Physicians 2011-12 - Colorado Business Group on Health

Transcription

Colorado Health Matters 2 011-12
Quality Report: Physicians
Focus on Obesity
Health Matters 2011-12 Your Partner in Health
Contents
3 . . . . . . . . . . . . . . American health and health care: is it the best?
4 . . . . . . . . . . . . . . Cutting the fat
5–9. . . . . . . . . . . . Bridges to Excellence recognitions
10–14. . . . . . . . . . Diabetes care recognitions
15–16. . . . . . . . . . Cardiac care recognitions
17–18. . . . . . . . . . Health plan tools to fight obesity
20–21. . . . . . . . . . A check-up on your doctor
Executive Director
Donna Marshall, MBA
Research
Kyle Pattridge
Publisher
The Colorado Business Group on Health
12640 West Cedar Drive, Suite A
Lakewood, CO 80228
www.coloradoHEALTHonline.org
Photos
National Geographic
22–23. . . . . . . . . . Resources
24–26. . . . . . . . . . Editors
Peter Castle
Shannon Vaughn
We gratefully acknowledge assistance
in the creation of this report:
Colorado Business Group on Health
Aetna Health Inc.:
Sandra Herrmann
CIGNA HealthCare of Colorado:
Katheliene Kohler
Anthem HMO Colorado:
Claire Goldstein
Kaiser Permanente:
Keechia Merriweather & Beth Newsom
Rocky Mountain Health Plans:
Jackie Hudson, Lori Stephenson & Terri Wright
UnitedHealthcare
Colleen Campbell
Colorado Health Matters Quality Reports are published
annually by the Colorado Business Group on Health.
This electronic publication or any portion of this
electronic publication may not be reproduced, duplicated, copied, sold, resold, or otherwise exploited for
any commercial purpose that is not expressly permitted
in writing by the Colorado Business Group on Health
(CBGH). This electronic publication may be reproduced,
duplicated or copied for non-commercial use if all
information so reproduced, duplicated or copied is
clearly attributed to the Colorado Business Group on
Health (CBGH).
The photos in this publication are rights-protected and
may not be reused or reproduced for any other purpose.
The information contained in this publication is meant
to increase reader awareness of quality in health care. Its
contents should not be construed as medical advice or
instruction on individual health matters, which should be
obtained directly from a health professional.
For more information, contact Colorado Business Group
on Health at 303-922-0939 or
www.coloradoHEALTHonline.org.
2
American health and health care:
is it the best?
Welcome to our 14th annual edition of
Colorado Health Matters Health Quality
Report: Physicians.
nly in America does the promise of life-saving drugs, transplanted hearts,
and leading cancer care coexist with the reality of nearly 50 million
people without health insurance and with the overall per capita cost
of health care twice as high as the next most expensive country in the
world, where everyone has insurance.
O
recommended schedules. You can be informed when you access health care for your
health issues. Helpful questions to ask yourself are: Do I understand my diagnosis?
Do I know how to preserve my health in spite of illness? Do I know what medicines
I take, what is the dosage? Do I have a list of questions for my physician? Do I make
routine visits to manage care if I have a chronic ailment?
Is American health care the most expensive because it is “the best?” Is it the
most expensive because people without insurance use emergency departments or become more ill while deferring needed care? Is it the most expensive
because most studies identify at least 30% waste in the system? The answer
seems to be in “all of the above.”
Good healthcare starts with you, too. You should use objective information about
high quality healthcare providers.
• D oes your physician help you manage your chronic condition? For example, is
your weight, blood pressure, and blood sugar in normal range? When you and
your physician are working as a team: then optimal health is your shared goal.
How do you find a physician like this? Look for them in the Colorado Health
Matters Quality Report: Physicians. This publication highlights those doctors who
attain high marks in patient care.
Americans feel pride in a system that can deliver the “best care.” Sometimes, we
do receive safe, timely, effective, and efficient care. But, often we do not have
a decent chance of getting this type of care. According to a study published in
the prestigious New England Journal, researchers found that there is essentially
a 50-50 chance that patients will get the care medical experts recommend for
routine conditions such as asthma, hypertension, or depression.
• D oes your hospital report its record on patient safety using a nationally tested
and respected survey? You will find those top performing hospitals in the
Colorado Health Matters Quality Report: Hospitals.
Even for patients with insurance, there is no guarantee that you will receive
the care you need. And how will you fair if you do not have health insurance?
Another study reports as many as 91,000 Americans die prematurely each year
because they do not receive routine care for common conditions, such as high
blood pressure, diabetes and heart disease due to lack of insurance.
• D oes choice of health plan also make a difference? Yes! Some health plans do
perform better than others in achieving good patient outcomes and good customer satisfaction. That information is published annually in the Colorado Health
Matters Quality Report: Health Plans.
The Colorado Business Group is an advocate for high quality health care, and most
hospitals and health plans voluntarily participate in our projects. Over 250 physicians have met standards for diabetes and cardiac recognition: up from only 4 in
2006. Use our publications to inform your decisions. Be an active participant in your
health. It’s good for you, good for your family, and good for your pocketbook.
This issue of waste in the system, which leads to higher costs and lower quality,
is multi-faceted. The math shows that we spend significantly more treating
common diseases for some individuals but get worse outcomes than others.
In addition, health care is not safe. At least 98,000 individuals die each year in
American hospitals due to preventable errors. Meanwhile, other individuals,
who would benefit from care, have no access. We educate many more specialists and fewer primary care physicians than other countries, so it is difficult for
many Americans to find a good doctor for routine care. We shift the costs of
uncompensated care from individuals without insurance into the premiums of
those who do, causing more working individuals to be unable to afford health
insurance. And the cycle continues.
Yours in good health,
Donna Marshall, MBA
What can you do about the problems in health care? Start with a realization
and a promise to yourself: good health starts with you. You can prevent the
poor health outcomes that accompany obesity, tobacco use, and sedentary lifestyle. You can immunize your children and get cancer screenings according to
Reproduction without permission is strictly prohibited. All rights reserved. © 2012 Colorado Business Group on Health.
The photos in this publication are rights-protected and may not be reused or reproduced for any other purpose.
3
Cutting the fat
Health Matters 2011–12 Your Partner in Health
Cutting the fat
The obesity epidemic
D
uring the past 20 years there has been a dramatic increase in obesity* in
the United States. Colorado is no exception. Between 1990 and 2007,
obesity among Colorado adults has more than doubled. As of 2009, 18.6
percent of Coloradans were considered obese and 36.7 percent were
considered overweight.
The costs of obesity
To your wallet
Around 9.1 percent of all health care costs in the US are related to obesity and
being overweight. People who are obese spend almost $1,500 more annually
on their health care than the non-obese. Additionally, worker absenteeism
due to obesity is estimated at $4.3 billion annually and lower worker productivity costs employers approximately $506 per obese employee per year.
Last year we reported that only
Colorado and the District of
Columbia had a prevalence of
obesity less than 20 percent. Sadly,
this is no longer true. In 2010, 21
percent of Coloradans were obese.
That is 2.4 percent rise from 2009’s
18.6 percent.
Obesity vs. Smoking
Obesity raises individual
• Health care costs by 36%.
• Medication costs by 77%.
With the alarming rate of increase of obesity in Colorado, the Colorado Business
Group on Health decided to devote the 2011-2012 Colorado Health Matters Quality
Reports to informing consumers, employers, and the community at large about
the impact of not maintaining a healthy weight on one’s overall health and the
American health care system.
Smoking raises individual
• Health care costs by 21%.
• Medication costs by 28%.
This publication focuses on a group of Colorado physicians that have chosen to
meet specific standards in treating their patients. Furthermore, we present evidence that these recognized physicians are improving
their patients’ health.
Adults categorized as obese are 44 percent more likely to say that they have
fair or poor health status than those adults who are not obese. Poor health
can affect daily activities, including workplace productivity. Obese adults are
21.7 percent more likely to report having one or more poor physical health
days per month.
56%
of Americans were
obese or overweight
between 1988
and 1994.
1990
To your health
* Overweight is defined as a body mass index (BMI) of 25 or higher;
obesity is defined as a BMI of 30 or higher.
2000
2010
68%
In addition to influencing the number of work days missed, obesity also
increases the risk for at least 20 health conditions, including diabetes, high
blood pressure, high cholesterol, stroke, heart disease, and asthma. For example, research shows that as weight increases to reach the levels referred to as
“overweight”“and “obese,” the risks of the following conditions also increase:
2020
of Americans
were obese or
overweight
in 2010.
4
• Coronary heart disease
• Type 2 diabetes
• Cancers (endometrial, breast, and colon)
• Hypertension (high blood pressure)
• D yslipidemia (for example, high total cholesterol or high levels
of triglycerides)
• Stroke
• Liver and gallbladder disease
• Sleep apnea and respiratory problems
• O steoarthritis (a degeneration of cartilage and its underlying bone
within a joint)
• Gynecological problems (abnormal menses, infertility)
Bridges to Excellence 1 of 5
Bridges to Excellence:
Colorado’s recognized physicians
How Colorado’s doctors partner with their patients
T
he evidence is clear: a patient whose health is carefully managed is more
likely to avoid or delay illness or complications of illness. This means that
patients are able to lead a healthier, more vibrant life. When a person has a
medical condition, such as diabetes or heart disease, it is even more important for the physician and the patient to work together to assure the best possible
health, and best health care.
Current Colorado BTE Recognitions as of 12-31-2011*
Colorado Front Range
In 2006, a number of Colorado health plans and employers joined together in a
national program called “Bridges to Excellence” (BTE). Under the leadership of the
Colorado Business Group on Health, these groups agreed to recognize physicians
who voluntarily applied to this national organization and who could demonstrate
that most of their patients could meet rigorous standards for metrics on blood pressure, cholesterol, blood sugar, and other vital statistics.
1
1
1
WELD
LARIMER
8
14
BROOMFIELD
12 39
BOULDER
When the Colorado program started, only four physicians had sought recognition.
By December 2011, 670 recognitions to 334 physicians have been awarded.
