Center on Health Care Effectiveness Forum Archives: 2012

New Evidence on Incentives for Electronic Health Records in Medicare
November 29, 2012

Presentation:

Webinar recording
PowerPoint presentation (PDF)

Participants:

• Robert Berenson, The Urban Institute
  
• Stacy Dale, Mathematica
• Suzanne Felt-Lisk, Mathematica

Participant bios

• Mat Kendall, ONC, USDHHS
  
• Lorenzo Moreno, Mathematica

Since 2005, the federal government has been encouraging the widespread use of electronic health records (EHRs) to help ensure that Americans have access to secure, interoperable health records. This initiative is part of a broader effort to improve health care quality while reducing costs. Several large evaluations of EHR use in Medicare have been conducted, with new findings that can inform future efforts.

This forum and webinar featured renowned national experts who:

• Highlighted new evidence showing that, under certain circumstances, financial incentives do promote EHR use in Medicare
• Discussed the impact of these incentives on the use of Medicare-covered services and costs as well as process quality measures
• Described how findings from this evaluation are likely to inform policies that foster nationwide EHR implementation

Paying Wisely: Using Incentive Reforms to Reduce Costs and Improve Patient Outcomes
October 23, 2012

Presentation:

Webinar recording
PowerPoint presentation (PDF)
White paper: "Paying Wisely: Reforming Incentives to Promote Evidence-Based Decisions at the Point of Care"

Participants:

• Robert Berenson, Urban Institute
  
• Christine Cassel, American Board of Internal Medicine

Participant bios

• Stuart Guterman, Commonwealth Fund
  
• Tim Lake, Mathematica
• Eugene Rich, Mathematica

Overview: How physicians are paid is a major driver of health care costs, and is at the forefront of discussions by policymakers, service providers, and payers. There is agreement that continued increases in cost of health care services are socially unsustainable, but there are many effective services that are underused as well. How can we simultaneously reduce costs and maximize good clinical outcomes?

This forum explored opportunities to promote evidence-based care through the use of provider payment reforms. A renowned panel of national experts:

• Explored major issues around payment incentives, including how reforms can promote both overuse and underuse of evidence-based services
• Explored opportunities and challenges for promoting more evidence-based care through payment reform
  
• Shared providers' views on lessons learned from he "Choosing Wisely" program, and how improved incentives could help rectify identified problems
• Outlined payment reform options and strategies for promoting more evidence-based care through Medicare

Implementing the Patient-Centered Medical Home: Remaining Questions and Challenges
June 7, 2012

Presentation:

Webinar recording
PowerPoint presentation (PDF)

Participants:

• Debbie Peikes, Senior Researcher, Mathematica
• David Meyers, Director, Center for Primary Care, Prevention, and Clinical Partnerships, AHRQ
  

• Pamela Eckhardt, Independence Blue Cross
• Thomas Graf, Geisinger Health System
  
• Sheila Hanley, CMS Center for Medicare and Medicaid Innovation
• Christine Bechtel, National Partnership for Women and Families

Overview: The Patient-Centered Medical Home (PCMH), a model designed to transform primary care in the United States, has the potential to improve quality of care and patient experience within our health care system, while potentially reducing costs. A recent systematic review of precursors to the PCMH indicate that the model is a promising approach. However, more evidence on the relative benefits of the PCMH model is necessary to inform the implementation and adoption decisions of insurers, primary care providers, and patients.

This forum highlighted the latest research findings, the types of evidence still needed by different stakeholders, and the policy implications of what is known about the effectiveness of the PCMH in the context of health care reform efforts. Representatives of payer, provider, and patient stakeholders will then discuss the type of evidence they still need, and how they plan to move forward.

A New Tool for Rapid-Cycle Comparative Effectiveness Research: The Promise of Orthogonal Design
April 18, 2012

Presentation:

Webinar recording
PowerPoint presentation (PDF)
Issue brief: "Orthogonal Design: A Powerful Method for Comparative Effectiveness Research with Multiple Interventions"

Participants:

• Randy Brown, Vice President and Director of Health Research, Mathematica
• Jelena Zurovac, Researcher, Mathematica
• Kieron Dey, Scientific Advisor, Nobi Group

• Jodi Segal, Associate Professor of Medicine, Johns Hopkins University
• David J. Vanness, Assistant Professor of Population Health Sciences; Affiliate, Center for Demography and Ecology, University of Wisconsin School of Medicine and Public Health

Overview: Disease management and health care coordination programs strive to improve health care quality while controlling costs.  A primary challenge for these programs is measuring the effectiveness of multiple, simultaneous interventions.  Orthogonal designs are widely used for this purpose in the agriculture, manufacturing, marketing, and chemical industries.  When applied to health care, orthogonal designs offer fast, multidimensional results on the relative effectiveness and efficiency of multiple interventions, how those interventions are provided, and their impacts on targeted subpopulations.

This issue forum highlighted the opportunities for orthogonal design in comparative effectiveness research in health care. Panelists discussed the origin of orthogonal design and its uses in other fields, describe efficient orthogonal design techniques, and describe studies conducted in health plans seeking optimal system change.