Health Policy
Evidence-Based Health Policy Project
 

2009 Project Events and Materials

October 8, 2009 8:30 am - 11:00 am, State Capitol, Room 411 South
Evidence-Based Health Policy Project Breakfast Briefing:
"Health Care Quality, Effectiveness, and Value: How Might State of Wisconsin Investments Pay Off?"

Christopher Queram, CEO of the Wisconsin Collaborative for Health Care Quality, will moderate the discussion. Speakers include Julie Bartels of the WI Health Information Organization (WHIO), Lisa Ellinger of the Department of Employee Trust Funds (DETF), and Jonathan Jaffery, Chief Medical Director of Medicaid and BadgerCare Programs. The State is a major direct purchaser of health care services, through Medicaid/BadgerCare and insurance coverage for state employees, giving it enormous leverage to steer the market toward value-based benefit designs and effective service delivery. The State also contributes to the innovative WHIO data warehouse aimed toward advancing quality and value. The speakers at this briefing will discuss how the State is using WHIO data to improve quality and efficiency and how these major investments position Wisconsin for the next chapter in health care reform.

April 7, 2009 9:00 am - 11:00 am, State Capitol, 412 East
Evidence-based Health Policy Project Breakfast Symposium: Medical Homes and Retail Clinics: Complementary Care or Conceptual Clash?

With presenters Barbara Starfield, MD, MPH, Professor, Johns Hopkins Bloomberg School of Public Health; Lowell Keppel, MD, CPE, FAADP, FACPE, Chairman of the Board and Immediate Past President, Wisconsin Academy of Family Physicians; Ken Berndt, Director of Business Development, Bellin Hospital, Fast Care Program

This Symposium considered the potential of these two recent trends in primary health care - medical homes and retail-based clinics - and their role within Wisconsin's health care system, highlighting practitioner and research perspectives. Dr. Barbara Starfield, of Johns Hopkins University, presented evidence regarding the importance of comprehensive primary care in achieving better health outcomes and greater equity in health. She reviewed the key principles of the patient-centered medical home (PCMH) model, and the definitions and measurements of these principles that create tension in the medical home community. Dr. Lowell Keppel, immediate past president of the Wisconsin Academy of Family Physicians, highlighted the status of patient-centered medical homes in Wisconsin and the process for obtaining third-party recognition of PCMHs. Mr. Ken Berndt, of Bellin Health, described the implementation of the FastCare retail-based clinics around the state. He emphasized the high demand for FastCare services and the importance of connecting clinic patients to primary care and local health networks. Mr. Jason Helgerson, the Medicaid Director at the Wisconsin Department of Health Services, served as a reactor and mentinoed the state's efforts to balance support of the patient-centered medical home framework with the need for specialists to treat chronic illnesses. Participants in the dynamic question and answer session covered a range of topics, including the role of health information technology, varying philosophies and models of retail-based clinics, and the use of evidence-based medicine.

March 3, 2009 - 3:00 p.m. - 4:30 p.m., State Capitol, Room 400 SE
An Evidence-Based Health Policy Project Briefing: Google's Gaps: The Art of Policy Research on the Internet

In this interactive session, Dr. Catherine Arnott Smith and Dr. Greg Downey examined the utility of Internet searches using sample questions from legislative service agencies and legislators. They discussed the mechanics behind search engine queries, such as the ranking of search results produced by a search, and the subsequent limitations for health policy research. Search engines such as Google access only about half of all available web pages. In their current form, theses search engines do not reach the 'invisible' or 'deep' web, composed of publicly available, but difficult to locate, databases and government documents. The speakers recommended that policy analysts expand searches to multiple search engines, narrow searches using specific search terminology (see Quick Tips below), and supplement searches with publicly available research databases such as Badgerlink.