GILPIN
17
Is your doctor recognized? We thank those physicians who attain recognition and
acknowledge their efforts. On the next several pages, the pictures and addresses
of recognized physicians are shown. Most of the physicians who are recognized
are “family doctors” who specialize in family practice and internal medicine. Some
physicians, such as surgeons, orthopedic doctors and many specialists who do not
routinely manage diabetes or heart disease are not in this program. We would
like to specifically acknowledge those and 133 physicians who have received BTE
recognition for both diabetes and cardiac programs.
31
21 43
ADAMS
36 54
ARAPAHOE
DENVER
14
56 97
ELBERT
15
DOUGLAS
JEFFERSON
1
1
TELLER
31
EL PASO
FREMONT
What is BTE?
PUEBLO
CUSTER
Bridges to Excellence (BTE) is a not-for-profit organization developed by
employers, physicians, health care services researchers, and other industry
493 Total Number of Recognitions in Colorado
experts. BTE’s mission is to create significant leaps in the quality of care that
166 Total Recognitions for Cardiac Program
doctors provide to patients because research shows that very few medical conditions are currently being well managed. The BTE organization has
Total Recognitions for Diabetes Program
327
developed programs that individual communities, health plans, or employers
133 Both Cardiac and Diabetes Programs
can adopt. These programs recognize and reward health care providers who
demonstrate that they properly manage the care of their
patients. To the patient, this means safe, timely, effecCumulative Number of Recognitions by Year as of date shown*
tive, efficient, equitable, and patient-centered care.
For more information about the BTE organization and
what types of programs they have developed, go to their
web site at www.BridgesToExcellence.org. For more
information about the Colorado BTE program, call CBGH
at 303-922-0939.
*Note: Graph and map show only number of recognitions,
not number of physicians receiving BTE recognitions.
700
650
600
550
500
450
400
350
300
250
200
150
100
50
0
670
Cardiac Recognition
Diabetes Recognition
Total
449
326
305
247
196
184
234
220
221
145
35 27
62
51
63
85
92
0 4 4
6/30/2006
6/30/2007
5
6/30/2008
6/30/2009
6/30/2010
12/31/2010
12/31/11
Colorado Bridges to Excellence
Doctors receiving both
cardiac and diabetes recognition
We would like to specifically acknowledge those physicians receiving BTE recognition
for both diabetes and cardiac programs. Out of the 493 recognitions awarded, only
these 133 doctors have received recognition in both diabetes and cardiac programs.
D
Attained diabetes recognition
❤ Attained cardiac recognition
HHReceived a second or third recognition in at least one program
R. Brian Aikin, MD
8015 W. Alameda Avenue
Suite 150
Lakewood, CO 80226-3042
D ❤ HH
Joseph T. Bednarek, MD
4500 W. 38th Avenue
Suite 220
Denver, CO 80212
D ❤
Michael K. Cavanagh, MD
12201 Pecos Street
Suite 500
Westminster, CO 80234-2073
D ❤
R. Victor Doyle, DO
7550 W. Yale Avenue
Building B, Suite 100
Denver, CO 80227-3460
D ❤ HH
David L. Glasscock, MD
7950 Kipling Street
Suite 101
Arvada, CO 80005-3925
D ❤ HH
Jeffrey A. Amundson, MD
205 S. Garrison Street
D ❤ HH
Brian P. Beezley, MD
200 W., County Line Road
Suite 130
Highlands Ranch, CO 80129-2342
D ❤
Kin-Lun Chan, MD
5555 E. Arapahoe Road
Centennial, CO 80122-2312
D ❤ HH
Roy J. Durbin, MD
1930 S. Federal Boulevard
Building A
Denver, CO 80219-5501
D ❤ HH
Dianne K. Glenn, MD
11245 Huron Street
Westminster-A, CO 80234
D ❤ HH
Steven M. Archer, MD
8758 Wolff Court
Suite 200
D ❤ HH
Richard P. Bishop, MD
11550 Sheridan Boulevard
Broomfield, CO 80020-3311
D ❤ HH
Vivian I. Chao, MD
4803 Ward Road
Wheat Ridge, CO 80033-1902
D ❤ HH
David R. Ehrenberger, MD
1420 W. Midway Boulevard
D ❤ HH
Gabriel J. Godina, MD
1930 S. Federal Boulevard
Building A
Denver, CO 80219-5501
D ❤
Brent M. Arnold, MD,
10168 Parkglen Way
Parker, CO 80138-3868
D ❤
Scott H. Blitz, MD
7550 W. Yale Avenue
Denver, CO 80227-3460
D ❤
Carleen C. Chartier, MD
7600 Shaffer Parkway
Littleton, CO 80127-3004
D ❤ HH
Bernard E. Engel, MD
8758 Wolff Court
Suite 200
D ❤ HH
B. Kevin Gordon, MD
16290 E. Quincy Avenue
Aurora, CO 80015-1594
D ❤ HH
Fernando L. Arroyo, MD,
D ❤
Terrence W. Boland, MD,
Arvada, CO 80003-2605
D ❤ HH
Dewey W. Chin, MD,
4803 Ward Road
D ❤ HH
John M. Fedack, MD
257 S. Wadsworth Boulevard
D ❤
John D. Gordon, MD
8585 W. 14th Avenue
Suite B-2
D ❤
James W. Arthur, MD
165 S. Union Boulevard Suite 800
D ❤
Daniel T. Borkert, MD
Lakewood, CO 80227
D ❤
Eric T. Christiansen, MD
280 Exempla Circle
Lafayette, CO 80026-3370
D ❤ HH
Susan I. Fixman, MD
D ❤ HH
Jeffrey K. Gori, MD
4803 Ward Road
D ❤
Julia K. Atkins, MD
1030 S. Johnson Road
Suite 200
Golden, CO 80401
D ❤
Bonnie J. Brooks, MD
2801 Youngfield Street
Suite 120
Golden, CO 80401-0208
D ❤
Laura Elaine Clark, MD
D ❤ HH
Brownie K. Flesche, MD
9285 Hepburn Street
D ❤
Kenneth W. Hahn, DO
10835 Dover Street
Suite 1100
Westminster, CO 80021
D ❤ HH
V. Karen Augustitus, MD
165 S. Union Boulevard Suite 800
D ❤ HH
Hillary L. Browne, MD
2575 Spruce Street
Boulder, CO 80302-3806
D ❤
Trevor L. Clayborn, MD
2345 Bent Way
Longmont, CO 80503-7614
D ❤
D. Paul Forward, MD
1707, Cole Boulevard
Suite 150
Golden, CO 80401-3255
D ❤ HH
R. Scott Hammond, MD
8601 Turnpike Drive
Suite 200
D ❤ HH
Elizabeth A. Baker, MD
7600 E. Park Meadows Drive
Suite 1500
Lone Tree, CO 80124
D ❤
Patricia A. Brumbaugh, MD
Suite 200
Golden, CO 80401
D ❤ HH
Kenneth R., Cohen, MD
30940 Stagecoach Boulevard
Suite 270-E
Evergreen, CO 80439-7984
D ❤ HH
Johanna R. Freedman, MD
9950 W. 80th Avenue
Suite 23
Arvada, CO 80005
D ❤
Regina A. Healy, MD
D ❤
Dawn M. Baker, MD
8199 Southpark Lane
Suite 100
D ❤
Richard L. Brundige, MD
Suite 050
D ❤ HH
Colin H., Combs, MD
4803 Ward Road
D ❤ HH
Dennis P. Genereux, MD
D ❤ HH
John R. Hedberg, MD
165 S. Union Boulevard
Suite 800
D ❤ HH
Werner K. Baumgartner, MD
Suite 800
D ❤ HH
Laird P. Cagan, MD
2030 W. Mountain View Avenue
Suite 400
D ❤ HH
Gregory J. DiLorenzo, DO
1707 Cole Boulevard
Suite 150 Golden, CO 80401-3255
D ❤
James C. Geyman, MD
14701 E. Exposition Avenue
Aurora, CO 80012-2623
D ❤
Melissa A. Helms, MD
Suite 120
Golden, CO 80401-0208
D ❤
Norse R. Bear, MD,
4803 Ward Road
D ❤
Ernest R. Castro, MD
1707, Cole Boulevard
Suite 150
Golden, CO 80401-3255
D ❤
Nicole C. Dorotik, MD
7950 Kipling Street
Suite 101
Arvada, CO 80005-3925
D ❤
Lisa K. Gidday, MD
8199 Southpark Lane
Suite 100
D ❤
Philip M. Henbest, DO
9981 N. Washington Street
Suite 21
Thornton, CO 80229-2165
D ❤
6
Christopher M. Hicks, MD
10400 E. Alameda Avenue
Denver, CO 80247-5104
D ❤
David R. Kresin, MD
2955 South Broadway
Englewood, CO 80113-1526
D ❤ HH
Daniel S. McAninch, MD
1245 Huron Street
D ❤
Mark W. Ptaskiewicz, MD
Arvada, CO 80003-2605
D ❤
Michelle T. Thomas, MD
425 S. Cherry Street
Suite 510
Denver, CO 80246-1200
D ❤ HH
James R. Hill, MD
D ❤ HH
Joseph Ladika, MD
8199 Southpark Lane
Suite 100
D ❤
Douglas G. McCallum, MD
25 S. Cherry Street
Suite 510
Denver, CO 80246-1200
D ❤
Swarupa T. Reddy, MD
11245 Huron Street
D ❤
Ronnie G. Thomas, MD
D ❤
Mark W. Hinman, MD
1350 Tulip Street
D ❤
Charles C. Lee, MD
8199 Southpark Lane
Suite 100
D ❤
Kate E. Miller, DO
4500 W. 38th Avenue
Suite 220
Denver, CO 80212
D ❤
Leanne L. Richardson, MD
D ❤ HH
Richard J. Valenziano, MD
6169 S. Balsam Way
Suite 220
D ❤
Gregory T. Hirons, MD
7625 W. 92nd Avenue
D ❤
Jonathan J. Lee, MD
D ❤
Michael K. Miller, MD
4803 Ward Road
D ❤
Harold G. Richardson, MD
Suite 200 Golden, CO 80401
D ❤ HH
Robert K. Von Rueden, MD
D ❤ HH
Tracy S. Hofeditz, MD
325 S. Teller Street
Suite 250
D ❤ HH
David C. Leistikow, MD
1022 Depot Hill Road
D ❤
Timothy G. Moser, MD
2955 South Broadway
D ❤
Susan J. Robertson, MD
D ❤ HH
Jonathan E. Walter, MD
9950 W. 80th Avenue
Suite 23
Arvada, CO 80005
D ❤ HH
Timothy E. Holcomb, MD
Arvada, CO 80003-2605
D ❤
David M. Leon, MD
2020 Wadsworth Boulevard
Suite 18-B
D ❤ HH
Suzanne C. Nash, MD
3655 E. 104th Avenue
D ❤ HH
I. Douglas Robertson, MD
D ❤
Deborah E. Way, MD
5730 Ward Road
Suite 102
Arvada, CO 80002-1300
D ❤
Gregory F. Hollar, DO
7030 S. Yosemite Street
D ❤ HH
Timothy M. Lewan, MD
12207 Pecos Street
Suite 800
D ❤ HH
Joan M. Neighbor, MD
1707 Cole Boulevard
Suite 150
Golden, CO 80401-3255
D ❤
Philip J. Rosenblum, MD
D ❤ HH
Brian K. Wegner, MD
8585 W. 14th Avenue
Suite B-2
D ❤ HH
Michael R. Iannotti, MD
1022 Depot Hill Road
D ❤
A. Christine Linares, MD
10103 Ridge Gate Parkway
Suite G-23
Lone Tree, CO 80124-5524
D ❤ HH
Aimee S. Nelson, MD
8585 W. 14th Avenue
Suite B-2
D ❤ HH
Mitchel G. Rossman, MD
8510 Bryant Street
Suite 350
D ❤
Sue E. Williams, MD
Arvada, CO 80003-2605
D ❤
Martha Ives, MD
5730 Ward Road
Suite 102
Arvada, CO 80002-1300
D ❤
Kevin T. Lutz, MD
180 Adams Street
