Call for Public Comment: Proposed Changes to KY Core Healthcare Measures Set

2018 KY Core Healthcare Measures Set

Modifications are being made to the Kentucky Core Healthcare Measures Set (KCHMS), and healthcare stakeholders throughout the Commonwealth are invited and encouraged to review and comment on those submissions during a public comment period that will run through August 9.

In 2018, the core measures set was developed and released through a public-private partnership with the goal of creating a core measures set for Kentucky stakeholders to align to. The 2018 core measures set includes 34 unique measures, focused in the areas of prevention, pediatrics, chronic and acute care management, behavioral health, and cost/utilization.

This year’s update will ensure that the measures on the core measures set are current, relevant, and sound. The Kentucky Performance Alignment Committee – or PMAC – and its subcommittees have spent the last months reviewing the current measures set, examining potential measures for addition, and confirming or questioning the current measures’ relevance.

This week, the subcommittees presented their final recommendations to the PMAC Oversight Committee, which will finalize the 2019 KCHMS measures on August 20.

If all recommendations are accepted, the core measures set will increase from 34 measures to 39. Measures that would be added include opioid treatment, depression treatment, diabetes blood pressure control, childhood and adolescent well care, and patient experience measures. Measures related to medication adherence and antibiotic avoidance would be removed.

Any healthcare stakeholder is invited to provide feedback for the PMAC Oversight Committee on these recommendations. The public comment period will close August 9, and you can find details on the proposed changes and public comment form here.

PRESS RELEASE: Randa Deaton Elected to National Alliance of Healthcare Purchaser Coalition Board

Press Release from National Alliance of Healthcare Purchaser Coalitions

 

 

 

National Alliance of Healthcare Purchaser Coalitions Elects New Board Officers

WASHINGTON July 15, 2019 The National Alliance of Healthcare Purchaser Coalitions, a non-profit network of business coalitions across the country, announced its slate of new officers for the Board of Governors. Officers are elected by their board peers based on proven leadership and commitment to the National Alliance, as well as their efforts to advance and strengthen value-based purchasing strategies.

The newly elected officers are:

• Cristie Upshaw Travis, CEO, Memphis Business Group on Health – Chair
• Gaye Fortner, President and CEO, Healthcare 21 Business Coalition – Vice Chair
• Chris Syverson, CEO, Nevada Business Group on Health – Secretary-Treasurer
• Randa Deaton, Co-Executive Director, Kentuckiana Health Collaborative
• Neil Goldfarb, President and CEO, Greater Philadelphia Business Coalition on Health

“The National Alliance’s tools and educational programs prepare coalitions and purchasers to leverage their collective influence to bring meaningful change in our healthcare system nationally and in markets across the US,” said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health and Board Chair. “I am excited to work with this strong Board and coalition leaders that bring expertise, experience and passion to move the market toward value-based purchasing so purchasers can obtain the highest quality care at the most reasonable cost.”

Gloria Sachdev, President and CEO, Employers’ Forum of Indiana, was elected as a Representative to the Board. Chris Skisak, Executive Director, Houston Business Coalition on Health, and Robert Smith, Executive Director, Colorado Business Group on Health, were re-elected as Representatives to the Board.

Continuing to serve their terms on the Board:

• Jessica Brooks, Chief Executive Officer, Pittsburgh Business Group on Health
• Christopher Goff, CEO and General Counsel, Employers Health
• Diane Hess, Executive Director, Central Penn Business Group on Health
• Cheryl Larson, President and CEO, Midwest Business Group on Health

There are four external board members and two are continuing second terms – Leah Binder, President and CEO, The Leapfrog Group, and Paul Fronstin, Director of the Health Research and Education Program, Employee Benefit Research Institute. Two newly elected members are:

• Lynn Quincy, Director, Healthcare Value Hub, Altarum
• Christa-Marie Singleton, Senior Medical Advisor, Centers for Disease Control and Prevention

“The National Alliance is fortunate to have the participation of these industry experts as we continue to lead and leverage efforts to promote transparency, reward and recognize value and performance, improve health and access to care, and facilitate alternative payment methodologies,” said Michael Thompson, National Alliance President and CEO.

