Coordinating State Health Reform in Kansas November 21, 2008 Doug - - PowerPoint PPT Presentation

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Coordinating State Health Reform in Kansas

November 21, 2008 Doug Farmer Kansas Health Policy Authority

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Creation of the KHPA Creation of the KHPA

• Built on Governor Sebelius’ “Executive

Reorganization Order” in 2005

• Modified by State Legislature to:

– Create an independent nine voting member private Board to govern health policy – Added a specific focus on data driven policy making – Creation of framework to coordinate health and health care in Kansas

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July 1, 2005 January 1, 2006 March 1, 2006 July 1, 2006 2007 Legislative Session 2008 Legislative Session

Kansas Health Policy Authority Established. Transfer program s to a Division first, then to a separate agency. Assum e responsibilities of Health Care Data Governing Board and oversight of KS Business Health Partnership program . Authority plan for various program transfers subm itted to Legislature. Transfer program s to Authority. Authority plan for additional program transfers subm itted to 2 0 0 7 and 2 0 0 8 Legislatures.

Timeline Timeline

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KHPA Mission KHPA Mission

To develop and maintain a coordinated health policy agenda that combines the effective purchasing and administration of health care with promotion

• riented public health strategies

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Programs Transferred Programs Transferred to KHPA in 2006 to KHPA in 2006

• Medicaid

Medicaid (Regular Medicaid) (Regular Medicaid)

• MediKan

MediKan

• State Children

State Children’ ’s Health s Health Insurance Program Insurance Program

• Ticket to Work/Working

Ticket to Work/Working Healthy Healthy

• Medicaid Management

Medicaid Management Information System Information System

• Medicaid Drug Utilization

Medicaid Drug Utilization Review & related programs Review & related programs

• State Employee Health

State Employee Health Insurance Insurance

• State Workers

State Workers Compensation Compensation

• Health Care Data

Health Care Data Governing Board Governing Board

• Business Health

Business Health Partnership Program Partnership Program

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KHPA Board KHPA Board

• Independent Board: Provide independent
• versight and policymaking decisions for the

management and operations of KHPA

• Make-up:

– Nine voting members appointed by the Governor and House and Senate leadership – Eight non-voting (ex-officio) members

• Secretaries of State Departments: Health and

Environment (including Director of Health), Social & Rehabilitation Services, Administration, Aging; Commissioner of Insurance, Commissioner of Education, and Executive Director of KHPA

7 Open Decision Making Responsible Spending Financial Reporting Accessibility of Information CMS Cooperation SRS KDHE KDOA

Quality and Efficiency Affordable, Sustainable Health Care Health and W ellness Stew ardship

Health Insurance Status

Health Professions Workforce Safety Net Stability Medicaid Eligibility Health Disparities Physical Fitness Nutrition Age appropriate screening Tobacco control Injury control Use of HIT/ HIE Patient Safety Evidence based care Quality of Care Transparency (Cost, Quality, etc.) Health insurance premiums Cost-sharing Uncompensated Care Medicaid/ SCHIP Enrollment Health and health care spending Council Participation Data Consortium Public Communication Community/ Advocacy Partnership Foundation Engagement

Public Engagem ent

• Mental Health
• LTC for Disabled
• Substance Abuse
• Health Prom otion
• Child, Youth & Fam ilies
• Consum er Health
• Health & Environ. Stats
• Local & Rural Health
• Aged
• I nstitutional Care
• Com m unity Care

KI D

• Private Health I nsurance
• Business Health Partner.

Access to Care

VI SI ON: Coordinating health & health care for a thriving Kansas

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Partnerships for Quality Improvement

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Types of Partnerships

• As Payers

– Leverage purchase power to create:

• Administrative

simplification

• Medical Home
• Community Health Record
• Health and Wellness

– As Employers

• Collaborations with

Employer groups

• Value based purchasing
• As Policy Leaders

– Statewide health reform:

• Public Health
• Data Consortium (Quality

Measurement and Reporting)

• Advisory Councils
• Community Dialogues

– As part of national agenda:

• State Quality Institute
• State Coverage Institute
• NASHP initiatives

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Health of Kansas: Health of Kansas: Room for Improvement Room for Improvement

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Data Consortium

• Chartered by the Board in April 2006 to:

– Guide KHPA in the management of programmatic and non-programmatic health data – Ensure continued public support and investment in the use of this data to advance health policy – Disseminate this wealth of data, in partnership with stakeholders – Ask and answer important health policy questions pertaining to:

• Affordability of health care
• Quality of health care
• Health status of Kansans

