In 2007, the BRT engaged McKinsey & Company to conduct a comprehensive diagnostic exercise and develop a definitive fact base against which the performance of Ohio health systems could be benchmarked and compared to health systems in other states and countries. The performance gaps that emerged from this analysis provided the basis for developing a road map for healthcare systems improvement in Ohio.
While one of the primary motivations for addressing healthcare reform was to stem the rising costs of healthcare to the state's employers, the BRT approached the challenge holistically and systemically and identified opportunities for improvement in four areas: (1) population health, (2) access to care, (3) quality of care and (4) healthcare costs.
The resulting BRT report - Improving Ohio's Health System - outlined 18 recommendations designed to address five reform priorities:
A number of the recommended reforms are in various stages of implementation. To date, the BRT has asserted its leadership by tackling three major reform initiatives:
As an initial follow-up to the its comprehensive health systems benchmarking diagnostic (2007-08), the BRT – leading by example – engaged in a focused examination of what employers can do to lower healthcare costs and improve healthcare outcomes without having to ask the government or others for intervention or assistance.
The BRT reviewed a wide array of third-party research studies, employer case studies and other materials to determine top employer best practices for healthcare-related investments as of December 2012. This research was coupled with a unique pilot initiative jointly led by the BRT and the Columbus Partnership. Guided by Cardinal Health CEO Kerry Clark and OhioHealth CEO David Blom, together with a team of health benefits managers and executives from both companies and from Nationwide Better Health, the BRT conducted a comprehensive 70-question survey of Columbus Partnership members to identify benchmark adoption levels for best practices that had been identified in the BRT's research and to solicit ideas for additional best practices.
The research and survey informed the development of a report - 10 Best Practices to Reduce Healthcare Costs While Improving Quality and Access - that outlined concrete recommendations for specific actions large employers (2,500+ employees) can take to reduce healthcare costs while improving quality and access. The report includes a rationale for adopting each of ten best practices, suggestions for implementation and benchmarks for measuring success.
In March 2009, the BRT published the results of its extensive diagnostic of Ohio's healthcare system, which included an examination of costs, access, quality and population health issues - including an analysis of risk factors and incidence and prevalence of disease and illness. We learned from our analysis that childhood obesity is the most profound public health issue confronting Ohio and that because of an alarming increase in obesity rates, unhealthy eating habits and physical inactivity, today's children could be the first generation of Ohioans to have shorter lives than their parents.
In response to this crisis, the BRT worked with a team of pediatricians and medical professionals from the leading healthcare institutions in the state, child advocacy organizations and BRT member companies to develop solutions. As a first step, our experts led us to a set of solutions focused on a setting where children spend the bulk of their time outside the home and where we know we can have an immediate impact: Ohio schools.
The result was Senate Bill 210, The Healthy Choices for Healthy Children Act, a comprehensive three-pronged approach to tackling childhood obesity. Specifically, the Act:
The solutions contained in the Healthy Choices for Healthy Children Act, which took effect in June 2010, will help Ohio take the important first step toward reversing the unacceptably high rates of childhood obesity and reducing the disease burden in our state.
As part of the BRT's ongoing healthcare reform efforts, the organization launched a Solutions for Patient Safety initiative in 2009 as a partnership between providers and the business community to improve quality of care and reduce healthcare costs.
The state's eight children's hospitals and Central Ohio's 17 hospitals worked to implement specific programs to reduce healthcare-associated infections and medication errors. Through their work, the hospitals identified data collection protocols and best practice processes that have been shared among the institutions and also will be shared with other interested organizations in Ohio and nationwide.
The partnership has realized significant positive results through its initial efforts. Specifically, Ohio's children's hospitals achieved a 60 percent reduction in surgical site infections in designated cardiac, neurosurgery and orthopedic procedures and a 40 percent reduction in overall adverse drug events. These efforts to-date have saved 7,700 children from unnecessary harm and avoided $11.8 million in unnecessary healthcare costs. As a result of their efforts, Central Ohio hospitals reduced specific hospital-acquired infections by nearly 40 percent and avoided approximately $7.5 million per year in unnecessary healthcare costs.