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Promoting Quality... Partnering for Change (Text Version)

Slide Presentation from the AHRQ 2008 Annual Conference

On September 9, 2008, Ron Finch, Ed.D., made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (9.5 MB).

Slide 1

AHRQ 2008 Annual Conference

Promoting Quality... Partnering for Change

By
Ron Finch, EdD
Vice President
National Business Group on Health
September 9, 2008

Slide 2

The slide shows an image of the front cover of "A Purchaser's Guide to Clinical Preventive Services: Moving Science into Coverage."

Slide 3

A Purchaser's Guide to Clinical Preventive Services

Developed by the Centers for Disease Control and Prevention (CDC), the Agency for Healthcare Research and Quality (AHRQ), and the National Business Group on Health, the Guide provides guidance to employers on recommended clinical preventive services for health benefits design.
It includes information on the economic benefit of preventive services, and effective system interventions to improve the delivery and use of preventive services.

Slide 4

Who Developed It?

National Business Group on Health (NBGH)
Centers for Disease Control and Prevention (CDC)
- National Center on Birth Defects and Developmental Disabilities
- National Center for Chronic Disease Prevention and Health Promotion
- National Center of Environmental Health
- National Center for Health Marketing
- National Center for HIV, STD, and TB Prevention
- National Center for Health Statistics
- National Center for Immunization and Respiratory Diseases
- National Center for Injury Prevention and Control
- National Center for Infection Diseases
- National Institute for Occupational Safety and Health (NIOSH)
Agency for Healthcare Research and Quality (AHRQ)

Slide 5

Why is Health Care Coverage Important?

Coverage for clinical preventive services is a key factor that determines whether people receive preventive services, which help people avoid disease and reduce health risks.
*In the U.S., coverage of physical exams, screening, and immunizations is fair; coverage of lifestyle modification/counseling services is poor. For example:
- Healthy diet-21%
- Weight loss-18%
- Alcohol misuse-19%
- Tobacco treatment-4%
Increase the number of children, adolescents, and adults who receive recommended preventive physical, mental, and dental health care services.

*Source: Results from survey completed by 2,180 employers in 2001. Bondi MA, Harris JR, et al. Employer coverage of clinical preventive services in the United States. American Journal of Health Promotion 2006; 20(3): 214-222.

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Why Employers?

Employers (public and private purchasers), not health insurers, determine access to health care services.
Benefits language, including coding and summary plan description language not developed.
Promote total value of health.
Employers have to make complex decisions about health care coverage and health promotion services.
Benefit managers are not healthcare experts.

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Objectives

To give employers and other purchasers of health care tools to improve coverage and use of clinical preventive services for millions of employees and their dependents.
To improve the delivery of effective interventions for quality health care.
To reduce and eliminate disparities for many diseases, conditions, and risk factors.

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Evidence-Based Preventive Services

Abdominal Aortic Aneurysm, Screening.
Alcohol Misuse, Screening and counseling.
Aspirin Therapy for the Prevention of Cardiovascular Disease, Counseling.
Breast Cancer, Screening, counseling, testing, preventive treatment, preventive medication.
Cervical Cancer, Screening.
Childhood Health Promotion.
Child Development, Screening.
Dental Caries, Preventive medication.
Immunizations.
Lead, Elevated Blood Level, Screening.
Newborn Screening for Genetic and Endocrine Disorders, Screening, medical foods, and treatment.
Newborn Hearing, Screening.
Vision, Screening.
Colorectal Cancer, Screening.
Contraceptive Use, Counseling and preventive intervention.
Depression, Screening.
Diabetes (type 2), Screening.
Healthy Diet, Counseling.

Healthy Pregnancy.
- Alcohol Misuse, Screening and counseling.
- Breastfeeding, Counseling.
- Folic Acid Supplementation, Counseling and preventive medication.
- Asymptomatic Bacteriuria, Screening.
- Group B Streptococcal Disease (GBS), Screening and preventive medication.
- Hepatitis B Virus (HBV), Screening, immunization, and treatment.
- Human Immunodeficiency Virus (HIV), Screening, counseling, and preventive medication.
- Influenza, Immunization.
- Preeclampsia, Screening.
- Prenatal Diagnosis of Chromosomal Abnormalities and Neural Tube Defects (NTDs), Screening and testing.
- Rh (D) Incompatibility, Screening and preventive medication.
- Rubella, Screening.
- Syphilis, Screening.
- Tetanus, Immunization.
- Tobacco Use Treatment, Screening and counseling.
Hypertension, Screening, counseling, and treatment.
Immunizations (Child, Adolescent, Adult).
Lipid Disorders, Screening, counseling, and treatment.
Motor Vehicle-Related Injury Prevention, Counseling.
Obesity, Screening, counseling, and treatment.
Osteoporosis, Screening and treatment.
Sexually Transmitted Infections (STIs).
- Counseling to Prevent STIs, Counseling.
- Chlamydia, Screening.
- Gonorrhea, Screening.
- Human Immunodeficiency Virus (HIV), Screening and counseling.
- Syphilis, Screening.
Tobacco Use Treatment, Screening, counseling, and treatment.
Tuberculosis, Screening.