February 19, 2009 9:00 am - 10:30 am, State Capitol, 412 East
Evidence-Based Health Policy Project Breakfast Briefing with Dr. Elliott Fisher: "Accountable Care Organizations: A Path Forward to Quality and Savings"

Dr. Fisher is Professor of Medicine and Community and Family Medicine at Dartmouth Medical School and Director of the Center for Health Policy Research in the Dartmouth Institute for Health Care Policy and Clinical Practice. In his third legislative briefing through the Evidence-Based Health Policy Project, Dr. Fisher highlighted the association between high health care spending and low quality health care delivery. He called this the "paradox of plenty," where regions with high per capita Medicare spending have poor health outcomes and quality in comparison to lower-spending regions. He proposed addressing this paradox through an "Accountable Care Organization" model, which promotes organizational accountability for local delivery systems through performance measures and shared savings payment reform. Dr. Fisher touted the feasibility of the model, which operates within existing physician-hospital networks. He concluded his presentation by recommending interim steps for attaining organizational accountability for local systems.

January 8, 2009, 9 to 10:30 am, State Capitol, 411 South
Evidence-Based Health Policy Project Briefing on "Rx for RNs: Addressing the Nursing Shortage"

This Briefing provided an opportunity to learn from state and national experts regarding the causes and implications of the nursing shortage, as well as successful state initiatives to recruit, retain and advance nurses. The University of Wisconsin School of Nursing co-sponsored the session, and Dean Katharyn May introduced the speakers and participated in the question and answer session. Janet Allan, Dean of the University of Maryland School of Nursing, provided a national perspective on the nursing crisis and presented her research on the causes and implications of the faculty shortage in nursing schools. She also described several successful state-level efforts and public-private partnerships focused on the faculty shortage. Judy Warmuth, Vice President for Workforce Development at Wisconsin Hospital Association, reviewed the state of nursing in Wisconsin, including the challenges in measuring Wisconsin's healthcare workforce needs. She highlighted WHA's work to advance the educational levels of the nursing workforce, as well as regional partnerships that unite technical colleges, workforce investment boards, nonprofit organizations and health-care providers to create leadership and advancement opportunities for nurses. Senator Judy Robson, herself a nurse, provided a brief reaction to the speakers' remarks and reviewed legislative initiatives related to the nursing shortage that focus on retention and safety regulations. During the question and answer session, the panel covered the nursing shortage in the context of health care reform, the role of technology in nursing education and practice, and the need for additional clinical experiences for nursing students.

2008 Project Events and Materials

May 6, 2008, 10am to noon, State Capitol, 411 South
Evidence-Based Health Policy Project Briefing on "Sobering News: How We Can Reduce Wisconsin's Top-Ranked Drinking Problem"

The Public Health Council appointed by Wisconsin Governor Jim Doyle identified risky and problem drinking as one of the three top public health issues in the state. At this briefing, Paul Moberg presented new evidence about how Wisconsin leads the nation in binge drinking, alcohol abuse, and impaired driving. He also presented research about the incidence and societal costs of alcohol abuse in the state. Richard L. Brown, of the Wisconsin Initiative to Promote Healthy Lifestyles, described innovative screening, prevention and treatment strategies currently being implemented among health care providers in primary care clinics throughout the state. Carolyn Heinrich, of the La Follette School of Public Affairs, presented research on the promise of pharmaceutical interventions for improving substance abuse treatment and health outcomes, and the policy options around adopting those treatments. The three also suggested a number of public policies that could be pursued to combat Wisconsin's top-ranked drinking problem.

April 29, 2008, 1:00-4:30pm, Monona Terrace Convention Center
UW La Follette Spring 2008 Symposium
"Health Care Payment Reform and Pay-for-Performance in Wisconsin:
How to Promote System Transformation (and What Not to Do)"

The Symposium provided an opportunity for researchers, policymakers and health care practitioners to address the challenges in aligning incentives with the goals of quality improvement and cost-containment as we move toward a value-driven health care system. The keynote speaker, Gwyn Bevan, provided examples of health care performance measurement in England, taken from serving on various government advisory committees and his research on performance measurement and devolution. Bevan discussed the results of the star rating system and other quality improvement initiatives and addressed the unintended consequences of payment reform in England. The first panel of health care practitioners then reviewed current and emerging efforts to reform health care payment systems in Wisconsin, including pay-for-performance initiatives at the Marshfield Clinic, at the Medical College of Wisconsin, and in Wisconsin Medicaid. The second panel of academic experts from the UW covered lessons learned from evaluations of pay-for-performance (P4P) in education, cash-assistance, and workforce development programs.

