Health Value – The New Measure in Ohio

Health Value – The New Measure in Ohio

Clinically Speaking with Dr. Wymyslo

The Health Policy Institute of Ohio has developed and recently released a new measure that is certain to create a lot of discussion and debate in the near future...the Health Value Dashboard.
This measure is meant to look beyond the usual quality metrics used to estimate population health (with Ohio most recently ranking 40th worst in the US in overall health), and factor in the cost per capita of achieving that level of health (for which, unfortunately, Ohio ranks as 40th highest cost per capita in the nation). Because we both scored low in overall health and high in cost, the health value score for our state is calculated to be 47th worst in the nation.

Since the nation is increasingly focused on developing a payment reform model that shifts from payment for volume (fee for service) to payment for value (value-based payment), this new performance indicator is expected to be of great interest to insurers, public policy makers, public health, employers, and the health systems. The overarching goal, of course, is to provide high quality care at an affordable, sustainable cost. FQHCs need to be aware of and aligned with the Health Value Dashboard if we are to maintain the high regard we have historically achieved over the years. That means, besides our quality

measures and PCMH recognition, we have to demonstrate that we can achieve the desired health outcomes at a cost that is sustainable. Unfortunately, much of what we struggle with in healthcare is due to unhealthy behaviors in the population we serve – strong predictors of chronic disease, poor health and high cost of healthcare – and hard-er to get our hands around.

To get at the need to demonstrate high health value in the population we serve, we will need to significantly change the way we approach our patients and our community. We will need to become adept at changing health behavior, engaging our entire community in the effort, and allow our patients to experience the benefits of living in a community that has a focus on health. We will necessarily have to become more expansive in how we address our patients’ health needs (biopsychosocial) and in what we are trying to impact with our efforts (entire community). To be successful, we must support efforts to integrate behavioral and public health into our clinical practices, embrace team care, teach our patients to more effectively manage their own health, practice prevention, and engage in other “not practice as usual” activities in our offices. Hopefully, future funding will be better aligned with such efforts, but we can’t wait for the funding to change
before we begin moving in this direction in our FQHCs – nor do we need to...
Early efforts in this expanded role can begin now in your everyday practice as you increasingly use motivational interviewing techniques to help patients take small steps in a healthier direction, tight-en your relationships with behavioral health to improve co-management of patients, build prevention questions into every patient visit no matter what the chief com-plaint might be, and become more involved in your community to help it move in a healthier direction with safer streets and neighborhoods, safer housing, cleaner air and water, opportunities for physical activity and healthy eating, education and employment opportunities, and better community decisions and policies that affect population health.

Giving out the right blood pressure medicine alone won’t be sufficient to achieve the high value in health that we desire and our patients and communities need. With our broad geographic presence and our understanding of the factors that impact total health, FQHCs are uniquely positioned to be a major part of the solution to Ohio’s health challenges.

Let’s not miss this opportunity to lead the change that is needed!

Resources:

• Health Measurement Initiative
• 2014 Health Value Dashboard