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.

“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.


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.


“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.

National Alliance Annual Forum Identifies Priority Issues and Key Actions for Employers

On November 12, the Kentuckiana Health Collaborative team ventured to our nation’s capital to attend the National Alliance of Healthcare Purchaser Coalition’s Annual Forum, “Leading the Future of Innovation, Health, and Value.” The forum brought together 427 representatives from employers, employer coalitions, and thought leaders in healthcare. Spread over three days, the forum featured numerous engaging speakers, panelists, innovators, and champions to highlight the employers’ role in improving health and healthcare quality for both their employees and their communities.

The first day of the forum focused on bringing together speakers from across the healthcare spectrum to share their insights on critical issues facing our nation. Afternoon workshops focused on topics of benefit design, obesity, the opioid crisis, and mental health, with conference attendees having their choice of attending two of the four workshops. A highlight of these workshops was the “Achieving Peak Performance: The Mental Health Difference.” This workshop focused helping organizations becoming more successful in implementing a value-based approach to mental health, using the National Alliance’s Mental Health Deep Dive Report as a guide. With only an hour and forty-five minutes allotted for the discussion, Mike Thompson, CEO of the National Alliance of Healthcare Purchaser Coalitions, entered the room to alert us that we had extended well past our session’s intended time. He exclaimed his pleasant surprise at having to interrupt a conversation about mental health among employers in a room that had become standing-room only. The enthusiasm for this topic among employers was evident, and it was clear that the KHC was not alone in prioritizing mental health among its organizational initiatives. The day was concluded with a panel of purchasers who are leading the way in improving healthcare value to share their innovative ideas, successes, and failures, including Walmart, General Dynamics Bath Iron Works, Miami Dade School District, American Speech-Language-Hearing Association, and Prudential.

Day two of the forum was kicked off with an engaging keynote from Dr. Ezekiel Emanuel, Vice Provost for Global Initiatives and Chair of the Department for Medical Ethics and Health Policy at the University of Pennsylvania, where he shared his insights on opportunities for healthcare transformation. He identified three pieces of advice for healthcare purchasers: (1) reaffirm the primary care relationship, (2) move to alternative payment models, and (3) choose quality metrics for quality reporting. A panel of journalists from leading healthcare news outlets followed Dr. Emanuel’s presentation, giving context to his advice with a discussion on the impact of midterm elections on healthcare reform efforts and innovations, and their  perspectives on the possibilities and perils that may be to come. Afternoon breakout sessions highlighted innovations in specialty drugs, bariatric surgery, stress, PBMs, organizational culture of health, onsite clinics, and biosimilars. During lunch, the National Alliance held a ceremony for their 2018 award recipients. The Kentuckiana Health Collaborative was honored to receive the 2018 Membership Leadership Award along with the Florida Health Care Coalition. Walmart received the 2018 Employer/Purchaser Excellence award.

The third and final day of the annual forum ended on a high note. A morning presentation from Dr. Christa-Marie Singleton on the CDC’s Total Worker Health initiative highlighted their six high-burden health conditions & six ways to spend smarter. Shifting back to mental health, Craig Kramer, Global Mental Health Ambassador at Johnson & Johnson, spoke of his own family’s experience with facing and overcoming a mental health challenge and how it motivated him to take action within his company. Marc Brackett, PhD, Director of the Yale Center for Emotional Intelligence gave a professionally and personally enriching conversation on the concept of emotional intelligence and its impact on the workplace.

The Kentuckiana Health Collaborative’s work surrounding mental health, substance use, healthcare quality, and affordability align closely with the national priorities being set forth by the National Alliance and other employer coalitions. The Annual Forum provided the KHC team with excellent context and tools that will help us move our initiatives forward for the benefit of our local, state, and national communities. The KHC looks forward to sharing all that we have learned with our members and partners. Visit our Twitter page to view additional insights from the forum.

Kentuckiana Health Collaborative Nationally Recognized for Leadership Efforts

The Kentuckiana Health Collaborative (KHC) was recognized along with the Florida Health Care Coalition as the 2018 Membership Leadership Award winner at last week’s National Alliance of Healthcare Purchaser Coalitions (National Alliance) annual forum. The coalitions were celebrated for efforts to improve quality and efficiency of the healthcare delivery system. Several members of the KHC attended the event in Washington, D.C. KHC Co-Directors, Dr. Teresa Couts and Randa Deaton, accepted the award and thanked the staff, members, and community for coming together to make these accomplishments possible. The National Alliance released a press release for the recognition.

