Equity of Care: All Payer Claims Databases U.S. Chamber of Commerce - - PowerPoint PPT Presentation

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Equity of Care: All Payer Claims Databases U.S. Chamber of Commerce - - PowerPoint PPT Presentation

The Business Case for Equity of Care: All Payer Claims Databases U.S. Chamber of Commerce Washington, D.C. April 7 , 2014 Tim Bartholow, MD Chief Medical Officer Wisconsin Medical Society Tim.Bartholow@WisMed.org Tbartholow@WEATrust.com 1


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The Business Case for Equity of Care:

All Payer Claims Databases

U.S. Chamber of Commerce Washington, D.C. April 7, 2014

Tim Bartholow, MD Chief Medical Officer Wisconsin Medical Society Tim.Bartholow@WisMed.org Tbartholow@WEATrust.com

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County Health Rankings: Interactive Maps

http://www.countyhealthrankings.org/app/wisconsin/2013/rankings/outcomes/overall/by-rank 3

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UW PHINIX: Uncontrolled A1c and Diabetes Prevalence 2007-9

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High Poverty High Economic Hardship High Social Vulnerability Low FF&V Consumption High T2DM Prevalence Lower Good A1c Control Higher Uncontrolled A1c

$3121 PMPM $2004 PMPM

LP Hanrahan (Larry.Hanrahan@fammed.wisc.edu) and B Arndt, http://videos.med.wisc.edu/videos/42741 11/5/2012 and https://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/111/3/124.pdf

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All Payer Claims Databases

http://www.apcdcouncil.org/state/map

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All Payer Claims Data Base, WI Health Information Organization (WHIO): $40B, 3.7 Million WI Residents

by Major Practice Category (MPC)

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Angioplasty, By County

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Angioplasty, By Physician

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Angioplasty, By Episode (Patient)

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IHD with Angioplasty, 2 Groups 2 Hours From One Another, Doctors with at Least 10 Episodes, DMV2

$36,009 $33,911 $33,508 $30,865 $29,853 $26,728 $25,221 $24,897 $24,890 $24,772 $21,863 $- $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 A A A A A A A B A B B

Doctor in Clinic A or B Std Cost per Episode

0.5 1 1.5 2 2.5 3

Health Risk, Retrospective

Std Cost per Episode Health Risk

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Extract from National Cardiovascular Data Registry

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Thank You

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