Health Care at the Crossroads: Trends, Opportunities and Challenges Ahead

April 26, 2013

Dr. Richard ShonkMarket Medical Director UnitedHealthcare

Our Community at a Cross Road

Greater Cincinnati Tri-State Region: Setting the Standard for Health Care in America The ONLY community in America with all these programs:

• 1 of 7 Comprehensive Primary Care Initiative communities,

• 1 of 16 Aligning Forces for Quality (AF4Q) communities,

• 1 of 17 Beacon Communities,

• 1 of 62 Health IT Regional Extension Centers,

• Among first seven communities selected for CMS Care Transitions

• >80% of physicians and hospitals exchanging data through HealthBridge

• 500 Physicians, 20+ Hospitals on YourHealthMatters.org

• 109 Patient-Centered Medical Homes

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Payment at a Cross Road

We’re being watched…

By the Feds…By the State…By the Commercial Health PlansBy National Companies

…But is it scale-able?

Quality at a Cross RoadSo many metrics… So little time…

– YourHealthMatters– CPCi Measures– ACO Metrics– HEDIS– CG-CAHPS– Health Plan Report Cards– Internal System Scorecards

Triple Aim Sounds Good!... But sometimes it is hard not to feel like the target.

When you come to a fork in the road…

• Control your data• Focus on what matters• Speak the same language• Insist on transparent

methodology• Timing can be important• Neutral Third Parties are

important• Continuously Improve

Thank You!