February 26, 2008 9:00 am - 10:30 am, State Capitol, 300 SE
Evidence-Based Health Policy Project Breakfast Briefing on "A Pathway toward Health Care Reform: Exploring Spending, Supply and Health Outcomes"

In his second legislative briefing through the Evidence-Based Health Policy Project, Dr. Elliot Fisher highlighted the interaction among quality of health care, supply of health services, and health care spending. He described how the local organizational context and policy environment drives each of these factors. Dr. Fisher also explained why "more is not better" in the supply and specialization of health care services, due to the increased risk of mistakes occurring as health care becomes more complicated. Dr. Fisher also touched on the policy implications of his research. He recommended addressing these issues by fostering local accountability organizations, providing better information on health care benefits and risks to patients, and implementing reforms to the payment system to avoid simply rewarding more care and capacity.

January 10, 2008
Evidence-Based Health Policy Project Breakfast Briefing on "Public Health Preparedness: Progress and Challenges for State Policy"

This briefing provided an opportunity to learn from local and national experts in public health preparedness, who highlighted research findings and successful initiatives, as well as on-going policy challenges. Dr. Kristine Gebbie, Director of the Center for Health Policy at the Columbia University School of Nursing, provided an overview of national issues in public health preparedness, and also described her research findings from evaluations of clinical workforce training and a recent study on legal issues in preparedness. During her career, Dr. Gebbie served as the National AIDS Policy Coordinator and held cabinet-level positions in health administration in Washington and Oregon. In addition, two other speakers highlighted several Wisconsin initiatives in public health preparedness. Bill Bazan, from the Wisconsin Hospital Association, reviewed his organization's efforts in workforce training and education. Lisa Pentony, from the Wisconsin Department of Health and Family Services, discussed lessons from successful preparedness efforts, based on her experience with the Pandemic Influenza Program.

2007 Project Events and Materials

October 3rd, 2007
Evidence-Based Health Policy Project Symposium on "Health Care Purchasing and Utilization Decisions: Challenges Facing Consumers and Employers"

The Evidence-Based Health Policy Project Symposium focused on the roles of consumers and employers in the current healthcare decision-making environment. Dr. Judith Hibbard highlighted the dynamics of consumer decision making, including the role of consumer motivation and activation, and its role in the patient's management of health. Dr. Hibbard's presentation focused on the need to understand how activated and equipped consumers are to be effective decision-makers; and furthermore, the importance of tailoring information to consumers so that it is both effective and meaningful in promoting activation. Presenter François de Brantes focused on the role of employers in the healthcare market, and the impact employer decisions can have upon consumer action. Key highlights of de Brantes' presentation included an overview of the impact employers have had historically on healthcare reform, and an overview of the routes by employers can impact consumer decision-making. Presenter Christopher Queram elaborated upon current national and state movements toward a more value-driven decision making environment in healthcare, and the current state of quality and cost measurement. Mr. Queram provided an overview of the tools currently available in Wisconsin to access information regarding healthcare value, and the current successes of, and challenges faced by Wisconsin regarding quality measurement.

Tuesday, July 17, 2007
Breakfast Briefing with Dr. Joel Cantor, Mr. Douglas McCarthy, and Dr. Patrick Remington - State Health Scorecard Forum

The State Health Scorecard Forum revealed the results of two independently conducted examinations of health in Wisconsin. Dr. Remington, director of the UW Population Health Institute, discussed the UW Population Health Institute's Health of Wisconsin Report Card. Dr. Remington described the health outcomes and disparities across gender, geography, socioeconomic status, race, and ethnicity. Dr. Joel Cantor of Rutgers University and Mr. Douglas McCarthy of The Commonwealth Fund presented the results from the nationwide report Aiming Higher: State Scorecard on Health System Performance. Dr. Cantor and Mr. McCarthy explained Wisconsin's ranking within the top quartile of states, and highlighted areas for improvement. There were over 40 people in attendance, including legislators, legislative and agency staff, private sector representatives, and university faculty.