Annual Forum

Convening employers, policymakers, business coalition leaders and other healthcare stakeholders, the National Alliance will host its Annual Forum, November 11-13, 2019 at the Marriott Wardman Park in Washington. Registration and sponsorship information can be found here.

About National Alliance of Healthcare Purchaser Coalitions

The National Alliance of Healthcare Purchaser Coalitions is the only nonprofit, purchaser-led organization with a national and regional structure dedicated to driving health and healthcare value across the country. Our members represent more than 12,000 employers/purchasers and 45 million Americans spending over $300 billion annually on healthcare. To learn more, visit nationalalliancehealth.org or connect with us on Twitter or LinkedIn.

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KHC Highlights Hospital Price Variation, Recruits Employers, Hospitals, and Health Plans for Workgroup

Last month, a new hospital price study by RAND Corporation revealed that depending on which side of the Ohio River they live, individuals with private insurance who receive hospital services pay more to Hoosier hospitals than to those in the Bluegrass State. On June 4, the Kentuckiana Health Collaborative brought together key healthcare stakeholders to explore the study that continues to make national headlines, from the New York Times to Modern Healthcare.

Gloria Sachdev, PharmD, President and CEO of the Employers’ Forum of Indiana and leader of the study, kicked off the KHC Community Health Forum by describing the study. She explained that employers in her coalition told her that hospital pricing, which accounts for one-third of healthcare spending in the U.S., was higher in Indiana than other locations in the U.S. She set out to find answers to their questions and partnered with RAND for a study to look at Indiana commercial hospital pricing relative to Medicare pricing. The results were startling, with outpatient pricing at 358% of Medicare prices for the same services. Indiana hospitals claimed that their pricing was normal for commercial insurance rates, so a second study was conducted comparing pricing nationally. The National Hospital Price Transparency Report, released in May, showed that Indiana’s hospital pricing was not normal as the hospitals claimed. The results of the 25 states that participated showed that on average, employers pay 241% of what Medicare would pay nationally. Indiana topped the nation at 311% of Medicare pricing. The study nationally showed prices rising and wide variation in pricing with some hospitals charging private insurance 500% of what Medicare would have paid.   

Stephanie Clouser, KHC Data Scientist, presented Kentucky’s results which looked favorably for pricing. Kentucky ranked fourth lowest of the states in the study, with an overall hospital price of 186% of Medicare pricing. In addition to below-average hospital pricing, Kentucky’s prices moved sharply downward over the three years of the study. However, Kentucky’s results showed wide variation between outpatient and inpatient pricing at 245% and 142%, respectively. Both Kentuckiana (including Southern Indiana) and Kentucky had among the worst hospital quality and safety ratings of all the regions and states in the study. Clouser explained the goal is for employers to find the hospitals in Kentucky with high value, meaning they have both high quality and best pricing. One of the big questions that came out of this study was to determine what is reasonable pricing for commercial insurance to pay above Medicare, and this answer will determine which hospitals are considered “high value.” For now, no Kentucky hospitals would be considered “high value” using Kentucky’s overall relative pricing of 186%, but there is one hospital that would be considered “high value” using the national average of 241% (see graph below).  

When comparing Kentucky hospital’s overall relative price to Medicare to their CMS quality ratings, there is wide variation in both among Kentucky’s facilities. Just one Kentucky hospital has below-national-average prices and excellent quality.

