The Business Case for Equity of Care: All Payer Claims Databases U.S. Chamber of Commerce Washington, D.C. April 7 , 2014 Tim Bartholow, MD Chief Medical Officer Wisconsin Medical Society Tim.Bartholow@WisMed.org Tbartholow@WEATrust.com 1
County Health Rankings: Interactive Maps http://www.countyhealthrankings.org/app/wisconsin/2013/rankings/outcomes/overall/by-rank 3
UW PHINIX: Uncontrolled A1c and Diabetes Prevalence 2007-9 LP Hanrahan (Larry.Hanrahan@fammed.wisc.edu) and B Arndt, http://videos.med.wisc.edu/videos/42741 11/5/2012 and https://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/111/3/124.pdf High Poverty High Economic Hardship High Social Vulnerability Low FF&V Consumption High T2DM Prevalence Lower Good A1c Control Higher Uncontrolled A1c $3121 PMPM $2004 PMPM 4
All Payer Claims Databases http://www.apcdcouncil.org/state/map 5
All Payer Claims Data Base, WI Health Information Organization (WHIO): $40B, 3.7 Million WI Residents by Major Practice Category (MPC) 6
Angioplasty, By County 7
Angioplasty, By Physician 8
Angioplasty, By Episode (Patient) 9
IHD with Angioplasty, 2 Groups 2 Hours From One Another, Doctors with at Least 10 Episodes, DMV2 $40,000 3 $36,009 $33,911 $33,508 $35,000 2.5 $30,865 $29,853 Health Risk, Retrospective $30,000 $26,728 Std Cost per Episode $25,221 $24,897 $24,890 $24,772 2 $25,000 $21,863 Std Cost per Episode $20,000 1.5 Health Risk $15,000 1 $10,000 0.5 $5,000 $- 0 A A A A A A A B A B B Doctor in Clinic A or B 10
Extract from National Cardiovascular Data Registry 11
Thank You 12
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