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Coordinating State Health Reform in Kansas November 21, 2008 Doug Farmer Kansas Health Policy Authority 1 Creation of the KHPA Creation of the KHPA Built on Governor Sebelius Executive Reorganization Order in 2005 Modified


  1. Coordinating State Health Reform in Kansas November 21, 2008 Doug Farmer Kansas Health Policy Authority 1

  2. 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 2

  3. Timeline Timeline July 1, 2005 Kansas Health Policy Authority Established. Transfer program s to a Division first, then to a separate agency. January 1, 2006 Assum e responsibilities of Health Care Data Governing Board and oversight of KS Business Health Partnership program . March 1, 2006 Authority plan for various program July 1, 2006 transfers subm itted to Legislature. Transfer program s to Authority. 2007 Legislative Session Authority plan for additional program transfers subm itted to 2 0 0 7 and 2 0 0 8 2008 Legislative Session Legislatures. 3 3 3

  4. 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 oriented public health strategies 4

  5. Programs Transferred Programs Transferred to KHPA in 2006 to KHPA in 2006 • Medicaid Drug Utilization • Medicaid • Medicaid Drug Utilization • Medicaid Review & related programs Review & related programs (Regular Medicaid) (Regular Medicaid) • State Employee Health • State Employee Health • MediKan • MediKan Insurance Insurance • State Children’ ’s Health s Health • State Children • State Workers • State Workers Insurance Program Insurance Program Compensation Compensation • Ticket to Work/Working • Ticket to Work/Working • Health Care Data • Health Care Data Healthy Healthy Governing Board Governing Board • Medicaid Management • Medicaid Management • Business Health • Business Health Information System Information System Partnership Program Partnership Program 5 5 5

  6. KHPA Board KHPA Board • Independent Board: Provide independent oversight 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 6

  7. Quality and Efficiency Affordable, Sustainable Health Care � Use of HIT/ HIE � Patient Safety Access to Care � Evidence based care � Health insurance premiums � Quality of Care � Cost-sharing � Transparency (Cost, � Health Insurance Status � Uncompensated Care � Health Professions Workforce Quality, etc.) � Medicaid/ SCHIP Enrollment � Safety Net Stability � Health and health care spending � Medicaid Eligibility � Health Disparities VI SI ON: Coordinating health & health care for a � Council Participation thriving Kansas � Data Consortium � Physical Fitness � Public Communication � Nutrition � Community/ Advocacy � Age appropriate screening � Open Decision � Tobacco control Partnership Making � Foundation Engagement � Injury control � Responsible Spending � Financial Reporting � Accessibility of Information � CMS Cooperation Health and W ellness Public Engagem ent Stew ardship KI D SRS KDHE KDOA • Health Prom otion • Mental Health • Private Health I nsurance • Aged • Child, Youth & Fam ilies • LTC for Disabled • Business Health Partner. • I nstitutional Care • Consum er Health • Substance Abuse • Com m unity Care • Health & Environ. Stats 7 • Local & Rural Health

  8. 8 Partnerships for Quality Improvement

  9. Types of Partnerships • As Policy Leaders • As Payers – Statewide health reform: – Leverage purchase • Public Health power to create: • Data Consortium (Quality • Administrative Measurement and simplification Reporting) • Medical Home • Advisory Councils • Community Health Record • Community Dialogues • Health and Wellness – As part of national – As Employers agenda: • Collaborations with • State Quality Institute Employer groups • State Coverage Institute • Value based purchasing • NASHP initiatives 9

  10. 10 Room for Improvement Room for Improvement Health of Kansas: Health of Kansas:

  11. 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 11

  12. 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. 12

  13. Data Consortium Charge To serve as a multi-stakeholder public advisory group to the KHPA Board with the following specific responsibilities: • 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 organizations and agencies; • Develop recommendations for public reporting standards for consumers, health care providers and other health care organizations. 13

  14. 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 14

  15. 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) 15

  16. Community Dialogues • Purpose: Gather public input on health reform in order 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 16

  17. 17 Challenges

  18. 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 18

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