The KHC was recognized for its work to improve healthcare measurement alignment, youth mental health, and opioid use disorder risk assessment.  The KHC and the Kentucky Department for Medicaid Services joined forces on the Kentucky Core Healthcare Measures Set, a public-private effort to create a common primary care measures set in the Commonwealth of Kentucky to improve the quality and value of care, reduce provider reporting complexity and align Kentucky’s healthcare measurement. Additionally, the National Alliance recognized the KHC for its mental health work with the Kentucky Cabinet of Health and Family Services Department of Behavioral Health to assist primary health care providers in implementing screening, brief intervention, and referral to treatment (SBIRT) into their practices and its partnership with StAMINA (Student Alliance for Mental Health Innovation and Action) to improve youth mental health.

The National Alliance of Healthcare Purchaser Coalitions is a nonprofit network of business coalitions, representing more than 12,000 purchasers and 45 million Americans, spending more than $300 billion annually on healthcare. The National Alliance is dedicated to driving innovation, health, and value along with its coalition members through the collective action of public and private purchasers. To learn more, visit nationalalliancehealth.org.

Round Table Reflections – Understanding Employer Needs, Goals, and Challenges for Opioid Use Disorder

Last week, the Kentuckiana Health Collaborative (KHC) convened a group of employers and experts at the LG&E/KU Cane Run Power Plant to discuss the needs, goals, and challenges facing employers as they address opioid use disorder (OUD) in their workforces. The event was conceptualized as a focus group to guide the development of the KHC’s newest project as part of the Kentucky Opioid Response Effort (KORE). With an expected release date of April 2019, the KHC is developing a toolkit for employers in implementing best practices for supporting prevention, treatment, and recovery from OUD in the workplace.

Attendants of the focus group were carefully chosen. It was important that the discussion represented multiple perspectives dependent on the size, industry, and status of OUD initiatives of employers. Experts were brought in to provide technical expertise and give additional insight.  The conversation was broken up into five domains: key metrics for evaluation, prevention, benefit design, treatment, and recovery. For each domain, our conversation was shaped by identifying goals, challenges, pertinent information for the toolkit, and any knowledge of best practices.

The focus group revealed many outstanding themes. First and foremost, there was a resounding amount of enthusiasm and recognition from employers in their role to address OUD not only in their employees, but in their communities. This was especially true when discussing prevention efforts. Another prominent point was the importance of building a culture of wellbeing and trust within the workplace. By doing so, prevention, treatment, and recovery among employees could be supported. A component of this culture would be innovation, particularly around mitigating the many barriers than often arise for employees in accessing treatment and maintaining recovery. Insurance coverage that is friendly towards virtual treatment options, Medication Assisted Treatment (MAT), defined treatment guidelines, and affordable deductibles was repeatedly addressed. Employers also recognized the importance of data and insurance benefit design in tackling this issue. Addressing OUD in the workplace will be a individualized process, as many barriers exist in implementing these changes and these barriers vary based on each employer’s demographics and capabilities. Despite this, the willingness of employers to engage in such a vibrant and transparent conversation left many of the group’s participants filled with hope and excitement for their organization’s future.

In conjunction with evidence-based research, information collected from this discussion will guide the development of the KHC’s employer toolkit. The KHC will continue to convene employers during our monthly Worksite Addiction Meetings. If you are an employer who is interested in joining this group or would like to share your perspective, please contact me at nmiddaugh@khcollaborative.org.

Keep Your Eyes Wide Open – Technological Advancements Are Rapidly Changing Our Future

Brenda Miles

(Note: This guest post was written by Brenda Miles, retired Director of Benefits for Papa John’s International. Brenda is a business development consultant for the KHC Employer and Healthcare Purchaser Network.) 

The recent KY SHRM conference in Louisville was well worth the time invested. As a long-time HR and employee benefits professional, the difficult part was choosing from the robust line-up of informative and action-oriented topics and amazing speakers.

