Kentucky lags well behind other states in achieving a high value delivery system.
A high value healthcare system leads to healthier communities. It eliminates unnecessary services and administrative waste and charges reasonable prices. This benefits everyone.
We all want to receive healthcare where the costs are reasonable, the outcomes are exceptional and equitable, the medical errors are minimal and we feel respected by providers that are energized and engaged in mission-driven work.
Healthcare quality and cost measurement is a strategy for providing better, more affordable care for individuals and the community. Getting health plans and providers aligned on the same measurement priorities and incentives is critical to reducing waste and driving optimal prevention, treatment and management on the conditions that are most important to our community, such as diabetes, depression and cancer.
The KHC has been engaged in driving local healthcare value for over 15 years in Greater Louisville and Kentucky. Part of that work requires leveraging employers’ purchasing power and fostering multi-stakeholder collaboration to ensure patients receive high value care.
The KHC has several key initiatives
included in this strategy. These include:
Kentucky Core Healthcare Measures Set
We can driving health improvements through measurement alignment.
Healthcare quality and cost measurement aims to provide better, more affordable care for individuals and the community. Measuring and incenting the right things is important but doing so requires experts to agree on what those things should be.
Creating a core set of healthcare measures to focus and align priorities is the first step toward aligning incentives around the things that matter. Experts from across the Commonwealth of Kentucky have created the Kentucky Core Healthcare Measures Set (KCHMS), which brings together the priorities of consumers, providers, payers, and purchasers. By focusing on everything, we focus on nothing. But by focusing on the right things, we can drive improvements.
Community Measurement
For the last 15 years, the KHC has led the way in healthcare quality measurement and transparency through Consolidated Measurement Reports.
These reports allow for comparison to local and state averages and benchmark scores on the quality of care patients receive on a variety of ambulatory care indicators. The KHC is the only organization that combines Commercial, Medicaid, and Medicare Advantage data for quality reporting. The data also allows us to see where we have improved – or not – as a community in these key indicators of quality healthcare.
All-Payer Claims Database
In partnership with the University of Louisville Commonwealth Institute of Kentucky, the KHC developed a policy brief titled Improving the Health of Kentuckians: The Value of an All-Payer Claims Database.
A growing movement towards more transparency in healthcare price and quality has brought the discussion of an All-Payer Claims Database (APCD) to the forefront of many discussions related to improving health outcomes in communities by understanding what is happening in those communities. An APCD’s aggregate data allows it to serve as a tool to monitor and assess patterns in healthcare access, quality, disparities, efficiency, costs, and affordability.
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