Health Care Reform Expert Panel
The Minnesota Department of Health (MDH) has awarded contracts to five nationally recognized health care industry experts and organizations to provide advice, counsel and analysis related to the 2008 health reform initiatives and related projects. The purpose of this expert advice is to complement work occurring at an individual project level and to help MDH connect important operational and policy “dots” across these initiatives.
Examples of specific project areas that will benefit from this industry expertise include:
- The formation and public reporting of “provider peer groupings” – a way of comparing health care providers on a composite measure of cost and quality.
- The creation and implementation of a statewide health care provider quality measurement and incentive payment system.
- The establishment of risk adjustment methodologies for quality measurement, payment and other purposes.
- The investigation of ways to reduce claims-adjudication costs of health care providers and health plans through the use of more uniform payment methods or uniform prices.
Currently a senior research fellow with the University of Minnesota, Knutson has extensive experience across multiple domains within the health system, including service delivery management, public health planning and development, financing and insurance and managed care. He brings a mixture of technical knowledge and practical policy-oriented considerations, with a research focus on improving the efficiency and equity of the U.S. health care system. Knutson has previously led or participated in numerous projects related to such topics as predictive modeling and risk adjustment, health care quality measurement, the development of resource use and efficiency performance measures, and investigation of methods for combining resource use measures with quality performance measurement. These projects have been funded by the Centers for Medicare & Medicaid Services, the Agency for Healthcare Research and Quality, the Robert Wood Johnson Foundation’s Changes in Health Care Financing and Organization initiative, Institute of Medicine, Center for Health Care Strategies and various states.
Over the past 15 years, Robinow has played the lead role in developing, evaluating and implementing the Patient Choice model of health care purchasing. This model emphasizes the use of provider cost and quality data by consumers to inform and improve purchasing decisions. Within this role, she was instrumental in a wide variety of activities, including developing a system for differentiating providers on value (i.e., cost and quality); determining appropriate risk adjustment methodologies; and educating health care providers, purchasers and consumers about the model’s methodology and results. Robinow also led the implementation of the Patient Choice model nationally across diverse markets. This expansion required adaptation of the model to meet the unique characteristics of each market, providing Robinow with extensive opportunity to examine value-based consumer-oriented purchasing methods in a variety of circumstances.
Christopher Tompkins, PhD
Tompkins, director of the Schneider Institute on Healthcare Systems and associate professor at the Heller School at Brandeis University, is a nationally regarded health services researcher with industry expertise in health care pricing and public reporting strategies. He has been actively involved in designing systems that measure and compare providers on value and create a strong financial incentive across the care system for value improvement. Tompkins has directed and supported a variety of research and policy development projects sponsored by federal and state agencies and foundations. His current projects include aggregating risk-adjusted quality scores for public reporting and value-based purchasing and the design and implementation of composite measures of hospitals, both for CMS.
Data Intelligence Consultants, LLC
Data Intelligence Consultants (Data IQ) is a Minnesota-based company that provides health services research expertise and support nationally to payers, providers and recipients of health care services in the public and private sectors. Data IQ’s recent research efforts include the utilization of encounter data to build episodes of care, examine health services resource utilization rates and identify variances in treatment patterns between providers; the development of economic and humanistic measures for use in clinical trials and health services studies; and the evaluation of new and existing program strategies. MDH will work most directly with Angeline Carlson, BS, RPh, PhD. Carlson provides a strong background in pharmaceutical research, health care delivery systems, and the use of large administrative databases within disease management and health policy initiatives. She additionally serves as an adjunct faculty member in the College of Pharmacy and the School of Public Health at the University of Minnesota.
Michael Pine and Associates, Inc.
Michael Pine and Associates, Inc. (MPA) is a nationally recognized analytic consulting firm specializing in the area of monitoring and improving clinical quality and the cost-effectiveness of health care. Serving all the major participants in the health care marketplace – providers, purchasers, financial intermediaries, professional societies and information specialists - the firm has focused on the measurement and reporting of comparative risk-adjusted clinical performance using large claims databases and specialized clinical registries; the development and application of risk-adjustment strategies and techniques; the use of health care data to measure and direct improvements in health care; and development and testing of pricing and claims adjudication strategies related to global fees for baskets of care. Michael Pine, MD, MBA, the firm’s founder and president, provides MDH with extensive clinical experience combined with advanced technical and analytical capabilities. Pine is additionally a lecturer in the Department of Medicine at the University of Chicago.