Understanding that things had to change if employers were to be able to continue to afford health care, a few forward thinking payers and influencers began to rethink their health care strategies. Two health care pilots began to take hold. One involved refocusing employees on the virtues of health and wellness. The other focused on decreasing the financial barriers to some of the care that would actually put healthier people back to work because they were compliant with their treatments.

These experiments that utilized reductions in co-pays for some populations continued to broaden with the inclusion of incentives for participation in annual or baseline health risk assessments, health fairs, and disease management. So began the development of behavior change through incentives that actively engage consumers to participate in their health and healthcare. The use of these incentives have evolved into the levers of population change that form the core of value-based design initiatives.

Learning Objectives:

Understand the nature of value-based design and the challenges it is designed to resolve.

Be conversant with the 4 Ds of value-based design . . data, design, delivery and dividends.

Know why health promotion is a foundational element of value-based design.

Learn the key skills and competencies that health promotion practitioners bring to successful implementation of value-based design.

Cyndy Nayer and John Riedel, Leveraging Health: A Primer for Health Promotion Practitioners using Value-Based Designs from Michaela Conley, HPCareer.Net on Vimeo.  Learn more about HPCareer.net here!

FOR IMMEDIATE RELEASE

TriZetto Joins Center for Health Value Innovation, Signals Role of Healthcare Information Technology in Accelerating Adoption of Value-Based Solutions

ST. LOUIS, Mo./NEWPORT BEACH, Calif. – March 01, 2010 – The Center for Health Value Innovation (www.vbhealth.org), the nation’s premier information exchange for value-based design, today announced that The TriZetto Group, Inc. (www.trizetto.com) has joined its growing membership of healthcare industry innovators.  This collaboration is expected to accelerate the development of new value-based strategies, which many industry analysts and leaders believe are vital to healthcare reform.

“TriZetto will share its knowledge to demonstrate how technology can be used to promote the adoption of value-based designs, and our value-based solutions will incorporate the ideas and principles of the Center,” said Jeff Rideout, M.D., chief medical officer and senior vice president of cost and quality at TriZetto. “As a leader in healthcare payer technology, TriZetto recognizes the potential of value-based designs for healthcare reform and will assist the Center in evaluating value-based strategies, developing critical analytics and leveraging technology to refine programs and measure outcomes.”

The introduction of “levers” of value-based design incentives is now recognized as one of the most effective approaches to encourage individuals to adopt healthier lifestyles and effectively manage chronic conditions by adhering to recognized healthcare guidelines. In its recently released book, Leveraging Health (2009), authors from the Center articulate the role of value-based solutions to enhance workplace health and productivity and promote financial sustainability for organizations.

Gail Knopf, vice president of enterprise strategy at TriZetto, added, “This collaboration presents both TriZetto and the Center with significant opportunities to leverage the latest innovations and best practices to help unlock the potential of value-based designs.  Together, we plan to develop value-based strategies that improve member health, successfully address healthcare economic inflation and drive Integrated Healthcare Management (IHM) and its subset, Systematic Health Management (SHM).”

TriZetto’s industry vision, IHM is the systematic application of processes, shared information and aligned incentives to optimize the coordination of benefits and care for the healthcare consumer. TriZetto’s IHM vision encompasses three areas for payers: administrative costs, supply-driven costs and demand-driven costs. TriZetto has become well recognized for its administrative solutions that increase efficiency for payers and their employer customers and members. TriZetto’s new SHM process focuses on the supply and demand drivers to address clinical cost and quality challenges that primarily manifest themselves in unwarranted variations in care, which create significant waste.

Cyndy Nayer, president and CEO of the Center, said, “With the recent introduction of its Value-Based Benefits Solution, TriZetto demonstrates a serious commitment to developing technology to administer value-based benefits on an individual level and integrate the process in real-time with claims processing. We are grateful to TriZetto for sharing its talent, expertise and technical experience, and look forward to working closely with its leadership.”

About The Center for Health Value Innovation
Information Exchange for Value-Based Design
The Center for Health Value Innovation has grown into the nation’s premier organization dedicated to sharing the evidence of improved health and economic outcomes through value-based designs for sustainable health and financial improvement.
www.vbhealth.org

About TriZetto
Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry. With its technology touching half of the U.S. insured population, TriZetto is Powering Integrated Healthcare Management®, the systematic application of processes and shared information to optimize the coordination of benefits and care for the healthcare consumer. The company’s offerings include enterprise and component software, hosting, outsourcing services and consulting that help payers implement and optimize their operations and minimize the risk of bringing to market new products that drive competitive differentiation.

