University of Utah Healthcare
Value Management System
Bob Pendleton MD FACP
Chief Medical Quality Officer
Goal: Exceptional Value
UUHC: Becoming the Provider of Choice
INPATIENT: Rate this Hospital 1-10 (% total patients choosing 9-10)
UHC National %tile Rank
100
UHC National %tile Rank
94
78
75
65
64
2010
2011
75
50
39
25
18
0
2008
2009
2012
2013
2014YTD
UUHC: Nationally Ranked Outcomes
1
*Ranking out
of >98 National
Academic
Medical Centers
7
4
9
37
50
2008
2009
2010
* UHC Quality & Accountability Annual Scorecard
2011
2012
2013
Use
of
Color
Payers of Healthcare & a sample of Value related Initiatives
Insurers
Government
Medicare
(CMS)
Employers
(e.g. Regence, etc.)
Medicaid
IPPS
ACO
OPPS
PQRI
PQRS
MU
Direct
Contract
HEDIS
Direct &
Rankings
CMMI
OQR
IQR
Public
VBP
MU
HAC
HRRP
MU
Growth of National Value Metrics
700
Measures
614 measures
& counting…
464 measures
402 measures
277 measures
Value Management System:
System
Management
Resource
Management
Inputs
Measure, Analyze,
Improve
ServiceDelivery
Delivery
Service
Service Delivery
Outputs
Clinical
Services
Safety
Committee (QM.8)
QMOC
HCEC
(QM7)
Document
Control Cmt
Value Creation
Team
Support
Services
Value Core
Value Council
(QM.7)
(GB.1)
Management Review:
Audit results
Corrective actions
Measurement
Analysis
Governing Body:
Operational oversight
of clinical delivery
system
Hospital Board
Medical Board
Basic Structure of our VMS
Clinical
Services
Value Council
(GB.1)
GME
Value Council
Chief Value Officers
Rob Glasgow - Surgery
Peter Yarbrough - Medicine
Chris Pelt- Orthopedics
Susan Baggaley - Neurology
Meic Schmidt - Neurosurgery
John Bohnsack -Pediatrics
Jerry Hussong- Pathology
Howard Sharp – OB GYN
Bernadette Kiraly – Family Medicine
Mark Eliason - Dermatology
Jim Ashworth- Psychiatry
Dave Gaffney- Rad Oncology
• System alignment
• System goals
• System mgt.
Measure & Analyze at the Department level…
Entitlement
• Typical approach to system
performance & improvement:
• BUT- isn't every patient entitled to
optimal performance?
Poor value
Average
value
Standard
Optimal
value
Value Management System: Focus on Improving Processes
• Focus on Results  Problem Solving (Reaction)
Fix Problem
1
Fix Problem
2
Fix Problem
3
• Focus on Process  Problem Prevention
Redesign Process to
Prevent Problem 1
Build Standard Work &
Forcing Functions
Redesign Process to
Prevent Problem 2
Monitor Results
Improve Process
Further
Build Standard Work &
Forcing Functions
Monitor Resu
Redesign Process to
Prevent Problem 3
Build Standa
Forcing Fu
How?
Value Improvement Methodology:
1. (re-)Define
2. Problem & Goals
3. Analyze & Investigate
4. Design & Implement
5. Impact
1
2
1
2
1
2
1
2
5
Improve
Value
3
4
5
Improve
Value
3
4
5
Improve
Value
3
4
5
Improve
Value
3
4
VALUE SUMMARY
VALUE SUMMARY
VALUE CREATION / VALUE SUMMARY
PROJECT INFORMATION
Title:
Team Lead Name:
Scope:
DNV Action: Please select all actions your project addresses, if applicable:
NC-1
NC-2
Corrective
Preventive
N/A
Date:
DEFINE & MONITOR: Use the table below to record project progress from baseline to final results. You must have at least 2 quarters data to coll ect MOC-P4 credit.
+/-
OPS Goals
Primary
EPE
Name of Measure
Baseline
Goal
Q1
Q2
Q3
Q4
Year 2
Primary Quality/Safety
Primary
Cost
+
Important: You must list at least one measure for each operational goal: Exceptional Patient Experience (EPE), Quality/Safety , and Cost. List your primary measures in the first fields and add any
additional measures using the +/- buttons. Due to space limitations, only the primary measures will be displayed in “Report” v iew.
1. PROJECT DEFINITION
QI QUICK TRAINING
UUHC Operational Goals
Metrics - General
Value Driven Outcomes
Value Measurement 101
UHC Data
Understanding Variation
Safety Events
VMS Audit
PROJECT DEFINITION: This is your reason for action. What problem are you trying to solve? Provide some background; include previous
efforts (if any) used to solve the problem. If local data doesn’t exist, is there peer-reviewed evidence of need?
VALUE SUMMARY
VALUE CREATION / VALUE SUMMARY
PROJECT INFORMATION
Title:
Team Lead Name:
Scope:
DNV Action: Please select all actions your project addresses, if applicable:
NC-1
NC-2
Corrective
Preventive
N/A
Date:
DEFINE & MONITOR: Use the table below to record project progress from baseline to final results. You must have at least 2 quarters data to coll ect MOC-P4 credit.
+/-
OPS Goals
Primary
EPE
Name of Measure
Baseline
Goal
Q1
Q2
Q3
Q4
Year 2
Primary Quality/Safety
Primary
Cost
+
Important: You must list at least one measure for each operational goal: Exceptional Patient Experience (EPE), Quality/Safety , and Cost. List your primary measures in the first fields and add any
additional measures using the +/- buttons. Due to space limitations, only the primary measures will be displayed in “Report” v iew.
1. PROJECT DEFINITION
QI QUICK TRAINING
UUHC Operational Goals
Metrics - General
Value Driven Outcomes
Value Measurement 101
UHC Data
Understanding Variation
Safety Events
VMS Audit
PROJECT DEFINITION: This is your reason for action. What problem are you trying to solve? Provide some background; include previous
efforts (if any) used to solve the problem. If local data doesn’t exist, is there peer-reviewed evidence of need?
YOU (& your residents) voice & input is critical:
 GMEC sponsored group to facilitate two-way input on
UUHC value efforts
 Coordination with the CVO in your Departments
 Should CRIT (empowered CMRs) remain a vehicle?
 System use of Value Summary
 Core training from Value U
 Safety event reporting & subsequent management