How are employers responding to this data? Christan Royer, M.Ed., Director of Benefits, Human Resources, Indiana University (IU) and Chairman of the Employers’ Forum of Indiana, told event attendees how her organizations is responding to their increasing healthcare and hospital costs. She indicated that increasing costs have affected their ability to give salary increases to employees. With their healthcare costs averaging 7% increases each year over the last four years and salary increases averaging 2% each year, healthcare costs continue to outpace employee pay and inflation year after year. Christan explained that employers can no longer keep raising premiums and deductibles or using Health Savings Accounts (HSAs) as they have always done in order to bend the cost curve. Employers will need to explore new levers to solve increasing costs, such as contracting for Medicare plus costs, direct contracting, or tiered networking. Currently, Employers’ Forum of Indiana is convening employers to explore these new ways of addressing unsustainable healthcare costs for employers. In 2018, family premiums for commercial insurance averaged nearly $20,000 per year in the U.S.

These findings turned on the light for many employers who generally operate in the dark around hospital pricing yet are responsible for purchasing healthcare for more than half (55%) of all Americans. The study showed wide variation in quality and cost among hospitals and states and illuminated that costs are often not a predictor of the quality and safety of care employees and families receive.

At the KHC, we bring together hospitals, providers, policymakers, plans, consumers, and employers to improve health status and healthcare delivery in the Louisville area and throughout the Commonwealth of Kentucky. The KHC has focused much of its efforts on working to improve primary care quality, transparency, and measurement alignment but has given little attention to hospital quality or pricing. We know that our hospital systems are committed to driving improvements to patient health and safety, but we have work to do to achieve the quality ratings of other states and communities. We are forming a new workgroup to discuss how we can collectively drive improvements to hospital value in our region. Hospitals, health plans, and employers are invited to join this workgroup.

The KHC is one of many National Alliance of Healthcare Purchaser Coalitions members participating in the study and is currently recruiting employers and health plans for the next iteration of the National Hospital Price Transparency Report, scheduled for release in January 2020. An information sheet is available for Kentucky employers along with a webpage for how to get involved. A national informational webinar for employers is scheduled for July 9.

To learn more about getting involved, email info@khcollaborative.org.

Mental Health Month a Time to Focus on the Connection between Physical and Mental Health

(Note: This guest piece was written by Marcie Timmerman, Executive Director of Mental Health America of Kentucky)

Marcie Timmerman
Executive Director
Mental Health America of Kentucky

Mental health is essential to everyone’s overall health and well-being, and mental illnesses are common and treatable. So much of what we do physically impacts us mentally. It is important to pay attention to both your physical health and your mental health, which can help you achieve overall wellness and set you on a path to recovery.

Did you know that Mental Health America (MHA) founded May as Mental Health Month back in 1949? That means this year marks MHA’s 70th year celebrating Mental Health Month! This May, Mental Health America of Kentucky is expanding its focus from 2018 and raising awareness about the connection between physical health and mental health, through the theme #4Mind4Body. We are exploring the topics of animal companionship, spirituality and religion, humor, work-life balance, and recreation and social connections as ways to boost mental health and general wellness.

A healthy lifestyle can help to prevent the onset or worsening of mental health conditions, as well as chronic conditions like heart disease, diabetes, and obesity. It can also help people recover from these conditions. For those dealing with a chronic health condition and the people who care for them, it can be especially important to focus on mental health. When dealing with dueling diagnoses, focusing on both physical and mental health concerns can be daunting but critically important in achieving overall wellness.

There are things you can do that may help. Finding a reason to laugh, going for a walk with a friend, meditating, playing with a pet, or working from home once a week can go a long way in making you both physically and mentally healthy. The company of animals – whether as pets or service animals – can have a profound impact on a person’s quality of life and ability to recover from illnesses. A pet can be a source of comfort and can help us to live mentally healthier lives. And whether you go to church, meditate daily, or simply find time to enjoy that cup of tea each morning while checking in with yourself– it can be important to connect with your spiritual side in order to find that mind-body connection.

Mental illnesses are real, and recovery is always the goal. Living a healthy lifestyle may not be easy but can be achieved by gradually making small changes and building on those successes. Finding the balance between work and play, the ups and downs of life, physical health, and mental health, can help you on the path towards focusing both #4Mind4Body.