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TriZetto Joins Center for Health Value Innovation, Signals Role of Healthcare Information Technology in Accelerating Adoption of Value-Based Solutions | Business Wire

FOR IMMEDIATE RELEASE
Center for Health Value Innovation Vice President Raymond Zastrow, M.D. Earns BizTimes Milwaukee Health Care Heroes Award at Sixth Annual Awards Ceremony

ST.  LOUIS, Mo./MILWAUKEE, Wis. – January 05, 2010 – The Center for Health Value Innovation (www.vbhealth.org), the nation’s premier information exchange for value-based design, announced today that Raymond Zastrow, M.D., FAAFP, president, QuadMed, and vice president for evidence of the Center, was recognized by BizTimes Milwaukee for Corporate Achievement in Health Care during its recent sixth annual Health Care Heroes Awards ceremony.

“Dr. Zastrow exemplifies the Center’s commitment to value-based design, and we are extremely gratified that his work is receiving such high-profile recognition,” says Cyndy Nayer, president and CEO of the Center. “As one of the brightest minds working at the frontlines of health care reform, his ongoing efforts to influence decision-makers in Washington D.C. and Wisconsin, as well as his accomplishments at QuadMed, have been nothing short of triumphant.”
Chosen from a field of nominations by an independent panel of health care professionals, Dr. Zastrow is responsible for clinical quality oversight, clinical process re-design, and health care benefit design for Quad/Graphics. QuadMed, a subsidiary of Quad/Graphics to provide affordable, high-quality health care for the company’s employees, has reduced health care costs to approximately $6,800 per employee – 30 percent less than the average similar-sized manufacturer in the Midwest. QuadMed provides on-site, employer-directed primary care and prevention/wellness programs to Quad/Graphic and several other large employers.
“I was very proud to receive this award, which I accepted on behalf of the entire Quad/Graphics / QuadMed organization,” says Dr. Zastrow. “The health care model developed for our employees is based upon staying healthy rather than attempting to fix avoidable problems after the fact. It’s an approach that empowers primary care and that has allowed QuadMed to serve as an example of excellence in on-site care for companies across the nation.”
About The Center for Health Value Innovation Information Exchange for Value-Based Design
The Center for Health Value Innovation has grown into the nation’s premier organization dedicated to sharing the evidence of improved health and economic outcomes through value-based designs for sustainable health and financial improvement.
www.vbhealth.org

Raymond Zastrow MD-Healthy Heroes Award

Interview with Cyndy Nayer from the Center for Health Value Innovation

January 22, 2010

Posted by George Van Antwerp in Blogroll, Books / Articles, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, Methodology, PBM / Pharmacy, Research, Silverlink, Value Propositions.
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I had a chance yesterday to sit down and talk with Cyndy Nayer (President, CEO, and co-founder) from the Center For Health Value Innovation. For some of you, this is a new buzzword for others it has been around a while. I remember back in the early 2000s when stories of Pitney Bowes kept popping up and then working with a few of our clients (like Marriott) when I was at Express Scripts on what were being called “value-based designs”. [I even had an offer to go to ActiveHealth (now part of Aetna) and work on their Value Based offerings several years ago.]

And, it’s a small world. Several people from my past are involved: (1) Peter Hayes was a client at Express Scripts and (2) Roy Lamphier played soccer with me in high school.

What is the Center For Health Value Innovation?

The center is an “information exchange” for value based design which as she points out is much more than just a prescription benefit and not simply giving people free drugs to make them more compliant. [If only it were that easy!]

What do you mean by Information Exchange?

A place where people can share stories, trends, info, and research. They see their job as getting information out there and providing support around modeling, analysis, and identifying gaps. [And, I know they do a lot of education as you can see Cyndy at many conferences.] She talked about educating the marketplace on an “actionable format” for implementing value-based design.

Can you describe Value Based Design?

Value Based Design is a suite of insurance design, incentives, and disincentives that support prevention and wellness, chronic care management, and care delivery. It is focused on linking stakeholders across the care continuum and developing structures like outcomes-based contracting where all stakeholders benefit from better health outcomes.

She mentioned that in an upcoming edition of the Journal of Benefits and Compensation that there will be a paper that builds on some adherence concepts to discuss the 5 Cs of Value Based Design: [Noting that the first 3 come from some work from Merck.]

• Commitment
• Concern
• Cost
• Communication
• Community

We talked about the need for communications to be multi-directional and include the patient, the physician, the pharmacy, and other caregivers. We talked about community needing to expand on that to include family, the employer, and other entities. [As we all know, health care is local and value based design is no different.]