Suite 200
Denver, CO 80206-5222
D ❤
John E. O’Connor, MD
205 S. Garrison Street
D ❤ HH
Raymond T. Rupel, DO
200 W. County Line Road
Suite 130
D ❤
Peter M. Wolsko, MD
280 Exempla Circle
D ❤ HH
Julie E. Jeffers, DO
9331 S. Colorado Boulevard
Suite 200
D ❤
J. Dugan Mahoney, MD
2345 Bent Way
D ❤ HH
Brian P. O’Sullivan, MD
D ❤
Eric J. Rydberg, MD
1707 Cole Boulevard
Suite 150 Golden, CO 80401-3255
D ❤ HH
James M. Yeash, DO
D ❤ HH
Thomas M. Jeffers, MD
7950 Kipling Street
Suite 101
Arvada, CO 80005-3925
D ❤ HH
Amy O. Maiocco, MD
2575 Spruce Street
D ❤
John M. Panozzo, MD
7550 W. Yale Avenue
Denver, CO 80227-3460
D ❤ HH
Zachary L. Shpall, MD
4301 Lowell Boulevard
Denver, CO 80211-1654
D ❤ HH
Soumya Yeturi, MD
11245 Huron Street
D ❤
Karen M. Kelly, MD
Suite 120
Golden, CO 80401-0208
D ❤ HH
James M. Martau, MD
8510 Bryant Street
Suite 350
D ❤
Mark F. Pattridge, MD
Suite 200 Golden, CO 80401
D ❤ HH
Heather A. Shull, MD
D ❤
Michael A. Yoesel, MD
8890 N. Union Boulevard
Suite 200
Colorado Springs, CO 80920-2701
D ❤ HH
Erika S. Kenney, MD
4500 W. 38th Avenue
Suite 220
Denver, CO 80212
D ❤
Mark K. Matthews, MD
375 E. 20th Avenue
Denver, CO 80205-5423
D ❤
John R. Pearse, MD,
D ❤
Robin L. Smith, DO
8601 Turnpike Drive
Suite 200
D ❤ HH
Jennifer A. Ziouras, MD
D ❤
Jude J. Kirk, MD
12201 Pecos Street
Suite 500
D ❤
Alexander K. W. Maybach, DO
7950 Kipling Street
Suite 101
Arvada, CO 80005-3925
D ❤
Henry Manning Pickett, MD
1805 Kipling Street
Suite 100
D ❤ HH
Thomas G. Swanson, MD
D ❤ HH
Dennis P. Zoglo, MD
8758 Wolff Court
Suite 200
D ❤ HH
Dale J. Kliner, MD
13650 E. Mississippi Avenue
Suite 100-B
Aurora, CO 80012-3572
D ❤ HH
Kathleen W. Mayer, MD
D ❤ HH
Mary B. Poole, MD
2030 W. Mountain View Avenue
Suite 400
D ❤
Franklin T. Thom, MD
2345 Bent Way
D ❤ HH
7
Health Matters 2011–12 Your Partner in Health
Bridges to Excellence recognition linked
to money savings and improved health
W
What We Observed. For diabetes, we found that BTE recognized physicians have:
e acknowledged those physicians receiving BTE recognitions for diabetes
and cardiac care programs. Now, we want to answer the question: Do BTE
recognized physicians have better outcomes for their patients? First, what
is a better outcome? A better outcome for a patient with diabetes is that
the control of the disease allows the patient to avoid trips to the emergency department to avoid hospitalizations and to avoid bad complications such as heart attack
or stroke. The same can be said for patients receiving cardiac care.
• L ower Costs. Diabetes recognized physicians had lower average relevant costs
than non-recognized physicians. They also showed a strong trend of lower average potentially avoidable costs as well.
• L ower Utilization. Recognized physicians fared better on a variety of utilization metrics including:
º Significantly lower number of emergency room visits (Figure 1)
º Less total days spent in a hospital (Figure 2)
º Lower frequency of hospital admissions (Figure 3)
How can we measure BTE physician performance? We compared the
performance of BTE diabetes recognized physicians with physicians who were also
primary care physicians, but who were not recognized. We looked at both utilization
and cost metrics. A utilization measure is determined by traditional actuarial methods,
for example how many patients per thousand went to the emergency department
and how many days were spent in the hospital. For costs, we used more clinicallybased measures defined by the proprietary PROMETHEUS Payment Model®. Most
simply these are:
This means that the patients with diabetes who see these BTE diabetes recognized
doctors are less likely than other similar patients to have to visit the emergency
room, or be admitted to the hospital in general. We also see that patients of recognized physicians are more likely to get all the routine care they need.
Interestingly, for coronary artery disease, we saw that BTE diabetes recognized
physicians demonstrated significantly lower average relevant costs as well.
• R elevant Costs. Costs that relate specifically and exclusively to a patient’s
underlying condition and co-morbid condition.
Other Observations. It is important to note that other than on the cardiac and
diabetes measures that are part of the BTE Recognition program, recognition as a
whole did not translate into better care in terms of either costs and utilization for
the other chronic diseases mentioned above.
• P otentially Avoidable Costs (PAC). Costs of care for services that reflect poor
outcomes for patients, such as emergency department visits, admission to the
hospital, heart attacks and other complications of the disease. For example, a
patient whose diabetes is well- managed should hopefully be able to avoid or
defer poor outcomes.
Conclusions. No one should be surprised that in medicine, as in other fields,
providers perform better for conditions on which they are measured. We applaud
the efforts those physicians have made to attain cardiac and diabetes recognition,
and patients can appreciate top quality management of their disease.
Using two years worth of medical claims for a national health care plan that covers
Colorado, we looked at performance measures for six chronic conditions: Asthma,
Coronary Artery Disease (CAD), Chronic Obstructive Pulmonary Disease (COPD),
Diabetes, Gastro-esophageal Reflux Disease (GERD), and Hypertension.
Figure 1
Number of emergency
room visits per 1,000
patients with diabetes
632
681
600
350
500
436
450
400
356
100
90
200
60
200
50
150
40
30
20
50
0
10
0
BTE Diabetes Recognized
Non-recognized
92
70
100
100
108
80
250
300
120
110
300
400
Figure 3
Number of hospital
admissions per 1,000
130
500
800
700
Figure 2
Number of days spent
in a hospital per 1,000
0
Non-recognized
8
Non-recognized
A physician’s perspective:
Obesity and related conditions
By Dr. Kenneth Hahn
O
besity is an epidemic in this country and
Colorado is no exception, although it does have
one of the lowest rates of obesity in the country.
Mississippi has one of the highest prevalence
rates where 34% of adults are obese. Colorado has approximately 3.7 million adults of which 36% are considered
overweight and another 20% are considered obese. About
10% of children between 12 and 18 years old living in
Colorado are overweight and another 10% are obese. Just
10 years ago, the prevalence of obesity in Colorado was
half of today’s estimates.
Start with the basics: recommending regular exercise and
a balanced diet help with all of the conditions previously
mentioned. Patients need to continue these behaviors for
the rest of their lives. This needs to be reinforced often.
When they slip up, that is OK, but they just need to get
back on track as soon as possible.
The hard part is getting people motivated to change.
Change is difficult for a multitude of reasons. I have had
several patients change their diet and lose weight just to
avoid paying a higher premium for their health insurance.
This short term achievement can actually have a positive
impact their health, which grows as they continue those
behaviors long term. I encourage patients to think about
their fight against obesity like they do about their retirement savings. The investment, sacrifice and hard work
now will pay off down the road. One of the most rewarding
parts of my job is watching patients transform to a healthier lifestyle and succeed!
Obesity plays a major role in the development and worsening of many diseases encountered every day in family
practice. These include type 2 diabetes, coronary heart
disease, high blood pressure, stroke, certain cancers
(colon, breast, endometrial), gallbladder and liver disease,
and osteoarthritis (for more information, see Colorado
Health Matters Quality Report: Health Plans 2011 available at www.ColoradoHealthOnline.org) . The incidence
of these conditions increases with obesity and lower levels
of physical activity. There are many theories as to how
obesity plays a role in these diseases. I think about it as a
vicious cycle where inactivity and poor diet cause weight
gain which increases insulin resistance and fatty infiltration
of the liver. These conditions in turn cause an increased
appetite which causes further weight gain.
About Dr. Kenneth Hahn
Every physician at Arbor Family Medicine, Dr. Hahn’s practice, chose
to meet Bridges to Excellence standards in both diabetes and cardiac
care programs. Dr. Hahn feels it is important not only to expound on
how to reach optimum health to patients, but to practice giving high
quality health care to patients. Receiving Bridges to Excellence recognitions has
enabled the physicians at Arbor Family Medicine to convey their intent to maintain
high quality standards.