Everyone has mental health. Isn’t it time we start taking care of it?

Concerned about yourself or someone you love? Take a free online mental health screening here.

Call for Applications – 2019 KY Performance Measures Alignment Committee

The Kentuckiana Health Collaborative is accepting applications for the 2019 Kentucky Performance Measures Alignment Committee (PMAC), which will select the 2019 Kentucky Core Healthcare Measures (KCHMS), a core healthcare measures set for Kentucky’s primary care providers, with the ultimate goal of aligning the priorities of Medicare, Medicaid, and commercial insurers.

The KCHMS was first released in June 2018 and includes 34 primary care measures in the areas of preventive care, behavioral health, chronic and acute care, pediatric care, and cost and utilization. The intent is to align measurement efforts toward shared areas of focus, making Kentucky one of the first states in the nation to create a healthcare measurement set.

PMAC, which selects the measures that are included in the core measures set, consists of an oversight committee and five subcommittees in the follow areas:

  • Behavioral Health
  • Chronic and Acute Care
  • Pediatrics
  • Preventive
  • Cost and Utilization

The 2019 PMAC team will consist of previous committee members and new applicants. Slots are limited and will reflect a diverse mix of payers, providers, purchasers, and consumers.

While the 2018 KCHMS timeline was approximately one year from conception to release, this year’s cycle will be more condensed and run from June 2019 to August 2019. Both subcommittee and oversight committee members will participate in an overview call in early June, each subcommittee will meet approximately twice in June and July, and the oversight committee will meet an anticipated two times in July and August. The 2019 KCHMS measures will be finalized by August 31, 2019.

For more information about the project, visit the KCHMS page on the KHC website. To apply for the oversight committee or subcommittee, click here.

Submissions are due by Friday, May 31. Any questions, please contact Stephanie Clouser at sclouser@khcollaborative.org.

Tackling Opioids in the Workplace

(Note: This guest piece was written by Tiffany Cardwell, Human Resources Consulting Principal, Mountjoy Chilton Medley and Director of Wellness, Louisville Society of Human Resources Management)

Tiffany Cardwell is a member of the KHC’s Worksite Addiction Group.

Opioids in the workplace is a topic that often gives pause for human resource professionals. The pause occurs since there are so many taboos and unknowns surrounding this issue for employers—no matter the size and no matter the industry. For the past year, I’ve had the wonderful opportunity to work with a talented team of experts through the KHC to create a toolkit for employers for supporting opioid prevention, treatment and recovery. Monthly meetings were held to focus on creating a tool for employers and their managers to assist with addressing opioids in the workplace. The toolkit was released last month at a half-day event where area employers explored the toolkit’s application and other relevant topics.

As an HR practitioner, I wasn’t quite sure what I would be able to add to the many experts who were involved with this initiative. What I quickly discovered is that everyone is in a continuous learning process with the subject matter of opioids. Although we had expert clinicians who have been practicing in the field for years, I was able to provide some insights from an HR professional consulting with managers daily who are doing their best to combat this issue. Although I do not have a clinical background, it was great to be able to share how we can create tools that employers will find easy to use and helpful as they address concerns with their direct reports.

Out of all of our discussions, I found it most helpful to become more educated about the definitions surrounding opioids. Using common language to speak with managers and employees provides clarity for this complicated workplace issue. Open communication is also key to successfully tackling opioids in the workplace. The more employees and employers are comfortable discussing this issue with each other, the quicker resolutions can be made to assist the employee to return back to work and effectively assist them through recovery.

If you have not downloaded your copy of the employer toolkit or reviewed it online, I encourage you to do so. Even if you’re not running into this issue now, it is helpful to proactively gain understanding about what you may run into in the future.

Recent Studies Reveal Variation in Price and Quality Among Kentucky’s Hospitals

New Hospital Safety Grade state rankings by the nonprofit The Leapfrog Group shows Kentucky ranks 33rd in overall hospital safety, holding that spot for the second time in a row. This, when paired with the new study released last week by RAND Corp., reiterates that hospitals in the Commonwealth vary in both price and quality.