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Data Consortium Membership

• Executive Director of the Health Policy Authority or designee (Chair)
• Department of Health and Environment
• Department of Social and Rehabilitation Services
• Kansas Insurance Department
• University of Kansas Medical Center
• University of Kansas Medical Center-Wichita
• Kansas Health Institute
• Kansas Foundation for Medical Care
• Kansas Medical Society
• Kansas Hospital Association
• Kansas Association of Osteopathic Medicine
• Kansas Mental Health Association
• Kansas Association for the Medically Underserved
• Kansas Nurses Association
• AARP
• Kansas Public Health Association
• Kansas Health Care Association (KHCA)
• Kansas Association of Homes and Services for the Aging (KAHSA)
• Two self-insured employers appointed by Kansas Chamber of Commerce and

Industry: Hills Pet Nutrition; Lawrence Paper Co.

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Data Consortium Charge

• Make recommendations regarding the scope of the Authority’s

responsibilities for managing health data;

• Recommend reporting standards and requirements for non-

programmatic data owned or managed by the Authority;

• Craft data use policy recommendations governing access to health

information by external users of both programmatic and non-programmatic data owned or managed by the Authority;

• Recommend empirical studies and evaluations supporting the goals

and objectives of the Authority;

• Provide input on health and health care data initiatives in other
• rganizations and agencies;
• Develop recommendations for public reporting standards for

consumers, health care providers and other health care organizations.

To serve as a multi-stakeholder public advisory group to the KHPA Board with the following specific responsibilities:

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Advisory Councils

• Make-up:

– Health Care Consumers – Health Care Purchasers (e.g., Insurers, Businesses) – Health Care Providers – E-Health Advisory Council (multi-stakeholder)

• Purpose: Assist the KHPA Board and Steering

Committee (Board and legislators) with the development of health reform

• Processes:

– Organized in March 2007; held monthly meetings – Delivered health reform recommendations to KHPA Board in Sept. 2007 – Participating in community outreach

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Informing the Public

• Online access to all health reform reports and

testimony through the KHPA website (w/i 24 hours)

• KHPA E-newsletter for weekly updates on the legislative

process and health reform

• Public meetings: KHPA Board, Listening Tour, Advisory

Councils and Steering Committees

• Presentations to organizations and communities
• “Community Toolbox Kit” for local communities to

present on the KHPA Board Health Reform recommendations

• News alerts available through new news-service at the

Kansas Health Institute website (www.khi.org)

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Community Dialogues

• Purpose: Gather public input on health reform in
• rder to provide direction for the KHPA Board

recommendations

• Processes:

– Three week tour in August 2007; Six week tour in 2008 – In 2007: 22 cities statewide and 34 meetings; in 2008: 15 cities and 45 meetings – Deliver summary comments to KHPA Board, legislature, and public – Publicized online “suggestion box” for public to provide suggestions and/or comments about health reform

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Challenges

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The Purpose of Health Reform The Purpose of Health Reform

To improve the health of Kansans – not just health insurance or health care – but the health of our children, our families, and our communities; WE ALSO SERVE AS PAYERS

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Transforming Medical Care Improving Public Health Expanding Affordable Insurance

• Transparency project:

health care cost and quality

• Health literacy
• Medical home

definition

• Medicaid provider

reimbursement

• Community Health

Record (HIE)

• Form standardization
• Increase tobacco user fee
• Statewide smoking ban
• Partner with community organizations
• Education Commissioner
• Collect fitness data in schools
• Promote healthy foods in schools
• Increase physical fitness
• Wellness for small businesses
• Healthier food for state employees
• Dental care for pregnant women
• Tobacco cessation in Medicaid
• Expand cancer screening
• Aggressive outreach and

enrollment of eligible children (target population: 20,000)

• Premium assistance for

low income adults without children (target population: 39,000)

• Small business initiatives

(target population: 15,000 young adults and 12,000 employees of small businesses)

21 Recommendations: 21 Recommendations: System Reform and Better Health System Reform and Better Health

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Summary of 2008 Summary of 2008 Legislative Action Legislative Action

• Nine of KHPA’s original 21 health reform

recommendations were passed by legislature in some form

• Any items that were considered

controversial were requested to be studied-only

• Final health reform bill (SB 81) left some

unfunded mandates

See Legislative Session at a Glance for summary of final bill See Legislative Session at a Glance for summary of final bill

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Priorities for the 2009 Priorities for the 2009 Legislative Session Legislative Session

• Statewide Indoor Smoking Ban
• Increase in the Tobacco User Fee
• Expanding Access to Health Insurance

and Promoting Public Health Programs

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Lessons Learned

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Partnerships Partnerships

• Under our governance structure,

partnerships are essential

• Pace of “payer partnerships” is related to

“policy partnerships”, patience is essential

• Consider success both what you

advance and prevent