Health Policy Commission Board Meeting December 13, 2018 AGENDA - PowerPoint PPT Presentation

Health Policy Commission Board Meeting December 13, 2018

AGENDA  Call to Order  Approval of Minutes from September 27, 2018 Meeting  Executive Director’s Report  Market Oversight and Transparency  Care Delivery and Transformation  HPC 2019 Public Meeting Calendar

AGENDA  Call to Order  Approval of Minutes from September 27, 2018 Meeting  Executive Director’s Report  Market Oversight and Transparency  Care Delivery and Transformation  HPC 2019 Public Meeting Calendar

AGENDA  Call to Order  Approval of Minutes from September 27, 2018 Meeting  Executive Director’s Report  Market Oversight and Transparency  Care Delivery and Transformation  HPC 2019 Public Meeting Calendar

VOTE: Approving Minutes MOTION: That the Commission hereby approves the minutes of the Commission meeting held on September 27, 2018 as presented. 5

AGENDA  Call to Order  Approval of Minutes from September 27, 2018 Meeting  Executive Director’s Report  Market Oversight and Transparency  Care Delivery and Transformation  HPC 2019 Public Meeting Calendar

2018 Year in Review: Public Engagement 26 public me e ting s T witte r (b o a rd, c o m m itte e , a dviso ry c o unc il, spe c ia l e ve nts, he a ring s, liste ning se ssio ns) 612,200 imp re ssio ns (p o te nti a l vi e w s b y uni q ue T w i tte r use rs) He a lth Ca re Co st Gro w th 26,227 p ro file visits Be nc hm a rk Mo dific a tio n > 50 He a ring (Ma r c h) 574 me ntio ns hours Pa rtne ring to Addre ss the So c ia l o f pub lic De te rm ina nts o f He a lth: Wha t m e e ting s o n the Wo rks? (Ma y) HPC YouT ube 6 th Annual 2018 Co st Tre nds He a ring c ha nne l He a lth Ca re Cost (Oc to b e r) T re nds He a ring 430 450 >2,000 33.3k in-pe rso n live stre am uniq ue a rtic le s uniq ue visits to the a b o ut the HPC’ s atte nd e e s vie we rs HPC’ s we b site wo rk 7

2018 Year in Review: Market Oversight and Transparency 56 $4.8 billion ide ntifie d a s Oppor tunitie s for pro vide r 26 tota l e Saving s in He alth Car o rg a niza tio ns r e g iste r e d public a tions 26 5 o nline Da ta Points Brie fs pro vide rs a nd pa ye rs re vie w e d fo r a po te ntia l Pe r for ma nc e Impr ove me nt Pla n 10 ma te ria l 329 40 c ha ng e notic e s to ta l pa g e s o f Cost e xhibits inc lud e d in the 2017 Annual re vie we d a nd Ma r ke t Impa c t Co st T r e nds R e po r t a nd Cha rtp a c k Re vie w re po rts 8

2018 Year in Review: Care Delivery and Transformation Stra te gic p a rtne r o f Ma ssCha lle ng e He a lthT e c h , 21 ne w pr wo rking to id e ntify p ro mising ac tic e s d igita l he a lth sta rt-up s par tic ipating in the HPC’ s Pa tie nt-Ce nte re d M e dic a l Ho m e (PCMH) pro g ra m 17 HPC- $17 million $10 million Ce rtifie d ACOs distrib ute d a m o ng 45 gr ants to suppo rt inno va tive c a re a utho rize d fo r 15 a wa r ds in de live ry m o de ls in the CHART the SHIFT -Ca r e Cha lle ng e a nd HCII Pro g ra ms Offic e of 280 826 17 2 Pa tie nt Prote c tion e nro llme nt wa ive rs ACO Po lic y e xte rna l a p p e a ls ACO Pro file s p ro c e sse d Brie fs issue d p ro c e sse d p ub lishe d (OPP) 9

AGENDA  Call to Order  Approval of Minutes from September 27, 2018 Meeting  Executive Director’s Report  Market Oversight and Transparency – Material Change Notice (MCN) Update – 2018 Cost Trends Report  Care Delivery and Transformation  HPC 2019 Public Meeting Calendar

AGENDA  Call to Order  Approval of Minutes from September 27, 2018 Meeting  Executive Director’s Report  Market Oversight and Transparency – Material Change Notice (MCN) Update – 2018 Cost Trends Report  Care Delivery and Transformation  HPC 2019 Public Meeting Calendar