In the Spring 2019 Hospital Safety Grade rankings, Kentucky’s share of “A” hospitals was just 21%, down from nearly 24% in the Fall 2018 rankings. Leapfrog uses an easy-to-digest A-F grading scale, with “A” being the best. Nearly 70% of Kentucky’s 52 hospitals received a “C” or below rating, compared to the nationwide average of 43%. A new study released by The Leapfrog Group along with the state rankings showed that avoidable deaths due to errors, accidents, injuries, and infections have an 88% greater risk at “C” hospitals and 92% greater risk at “D” and “F” hospitals.

RAND STUDY SHOWS VARIATION IN PRICE, QUALITY IN KENTUCKY’S HOSPITALS

In addition to the Leapfrog safety rankings, Kentucky was one of 25 states that was included in last week’s RAND hospital price transparency report, which for the first time used actual payments by privately insured employers to report inpatient and outpatient prices by hospital. The report shows prices as a percent of what Medicare paid for the same services, thus making these relative prices comparable across the country. The study has been a hot news item in the healthcare world, featured in publications such as The New York Times, The Wall Street Journal, and Forbes.

Kentucky ranks fourth lowest in price of the 25 states in the RAND hospital price transparency study.

Overall, Kentucky came out favorably for its relative pricing to Medicare for private insurance in the report, well under the national average of the states in the study. Of the 25 states included in the data, Kentucky ranked fourth lowest in prices paid to hospitals, at 186% of Medicare compared to the national average of 241%. Similar to what the report illuminates nationally, there is large variation in price – inpatient, outpatient, and overall – among Kentucky’s facilities.

The RAND study looked at the CMS Hospital Compare five-star rating to highlight variation on quality, and that system illuminated similar trends as Leapfrog’s new results. Looking at the CMS ratings, which, like Leapfrog, puts hospitals into five levels of performance, more of Kentucky’s facilities named in the RAND study have poor to average ratings compared to the nation as a whole – 84% compared to the nation’s 51%. This means that just 16% of Kentucky’s hospitals are considered above average or excellent by CMS Hospital Compare.

KHC BRINGS IN RAND STUDY LEADERS FOR COMMUNITY FORUM

These variations in price and quality in Kentucky’s hospitals will be the focus of the Kentuckiana Health Collaborative’s June 4 Community Health Forum, which will bring in the RAND study’s leaders to dive into the results and what this means for Kentucky.

Gloria Sachdev, President and CEO for Employers’ Forum of Indiana, which partnered with RAND on the study, will walk through the study results, focusing on Kentuckiana and Kentucky’s hospital prices and how they compare to the rest of the nation. We will also hear from an employer, Indiana University, that was part of that first-year study in Indiana to discuss how seeing hospital pricing information has impacted their benefit strategy.

Although hospital pricing is important to all stakeholders, this event will be particularly relevant to those interested in employee health benefits, health plan design, and provider payment. RAND is now recruiting more participants for the next iteration of the study, so any employer or health plan that is interested in participating is encouraged to attend and for more information on what is involved.

Register today to join the conversation at the UofL Shelby Campus Founders Union Building. As with most KHC Community Health Forums, attendance is free for KHC members and $35 for non-members, which includes the program, networking, and breakfast. If you are unsure if your organization is a member of the KHC, see the full list here.

“Opioids and the Workplace” Employer Roundtable Paves the Way for Continued Work

If you have visited the Kentuckiana Health Collaborative’s website in recent months, you may have noticed a small box in the lower right-hand corner of the home page. Minute by minute, hour by hour, and day by day this countdown marked the nearing release date of “Opioids and the Workplace: An Employer Toolkit for Supporting Prevention, Treatment, and Recovery.” As part of the Kentucky Opioid Response Effort (KORE), the KHC spent the past year convening employers and key healthcare stakeholders alike to guide the development of a toolkit to provide recommendations and tools for employers to support their employees and their dependents in prevention, treatment, and recovery from opioid misuse and opioid use disorder (OUD).