What is a primar y care physician to do?
Dr. Hahn is Board Certified in Family Medicine since 1996. He moved to Colorado in
1993 to do his Family Medicine Residency at Presbyterian/St. Luke’s Medical Center
in Denver, Colorado. He is a member of the American Osteopathic Association. He
has an active interest in most aspects of Family Medicine including gynecology,
pediatrics, dermatology, orthopedics and gastrointestinal disorders.
We do not treat populations, we treat patients on an individual basis. It is critical that we make an impact on an
individual’s behavior in order to help the whole country
get healthier. This is the heart of primary prevention!
9
Bridges to Excellence diabetes care recognitions 1 of 5
Are you living with diabetes?
The diabetes epidemic
T
he number of people with diabetes in this country is continuing to rise. More
than 23.6 million Americans are currently living with the disease. In Colorado
alone the number of patients with diabetes exceeds 220,867. The burden of
diabetes and the cost of treatment contribute to potentially preventable longterm complications such as heart disease, blindness, kidney disease, and stroke.
In order to prevent these long-term complications, people with diabetes should
measure and control their HbA1c, blood sugar, cholesterol, and blood pressure while
receiving regular eye exams and urine tests. While the majority of the burden for getting tehse tests is on the individual, physicians should be directly engaging patients.
superior control, and process measures. For more information, please see Colorado
Health Matters Quality Report: Health Plans.
Fatty foods trigger diabetes
It is well known that an increase in weight leading to obesity is directly related to an
increased risk of type 2 diabetes. However, the direct connection between obesity and
type 2 diabetes was not discovered until recently. In Nature Medicine August 2011,
scientist reported that high levels of fat disrupt two proteins that turn genes on
or off in mice. The specific genes are responsible for a system that monitors blood
sugar. With the genes effectively turned off, the body cannot regulate insulin levels
and type 2 diabetes presents. That is to say, those persons who eat fattier foods are
more likely to develop type 2 diabetes.
CBGH with BTE would like to recognize the doctors on the following pages for
their dedication to helping patients with diabetes through utilizing poor control,
Know your ABCs of diabetes and heart health
Take note
HbA 1c (diabetes only blood test)
• D iabetes is the seventh leading cause of death from disease in the
United States.
• T est results are expressed as a percentage, with 4 to 6 percent being normal in most
cases. Diabetes patients should aim for less than 8 percent.
• All patients with diabetes not meeting their plan goals should test their HbA1c levels
quarterly. Every patient with diabetes should have their levels checked at least twice a year.
• T hose living with diabetes have an increased chance of suffering from
serious health complications.
B lood pressure
• P reventive care practices have been shown to be effective in decreasing
both the incidence and progression of diabetes-related complications.
• S ee your doctor to have your blood pressure tested at least once every two years or
more frequently if you have high blood pressure.
• To prevent high blood pressure, exercise often, avoid high sodium foods, drink
alcoholic beverages in moderation, and find healthy ways to manage stress.
• 9 out of 10 people newly diagnosed with type 2 diabetes are overweight.
• D irect medical expenditures incurred by individuals with diabetes equal
$13,243 vs.or persons without diabetes.
C holesterol
• E veryone over 18 years old should have their cholesterol checked at least once every
five years.
• To maintain healthy cholesterol levels, eat foods low in saturated fats. Your total
daily fat intake should fall between 20–35 percent of your daily caloric intake.
A study published in the journal Diabetes Care in 2005 investigated the effect
of depression on overall mortality in adults with and without diabetes.
During the eight-year study, 1,925 deaths were documented, and 522 of
those deaths were caused by heart disease. Researchers concluded that the
coexistence of diabetes and depres
sion is significantly associated with
an increased risk of death
from all causes, beyond
having just diabetes or just
depression alone.
D iet
• A healthy diet is rich in fruit and vegetables, whole grains, lean meats, and poultry.
• I n maintaining a healthy diet, eat fish at least twice a week and limit dairy intake to
fat-free and 1 percent fat dairy products.
• Limit foods that are high in fat or sugar and those foods that contain hydrogenated oils.
E xercise
• To increase your everyday exercise, take these small steps:
➤ Use the stairs, instead of the elevator or escalator
➤ Park farther away from the office or store
➤ Work in the garden, clean out the garage, or mow the lawn
➤ Go for short evening walks
➤With your physician’s permission, participate in activities like brisk walking,
aerobics classes, swimming, running, or jumping rope three to four times a
week, for 30 minutes at a time.
• To know more, contact your doctor, health plan websites, Colorado
Diabetes Association, or the Colorado Heart Association.
10
Doctors receiving
diabetes recognition
Is treating your diabetes becoming too costly?
The Consumer Reports Best Buy Drugs public education project is a
tool that will help you talk to your doctor about prescription drugs,
and find the most effective and safe drugs that also give you the
best value for your health care dollar. Consumer Best Buy Drugs
aims to improve access to needed medicines for tens of millions of
Americans—because they lack insurance coverage for prescription
drugs, because the prices of many medicines today are so high,
and because many consumers and physicians may not be aware of
proven and affordable alternatives.
For more information on this program, visit
www.ConsumerReports.org.
This is a public service notice.
More than
25.8 million
Americans have
diabetes.
James A. Adams, MD
Sheila S. Bee, MD
2620 Tenderfoot Hill
Suite 110
Vivian I. Chao MD
4803 Ward Road
Wheat Ridge CO 80033-1902
HH
Rebecca L. Agnew, MD
Arvada, CO 80003-2605
Robert B . Beeson, MD
280 Exempla Circle
HH
Amy K. Chudik DO
Jonathan A. Albert, MD
Christine V. Bellantoni Laycock, MD
2222 N. Nevada Avenue
Suite 2010
Duane A. Claassen MD
1707 Cole Boulevard
Suite 150
Golden CO 80401-3255
Brandy M. Allen, MD
Byron L. Berge, DO
3550 Lutheran Parkway
Suite G-20
Douglas P. Clark MD
6140 Tutt Boulevard
Suite 200
HH
Lawrence S. Allen, MD
Vincent A. Bilello, MD
1000 W. South Boulder Road
Suite 214
Lafayette, CO 80026
Stephen W., Cobb, MD
16570 Washington Street
Karen Y. Anderson, MD
Aurora, CO 80012-2623
Sonya L. Black, MD
2955 South Broadway
Mary E., Coleman, MD
Suite 324
Lone Tree, CO 80124-2890
Tracy E. Ayers, MD
4760 Flintridge Drive
Suite 200,
HH
Abby L. Bleistein, MD
8753 Yates Drive
Suite 110
Westminster-A, CO 80031-3679
Melissa R., Coomes, MD
Jennifer E. Bajaj, MD
Denver, CO 80247-5104
HH
Sarah L. Boyer, MD
9285 Hepburn Street
Lillian M., Coppola, MD
1375 E. 20th Avenue
Denver, CO 80205-5423
HH
Glenn A. Baker, MD
Aurora, CO 80012-2623
Joshua A. Brauer, MD
11245 Huron Street
Anna F. Cosyleon MD
HH
Paulanne B. Balch, MD
Arvada, CO 80003-2605
Kevin A. Briggs, MD
11245 Huron Street
David A. Craigie MD
9285 Hepburn Street
HH
Scott I. Barclay, MD
HH
Janet Brown, MD
3235 Mill Vista Road
Highlands Ranch, CO 80129 2440
Thomas P. Dlugos, MD
309 E. Espanola Street
Colorado Springs, CO 80907
HH
Eric D. Barnhart, MD
Suite 115
Lucy M. Budde, MD
John D. Douthit DO
9981 N. Washington Street
Suite 24
Thomas J. Bartlett, MD
Suite 2010,
HH
John R. Burchinal, DO
Arvada, CO 80003-2605
HH
David A. Downs, MD
Denver, CO 80247-5104
Suzanne M. Beck DO
12790-A W. Alameda Parkway
Christopher J. Carlson, MD
4301 Lowell Boulevard
Denver, CO 80211-1654
Meighan W. Elder MD
580 Mohawk Drive
HH
11
Doctors receiving diabetes recognition
continued
Ifeoma R. Eleazu, MD
Denver, CO 80247-5104
HH
Stuart G. Geer, MD
2345 Bent Way
Mark S. Hoskinson, MD
580 Mohawk Drive
HH
F. Paul Knapp, MD
Mark A. Levstik, DO
Julia A. Essig, MD
HH
J. Michael Gibson, MD
11245 Huron Street
Sarah Lynn Huffman, MD
Suite 200
HH
Loree A. Koza DO
Jill R. Levy, MD
Denver, CO 80247-5104
Clifton Etienne, MD
12201 Pecos Street
Suite 500
Michelle L. Glasgow, MD
11245 Huron Street
Westminster,CO 80234
Brian R. Hughes, DO
205 S. Main Street
Suite B
Paula M. Kral, MD
Arvada, CO 80003-2605
Chia-Yen Lien, MD
Mary E. Faini, MD
1309 Sunset Street
Sarah C. Goldberg, MD
11245 Huron Street
Ann M. Imhof, MD
2200 E 104th Avenue
Suite 115
Jennifer O. Kubista, MD
12371-B W. 64th Avenue
Arvada, CO 80004-4035