Slide 9

The slide shows the overviews for Chapter 1: "The Role of Clinical Preventive Services in Disease Prevention and Early Detection" and Chapter 2: "Summary Plan Description (SPD) Language Statements for Recommended Clinical Preventive Service Benefits," from the Purchaser's Guide.

Slide 10

The slide shows a page from the Purchaser's Guide presenting the "Summary Plan Description Language: Hypertension. It shows the language for both screening, and counseling and treatment."

Slide 11

The slide shows the overviews for Chapter 3: "Evidence-Statements for Recommended Clinical Preventive Service Benefits" and Chapter 4: "The Prioritization and Strategic Implementation of Clinical Preventive Service Benefits," from the Purchaser's Guide.

Slide 12

The slide shows the overviews for Chapter 5: "I Statements and C and D Recommendations of the U.S. Preventive Services Task Force (USPSTF)" and Chapter 6: "Leveraging Benefits: Opportunities to Promote the Delivery and Use of Preventive Services," from the Purchaser's Guide.

Slide 13

The slide shows the overview for Chapter 7, "Resources and Tools," from the Purchaser's Guide.

Below the overview of Chapter 7 is the note: "All materials featured on this CD are available on the National Business Group on Health Web site at: wwww.businessgrouphealth.org/prevention/purchasers/ and on the Centers for Disease Control and Prevention (CDC) Web site at: http://www.cdc.gov/business"

Slide 14

Screen shot of a diagram showing a large, blue centered oval with two, smaller, yellow ovals on the left and one, small, yellow oval to the right. Three arrows, pointing to both the yellow ovals and blue oval show their connection. The blue oval represents "Working Teams." The two ovals on the left represent the "Public Sector's AHRQ and CDC," and the one oval to the right represents the "Private Sector's NBGH." All have a role in the "Purchaser's Guide."

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Purchaser's Guide Dissemination

Goals:

To raise awareness of, generate use of and create champions for the Purchasers Guide within the employer and public health and related communities.

Target Audience:

Chamber of Commerce, America's Health Insurance Plans (AHIP), National Association of Manufacturers, National Business Coalition on Health, Partnership for Prevention.
Public health partners.
State and local public sector purchasers.
Other purchasers and advocates (e.g., Office of Personnel Management [OPM]).

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Promotional Materials

Hard copy Binders.
CDs.
E postcards.
Power point Presentations.
One pagers and Talking Points.
Press Releases.

Slide 17

Selected Dissemination Results

Over 1500 Hard copy binders and 2500 CDs distributed.
Over 320,000 downloads since 11/06 release. Endorsed by the American Medical Association (AMA), American College of Preventive Medicine (ACPM), National Association of Chronic Disease Directors (NACDD).
Numerous Webinars to various audiences.
Numerous Conferences and Presentations, NIOSH WorkLife, Healthy Heart and Obesity Prevention (NY, MI), many health care coalitions, Joint Forum-From Science to Service.

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How Others Are Using the Guide

Gold standard—gap analysis to determine delivery of Clinical Preventive Services (CPS) to employees; encouraging employees to obtain services.
Vendor selection—i.e. using the tobacco evidence and SPD to determine work for tobacco cessation vendors.
Guide worksite health promotion efforts, i.e. health fairs and health education.
Inform healthcare strategies; evaluate employee global health status.
Teach providers and medical students about the scope and value of clinical preventive services & prev. medications.

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Value of the Purchaser's Guide

Closes the gap between knowledge and practice.
"Plug and Play" ease of use:
- Appropriate for different organizations, workforces, priorities, and resources.
- Precise SPD language: both screening and intervention.
- Precise codes.
- Up-to-date cost, cost-effectiveness, and return on investment (ROI) estimates.
Valuable with or without:
- Medical Department.
- Benefit consultants.
Trustworthy:
- Authoritative sources.
- Evidence based: What works and what doesn't work.

Slide 20

Next Steps

Total Value of Health (build the policies and processes).
- Preventive services will the base.
Keep Guide Current:
- AHRQ and CDC.
Develop Web site for preventive services.
Republish the Guide periodically.

Current as of January 2009

Internet Citation:

Promoting Quality... Partnering for Change. Slide Presentation from the AHRQ 2008 Annual Conference (Text Version). January 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/annualmtg08/090908slides/Finch.htm