As countdown ended on Thursday April 18, employers and other key healthcare stakeholders gathered at GE Appliance Park’s Monogram Hall for the release of the toolkit and to lay the foundation for next steps and implementation. The four-hour event, presented by the KHC Employer and Healthcare Purchaser Network, was full of presentations and discussions that explored the toolkit’s application and other relevant topics.

DIVERSE PERSPECTIVES BRING THE DISCUSSION FULL CIRCLE

Attendees kicked off the program by answering a poll about what they hoped to gain from the event.

To set the stage for the day, Patrick Kullman, an interventionist, shared his personal story of how an employer can be instrumental in supporting an employee facing substance and opioid related challenges. He was followed by addiction psychiatrist Dr. Kelly Clark, Addiction Crisis Solutions, who presented on facts and debunked myths surrounding opioids, addiction, and what it looks like in the workplace.

With the employee perspective at the forefront of the discussion and the record set straight on the chronic disease of addiction, a panel, moderated by Tiffany Cardwell, Mountjoy Chilton Medley, gave context to the challenges employers face in this area and opportunities for improvements. As employers and early adopters of strategies to address opioid misuse, Dr. Diana Han, GE Appliances, a Haier company, and Amanda Elder, LG&E and KU, highlighted their experiences and paths forward in adapting their data analytics and workplace policies to best support their employees and their dependents, as well as their business. Eric Bailly, Anthem, explored the health plan’s role as an employer partner for determining and provider optimal benefit design. Cynthia Doll, Fisher & Phillips, LLP, addressed many of the legalities that employers may need to consider. Highlights of the conversation included the available of Narcan in the workplace, workplace accommodations for employees on Medication Assisted Treatment (MAT), the identification and utilization of high-quality evidence-based treatment, and the Mental Health Parity and Addiction Equity Act (MHPAEA).

Panelists discuss challenges and paths forward in adapting policies to best support employees and their dependents, as well as their business.

As the lead author of “Opioids in the Workplace,” I presented on the toolkit itself, exploring what exactly employers can expect to learn from it and explaining how it can be used.

Dr. Brittney Allen and Dr. Katie Marks from the Kentucky Opioid Response Effort (KORE) closed out the day of by highlighting available community resources for people facing opioid related challenges, including Find Help Now KY and the Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioral Health Treatment Services Locator.

EMPLOYERS TO DRIVE CONTINUED WORK

“Opioids and the Workplace: An Employer Toolkit for Supporting Prevention, Treatment, and Recovery” is now available on the KHC website.

Although the countdown is now at zero, the work is certainly not over. In the upcoming year, the KHC will continue to improve this toolkit based on industry advancements and employers’ needs and feedback. At the roundtable, attendees were offered a chance to communicate their needs and give input on the potential direction of the toolkit. Three key questions were presented:

  • The business community has an active role in supporting the health and well-being of their employees. What should be their primary role in addressing the opioid crisis?
  • What is your biggest personal obstacle in acknowledging substance use in your workplace?
  • What tools can help you overcome this obstacle?

A major theme of this discussion was employers’ role in addressing stigma and creating awareness among employees not only about opioid related risks and addiction, but about what their employer can do to support them. Challenges to fulfilling this role included communication among different parts of the workplace chain of command, lack of understanding around confidentiality, and community culture’s that lacked empathy. Tools to overcome these challenges aligned closely with what the toolkit already offers, but also called for increased interconnectedness and partnership among employers, employees, and community supports.

To continue this conversation, the KHC will be convening a cohort of employers to discuss the implementation of the recommendations presented in the toolkit. Additionally, the KHC will be taking an increased focus on how employers can play a role in chronic pain management – a prominent factor in the development of the opioid crisis. If you are an employer interested in getting involved with this cohort, please contact me at nmiddaugh@khcollaborative.org.