Types of Transactions Noticed TYPE OF TRANSACTION NUMBER FREQUENCY Clinical affiliation 22 23% Physician group merger, acquisition 20 21% or network affiliation Acute hospital merger, acquisition or 19 20% network affiliation Formation of a contracting entity 17 18% Merger, acquisition or network affiliation of other provider type (e.g., 11 12% post-acute) Change in ownership or merger of 5 5% corporately affiliated entities Affiliation between a provider and a 1 1% carrier 12

Elected Not to Proceed  Proposed joint venture among Shields Health Care Group , Reliant MSO , and ASC HoldCo , a holding company owned by the orthopedic specialty groups Orthopedics New England and New England Hand Associates. The proposed joint venture would build and operate a freestanding ambulatory surgery center in Natick, where Reliant and ASC HoldCo physicians would provide outpatient orthopedic and general surgical services. \ Received Since 9/27  Proposed clinical affiliation between Dana-Farber Cancer Institute (DFCI) and Cape Cod Healthcare . Under the proposed affiliation, Cape Cod Hospital's cancer center would become a member of the Dana-Farber Cancer Care Collaborative, and DFCI would provide consulting, educational, and clinical support services to Cape Cod Hospital and its patients. 13

AGENDA  Call to Order  Approval of Minutes from September 27, 2018 Meeting  Executive Director’s Report  Market Oversight and Transparency – Material Change Notice (MCN) Update – 2018 Cost Trends Report  Care Delivery and Transformation  HPC 2019 Public Meeting Calendar

2018 Cost Trends Report: Presentation Outline Topics Overview Utilization Price Total Spending  Trends  Oncology drug  Total Medical  Trends in prices Expenses by spending,  Low value care Provider Group affordability, and  Commercial  Admissions from care delivery  Provider prices compared the ED to Medicare organization prices cohort study 15

Select Findings from the 2018 Cost Trends Report Topics Overview Total Utilization Price Spending Trends in spending, premiums, affordability , and payment methods 16

Growth in THCE per capita was 1.6% from 2016-2017, significantly below the health care cost growth benchmark Annual growth in total health care expenditures per capita in Massachusetts Annual growth averaged 3.2% between 2012 and 2017 Notes: 2016-2017 spending growth is preliminary. 17 Sources: Center for Health Information and Analysis Annual Report, 2018

In 2017, total health care spending growth in Massachusetts was well below the national rate, continuing a multi year trend Annual growth in per-capita health care spending, MA and the U.S., 2000 – 2017 Notes: US data include Massachusetts. Sources: Centers for Medicare and Medicaid Services National Healthcare Expenditure Accounts, Personal Health Care Expenditures Data (U.S. 2014-2017), and State 18 Healthcare Expenditure Accounts (U.S. 1999-2014 and MA 1999-2014); Center for Health Information and Analysis Annual Report (MA 2014-2017)

Spending growth per enrollee was below the health care cost growth benchmark for each major coverage category Change in enrollment and per enrollee spending by major market segment, 2016-2017 Total Total growth growth +3.1% +1.2% Total growth Total +2.0% growth -1.1% Notes: Medicare FFS spending does not include Part D prescription drug coverage. Commercial spending and enrollment growth includes enrollees with full and partial claims. MassHealth includes only full coverage enrollees in the PCC and MCO programs. Figures are not adjusted for changes in health status. 19 Sources: Center for Health Information and Analysis Annual Report, 2018

Hospital outpatient and pharmacy spending were the fastest-growing categories in 2016 and 2017 Rates of spending growth in Massachusetts in 2016 and 2017 by category, all payers Notes: Total expenditures exclude net cost of private health insurance, VA and Health Safety Net. Pharmacy spending is net of rebates. Other medical category includes long- term care, dental and home health and community health. Non-claims spending represents capitation-based payments. 20 Source: Payer reported TME data to CHIA and other public sources; appears in Center for Health Information and Analysis Annual Report, 2018

Commercial spending growth in Massachusetts has been below national trends since 2013, avoiding billions in spending Annual growth in commercial spending per enrollee, MA and the U.S., 2006-2017 Notes: U.S. data includes Massachusetts. Center for Health Information and Analysis data are based on full-claim commercial total medical expenditures (TME). Sources: Centers for Medicare and Medicaid Services, National Healthcare Expenditure Accounts Personal Health Care Expenditures Data (U.S. 2014-2017), and State 21 Healthcare Expenditure Accounts (U.S. 2005-2014 and MA 2005-2014); Center for Health Information and Analysis Annual Reports (MA 2014-2017)