Coordinating State Health Reform in Kansas November 21, 2008 Doug Farmer Kansas Health Policy Authority 1
Creation of the KHPA Creation of the KHPA • Built on Governor Sebelius’ “Executive Reorganization Order” in 2005 • Modified by State Legislature to: – Create an independent nine voting member private Board to govern health policy – Added a specific focus on data driven policy making – Creation of framework to coordinate health and health care in Kansas 2
Timeline Timeline July 1, 2005 Kansas Health Policy Authority Established. Transfer program s to a Division first, then to a separate agency. January 1, 2006 Assum e responsibilities of Health Care Data Governing Board and oversight of KS Business Health Partnership program . March 1, 2006 Authority plan for various program July 1, 2006 transfers subm itted to Legislature. Transfer program s to Authority. 2007 Legislative Session Authority plan for additional program transfers subm itted to 2 0 0 7 and 2 0 0 8 2008 Legislative Session Legislatures. 3 3 3
KHPA Mission KHPA Mission To develop and maintain a coordinated health policy agenda that combines the effective purchasing and administration of health care with promotion oriented public health strategies 4
Programs Transferred Programs Transferred to KHPA in 2006 to KHPA in 2006 • Medicaid Drug Utilization • Medicaid • Medicaid Drug Utilization • Medicaid Review & related programs Review & related programs (Regular Medicaid) (Regular Medicaid) • State Employee Health • State Employee Health • MediKan • MediKan Insurance Insurance • State Children’ ’s Health s Health • State Children • State Workers • State Workers Insurance Program Insurance Program Compensation Compensation • Ticket to Work/Working • Ticket to Work/Working • Health Care Data • Health Care Data Healthy Healthy Governing Board Governing Board • Medicaid Management • Medicaid Management • Business Health • Business Health Information System Information System Partnership Program Partnership Program 5 5 5
KHPA Board KHPA Board • Independent Board: Provide independent oversight and policymaking decisions for the management and operations of KHPA • Make-up: – Nine voting members appointed by the Governor and House and Senate leadership – Eight non-voting (ex-officio) members • Secretaries of State Departments: Health and Environment (including Director of Health), Social & Rehabilitation Services, Administration, Aging; Commissioner of Insurance, Commissioner of Education, and Executive Director of KHPA 6
Quality and Efficiency Affordable, Sustainable Health Care � Use of HIT/ HIE � Patient Safety Access to Care � Evidence based care � Health insurance premiums � Quality of Care � Cost-sharing � Transparency (Cost, � Health Insurance Status � Uncompensated Care � Health Professions Workforce Quality, etc.) � Medicaid/ SCHIP Enrollment � Safety Net Stability � Health and health care spending � Medicaid Eligibility � Health Disparities VI SI ON: Coordinating health & health care for a � Council Participation thriving Kansas � Data Consortium � Physical Fitness � Public Communication � Nutrition � Community/ Advocacy � Age appropriate screening � Open Decision � Tobacco control Partnership Making � Foundation Engagement � Injury control � Responsible Spending � Financial Reporting � Accessibility of Information � CMS Cooperation Health and W ellness Public Engagem ent Stew ardship KI D SRS KDHE KDOA • Health Prom otion • Mental Health • Private Health I nsurance • Aged • Child, Youth & Fam ilies • LTC for Disabled • Business Health Partner. • I nstitutional Care • Consum er Health • Substance Abuse • Com m unity Care • Health & Environ. Stats 7 • Local & Rural Health
8 Partnerships for Quality Improvement
Types of Partnerships • As Policy Leaders • As Payers – Statewide health reform: – Leverage purchase • Public Health power to create: • Data Consortium (Quality • Administrative Measurement and simplification Reporting) • Medical Home • Advisory Councils • Community Health Record • Community Dialogues • Health and Wellness – As part of national – As Employers agenda: • Collaborations with • State Quality Institute Employer groups • State Coverage Institute • Value based purchasing • NASHP initiatives 9
10 Room for Improvement Room for Improvement Health of Kansas: Health of Kansas:
Data Consortium • Chartered by the Board in April 2006 to: – Guide KHPA in the management of programmatic and non-programmatic health data – Ensure continued public support and investment in the use of this data to advance health policy – Disseminate this wealth of data, in partnership with stakeholders – Ask and answer important health policy questions pertaining to: • Affordability of health care • Quality of health care • Health status of Kansans 11
Data Consortium Membership • Executive Director of the Health Policy Authority or designee (Chair) • Department of Health and Environment • Department of Social and Rehabilitation Services • Kansas Insurance Department • University of Kansas Medical Center • University of Kansas Medical Center-Wichita • Kansas Health Institute • Kansas Foundation for Medical Care • Kansas Medical Society • Kansas Hospital Association • Kansas Association of Osteopathic Medicine • Kansas Mental Health Association • Kansas Association for the Medically Underserved • Kansas Nurses Association • AARP • Kansas Public Health Association • Kansas Health Care Association (KHCA) • Kansas Association of Homes and Services for the Aging (KAHSA) • Two self-insured employers appointed by Kansas Chamber of Commerce and Industry: Hills Pet Nutrition; Lawrence Paper Co. 12
Data Consortium Charge To serve as a multi-stakeholder public advisory group to the KHPA Board with the following specific responsibilities: • Make recommendations regarding the scope of the Authority’s responsibilities for managing health data; • Recommend reporting standards and requirements for non- programmatic data owned or managed by the Authority; • Craft data use policy recommendations governing access to health information by external users of both programmatic and non-programmatic data owned or managed by the Authority; • Recommend empirical studies and evaluations supporting the goals and objectives of the Authority; • Provide input on health and health care data initiatives in other organizations and agencies; • Develop recommendations for public reporting standards for consumers, health care providers and other health care organizations. 13
Advisory Councils • Make-up: – Health Care Consumers – Health Care Purchasers (e.g., Insurers, Businesses) – Health Care Providers – E-Health Advisory Council (multi-stakeholder) • Purpose: Assist the KHPA Board and Steering Committee (Board and legislators) with the development of health reform • Processes: – Organized in March 2007; held monthly meetings – Delivered health reform recommendations to KHPA Board in Sept. 2007 – Participating in community outreach 14
Informing the Public • Online access to all health reform reports and testimony through the KHPA website (w/i 24 hours) • KHPA E-newsletter for weekly updates on the legislative process and health reform • Public meetings: KHPA Board, Listening Tour, Advisory Councils and Steering Committees • Presentations to organizations and communities • “Community Toolbox Kit” for local communities to present on the KHPA Board Health Reform recommendations • News alerts available through new news-service at the Kansas Health Institute website (www.khi.org) 15
Community Dialogues • Purpose: Gather public input on health reform in order to provide direction for the KHPA Board recommendations • Processes: – Three week tour in August 2007; Six week tour in 2008 – In 2007: 22 cities statewide and 34 meetings; in 2008: 15 cities and 45 meetings – Deliver summary comments to KHPA Board, legislature, and public – Publicized online “suggestion box” for public to provide suggestions and/or comments about health reform 16
17 Challenges
The Purpose of Health Reform The Purpose of Health Reform To improve the health of Kansans – not just health insurance or health care – but the health of our children, our families, and our communities; WE ALSO SERVE AS PAYERS 18
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