One standout for me was a keynote presentation by author and speaker Jack Uldrich. Focused on helping organizations plan for the future, Uldrich spoke on “Business as Unusual: How to Future-Proof HR Against the Trends Transforming Tomorrow.” His lively and interactive presentation emphasized the importance of awareness, humility, and action:

  • Awareness of the rapid, staggering pace of change resulting from emerging technologies
  • Humility to unlearn the truths we knew for years that may no longer be true
  • Action to regularly take time to think about the future and what those changes mean to us and our businesses, so we can prepare accordingly

He described how the collection and analysis of “big data” is helping businesses understand consumer behavior more than ever before. The expansion of data scientists in the workforce help businesses understand the data to design strategies for products and services more highly valued by consumers. From a health standpoint, we are seeing companies such as Amazon move into the pharmacy and telemedicine space, manufacturers expand wearable robotics to reduce worker safety, genomics to predict disease and design treatment for improved outcomes, and the application of artificial intelligence to identify and aid in mental health initiatives.

I was proud to see the Kentuckiana Health Collaborative participate as a first-time exhibitor at the conference. They bring multi-stakeholder professionals together to learn from each other. The approach is a perfect complement for employers as they try to understand the dynamics and complexities of the health care delivery system as it impacts their health plans and covered employees.

So, keep your eye on the Kentuckiana Health Collaborative (KHC), the Society for Human Resource Management, and the International Society of Certified Employee Benefits Specialists for more information as technology changes the future in healthcare and employer-sponsored health plans.

KHC Employer and Healthcare Purchaser Network Ramps up with Monthly Newsletter, Events

With commercial spending the bulk of the nation’s healthcare spending, it goes without saying that employers and healthcare purchasers are important stakeholders for driving improved healthcare quality, value, and health, most importantly at the local market level. However, healthcare purchasers are often missing from important community healthcare improvement conversations. The KHC Employer and Healthcare Purchaser Network is working to provide new opportunities and activities to better engage local employers and healthcare purchasers in these conversations.

Before we talk about these new KHC offerings, let’s start with the fact that the term “healthcare purchaser” is confusing at best. If you have ever attended a KHC event or a monthly meeting, you would hear the terms healthcare payer, provider, and purchaser used often, and you would also hear confusion and disagreement on the use of all of these terms. By the simplest of definitions, healthcare payers or plans pay for healthcare services, healthcare providers provide healthcare services, and healthcare purchasers (such as employers) purchase healthcare services for a set of covered lives.

One of the biggest challenges in working with healthcare purchasers is that they come in a variety of shapes, sizes, and perspectives with a unique set of challenges, goals, and needs. The KHC’s goal is to find areas where purchasers can best find value in coming together both separately and with other key healthcare stakeholders to drive improved health and healthcare.

To better communicate with employers and healthcare purchasers, the KHC, convened by UAW/Ford Motor Company, recently launched a newsletter with a monthly compilation of the most relevant data, news, and events for healthcare purchasers in Kentucky and Southern Indiana. Anyone interested in this more targeted newsletter may join by subscribing here.


There are two valuable events planned for the remainder of the year that we invite healthcare purchasers to attend:

  • Understanding Employer Challenges, Goals, and Needs for Opioid Use Disorder will be held the morning of September 19, 2018. The KHC is seeking up to 25 employer and purchaser representatives to discuss the challenges, goals, and needs in addressing opioid use disorder (OUD) prevention, treatment, and recovery in their current and future workforce.
  • The Path to Affordable Healthcare will be held on December 4, 2018. Achieving affordability will require focused efforts on three major drivers: health, price, and waste. The KHC will host an Affordability Summit with key healthcare stakeholders and like-minded local change agents to help develop an action plan to address healthcare affordability in our community.

If you are an employer or healthcare purchaser interested in learning more about the value of the KHC and its Employer and Healthcare Purchaser Network, we would be happy to schedule a meeting with you. The KHC’s current Employer Chairperson is Diana Han, Global Medical Director, GE Appliances, a Haier company. You may email the KHC at info@KHCollaborative.org. Brenda Miles, retired Benefits Director, Papa John’s International is available to meet with you.



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 26, 2018 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 National Alliance and it coalition members play a critical role in offering tools, programs and education to bring about meaningful change to our healthcare system, said Neil Goldfarb, President and CEO, Greater Philadelphia Business Coalition on Health and Board Chair. “Our board is comprised of knowledgeable and enthusiastic leaders working to move the market toward value-based purchasing to ensure purchasers can obtain the highest quality care at the most reasonable cost.”