Judith A. Lindauer-Gosik, MD
Andrea M. Fedele, MD
Scott T. Goodall, MD
7600 E. Park Meadows Drive
Suite 1500
Lone Tree, CO 80124
Warren P. Jaeger, MD
550 Highway 150
Monument, CO 80132-9122
HH
Nirmala S. Kumar, MD
1800 15th Street
Suite 310
Greeley, CO 80631-4562
Valerie E. Lipetz, MD
4745 Arapahoe Avenue
Suite G-50
Michael D. Feil, DO
280 Exempla Circle
HH
James J. Gregory, MD
2200 E 104th Avenue
Suite 115
Karen A. Johnson, MD
8585 W. 14th Avenue
Suite B-2
Mark M. Laitos, MD
1309 Sunset Street
Tracy E. Lippard, MD
2345 Bent Way
Daniel R. Fellhauer, MD
Suite 200
Lauren J. Halby, MD
Suite 200
Thomas G. Johnson, DO
5115 Fontaine Boulevard
Suite 101
Fountain, CO 80817-1061
Huong M. Lam, MD
Troy A. Long, MD
4803 Ward Road
Patricia J. Flood-Speidel, MD
Steve D. Haley, MD
2345 Bent Way
HH
Cynthia L. Justice, MD
1375 E. 20th Avenue
Denver, CO 80205-5423
Tish R. Landrum, MD
8550 W. 38th Avenue
Suite 206
David H. Lookner, MD
580 Mohawk Drive
HH
John J. Ford, MD
8601 Turnpike Drive
Suite 200
Douglas C. Hammerstrom, MD
3470 Centennial Boulevard
Suite 205
HH
Ingrid M. Justin, MD
11245 Huron Street
HH
Anita K. Lane, MD
Suite 2010
HH
Luis H. Lorenzo, MD
MS-C312
Aurora, CO 80045-7109
Eric S. Francis, MD
4803 Ward Road
Eric J. Harker, MD
580 Mohawk Drive
Michael B. Keller, MD
1700 Marion Street
Denver, CO 80218
Karen L. Larson, MD
7615 W. 38th Avenue
Suite B-117
Wheat Ridge, CO 80033
Christopher C. Madden, MD
1309 Sunset Street
James E. Franzbrooke, DO
10465 Melody Drive
Suite 306
Northglenn, CO 80234-4126
HH
Ronald R. Harris, MD
2955 South Broadway
Tanya Michelle Kern, MD
Theodore S. Lawson, MD
Suite 200
HH
Matthew T. Maloney, MD
James M. Fretwell, MD
205 S. Main Street
Suite B
Mark P. Hayman, MD
HH
Joseph H. Kim, MD
Suite 350
HH
Li-Fen Lee, MD
Angie N. Martinez, MD
Arvada, CO 80003-2605
Debra A. Friesen, MD
4803 Ward Road
Felipe Hernandez, MD
2955 South Broadway
James M. Kinsman, MD
Suite 350
Amy L. Lemke, MD
Aurora, CO 80015-1594
Stacey L. Mason, MD
David F. Garfias, MD
4350 Wadsworth Boulevard
Suite 425
HH
T. Kevin Hetherington, DO
Denver, CO 80247-5104
Mary E. Kirker, MD
630 15th Avenue
Suite 103
Longmont, CO 80501
Lorena R. Letkomiller, MD
300 Exempla Circle
Suite 310
Kimberly M. Mayhew, MD
580 Mohawk Drive
HH
12
continued
Edward P. McAuliffe, MD
280 Exempla Circle
John D. Norton, MD
Suite 2010
Innessa T. Porter, MD
Michael A. Schindel, MD
7444 W. Alaska Drive
Suite 200
John K. Stanton, DO
12004 Melody Drive
Westminster, CO 80234 4212
Anne B. McLean, MD
30940 Stagecoach Boulevard
Suite 270-E
Evergreen, CO 80439-7984
HH
Atsuko J. Ohtake, MD
HH
Carla J. Rail, MD
8550 W. 38th Avenue
Suite 206
Leslie A. Schipper, DO
Suite 130
Richard M. Stiphout, MD
3670 Parker Boulevard
Carolyn Alice Mellette, NP
Rafael J. Olivares, MD
255 Union Boulevard
Suite 300
Carol J. Ramatowski, DO
7850 N. Vance Drive
Suite 100
Arvada, CO 80003-2127
Kathryn E. Schorr-Winchell, MD
1375 E. 20th Avenue
Denver, CO 80205-5423
Helen M. Story, MD
6169 S. Balsam Way
Suite 250
Thomas P. Merkert, MD
4803 Ward Road
Caryn E. Orr, MD
Denver, CO 80247-5104
Janisse Cayanan Rears, DO
Arvada, CO 80003-2605
Kent Schreiber, MD
Nancy L. Stoudt, MD
Suite 115
Joyce E. Michael, DO
Suite 200
HH
Amy J. Owen DO
6140 Tutt Boulevard
Suite 200
Juanita R. Redfield, MD
11245 Huron Street
Veronica A. Serna-Eberhart, MD
Suite 2010
Kyle M. Suire, DO
1823 Ford Street
Golden, CO 80401-2464
Jennifer J. Miller, MD
Aurora, CO 80015-1594
Robert D. Pane, MD
1000 W. South Boulder Road
Suite 214
Lafayette, CO 80026
Jay Reinsma, MD
Suite G-20
HH
Patrick B. Shahan, MD
550 Highway 150
Monument, CO 80132-9122
HH
Tod M. Sweeney, MD
6390 Gardenia Street
Suite 140
Arvada, CO 80004
Patrick A. Miller, MD
Suite 350
HH
Ian E. Parsons, MD
Aurora, CO 80015-1594
Vernon D. Ritzman, MD
8550 W. 38th Avenue
Suite 206
Phillip A. Shriver, MD
6140 Tutt Boulevard
Suite 200
Margret S. Thompson, MD
Aurora, CO 80012-2623
Richard A. Miller, MD
Suite 101
Karla C. Pastrana, MD
Susan I. Roach, MD
1309 Sunset Street
Amarbir K. Sidhu, MD
10835 Dover Street
Suite 1100
Albert G. Ting, MD
Aurora, CO 80012-2623
HH
Victoria L. Moffatt, MD
2345 Bent Way
Manoj V. Pawar, MD
1400 E. Boulder Street
Juan B. Rodriguez DO
4674 Snow Mesa Drive
Suite 140
Fort Collins, CO 80528-8614
Linda M. Silveira, MD
6025 Delmonico Drive
Tony J. Toloczko, MD
Morris Moore, MD
580 Mohawk Drive
HH
Kerry A. Peel, MD
580 Mohawk Drive
Mark D. Rojec, MD
Aurora, CO 80015-1594
Robert M. Sims, MD
6169 S. Balsam Way
Suite 250
Deanne L. Veselka, MD
Suite 101
Barbara A. Morris, MD
3235 Mill Vista Road
Mark A. Perea, MD
2425 S. Colorado Boulevard
Suite 160
Denver, CO 80222-5937
Richard P. Rubenstein, MD
1655 Lafayette Street
Suite 110
Denver, CO 80218
Jacqueline A. Skaggs, DO
Suite 200
Rachel A. Voogt-Clayborn, MD
280 Exempla Circle
Lafayette, CO 80026 3370
Jeffrey M. Morse, MD
Denver, CO 80247-5104
Michael J. Perlman, MD
580 Mohawk Drive
Monica P. Salas-Meyers, DO
Bruce R. Smith, MD
1655 Lafayette Street
Suite 110
Denver, CO 80218
Jeannine S. Wallnutt, MD
Arvada, CO 80003-2605
Nicole A. Nagel, MD
280 Exempla Circle
Melissa B. Peters, DO
E. Mark Sarinopoulos, MD
HH
Jeffrey G. Snyder, MD
16222 US Highway 24
Suite 200
Woodland Park, CO 80863-8763
Kristine E. Walsh, MD
2803 Roslyn Street
Denver, CO 80238-2624
Dawn M. Newell, MD
9285 Hepburn Street
Susan P. Peterson, MD
11245 Huron Street
Rebecca J. Schaefer, MD
4500 W. 38th Avenue
Suite 220
Denver, CO 80212
Michael W. Spangler, DO
Suite 350
HH
Harry J. Walter DO
8515 Pearl Street
Suite 202
Thornton, CO 80229
13
continued
Donald G. Ward, DO
HH
James H. Weingart, MD
Suite 115
Cydney N. West, DO
12371-B W. 64th Avenue
Arvada, CO 80004-4035
Camilla S. Wright, MD
9285 Hepburn Street
Christine A. Yang, MD
Terri B. Weber, MD
6140 Tutt Boulevard
Suite 200
HH
Teresa S. Welsh, MD
Aurora, CO 80015-1594
Jason R. West, DO
Suite G-20
HH
George H. Yamasaki, MD
8550 W. 38th Avenue
Suite 206
Paula J. Zegob-Hartmann, MD
2345 Bent Way
HH
Disease management programs
Many health plans offer programs to their members with asthma,
cardiovascular disease, diabetes, obesity, and other chronic conditions.
Through these programs you can learn to manage continuing health
conditions so you stay active and avoid complications. Many plans will
provide you with a case manager, a nurse, or a call-in number so you can talk
to a health professional. You may use these resources to answer day-to-day
questions that you may have such as:
• What diseases may cause the symptoms I have?
• What tests might I need, or what do these test results mean?
• What are these medications and how can I take them most effectively?
Suggestions on disease management from a physician
• When do I need to see my physician again?
1. Follow up on your tests, because not all physicians have reliable systems to
notify patients of results in a timely way.
• How can I change my daily activities so that I can start feeling better?
2. Know your numbers! What is the optimal level for your blood pressure, your
cholesterol, and your blood sugar? What is your healthiest weight?
Your nurse or case manager can work directly with you and your doctor to
design a plan that is right for you. Effective disease management programs are
based on the best evidence and practices available in the medical literature.
3.If you are told you have diabetes, heart disease, or any other chronic health
problem, find out more! Find a health educator or a care manager, or see if you
are eligible to join a disease management program through your health plan.
You have questions; they have answers.
How can disease management help my family member or me?
Common benefits of disease management programs include: children
missing fewer days of school, adults missing fewer days of work, and fewer
complications from chronic conditions.
4. Follow through with your health provider’s recommendations. Lose a few
pounds, quit smoking, and get active. Take your medications exactly as
prescribed. Go back to see your physician routinely, so you have the time to talk
about managing your health, tracking your progress, getting preventive care as
scheduled, and making changes in medications if necessary.
How can I get into a disease management program?
Contact your health plan or your physician to learn more about these
programs. Many of these programs are available to plan members at no cost.
How can I organize my health care information?
Track your health and your health care services in an electronic personal health
record. A personal health record can organize your medications, test results,
and allergies into a private, personal, and accessible record.
5.Be persistent. A patient without a physician’s knowledge might make
assumptions that could have proved deadly. You must be your own advocate.
For more information, call the Colorado Business Group on Health at
303-922-0939.
