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Delivering Better Care at Lower Cost
Value-Based Improvement
@neel_shah
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1. Grants: Robert Wood Johnson Foundation,
Rx Foundation, Harvard Risk Management Foundation, ABIM Foundation
2. Advisory: Healthcare Financial Management Association, National Partnership for Women
and Families, Square Roots
3. Royalties: McGraw-Hill
Disclosures
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Cap
abil
ity
Too Little
Too Much
Time
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Plan Provider … Service
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80%
18%
2%
should discuss
not necessary
no opinion
Series 1
Do you think your doctor should discuss the cost of recommended medical treatment with you ahead of time?
CBS / New York Times Poll, December 2015
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United States Cesarean Deliveries, 1970-2010
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Key Elements for Successful High-Value Care Campaign
PLUS an implementation strategy that includes:
Culture change Oversight Systems Change Training
Data, data, data
Champions on the ground
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• With your neighbor, you’ll have 20 minutes to:
– Pick an area in need of high-value improvement
– Use “COST” Framework to develop your “pitch”
– Select a “pitch” person
– Ok to be creative!
• Present your ideas
– 3 minute pitch per group
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Intervention
Description Example
C Culture Valuing appropriate resource use at the individual and team level
Hospital-wide campaign led by peer-champions to reduce lab tests overuse
O Oversight Requiring accountability for decision-making at both a peer and organizational
level
Requiring attending to review labs residents
order to reduce overuse
S Systems Change
Creating systems to support appropriate care using institutional policy, decision-
support tools, and clinical guidelines
EHR displays cost of lab tests next to order for
specific tests
T Training Providing knowledge & skills clinicians need to make cost-conscious decisions
Lecture or workshop on ordering of lab tests
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@neel_shah