The 2020 Open Minds Performance Management Institute brought together leaders from the health and human service sector, technology vendors, and health plans from across the nation to focus on “performance management tools…to build a strategy for innovation in a complex market.” I had the pleasure of participating in the Institute this year. Here are just a few of the ideas that have fueled my thinking about how we continue to improve here in New York.
- Behavioral health and social determinants of health are key drivers of cost. Medicaid spending on people with mental health conditions is nearly 4 times higher than for other enrolleesa. 20% of Medicaid enrollees have behavioral health conditions, though they account for nearly half of Medicaid spendinga. Most of us don’t need any further convincing about this. However, seeing data highlighting this point across several presentations confirms that there’s a deeper understanding spreading among hospitals and health plans of what we’ve known for some time; behavioral health is complicated and social needs are critical. Consider: Are we using these findings to build stronger value propositions and energize conversations with partners, payors, and other funders? If this data is out there, there’s no need to “re-discover” it.
- What should we be measuring? I most often answer this question with more questions. What do you do well and are you measuring it? Can you show how what you do well contributes to system goals like reducing avoidable Emergency Room and inpatient services? Are you looking at your key measures by demographic groups? In the OPEN MINDS annual survey of health and human service providers, the top performance measures in Value-Based reimbursement contracts for specialty provider organizations that emerged looked familiar. What are you already measuring that helps tell the story of how your services contribute to performance metrics like these?
- How are we communicating about quality? True or false: With a few exceptions, the majority of health care providers have the same capabilities and offer similar quality services. Would you guess that over 80% of people answer true? As a provider, how would you answer this question? We have the pleasure of working with so many innovative providers who are using creative problem solving to change the status quo and improve outcomes; I’m confident I’d answer “false”. Thinking about quality, a few health plans described emerging Centers of Excellence/Preferred Providers; specific designations for providers offering exceptional value. They are few and far between in the behavioral health field, but there’s growing interest from payors in developing them. All of this got me wondering if we are saying enough about quality in New York. How can we leverage consumer satisfaction (real consumer satisfaction, not just the survey results!) into marketing and value? What would it take to show the outcomes needed to become a behavioral health Center of Excellence?
- The culture of change. “If you don’t like change, health care isn’t for you.” How many of us have heard this recently? Honestly, even if that change often feels exciting, most of us have days when it also feels overwhelming and hard. In his presentation, Raymond Wolfe shared a quote from Parker Palmer, the Quaker educator and activist, as an acknowledgement that in trying to get to the unattainable best, we will be better: “The insight…is that we live in a tragic gap-a gap between the way things are and the way we know they might be. It is a gap that never has been and never will be closed…we must learn to stand in the tragic gap, faithfully holding the tension between reality and possibility.” How are we persevering through great changes without losing our purpose? How can we support a culture that continues to strive for better and better outcomes knowing we’ll never fully finish the job?
Connect with Briannon O’Connor, PhD, CCSI’s Director of Strategic Analytics and Performance Improvement at boconnor@ccsi.org to talk more about “measuring what matters” and how to put your data to use to understand performance, drive improvement, and maximize your impact.