The KHC will also be offering a complementary webinar on May 15 from 12pm to 1pm to review the employer toolkit. The toolkit and registration for the webinar can be found here.

We know employers play an important role in driving health of their employees and their families. By continuing to engage and invest in their specific role of supporting them through opioid related challenges, employers will be best positioned to achieve optimal health and workplace outcomes.

KHC Highlights Work at the Rx Drug Abuse & Heroin Summit

For the past couple of years, Kentucky employers have come together to not only address the opioid crisis within their own population but at a broader community level through the Kentuckiana Health Collaborative, and we had the opportunity to highlight that work last week at the Rx Drug Abuse & Heroin Summit. The summit brings together stakeholders to discuss what’s working in prevention and treatment each year.

Dr. Kelly Clark, Dr. Diana Han, and I presented “Employers Respond: Kentuckiana Health Collaborative’s Evidence-Based Approach to Community Health.” Clark, a national expert on opioid use disorder, played a key role in the development of the KHC’s “Opioids and the Workplace” employer toolkit that was released this month. An addiction psychiatrist and KHC member, Clark is the immediate past president of the American Society of Addiction Medicine and founder of Addiction Crisis Solutions. Han, Global Medical Director for GE Appliances and KHC Co-Chair, has also played an integral role with her team in providing boots-on-the-ground feedback for the newly released toolkit.

Clark kicked off the session by explaining the differences between opioid use, misuse, dependence, and disorder and the current evidenced-based guidelines for opioid use disorder treatment. Han then discussed how the opioid epidemic is impacting Kentucky’s businesses and the significant commitment employers are making to identify strategies to better ensure employees and family members are being supported through prevention, treatment, and recovery. Finally, I presented how employers are coming together to find and share opioid-related best practices and how the coalition has prioritized opioid-related initiatives into all four pillars of its work:


Healthcare Measurement: Improving quality and value of care through measurement, alignment, and transparency

Selection of two opioid stewardship measures into the Kentucky Core Healthcare Measures Set

Service on the National Quality Forum’s Opioid Stewardship Committee


Community Health: Improving health and wellbeing

Development and distribution of the Screening, Brief Intervention, and Referral to Treatment guide to 4,000+ Kentucky providers

Partnership with Student Alliance for Mental Health Innovation and Action (StAMINA) to improve youth mental health


Employer and Healthcare Purchaser Network: Engaging employers to drive the Triple Aim goals

Creation and distribution of “Opioids and the Workplace” toolkit

Communication of relevant information in newsletter and action briefs


Education: Catalyzing transformation of healthcare through education, communication, and collaboration

Convening of an employer focus group on the impact and needs around opioid use disorder in the workplace

Hosting of an employer roundtable sharing opioid-related benefits and policy best practices

Hosting of two annual conferences with specific sessions around opioid use disorder


As part of my presentation, I spent a good deal of time focused on the “Opioids and the Workplace” toolkit that was developed through the KHC’s worksite addiction committee, a cross section of employers and opioid use disorder experts. The Kentucky Opioid Response Effort (KORE), which funded the development of the toolkit, has been very visionary about how employers can be key partners in the prevention, treatment, and recovery of opioid use disorder. One of the goals of our session was to help other communities engage the business community in their opioid-related efforts.

The “Opioid and the Workplace” toolkit was released this month with an employer roundtable. The KHC’s opioid toolkit has received excellent reviews and will be distributed more widely in the coming months at the Kentucky Chamber’s opioid summit and the Kennedy Forum Annual Meeting in Chicago this summer. If you would like to learn more about the toolkit, be sure to sign up for our webinar on May 15. The webinar will feature Natalie Middaugh, KHC Community Health Program Manager, who led the development of the toolkit.

