harm's way, we can and must engage all other states in adopting measures that are freely available and powerful indicators of hospital and physician quality. We're going to do our part in 2015, but so must you. Similarly, many employers often struggle to get concrete and actionable data from their third party administrators and/or consultants. And yet we know that there are considerable opportunities to improve the affordability and quality of care provided to employees and their families. Our Discover Your Opportunity application will get you that actionable information, but it's only the start. In exchange for getting that information for free, we want you to commit to launching initiatives that will harvest the discovered opportunities. We'll stick to our 2015 resolutions, and we're asking you to join us in that resolve.