Re-elected to a second term were Neil Goldfarb, President & CEO, Greater Philadelphia Business Coalition on Health, who will continue as the Chair, and Jessica Brooks, Chief Executive Officer, Pittsburgh Business Group on Health, who will continue as Vice-Chair.

Newly-elected to the Board of Governors:

  • Randa Deaton, Co-Executive Director, Kentuckiana Health Collaborative
  • Gaye Fortner, President and CEO, HealthCare 21 Business Coalition
  • Cheryl Larson, President and CEO, Midwest Business Group on Health

Members continuing terms on the Board of Governors:

  • Christopher Goff, CEO and General Counsel, Employers Health
  • Diane Hess, Executive Director, Central Penn Business Group on Health
  • Anne Ladd, CEO, Wyoming Business Coalition on Health
  • Chris Skisak, Executive Director, Houston Business Coalition on Health
  • Chris Syverson, CEO, Nevada Business Group on Health
  • Cristie Upshaw Travis, CEO, Memphis Business Group on Health
  • Lisa Wear-Ellington, President/CEO, South Carolina Business Group on Health



There are four external board members and two are continuing second terms – Garry Carneal, Founder, Schooner Strategies and Senior Policy Advisor, Kennedy Forum, and Kulleni Gebreyes, Principal, Health Industries Advisory Practice, PricewaterhouseCoopers. The two newly-elected members:

  • Leah Binder, President and CEO, The Leapfrog Group
  • Paul Fronstin, Director, Health Research and Education Program, Employee Benefit Research Institute

Annual Forum

Convening employers, policymakers, business coalition leaders and other healthcare stakeholders, the National Alliance will host its 23rd Annual Forum, November 12-14, 2018 at The Mayflower Hotel, Washington, DC. Registration and sponsorship information can be found here.

About National Alliance of Healthcare Purchaser Coalitions

The National Alliance of Healthcare Purchaser Coalitions is a nonprofit network of business coalitions, representing more than 12,000 purchasers and 45 million Americans, spending more than $300 billion annually on healthcare. The National Alliance is dedicated to driving innovation, health, and value along with its coalition members through the collective action of public and private purchasers. To learn more, visit nationalalliancehealth.org or connect with us on Twitter or LinkedIn.

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PRESS RELEASE: Kentucky Core Healthcare Measures Set Announced

Louisville, Kentucky, July 26, 2018: Kentucky now has an agreed upon set of healthcare measurement priorities. The Kentucky Core Healthcare Measures Set (KCHMS) was developed through a public-private partnership between the Kentucky Department for Medicaid Services (KDMS), within the Cabinet for Health and Family Services (CHFS), and the Kentuckiana Health Collaborative (KHC). The Commonwealth becomes one of the first states in the nation to enact a healthcare measurement set.

The purpose of this effort is to get Kentucky’s health plans and employers to reward primary care and pediatric providers on a shared set of relevant measures to drive improved health, quality of care, and value, to reduce administrative complexity, and to align healthcare organizations to have a shared focus.

For the last year, over 70 experts that provide, pay, purchase, and consume healthcare across Kentucky met as members of the Kentucky Performance Measures Alignment Committee (PMAC). They identified Kentucky’s current measurement situation is as follows:

  • Insurers and government programs define quality differently and are often unaligned in scope and focus
  • Primary care providers are incented on too many quality measures, 89 in 2018
  • Providers and their teams are overwhelmed with the burden of state, federal, and commercial measurement requirements

The new core measures set contains 32 measures, less than half of the number of 89 currently incented measures in Kentucky by various state and national programs. Measures are focused in the areas of prevention, pediatrics, chronic and acute care management, behavioral health, and cost/utilization. The PMAC team is currently requesting letters of support from key healthcare organizations

“It has been truly inspiring to see Kentucky’s various stakeholders come together for the good of Kentucky’s residents to drive improvements in health,” said Stephanie Clouser, KHC Data Scientist and PMAC coordinator.

“The Kentucky Medicaid team, which includes not only state government representation, but also partners from nationally prominent health insurance corporations, is committed to ensuring that every citizen can access health care that is proven in terms of quality and patient experience,” concluded Chief Medical Officer for Kentucky Medicaid, Gil Liu, MD, MS. “We look forward to building on this highly collaborative work of developing a core set of measures, to go forward and successfully accomplish measurably better health outcomes.”