We spent a little time here talking about community, and the need for this to happen at a community level. [Much like e-prescribing and other things have found out that localized momentum is important.] One question in my mind is who is the catalyst – the hospitals, the physicians, the local managed care companies, employers, grocery stores, wellness companies, pharmacies.

We talked about the fact that this isn’t the same as Accountable Care Organizations, but like that concept, this has to be developed as part of the fabric of the community not imposed on the community.

Being from Detroit, I asked if this was a model for them to help develop around. That is an area of focus and there has been some work done in the Battle Creek, Michigan area.

Why are employers so interested in Value Based Design?

Originally, employers were interested since it was something new, but the recession forced them to look at this more seriously. But, this is a long-term process and something which they benefit from. Better health lowers absenteeism, and businesses need health communities and healthy workers for growth.

Why don’t companies implement Value Based Design programs?

Companies don’t implement them because they’re not prepared for the amount of work needed to get started and it’s not a cheap fix. [If you want to save money, just drop the benefits…not that anyone really advocates that.] We talked about that lots of people react to the urban legends of just giving out free drugs [which isn't Value Based Design] which would be easy. Companies need to realize there is work to be done to communicate this, design it, and manage the implementation across the community. BUT, once it’s installed, it’s completely sustainable.

Is there a certification (i.e., URAC) for value-based design?

She told me that nothing exists today and that it would be hard to do. Today, there isn’t alignment in the marketplace around incentives and a standard model. They spend a lot of time working with different groups to drive education and training to link health and productivity measurement with value and functional performance.

What’s next for 2010?

In 2010, they will be bringing much more information forward on how to support and extend the work done in the 1^st book (Leveraging Health…which Dr. Jan Berger, Silverlink’s Chief Medical Officer co-authored with the Center) and the decision matrix that they recently published. They will continue to serve more as a guide helping interested parties in private, invitation only events to design solutions and then bring those solutions to market.

You can learn more about George and his work at this site:  Enabling Healthy Decisions

FOR IMMEDIATE RELEASE

Wayne Burton, M.D, Longtime Corporate Medical Director of JPMorgan Chase, Joins Center for Health Value Innovation Board of Strategic Advisors.
ST.  LOUIS, Mo. – January 19, 2009 – Wayne Burton, M.D., retired corporate medical director at JPMorgan Chase and nationally recognized expert on health and productivity management, has joined the Center for Health Value Innovation’s Board of Strategic Advisors (www.vbhealth.org). As a member of this seven-member advisory board to the Center, the nation’s premier information exchange for value-based design, Dr. Burton will share his wealth of experience and practical strategies for applying value-based designs to benefit both the health of workers and the companies that employ them.

“I’m looking forward to contributing to the Center’s mission to advance analytic tools and educational programs that improve individual health and financial sustainability for organizations,” says Dr. Burton. “I have spent my entire career developing value-based interventions that improve function, reduce disability, increase productivity, ease costs, and strengthen the commitment of workers to their employers.  As a member of this distinguished advisory board, I anticipate robust information exchange with Center members.”

At JP Morgan Chase, and previously at Bank One (which was acquired by JP Morgan Chase), Dr. Burton was responsible for managing worksite occupational health services at 20 major locations in the United States and Canada, while managing corporate health initiatives and wellness/disease management programs. Dr. Burton is the author of numerous articles and research that demonstrate the linkages between health risk and medical condition management and improved cost trends at the worksite, such as reduction in short term disability, absenteeism, presenteeism, and total cost burden for the employer.

Dr. Burton is Board Certified in Internal Medicine and is a Fellow of the American College of Occupational and Environmental Medicine, the American College of Physicians, and the Institute of Medicine of Chicago. He is associate clinical professor of Medicine, Feinberg School of Medicine Northwestern University in Chicago, and adjunct professor of Environmental and Occupational Health Sciences, University of Illinois at Chicago.

“Dr. Burton’s unparalleled work in health and productivity management has paved the way for employers to measure, manage, and significantly enhance worker health and improve the return on investment in human capital,” says Cyndy Nayer, president of the Center.

About The Center for Health Value Innovation Information Exchange for Value-Based Design
The Center for Health Value Innovation has grown into the nation’s premier organization dedicated to sharing the evidence of improved health and economic outcomes through value-based designs for sustainable health and financial improvement.
www.vbhealth.org

Wayne Burton is strat advisor (PR)

Looking Back… and Ahead

Although the ADVANCE for Health Information Executives magazine and website have come to an end, we look forward to taking our next step in reaching an elite group of healthcare executives. First, we would like to extend our deepest gratitude to each person we’ve had the pleasure of interacting with over the years in the HIT market. Whether you were a devoted reader or dedicated contributor, we appreciate you bringing ADVANCE into your life. You helped us build a powerful community of HIT professionals and become the defining voice for healthcare IT executives everywhere. And for that, we thank you!