The Rx Drug Abuse & Heroin Summit has Kentucky roots and began in 2012 under the leadership of Operation UNITE and U.S. Rep. Harold “Hal” Rogers (KY-5th). Notable speakers in past years have included President Barack Obama in 2016, Congressmen Patrick Kennedy and Newt Gingrich in 2017, former President Bill Clinton and Counselor to the President Kellyanne Conway in 2018. This year, President Donald Trump and First Lady Melania Trump addressed attendees. Unfortunately, I didn’t get to rub elbows with any of the notable speakers, but I did make a commitment to put this event on the KHC’s list of conferences to attend next year.

National Hospital Prices: How do Kentucky Hospitals Stack up?

Imagine that you and your best friend are injured in a car accident. It’s nothing major, just some scrapes and bruises. But because the car is in pretty rough shape and you are both feeling pretty beat up, you decide to go to a hospital for a series of routine tests. You get some X-ray images and MRI to make sure that there are no broken bones, internal bleeds, etc.

You are your best friend go to different hospitals. She has one that she prefers, and your primary care provider is with another system with all your records in one place. But as you are going through these tests, you get anxious just thinking about a few weeks from now, when the bills start rolling in. Because you won’t know how much it’s actually going to cost until then.

On top of that, although you and your friend received the same or similar tests, the costs of your services are nearly twice as high as hers! Simply because you chose to go to different facilities.

Everyone is familiar with scenarios like this. The healthcare pricing system is opaque and confusing, with negotiated allowed prices that vary between payers. We’ve long been frustrated by this but have done little to shine the light on hospital pricing information.

INDIANA STUDY REVEALED HIGH HOSPITAL PRICES, EXPANDED NATIONALLY

National employers located in Indiana noticed higher healthcare costs in the Hoosier state compared to costs in other states. To examine whether these observations were true, the Employers’ Forum of Indiana, an employer-based healthcare coalition of employers, providers, payers, public health officials, and other interested parties, partnered with RAND Corporation for a first-of-its-kind study that measured average amounts paid for hospital inpatient and outpatient services using pricing relative to Medicare, and reported hospital-specific prices.

That study, released in 2017, surprised the employer and healthcare community in the Hoosier state. Indiana hospitals were paying 272% more than the Medicare prices for inpatient and outpatient services, and there were large variations in price that didn’t correlate with the quality of care patients were receiving.

That’s great insight, certainly, but as with any analysis, it’s imperative to put it into context. Thus, a second iteration of the study, this time including employer data from 25 states, was completed and will be released as part of the first national hospital price transparency study in the U.S. Because the prices use Medicare pricing as a benchmark, this makes these relative prices comparable across the country.

The new study shows that the 272% of Medicare that Indiana was paying is not typical. Although the full results haven’t been released yet with states ranked in terms of relative price, the report will show that Indiana has prices higher than the national median. Kentucky is included in this study, and hospitals throughout the Commonwealth and Kentuckiana region will be included in the results, making this study of note to our region.

NATIONAL HOSPITAL PRICE TRANSPARENCY RESULTS: HOW DOES OUR REGION STACK UP?

The June 4 KHC Community Health Forum will reveal the results of the National Hospital Price Transparency Study.

Given the implications (nationally and locally), our June KHC Community Health Forum will reveal the results of the study and discuss its implications. Gloria Sachdev, President and CEO for Employers’ Forum of Indiana, will walk through the study results, focusing on Kentuckiana and Kentucky’s hospital prices and how they compare to the rest of the nation. We will also hear from an employer, Indiana University, that was part of that first-year study in Indiana to discuss how seeing hospital pricing information has impacted their benefit strategy. Although hospital pricing is important to all stakeholders, this event will be particularly relevant to those interested in employee health benefits, health plan design, and provider payment.

Space is limited, so register today to join the conversation on June 4 at the UofL Shelby Campus Founders Union Building. As with most KHC Community Health Forums, attendance is free for KHC members and $35 for non-members, which includes the program, networking, and breakfast. If you are unsure if your organization is a member of the KHC, see the full list here.