Policy Roundtable Abstracts - AcademyHealth

Moderator Walter Zelman is Chair of the
Department of Health Science , California State
University
MollyAnn Brodie is Director of Public Opinion and
Survey Research at the Kaiser Family Foundation.
Her focus on the panel will be on matters of public
opinion
Len Nichols is the Director of the Center for Health
Policy Research and Ethics at George Mason
University. He will focus on national developments,
especially Congressional activity around health
reform opposition or support
Alan Weil is Executive Director of the National
Academy for State Health Policy. Alan will provide
particular insight into the efforts of states to
establish the infrastructure for health reform and
the politics of those efforts.
The proposed panel will be a roundtable discussion in
which the moderator will pose questions to panelists.
Initial questions will be asked of individuals, drawing out
their views on the particular expertise they bring to the
subject. Additional questions will be intended inspire
interaction among the panelists. Panelists will be able to
use slides in answering the questions. Panelists will be
given most of the questions in advance so that they may
prepare background information that will be available,
via slides, for sharing with the audience. Audience
participation will be encouraged.
Walter Zelman has moderated several similar panels
at recent ARM conferences. They used similar formats
of roundtable discussion and panel interaction to explore
political themes and issues in health reform. According
to ARM reports and feedback these discussions were
very well received.
Achieving Better Population Health, Better Patient
Experience, and Reducing Cost: Learning from
Variations in Health and Healthcare
Organizer/Moderator: David Radley
Monday, June 13 * 3:00 p.m.–4:30 p.m.
Panelists: Michael Chernew, Ph.D., Harvard Medical
School; Elliott Fisher, M.D., M.P.H., Dartmouth Medical
School; David Kindig, M.D., Ph.D., University of
Wisconsin, Madison; Cathy Schoen, Ph.D.; The
Commonwealth Fund
Roundtable Summary: A robust body of evidence
describes unwarranted variations in the healthcare
individuals receive—identifying duplication of services
and the receipt of inappropriate or unsafe care that drive
up costs and put patients at risk. These findings highlight
an important chasm between healthcare spending and
consistent receipt of high-quality healthcare. Other
research points out wide variations in the underlying
health of local populations and calls attention to the
importance of social and environmental determinants of
health. Rising health care costs stress household,
business and public budgets. Efforts to slow cost growth
while improving health outcomes have risen to the top of
the national and local health policy agenda.
Variation in health and healthcare motivates
quality improvement initiatives locally and systematic
reform efforts at regional, state, and national levels.
Such efforts have, to date, focused primarily on cost
control and healthcare quality, often targeting narrowly
defined patient populations or specific processes of care.
With rare exception, improvement efforts generally lack
the explicit goal of improving population health.
Recognizing that health system improvement
efforts require a multidimensional approach, the Institute
for Healthcare Improvement (IHI) developed the Triple
Aim initiative. Its goal is to encourage new system
designs that simultaneously improve the health of the
population, enhance the patient experience when
healthcare services are used (including access, quality,
and reliability), and to reduce—or control—the per capita
cost of healthcare. By pursuing these three objectives in
concert, healthcare systems can identify and more easily
address problems that impede care coordination, lead to
overuse and inefficiency, and direct resources to
activities that have the greatest impact on health.
Without balancing the three objectives of the Triple Aim,
improvement and reform efforts may enhance quality,
but at the expense of cost, or conversely, reduce cost
while alienating patients.
The ability to accurately and effectively measure
each dimension of IHI’s Triple Aim is fundamental to the
success of efforts to improve health system
performance. This roundtable will discuss regional
variations across each of the Triple Aim’s three
dimensions. Special attention will be given to
measurement considerations including the definition of
system-level metrics, the availability of data that allows
local comparisons against standardized inter-regional
benchmarks, and the practical action-oriented use of
data by local improvement integrators. In addition to
metrics, roundtable panelists will discuss efforts to
improve performance and the potential of approaches
that focus on the triple aim of improving population
health, care experiences and slowing cost growth.
This roundtable discussion will be facilitated by
Cathy Schoen, Senior Vice President for Policy,
Research and Evaluation at The Commonwealth Fund,
and one of the nation’s foremost experts in health policy
appraisal. The panelists will launch an interactive
discussion with the audience by each offering a short
presentation drawing from their own knowledge and
experience, using evidence from scientific studies, and
current reform initiatives. The roundtable will begin with
three of the panelists each sharing their perspective and
measurement expertise in one dimension of the IHI’s
Triple Aim—cost, the patient experience, and population
health; the fourth panelist will discuss the action-oriented
use of locally representative data to evaluate ongoing
improvement initiatives. Audience members will then be
engaged and asked to share their experience and the
challenges they’ve faced measuring the impact of
improvement in their own work, with the panel providing
direct response to audience questions.