14
Bridges to Excellence cardiac care recognitions 1 of 2
Heart health
A
ccording to an American Heart Association publication, more than 81 million
Americans have had one or more forms of cardiovascular disease. It is no
surprise that cardiovascular diseases are the single largest killer of Americans
and Coloradans alike. In fact, every 26 seconds, an American suffers a coronary event, and about every minute an American dies from one. In Colorado alone,
someone dies every hour from cardiovascular disease. BTE’s cardiac care program
hopes to lower the financial and human burden of unnecessary hospitalizations
and complications. Physicians are evaluated based on care provided to a sample
of individual patients regarding the following clinical measures: blood pressure
control, LDL control, complete lipid profile, use of aspirin or another antithrombotic,
and documentation of smoking status and cessation advice and treatment.
CBGH and BTE would like to recognize the doctors on the following pages for their
commitment to patients with cardiovascular disease.
Cardiovascular disease includes, but is not limited to the following:
•
•
•
•
High blood pressure (140/90)
Coronary
º Myocardial infarction (MI or heart attack)
º Heart failure
Stroke
Congenital cardiovascular defects
Tips to reduce your risk of heart disease:
•
•
•
•
Do not smoke
Control your blood pressure
Exercise regularly
Eat a healthy diet
Even while a person is still overweight or obese, losing 5-10% of one’s weight may
lower the likelihood of developing heart disease. A stronger heart means more
efficient pumping, oxygenation, and nutrient carrying benefits of the blood. Weight
loss will help:
• Lower blood pressure
• Lower triglycerides
• Lower cholesterol
• Improve heart function and blood flow
• Decrease inflammation through the body.
Take note
Smokers have two to three times the risk of suffering coronary heart disease. In Colorado, someone
dies every hour due to cardiovascular disease. Call the Quitline number or visit colorado.quitlogix.org.
This is a public service notice.
15
8 0 0 - Q U I T- N O W
(800-784-8669)
Bridges to Excellence cardiac care recognitions 2 of 2
Doctors receiving cardiac recognition
Jack D. Aikin MD
Suite 310
Dennis C. Channel, MD
11245 Huron Street
John H. Gale MD
1823 Ford Street
Golden, CO 80401 2464
HH
Arthur Levene, MD
1000 Southpark Drive
HH
Stephan W. Shane, DO
11245 Huron Street
Jason V. Barmore, MD
William C. Choe MD
HH
W. Terry Gipson, MD
Suite 380
Peter W. Levitt, MD
Michael E. Staab, MD
HH
Frank R. Becky, MD
4803 Ward Road
Roger S. Damle MD
HH
Jeffrey J. Glaves, MD
9285 Hepburn Street
Sheila L. T. Ling, MD
2575 Spruce Street
Paul M. Sunde, MD
6169 S. Balsam Way
Suite 220
John L. Bender, MD
4674 Snow Mesa Drive
Suite 140
Fort Collins, CO 80528-8614
Ira M. Dauber MD
HH
James T. Hardee, MD
11245 Huron Street
Laura A. Makaroff, DO
12543 N Highway 83
Suite 228 Parker, CO 80134-8800
C. Rockney White, MD
Denver, CO 80247-5104
Joseph E. Burchenal, MD
Littleton, CO 80120 5654
HH
Jamie J. Doucet MD
3000 Center Green Drive
Suite 120
David C. Hutchings, MD
Denver, CO 80247-5104
Michael D. Mignoli, MD
9218 Kimmer Drive
Suite 106
Lone Tree, CO 80124
Thomas C. White, MD
200 West County Line Road
Suite 370
Highlands Ranch, CO 80129
Ellen M. Burkett, MD
4185 E. Wildcat Reserve Parkway
Suite 100
Andy M. Fine MD
7720 S. Broadway
Suite G-30
David L. Kauffman, MD
Juventino Saavedra, MD
1375 E. 20th Avenue
Denver, CO 80205-5423
Heather L. Burton, MD
Steven P. Friedrich, MD
HH
Dimitri A. Kaufman, MD
HH
Harvey A. Schuchman, MD
HH
What you need to know about cholesterol
There are two types of cholesterol. It is very important for you to
understand the difference. Too much of one or not enough of the
other can put you at risk for coronary heart disease or stroke. LDL is
commonly referred to as the “bad” cholesterol. LDL has been linked
to the formation of blockages or plaques that narrow the arteries,
raise blood pressure, and make the heart work harder. HDL, on the
other hand, is referred to as “good” cholesterol because it prevents
formation of plaques with the arteries. Low LDL levels coupled with
high HDL levels indicate a reduced risk of heart attack or stroke.
♥
19.7%
of all deaths in Colorado
are caused by heart disease.
1.25 million
heart attacks occur in the
United States
annually.
16
Health plan tools to fight obesity 1 of 2
Colorado health plans provide
tools to keep members healthy
M
aintaining a healthy weight is beneficial for an improved physical,
emotional, and financial lifestyle. Many health plan members do not know
that health plans offer programs that guide them on ways to maintain a
healthy weight and inform them about the healthiest manner in which to
lose excess weight. Additionally, plans offer employers and physicians tools and
products that help them engage their employees and patients in exercise, weight
loss and healthy lifestyle programs.
Mountain Health Plan (RMHP), and UnitedHealthcare (United) each have areas of
their websites that allow members to explore healthy eating habits and guidelines for
maximizing the benefits of exercise. Often these sites present the information in an
interactive medium that the member can tailor to his or her particular needs.
Personalized Programs
Each health plan has some type of one-on-one counseling they offer to help members
manage their weight. Participants in RMHP’s Well Being Index receive individual assessments to evaluate health status in six domains of life: Life Evaluation, Emotional Health,
Physical Health, Healthy Behavior, Work Environment, and Basic Access to health care.
Aetna’s Healthy Body, Healthy Weight program offers telephonic counseling sessions
that integrate educational material and web-based interactive tools. United offers both
online, real-time health coaching with registered nurses and obesity-centric telephonic
coaching. Likewise, Kaiser offers telephone health coaching on health eating, active living as well as weekly classes at local medical offices and employer sites to cover multiple
weight related topics. Several plans also offer discounted or free commercial weight loss
programs such as Jenny Craig or WeightWatchers.
Targeting/Identifying Patients
In 2011, health plans identified only 4% of their population as obese despite
recognized studies putting the number at around one-third of Americans. Why
the disparity? Currently, most health plans can only identify if a patient is obese if
the patient completes a self-administered health assessment survey. One way to
improve the tracking of patient’s weight is to require, for accreditation purpose,
plans to know if a physician is tracking patient BMIs. The Healthcare Effectiveness
Data and Information Set (HEDIS), the most widely reported set of performance
measures in the industry, has measures relating to health plans measuring obesity
in their populations: Adult BMI Assessment (ABA) and Weight and Counseling for
Nutrition and Physical Activity in Children/Adolescents (WCC). ABA measure reports
what percentage of plan members had their BMI measured at a doctor visit while
WCC measure encourages BMI assessment by physicians bolstered by counseling for
nutrition and physical activity in minors. The good news is many Colorado health
plans decided to voluntarily report these measures in the near future. Hopefully
with increased awareness of the prevalence of BMI testing, plans will be able to
better follow their patient population and target patients who would most benefit
from their educational programs.
Member Interventions
Access to Information on the Internet
Plans disseminate information regarding the free weight loss/weight management
benefits each plan offers on their websites. Aetna, Kaiser Permanente (Kaiser), Rocky
17
Health plan tools to fight obesity 2 of 2
Tools to keep members healthy
The community approach
Community Interventions
Lastly, many plans support community initiatives geared to prevent obesity.
CIGNA collaborates with the Healthy Kids Challenge program to aid schools and
communities in preventing childhood obesity by encouraging healthier eating
habits and physical activity in children. With grant support, Aetna is sponsoring
the Partnership for Prevention, which will quantify the likely impact of childhood
obesity. Anthem awarded the Rocky Mountain Public Broadcasting Network a
grant to help adults improve and sustain healthy physical activity levels. Also, with
grant funding, Anthem provided wounded military service members in eleven
states rehabilitation programs in sports and recreation. Similarly, United, Children’s
Hospital Colorado and the USA Pro Cycling Challenge are launching a new program,
“Bikes for Life,” that will provide 1,000 bicycles and 1,000 helmets to Denverarea kids over the next three years. RMHP and Kaiser have partnered with and/
or sponsored LiveWell Colorado to support and collaborate in their programs that
encourage healthy weight maintenance.
Health plans support a community approach to weight management by providing
employers, physicians, local health agencies, and other health care providers with
tools and programs that encourage healthy habits and choices. For example, CIGNA,
Aetna, and United distribute free toolkits to employers that include educational
posters, body mass index (BMI) calculators, pedometers, and informative weight
management pamphlets for distribution to employees.
Health care providers, as those who interface directly with patients, are key in
encouraging plan members to lose weight and in providing information to patients
on how to maintain weight in a healthy manner. Kaiser physicians directly refer
members to a clinical weight management program. RMHP gives primary care physicians an Overweight and Obesity Toolkit that includes assessment and counseling
guidelines, BMI wheels, tape measures, and Centers for Disease Control BMI-ForAge Growth Charts. Meanwhile, United and HMO Colorado (Anthem) give health
care providers Continuing Medical Education credits if that provider participates
in obesity management education opportunities. The Fun & Fit Families Toolkit for
Providers, from CIGNA, helps physicians appropriately broach the subject of obesity
with patients and their families and discuss the patient’s weight management,
nutrition, and physical activity status and goals. Anthem’s Child and Adolescent
Obesity Provider Toolkit provides physicians quick access to updated information
and resources related to child and adolescent obesity.
18
✁
As we attempt to lower health care costs and increase the fitness of our population, health plans play a critical role in educating and assisting patients to lose
weight, stay active, and eat healthy. Likewise, health plans are in a key position
to collaborate with employers and providers in creating health programs that
effectively engage employees and patients in weight-wise activities and choices.
The interventions listed above should encourage employers and patients to work
with their health plans to develop ever more cost-effective and measurable weight
management tools.
fruit
burrito
steak
cheese
potato
butter
Photo: National Geographic
pasta
Cut out this page and post it on your refrigerator.
Thinking about…
HOW MUCH TO MUNCH?
Use these objects as a guide to por tion size.