Our new print and online product, Executive Insight: Strategies and solutions for healthcare leaders, will provide in-depth analysis and strategic planning solutions for healthcare leaders to respond, adapt and thrive in today’s rapidly changing environment. Through our exclusive webinars, interactive online community, multimedia and cutting-edge content, healthcare executives will have the opportunity to engage with one another and implement forward-thinking strategies to lead their facilities to success.
This new quarterly print magazine and robust website are slated for a fall 2010 debut, so stay tuned as
we release more details leading up to the big launch.

Burton-Advance for Health Information Exec

“’Tis a sordid profit that’s accompanied by the destruction of Health.” –Bernardino Ramazzini,

Treatise on the Diseases of Tradesmen, 1705
By Karen O’Hara

Amovement is afoot to get more occupational health programs and modestly sized companies to embrace workplace health and productivity management (HPM) initiatives that have been the domain of larger corporations.  When appropriately applied, proponents say HPM significantly expands the net cast by occupational medicine practitioners, who are population-health oriented.
The objective is to extend outreach from individual employees, to groups of workers, to the community at large – somewhat analogous to the circles that radiate from a pebble dropped in a pond.  “I would hope an occupational medicine program would offer health and productivity management services to the employers they serve and to their community,” said Doug Benner, M.D., occupational health coordinator for Kaiser Permanente in Northern California, where he works closely with Kaiser’s group health plan.  “Many people in our field feel you can’t do this just at the worksite. You have to make the whole community healthy. You can’t fix the employees if you have an unhealthy workplace or if the whole community is not health focused.”  Pamela Hymel, M.D., M.P.H., president of the American College of Occupational and Environmental Medicine (ACOEM), corroborates Dr. Benner’s view.  “A healthy workplace, workforce and community are vital to the long-term financial stability of the country,” she said. “The U.S. has far underestimated the impact of poor health in the workplace and on the economy. As we look at our gross domestic product and how much we spend on health care, it’s important for us to determine how we can provide greater efficiency and not have to treat so many chronic and end-stage diseases.  “We can’t just look at insurance coverage. We need to look at how we can increase the baseline health of the population. . . .

Burton Visions continues here. . .

Wayne Burton and Cyndy Nayer, from the Center for Health Value Innovation, speak with David Harlow about value-based health designs for health improvement and cost savings

I recently spoke with Wayne Burton, MD and Cyndy Nayer.  Cyndy is co-founder and President of the Center for Health Value Innovation; Wayne is a member of the Board of Strategic Advisors, and former longtime Corporate Medical Director of JP Morgan Chase.  The Center focuses on sharing evidence of improved health and economic outcomes through value-based designs.  In the current environment, this sort of private-sector focus on value-based health improvement and cost savings is critical.

Given the recent collapse of health reform inside the Beltway, now is the time for organizations such as the Center to prove themselves and their approaches, by demonstrating that they are able to “bend the cost curve” while improving health indicators, and ensure that efforts to do so yield a significant ROI.  Wayne and Cyndy shared with me a number of ways in which programs run by large employers in the public and private sectors are a step ahead of the health care systems in place for other folks.  Here’s one excerpt from our conversation:

No one succeeds in a value based design without two things.  One, an incredible focus on prevention and wellness, an expectation that people will take care of their health.  And the second is consistent and ongoing communication.  We have several instances where companies thought if they announced a value based design during benefits enrollment people would dive on to it.  And within eighteen months they had left the value based design space because it’s a complicated message and it takes a while for people to understand what exactly we want them to do.  Value based design is not just about moving copays to zero for a drug.  It really is about teaching people what part of the highway do we want them to travel on.  How do we help them get to their destination, healthier, higher performing, more productive and that’s what the levers are about.  Think of them as cones on the highway, and as we fix the highway or encounter new bumps we move the cones around to get the cars to move a different direction – that’s exactly what a lever does.

For more on the topic, check out the many articles posted on the Center’s website.

