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| 8.5 | Reward providers who generate good outcomes. |
| 8.5 | Need to have all physicians computerize medical records |
| 8.4 | Medical home care as a model for primary care of chronic care, reward primary care physicians to coordinate care |
| 8.0 | Stop paying for "never events" — care that causes avoidable harm. |
| 7.7 | Create a patient controlled health record for everyone that includes not only their records, but also personalized pertinent information tailored to their condition/situation |
| 7.7 | Integrate things like dieticians and nurse practitioners into new care models that reinforce the general practice. |
| 7.5 | Have the ability for provider networks to share information for co-morbidities with providers for patients with chronic conditions; provide information coordination and transparency. |
| 7.4 | Participate in shared savings experiments — consider giving both patients and providers a portion of the savings. |
| 7.4 | Employers need to demand a regional exchange system where you can put together evidence based data on comparative effectiveness. That data has to be updated constantly. |
| 7.2 | Find those areas that provide the best care with the best outcome and make that the standard payment. Add little geographic due cost of living. |
| 7.1 | Restore primary care by paying primary care physicians appropriately |
| 7.0 | Focus on wellness programs that correspond to employers top five or so cost issues that are preventable, e.g., back problems. |
| 7.0 | Develop metrics for screening and then provide patients information to know what to expect |
| 6.9 | Data in an open source format |
| 6.8 | Determine the baseline care that everyone should have, e.g. major-medical and preventive care. Make this affordable and portable between jobs to foster coordination. |
| 6.7 | A value template for affordability should be a metric of hospitals using a balanced scorecard approach to look at their business — challenge hospitals to add this to their scorecards. |
| 6.7 | Providers should compete for business. |
| 6.7 | Payers require e-transaction for reimbursement and prescriptions and to enable this they provide funds to support the technology necessary to accomplish |
| 6.6 | Create a national referee to define data standards |
| 6.6 | Have all stakeholders agree that what we are trying to accomplish is value = outcomes, safety and service divided by costs over time. |
| 6.6 | Develop metrics for behavioral preventive care |
| 6.5 | Get the right patient to the right facility at the right time. Build a system where private employer pays transportation to a facility that does a high volume in a given procedure area. Achieve high quality results and define what facilities need to be doing large numbers of which procedures. |
| 6.4 | Benefit package for palliative care services while patients are in active medical treatment |
| 6.4 | Define workable best practices in programs such as obesity prevention efforts and provide the resources to support those practices/programs. |
| 6.3 | Eliminate state mandates for plan design |
| 6.2 | Discontinue fee-for-service payment, which causes fragmentation and rewards volume of care not value. |
| 6.2 | Demonstrate value created via coordination by selecting a specific issue/segment (e.g., depression) to experiment with and use it to entice more coordination. |
| 6.2 | The Kennedy Group (a bundled solution)
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| 6.2 | Pay for shared-decision making |
| 6.0 | Publicly funded evidence-based research and pay for evidence-based medicine |
| 5.8 | Ask specialist groups to identify the top ten areas of waste in their specialty in order to reduce it. |
| 5.6 | Re-engineer and replicate. Consider example of convenience care clinics — a reorganized way of delivering a specific set of care — employers can incent employees to utilize — repeatable to re-engineer other specific care instances. |
| 5.6 | Require insurance companies be non-profit like Minnesota |
| 5.6 | Provide benefits for new groups working together in innovative ways to drive things like diabetes messaging. |
| 5.5 | Shared savings should work with capitation - better than fee for service |
| 5.4 | Electronic medical records can serve as the virtual medical home for patients (patient EMRs need to be portable and accessible regardless of the person's employer or insurer. |
| 5.4 | Problem with fee-for-service is that payment is not being made by the consumer (patient). Give patients more "skin in the game?" |
| 5.4 | Change the tangle of state laws that inhibit innovation |
| 5.2 | Waste: employers and purchasers could hold advocacy groups responsible for their recommendations (e.g., ACS recommended CT colonography for colorectal cancer which is not recommended by the USPSTF). |
| 4.9 | Make groups of providers responsible to work together to create new models. Work with doctors to create patient buy-in on lower rates to bring people into the system who would not have coverage otherwise. |
| 4.9 | Move to pay providers through mini-capitation — transplants are an example of mini-capitation or sub-capitation. |
| 3.5 | Electronic medical records (and health information exchange) have a public benefit and are a utility. The provision of data for the EMR and funding is the responsibility for all. All payors (public and private) should contribute. |
| 3.4 | Push primary care only services plans |
Do we need hospitals in every community? Use centers of excellence.
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