YES, I CAN! Small Steps, Great Rewards
ACTIVITY AND FOOD
Eat a little less! Walk and exercise more!
100 extra calories per day could add 10 extra pounds per year.
Nutritionists suggest what a single serving should be.
Portion sizes based on recommendations from the American Dietetic Association
and Weight Watchers International.
19
A check-up on your doctor 1 of 2
Patient ratings on doctors are available
Check-up on your doctor
T
he Colorado Business Group on Health proudly announces its participation
in a survey that allows patients to rate their own physicians. Results for 475
primary care physicians in the Denver/Boulder area are available.
What was the purpose of the survey?
Patients rated their doctors on several important factors, including how well their
doctors listen and explain things, make themselves available for appointments and
care when needed, arrange to have helpful and courteous office staff, and whether
they would recommend their doctor to family and friends.
What did doctors think about the survey?
The Colorado Medical Society and the Colorado Academy of Family Physicians supported this survey. Together, they sent a letter to area physicians about the project
encouraging them to participate. The physicians who commented on the survey
were pleased with the project because:
• It is a way to compare their results to other physicians.
Comments of health care leaders on the CHECKBOOK initiative
• P hysicians can use these results to improve their relationship with
their patients.
“With its new large-scale survey of patients’ experiences with physicians, CHECKBOOK
has shown that this effort is feasible and that its results can help consumers make
informed decisions and improve quality,” said Carolyn Clancy, M.D., Director of
the U.S. Agency for Healthcare Research and Quality (AHRQ). “I am particularly
pleased that this survey is based on questions and procedures that were scientifically
developed by the AHRQ-funded researchers.”
• It uses a nationally endorsed survey that was developed by experts.
• I t is conducted by nonprofit groups, including the Colorado Business Group
on Health and its partner, the Consumers’ CHECKBOOK/Center for the Study
of Services, a nonprofit consumer organization.
The reports on doctors are available free to the public at the CHECKBOOK website
(www.checkbook.org/patientcentral) and also through the website of the Colorado
Business Group on Health (www.coloradohealthonline.org).
“Consumers want information to help them find a good doctor,” said John Rother,
Executive Vice-president for Policy of AARP. “AARP commends CHECKBOOK
and the participating health plans for making available reliable information on
how patients experience care in their doctors’ offices. Now that CHECKBOOK has
successfully demonstrated it is feasible and economical to obtain this information,
we hope that health plans in other parts of the country also will offer consumers
this type of information about their doctors.”
There are increasing numbers of websites that collect and report patient ratings
of doctors, but most have fewer than five reports on physicians. At many of these
websites, it is possible for anyone (even a doctor or the doctor’s staff) to “stuff
the ballot box.” In contrast, this report is based on statistically valid numbers of
completed surveys. In Colorado, we received an average of 48 completed patient
surveys per doctor.
“This initiative provides important information to patients about care they can
expect to receive in a particular physician’s practice,” said Colorado Medical
Society President Ben Vernon, M.D. “Transparency in the health care system is
paramount. We expect this information not only to be helpful to the patients, but
also to all of the physicians. After all, achieving good outcomes for our patients is
about working together.”
CHECKBOOK’s website also has extensive advice, videos, checklists, and other
resources to help doctors improve and to help patients do their part—especially
in communicating with physicians. CHECKBOOK expects that, as the survey spreads
around the country, physician leaders will put together quality improvement
programs, as they are doing in the pilot communities.
“Patient- and family-centered care is a key goal of health care reform, and we
can’t get there without asking patients about their experience receiving care,”
said Debra Ness, President of the National Partnership for Women and
Families. “Patient experience surveys, like the one piloted by CHECKBOOK, can
help patients make better health care choices and help health care providers make
needed improvements. Patient experience surveys play a central role in both the
assessment and improvement of care by asking the right questions and providing
critically important information for both patients and providers.”
Where can I get more information on Denver/Boulder–
area physicians?
20
A check-up on your doctor 2 of 2
A check-up on your doctor:
What consumers can find out
Visit our websites
How to use the public website
Go to the patients survey under progress at
www.ColoradoHealthOnline.org or www.checkbook.org/patientcentral.
You can search for a doctor in many ways:
• Alphabetically, by last name
• By specialty (either Family Medicine, General Practice, Geriatric Medicine,
and Internal Medicine)
• By ZIP code
Results are available on 475 physicians who provide primary care in the Denver/
Boulder area. We hope to repeat this survey in the future, and provide information
about more Colorado physicians. Colorado consumers can use this site to find out
about their own doctor or find a new one.
On the main page, there is a list of physician names, addresses, specialties, distance
from the ZIP code you input, and the overall rating of each physician.
Sample Page:
What patients say about their doctors
Doctor’s name
Click on name for full report on doctor.
Dr. Jane Doe
1234 First Drive,
Denver, CO
How many
patients answered the
survey about
this doctor
Specialty
Miles from the zip code
you entered
52
Family Medicine
30.67
miles
Overall rating of this doctor and
either the word “Better, Average or Lower”
as compared to the other doctors in the community
|——————————————————|
0
100
86
Better
On this page you can select up to four physicians and then click “compare” to view a page that sets the scores of those four doctors next to each other.
Or, you can click on one doctor’s name, and view more detail about that doctor on this page.
Once you choose a physician, you will see this page.
Doctor’s score and whether statistically Better or
Lower than community average
Dr. Jane Doe
Overall rating of Doctor
Overall, being able to get appointments and care when needed
Overall, how well doctor communicates
When doctor ordered a blood test, x-ray, or other test, how often
someone from doctor’s office followed up to give you those results
Overall, helpfulness and courtesy of office staff . . .
Would you recommend this doctor to your family and friends (%
definitely yes)
|—————————————————————|
0
100
Dr. Doe 86
79
Community Average
Dr. Doe 78
81
Community Average
Dr. Doe 95
91
Community Average
Better
Dr. Doe 94
90
Community Average
Dr. Doe 90
86
Better
Dr. Doe 97
91
Better
Community Average
Community Average
Number Responding
Better
52
21
Resources
Resources
Page 4: Cutting the fat
Centers for Disease Control and Prevention. “Overweight and Obesity: Health Consequences.” 2011.
http://www.cdc.gov/obesity/causes/health.html
Colorado Department of Public Health and Environment. “Adult Obesity in Colorado: Results from the Behavioral Risk Factor
Surveillance System.” 2002. http://www.who.int/topics/obesity/en
Centers for Disease Control and Prevention “U.S. Obesity Trends.” http://www.cdc.gov/obesity/data/trends.html
Centers for Disease Control and Prevention “Behavioral Risk Factor Surveillance System: Prevelance and Trends Data.”
http://apps.nccd.cdc.gov/brfss/display.asp?cat=OB&yr=2009&qkey=4409&state=UB
Finkelstein E.A., et. al. “Annual Medical Spending Attributable to Obesity: Payer- and Service-specific Estimates.”
Health Affairs 2009.
Gates, D.M., et. al. “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity.”
Journal of Occupational and Environmental Medicine. January 2008.
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. 2002.
“Overweight and Obesity: Health Consequences.” www.cdc.gov/nccdphp/dnpa/obesity/consequences.htm
Sturm, R. “The Effects of Obesity, Smoking and Drinking on Medical problems and Costs.” Health Affairs 21.
Page 10–14: Diabetes care and recognitions
American Heart Association. “Heart Disease and Stroke Statistics—2007 update.”
http://www.americanheart.org/downloadable/heart/ 1166711577754HS_StatsInsideText.pdf
Centers for Disease Control and Prevention. “Diabetes-Related Concerns.”
http://www.cdc.gov/diabetes/faq/concerns.htm#1
Centers for Disease Control and Prevention. “National Diabetes Fact Sheet.”
http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2005.pdf
Centers for Disease Control and Prevention. “National Diabetes Fact Sheet.” www.cdc.gov/diabetes/pubs/estimates.htm
Colorado Department of Public Health and Environment. “Diabetes Prevention and Control Program—Colorado Data and Trends.”
http://www.cdphe. state.co.us/pp/diabetes/stats.html
Diabetes Care, Volume 33, Supplement 1, January 2010. “Executive Summar: Standards of Medical Care in Diabetes -2010” Accessed
at: http://www.coloradoguidelines.org/pdf/guidelines/diabetes/ada_executive_summary_2010.pdf
Diabetes Control and Complications Trial Research Group. “The Effect of Intensive Treatment of Diabetes on the Development and
Progression of Long-Term Complications in Insulin-Dependant Diabetes Mellitus.” New England Journal of Medicine. 1993.
Egede, Leonard E., Nietert, Paul J., and Zheng, Deyi. “Depression and All- Cause and Coronary Heart Disease Mortality Among
Adults With and Without Diabetes.” Diabetes Care. 2005.
Jacobs, P. et. al. “Productivity Losses Associated with Diabetes in the U.S. Diabetes Care.” 2001.
National Institute of Diabetes and Digestive and Kidney Diseases. “National Diabetes Statistics.”
http://diabetes.niddk.nih.gov/populations/index.htm
National Institute of Diabetes and Digestive and Kidney Disesases. “Kidney Disease of Diabetes.”
http://www.catalog.niddk.nih.gov/
National Institute of Health. “Why Taking Care of Your Diabetes is Important.”
http://diabetes.niddk.nih.gov/dm/pubs/type1and2/care.htm#4
Ohtsubo, K., Chen, M. et. al. “Pathway to diabetes through attenuation of pancreatic beta cell glycosylation and glucose
transport.” Nature Medicine. August 2011.
Wolf, A.m., Colditz, G.A. “Current Estimates of the Economic Cost of Obesity in the US.” Obesity Research. 1998.
22
Resources
Resources
Pages 15–16: Cardiac care and recognitions
American Heart Association. “Heart Disease and Stroke Statistics—2007 Update.”
http://www.americanheart.org/downloadable/heart/ 1166711577754HS_StatsInsideText.pdf
Centers for Disease Control and Prevention. “Health Weight - it’s not a diet, it’s a lifestyle!” 2011. http://www.cdc.gov/
healthyweight/losing_weight/index.html
Cokkindes VE, et. al. “Under-use of Smoking Cessation Treatments: Results from the National Health Interview Survey.”