Burton-Nayer Blog w/Harlow

David Harlow continues the value-based design conversation with Wayne Burton, MD and Cyndy Nayer of the Center for Health Value Innovation

Today we bring you Part II of my conversation with Wayne Burton and Cyndy Nayer of the Center for Health Innovation, where we get into some specific examples of successful programs.  The Center represents over 40 million lives, and brings together employers and providers to focus on a limited number of levers targeted at health and wellness – rather than health care.  The ROI of wellness efforts in the workplace is pegged at nearly 300% in a recent Health Affairs article by Karen Baicker et al. and accompanying Health Affairs blog post by Jaan Sidorov – one of my fellow “Health Wonks.”  Clearly this is an area that demands our attention.

Burton-Nayer Blog Part II w/Harlow

Read the PR release jointly issued by the Center and Center for VBID here.  Release re MI Testimony October 22

Read Cyndy’s testimony here  C Nayer Testimony before Michigan House Committee

Read Mark’s testimony here Fendrick Testimony to Michigan 10.22

“Now more than ever, we need to amplify the message that poor health adversely impacts the physical and financial health of a community, and identify options for improvement,” says Cyndy Nayer, president and CEO of the Center. “We anticipate that program participants will begin utilizing key value-based strategies for designing healthcare programs, including HPM modeling and finely honed measurement tools.  As a result, compromised communities will begin to see improved health and a reduction in health cost trends.”

These organizational relationships further position the Center as a proving ground for innovative thinking, providing all stakeholders in the health care continuum a platform for fertilizing and implementing fresh ideas that advance individual health and contain costs.

Forbes.com Center-IBI-ACOEM news release FINAL

“This dynamic group of people will be a welcome injection of fresh thinking into our already vibrant mix of healthcare innovators at the Center,” says Cyndy Nayer, president and CEO of the Center. “As healthcare reform gets under way and there is increased focus upon creating financial value for all stakeholders in the healthcare system, the Center will continue to promote its game-changing initiatives.”

The Center elected six new members to its Board of Advisors:
• Cindy Johnson, Vice President of Human Resources, Group Health Cooperative
• Frank Johnson, Executive Director of Benefits, State of Maine
• Gregg Kamas, Director of Health Risk Management, IMA Financial Group, Inc.
• Jeff Kluever, Risk Manager, Journal Communications and Co-Founder of the SE Wisconsin Business Healthcare Group
• Mike Kushner, Risk Management Director, Polk County, Florida
• Bruce Sherman, MD, Consulting Medical Director, Goodyear Tire & Rubber Company

Mike Taylor, M.D., Center chairman and medical director for Health Promotion at Caterpillar, Inc., adds, “As we approach a new era in our country’s healthcare system, the addition of these stellar thought-leaders to the Center’s team will enhance our efforts to serve communities and stakeholder organizations, improve individual health, and lower consumption of health resources and cost trends through the exchange of value-based design ideas and strategies.”

ST. LOUIS, Mo. – September 09, 2009 –The Center for Health Value Innovation (www.vbhealth.org), the nation’s leading information exchange for value-based design, announces the publication of its first book, Leveraging Health. Authored by three of the recognized experts in value-based design — Cyndy Nayer, president and CEO of the Center, Jack Mahoney, M.D., chief medical officer of the Center, and Jan Berger, M.D., strategic advisor — the book uses real-world case studies from public and private organizations to illustrate 15 “levers” of value-based design.

Raymond Zastrow, M.D., vice president of the Center, will chair the book launch event, September 30, 2009, 8 a.m., at the National Press Club, Washington, D.C. The authors will attend an evening book signing event, 5:30 p.m. at the World Congress, Consumer Health Care Congress, Alexandria, Va. Use coupon code MCM464 to receive a 50 percent discount on registration fees.

“In the past 25 years, cost compression has done little to slow the growth of chronic disease and related costs,” says Dr. Mahoney. “We used our collective expertise and real-world business experiences to showcase the innovations that change the dynamics of poorly managed health. Readers can access insights on where to start, which levers to use, and how to measure outcomes that matter to the C-suite.”

Leveraging Health uses “suites” of levers, a metaphor for plan designs and incentives, to show benefits decision makers how to make informed decisions on benefits and services for better corporate performance.

“The Center’s first book will be a valuable tool for senior level executives at public and private organizations,” says Nayer. “Organizations of all sizes and sectors are faced with the economics of health cost and impact. Leveraging Health is the definitive reference work that dissects plan design and incentives for prevention, wellness, chronic care and delivery services. We expect that this book will expand our scope of influence far beyond the 40 million covered lives that the Center represents.”

“These are exciting times in the world of value-based design,” says Berger. “The Center and value-based design are becoming part of the national dialogue on health policy in this country. The levers of value-based design are thoughtfully articulated and positioned for those seeking strategic and practical solutions.”