Wednesday, June 20th, 2007
Breakfast Briefing with Dr. Murray Katcher, Dr. Sheri Johnson, and Dr. Teresa Johnson - Infant Mortality Rates in Wisconsin

This breakfast briefing centered on infant mortality rates in Wisconsin. The presentations included information on racial and ethnic disparities in birth outcomes as well as geographic differences in infant mortality rates. Dr. Murray Katcher and Dr. Sheri Johnson, both of the Wisconsin Department of Health and Family Services, provided information on birth rates in Wisconsin, possible underlying determinants of racial and ethnic disparities, and evidence-based interventions. Dr. Teresa Johnson, associate professor at the University of Wisconsin-Milwaukee, highlighted the work being done within Racine to improve birth outcomes, including the partnerships formed, funding received, and the goals of the work. Over 30 people, including legislators, legislative staff, state agency staff, and university faculty were in attendance for this breakfast briefing.

Friday, May 18th, 2007
Roundtable Discussion with Senator David Durenberger - Policy and Politics: The Road to Value in Our Systems

This Friday morning roundtable discussion with former U.S. Senator David Durenberger highlighted our current health system, the responsibilities of both the state and federal government in the health care arena, and the role that politics has played in healthcare reform. Senator Durenberger discussed his current work with the National Institute of Health Policy, as well as his past experiences as a U.S. Senator from Minnesota. Over 20 people, including Legislators, their staff, university staff, and state agency employees, attended the roundtable discussion.

Thursday, March 29th, 2007
Breakfast Briefing with Dr. Jonathan Temte - The HPV Vaccine: HPV Background and Risk Factors & Vaccine Performance Data and Policy Issues

Dr. Jonathan Temte, Associate Professor of Family Medicine at the UW School of Medicine and Public Health, began the breakfast briefing with background information on the Human Papillomavirus (HPV) and its connection with cervical cancer cases. Dr. Temte also discussed the vaccine that has been developed to treat certain strains of the HPV virus, including the costs per vaccine dose and other medical costs associated with HPV. Additionally, Dr. Temte discussed policy issues around the HPV vaccine, including the mechanics, safety issues, costs, supply, considerations for health systems, ethics, and the public perception. Fifty people attended the breakfast briefing with Dr. Temte to learn more about the HPV vaccine and any policy implications.

Monday, March 26th, 2007
Videoconference Briefing - Governor Schwarzenegger's Healthcare Reform Plan for California and President Bush's Healthcare Reform Proposals

This Monday videoconference briefing involved Alan Weil, Executive Director of the National Academy for State Health Policy and Dr. Paul Fronstin, Senior Research Associate at the Employee Benefit Research Institute. Mr. Weil highlighted the recent California healthcare reform plan proposed by Governor Schwarzenegger. Dr. Fronstin discussed President Bush’s recent tax-related healthcare reform proposals in comparison with the current tax incentives provided for healthcare purchasing. Nearly 40 people were in attendance to take note of recent healthcare proposals at the state and national levels and to pose questions to the speakers on how those proposals’ provisions could affect or be used in Wisconsin.

Monday, February 26th, 2007
Breakfast Discussion with Dr. Elliot Fisher - The Relationship among Healthcare Spending, the Supply of Health Services, Quality & Outcomes

This Monday morning breakfast discussion with Dr. Elliot Fisher highlighted the interaction among quality of health care, supply of health services, and health care spending. Dr. Fisher discussed the evidence on what causes differences in spending and quality, including how this has implications for both policy and practice. Dr. Fisher talked about his work, which has looked at the differences in per capita Medicare spending across regions that are independent of both local medical prices and underlying illness levels. About 30 people, including Legislators, their staff, State agency employees, and University faculty were in attendance to listen to the presentation as well as discuss relevant questions they had surrounding Dr. Fisher’s findings.