Colorado Department of Public Health and Environment. “Colorado Adult and Youth Smoking Rates Lowest Since 1990.”
http://www.colorado.gov/cs/Satellite?c=Page&cid=1190622828988&pagename=GovRitter%2FGOVRLayout
Henkel, John. “Keeping Cholesterol Under Control.” http://vm.cfsan.fda.gov/~dms/fdcholes.html
Hurt, Richard D., M.D. “Quit smoking.” Advice column for Mayo Clinic. 2010. http://www.cdc.gov/obesity/causes/health.html
National Institute of Diabetes and Digestive and Kidney Diseases. “Do You Know the Health Risks of Being Overweight?” 2007.
http://win.niddk.nih.gov/publications/health_risks.htm
Phillips, K. et al. “Health and Economic Benefits of Increased Beta-Blocker Use Following Myocardial Infraction.”
JAMA 2000. 284(21): 2748–2754.
World Health Organization. “Why is Tobacco a Public Health Priority?” http://www.who.int/tobacco/health_priority/en/index.html
23
President’s letter from Tamara Kirk
We survive and press on
H
aving survived the initial requirements of health
care reform, some of us chose to lose grandfathered
status, sometimes because we had no choice but to
shift more cost to employees immediately. Some of
us maintained grandfathered status because we had positive experience perhaps due to the economic downturn or
because of good management of wellness programs, or just
because of good luck. Others marched forward to strategic
planning for benefits and health care with a longer term
view. When it comes to strategic planning, there are a lot of
questions to “noodle on.”
Tamara Kirk, President,
From what you’ve seen of reform, no doubt, you are starting
to ask yourself questions like:
HR Supervisor,
Colorado Springs Utilities
• S hould we continue to offer health care benefits or let the
exchanges take care of it? How will the exchange offer
benefits that are competitive and affordable? How will my
offering remain competitive, or will I lose enrollment to the
plans on the exchange? How will I keep my plan affordable?
• I f our organization isn’t involved in health care anymore,
how would that affect my bottom line as a business? Will
it cause my business to care about health and productivity
more, or, less?
hat will my workforce expect? Does my offering health
• W
care to my workforce add value? Will offering health
care benefits and access, or not offering it, affect ability
to compete for labor? Will my workforce appreciate the
convenience of group health care benefits or prefer to shop
for access to insurance on their own? What will the plans
on the exchange look like compared to my plan(s)?
• I f employers are not engaged in health care access,
preferring to pay taxes, what will this do to compensation
strategies and the cost of wages? Will labor cost rise more
or less?
• I f you project your trend forward, will your plan be subject
to tax penalties? Will you have to reduce benefits? How
much will the taxes cost if I make Decision A or Decision B?
• W
hen should I take my plan out to bid? What will I be able
to buy? How will the evolution shape group carriers, Third
Party Administrators and Pharmacy Benefit Managers?
When you start really thinking through the possibilities, they
are endless and mind-numbing. Benefits professionals will
have a lot to deal with, and of that we are certain.
24
Given where things are, and what we’ve seen so far, we
are also certain that health care costs will continue rising.
Required access to health care insurance does not mean that
health care will suddenly be affordable. We have a long way
to go before we can get cost under control. The underlying
drivers of cost are increased demand, increased utilization
and unhealthy lifestyle choices. Additional cost is incurred
because of waste, duplication, unsafe practices, lack of
primary care doctors and poor quality.
Even if you are of the mind that your organization is going to
get out of health care, that decision is not without consequence. Even if you are of the mind that your organization
is planning to offer health care benefits for the foreseeable
future, you will be facing purchasing and plan design decisions that have to take new and uncharted experience and
new developments into account.
So, while we faced the first hurdles of health care reform
with success, and have had some time to see a few reform
developments, the future is still uncertain for employers on
many fronts.
That’s why the Colorado Business Group on Health is so
important to those of us who are members and employerpurchasers. The best way to address these issues is through
collaboration, sharing ideas and community initiatives like
those listed here. Be sure to consider joining us as we tackle
the true cost drivers and adapt to ongoing reform. We’re looking forward to seeing you!
Creating a state of quality
Your partners in quality
The Colorado Business Group on Health is a non-profit coalition representing large purchasers of
one of your most important benefits—health care services. By working together, we can assure
that consumers have the best possible information on health care quality. CBGH and Colorado
health plans have been working on the “big picture” of health care quality since 1996. Health care
is a service that is delivered locally; therefore the only way to successfully incorporate value-driven
principles is to act locally.
www.ColoradoHealthOnline.org • 303-922-0939
Members
Boards of Education Self-funded Trust
Boulder Valley School District
City of Colorado Springs
Colorado College
Colorado Public Employees’
Retirement Association (PERA)
Colorado Springs School District 11
Colorado Springs Utilities
Poudre School District
St. Vrain Valley School District
TIAA-CREF
University of Colorado
Association members
Denver Metro Chamber of Commerce
Mountain States Employers Council
Rocky Mountain Healthcare Coalition
South Metro Denver Chamber
of Commerce
Affiliate members
AspenPointe
AstraZeneca
Boehringer Ingelheim
Centura Health
Colorado Foundation for Medical Care
Colorado Permanente Medical Group
Colorado Springs Health Partners
Craig Hospital
Daiichi Sankyo
Ethicon Endo-Surgery
(part of Johnson & Johnson)
Exempla Healthcare Inc.
GlaxoSmithKline
Jefferson Center for Mental Health
Memorial Health System
Merck & Co., Inc.
New West Physicians, P.C.
Novartis Pharmaceuticals Corporation
Penrose–St. Francis Health Services
Pfizer, Inc.
Physician Health Partners
Roche Diagnostics Corporation
Rocky Mountain Cancer Centers
sanofi-aventis U.S.
The Denver Hospice
What does CBGH do?
Why should employers join CBGH?
We engage the health care marketplace through leadership and active participation,
driving positive change to address quality and realize savings.
• To step up and lead positive changes in the health care marketplace locally and
regionally to address the above areas
Here’s how we are doing this:
• To stay up to date on developments in health care reform; be at the front of the curve
• Restructuring and reforming health care delivery systems
• To engage your employees and consumers about the importance of quality in the
purchasing decision
• Creating uniform standards of care
• To unite together in joint purchasing projects with other employers in order to leverage purchasing opportunities and our influence on the health care market
• Improving accountability and data about providers and hospitals
• Improving accountability and data from insurance plans and carriers
• To collaborate, prioritize, and leverage those initiatives that have the greatest impact
on health care cost management and quality
• Providing data about high performing providers and hospitals so lower performing entities
are inspired to improve
• To add quality to your arsenal, providing a fundamental strategy for cost management
• Focusing on key strategies for managing cost such as wellness, demand management,
and incentive design; developing incentives and benefits focused on rewarding quality
• Advancing use of technology to reduce redundancy, increase quality, improve patient
outcomes, and engage employees in their own health
• Engaging consumers/employees in purchasing decisions based on quality and price
• Reducing redundancy and the risk of medical errors
• Improving the health of our employees.
25
CBGH publications are available at no cost at www.ColoradoHealthOnline.org
Colorado Type 2
Diabetes
Report 2011
Health Care and
Business:
The Bottom Line
An analysis featuring
demographic, utilization,
charges, and pharmacotherapy data. The report
also provides state and
national benchmarks.
Health care costs have
risen fast in Colorado. See
this impact on Colorado’s
businesses.
Policy and Perspective
on Never Events
Colorado Health Matters 2011-12 Quality Reports
With all the health plan offerings in Colorado, it can be difficult to decide which
plan would benefit you or your employees the most. Health Matters Quality Report:
Health Plans aids in evaluating health plans by presenting key information for
Colorado plans in a comparative, graphical, and numerical format.
Thousands of patients die
each year from preventable medical errors, but
there are things employers can do.
Colorado Health Matters Quality Report: Physicians recognizes those Colorado
physicians that work on improving the health of their patients and gives guidance
on how consumers can proactively improve their health. Colorado Health Matters
Quality Reports leaves a Coloradan with the know-how to make informed decisions
regarding his or her health care.
Colorado Health Matters Quality Report: Hospitals displays ratings that focus on
improving hospital quality, safety and efficiency. The report defines “Never Events”:
which are those events in hospitals that result in bad outcomes for patients, and
what hospitals, health plans, and consumers can do to prevent a Never Event.
Quality Report: Hospitals provides savvy consumers with objective and credible
help in selecting safe and high quality patient care.
Please view our library of Colorado Health Matters Quality Reports at
www.ColoradoHealthOnline.org.
Quality health care is more than just having a health plan, a certain provider, or a
particular treatment. It’s more than a matter of cost. Quality means getting what
benefits you most—balancing risk, cost, and quality of life.
What is quality
health care?
It’s effective—the right kind of care for your health condition based on up-to-date scientific knowledge
about what works best.
It’s efficient—using precious resources wisely, not wasting time and effort.
It’s safe—delivered without error and avoiding harmful results.
It’s timely—getting the most effective care without delays.
It’s focused on the individual—provided in a manner respecting a person’s individual
characteristics, needs and concerns.
It’s equitable—delivered without discrimination based on income, ethnicity, culture, or beliefs.
Important aspects of quality health care are measured in different ways. Health
Matters provides you with the information necessary to make cost-effective decisions
regarding your health care.
26
For the average person, finding quality
health care can be a daunting task.
Where can a person find information
to help them select a high quality
doctor, hospital or health plan? The
created the Colorado Health Matters
Quality Reports to deliver concise and
objective information on what matters most to health care consumers.
Colorado Health Matters Quality Report:
Health Plans aids in evaluating health
plans by presenting key information
for Colorado plans in a comparative,
graphical, and numerical format.
Physicians recognizes those Colorado
physicians that work on improving the
health of their patients and gives guidance on what a consumer can do to
proactively improve his or her health.
Hospitals ranks Colorado hospitals
based on national hospital quality,
safety, and efficiency standards. When
read together, Colorado Health Matters
Quality Reports leaves a Coloradan
with the know-how to make informed
decisions regarding his or her health
care. Please view our library of Colorado
Health Matters Quality Reports at
www.ColoradoHealthOnline.org.
www.ColoradoHealthOnline.org
303-922-0939

Physicians 2011-12 - Colorado Business Group on Health

Transcription

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