The full list of measures can be found here. A public webinar will be held on Thursday, July 26, from 12 p.m. to 1 p.m. EST, to give an overview of the initiative and give Kentucky’s healthcare stakeholders a chance to ask questions of PMAC Chairs Gil Liu, KDMS, and Randa Deaton, KHC.

About the KHC: The Kentuckiana Health Collaborative (KHC) is a non-profit organization comprised of representatives who have a major stake in improving the health status and the healthcare delivery system in Greater Louisville and Kentucky. The KHC creates a space for multiple stakeholders to work collaboratively toward the Triple Aim goals of Better Health, Better Care, and Better Value. For more information on the KHC, visit www.KHCollaborative.org.

About CHFS: The Cabinet for Health and Family Services is home to most of the state’s human services and healthcare programs, including the Department for Medicaid Services, the Department for Community Based Services the Department for Public Health, the Department for Aging and Independent Living and the Department for Behavioral Health, Developmental and Intellectual Disabilities. CHFS is one of the largest agencies in state government, with nearly 8,000 full- and part-time employees located across the Commonwealth focused on improving the lives and health of Kentuckians.


Kentucky Core Healthcare Measures Set Finalized

Stephanie Clouser

Nine months. That’s how long it takes to develop and birth a baby.

It’s also how KHC co-director Randa Deaton has described the KHC’s initiative with Kentucky Department for Medicaid Services to create a core set of primary healthcare measures, which began approximately nine months ago and was completed last night.

Folks, reducing from 89 incented measures to a set of 32 definitely felt very much like birthing a baby.

The journey to create a core measures set for the Commonwealth of Kentucky began last summer, when KHC co-directors Randa Deaton and Teresa Couts met with then-Secretary of the Kentucky Cabinet for Health and Family Services Vickie Yates Brown Glisson and discovered a mutual interest in addressing measurement mayhem through alignment. Thus began a partnership with the Kentucky Department for Medicaid Services (KDMS) to create 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 project was announced in September by Glisson, and soon after, four subcommittees formed in key areas got to work, evaluating national core measures sets, Kentucky performance data, organizational healthcare priorities, and more.

This spring, subcommittees presented their recommendations to a large oversight committee, which spent the next few months reviewing the recommendations and confirming the final set. The Kentucky Performance Measures Alignment Committee (PMAC) oversight committee and four subcommittees were made up of more than 70 expert volunteers from varying backgrounds and geographic regions. These various stakeholders, some of which have competing incentives, have spent the last several months engaging in consensus-based discussions, often coming to some surprising agreements. Because we created a “limited” set, to reduce complexity and improve focus, committee members have had to make tough decisions to select only the measures that have significant impact.


The resulting final set includes 32 primary care measures, 21 of which are considered high priority, focused in the areas of prevention, pediatrics, chronic and acute care management, behavioral health, and cost/utilization. This is less than half of the number of 89 currently incented measures in Kentucky by various programs. Many of the measures are ones that anyone with a healthcare measurement background would quickly recognize. But our PMAC committee also chose – wisely, in my opinion – a few “stretch measures” that might have a few more challenges to them but ultimately are important to impacting the health of Kentuckians.

This list of leading quality indicators is but a start toward driving meaningful measurement in Kentucky. PMAC members also got a chance to identify areas of development for future iterations of the measures set. Sometimes this involved listing existing measures that need improvement or establishment and sometimes these were blanket statements identifying the need to develop a measure in a particular area.


The confirmation of the KCHMS is not the end of PMAC. Now that the set has been finalized, there is new work to be done. We have planned multiple events around Kentucky Core Healthcare Measures Set (KCHMS), including a webinar on July 26 and an employer forum in October. Additionally, we now begin the process of working with organizations to adopt this core measures set and utilize it in contracting. You can find all the news related to PMAC here.

Thank you to everyone who participated in this initiative, whether by serving on or chairing a committee, taking meetings with KHC staff members, securing meeting space, or providing expertise on measure nuances. Now let’s put this set to use. When we focus on everything, we focus on nothing. However, when we focus on the right things, we can drive meaningful change.

View the Kentucky Core Healthcare Measures Set