1st Annual Central Valley Health Forum
May 27, 2009, Fresno Convention Center
Exhibit Hall III, 848 M Street, Fresno, CA 93721

Session Descriptions

LUNCH PANEL:

The Role and Responsibility of Commercial Health Plans in Raising Health System Performance

Representatives from Anthem Blue Cross, Blue Shield of California and Kaiser Foundation Health Plan will each have five to seven minutes to present what s/he believes are the major challenges to health system improvement. The moderator will then pose questions, followed by questions asked by members of the audience.

Moderator: Sally Covington, California Health Care Coalition
Panelists: Steve Scott, VP, General Manager, Anthem Blue Cross
Paul Markovich, Chief Executive Officer, Blue Shield of California
Representative, Kaiser Foundation Health Plan

CONCURRENT SESSIONS:

Preventing obesity, improving diabetes care: how we can, why we must

Obesity and physical inactivity are associated with poorer health. Overweight and obese children are hospitalized more often than normal weight children and they are nine to 10 times more likely to have high blood pressure as adults. Overweight, obese and physically inactive children and adults are at risk for Type 2 diabetes, high blood pressure, asthma, cardiovascular disease, and orthopedic problems. The economic costs are also significant. Overweight and obesity are associated with a 36% increase in inpatient and outpatient costs and a 77% increase in the cost of medications. To improve health and control costs, preventive strategies and improvements in provider and patient compliance with treatment guidelines are essential. This session will discuss regional prevention and care improvement efforts.

Moderator: Richard P. Yanes, Fresno Metro Ministry
Presenters: Reyna Villalobos, Director, California Regional Obesity Prevention Program
Helen Jones, MD, Internal Medicine Associates of Fresno
MariaElena Avila-Toledo, MPH, Area Health Promotion Specialist, South Central Valley, California Diabetes Program

Getting the right care: eliminating overuse, underuse and misuse

Medically unwarranted variation in the utilization and costs of medical care have been studied since the early 1980s, when Dartmouth researcher, John Wennberg, MD, first reported that service utilization is more affected by the number and type of doctors in a community than by the health status or treatment preferences of the population. Since then, numerous studies have documented unnecessary surgical and medical hospital admissions, at the same time finding low rates of provider compliance with evidence-based treatments and recommended preventive and diagnostic services. The human and economic costs of overuse, underuse and misuse are substantial. This session will discuss specific areas where costly overuse and underuse commonly occur and propose a regional strategy to help ensure that your plan beneficiaries receive recommended care and are not subjected to risky procedures and services of no clinical benefit.

Presenters: Adams Dudley, MD, UCSF
Tom Moore, Jr., CHCC Senior Health Program and Policy Consultant

Effective communications on health and health care quality

Communicating with health plan members about quality of care is not an easy task. Recent research has found that the jargon of health care has very different meanings to typical employees than it has to health care or benefit professionals. Through focus groups and interviews, the American Institutes of Research found that workers are skeptical that industry or employer promotion of “care standards” or “evidence-based medicine” will benefit them. They are wary that “standards” will be used to deny them needed care. Based on this research, AIR has developed a highly flexible teaching toolkit for employers and unions to use in employee and member communications. This session by AIR will present information on how employers, trust funds and unions can use these free communications materials to help their health plan beneficiaries understand, recognize and insist on quality care while motivating them to better manage their own health.

Presenter: Kristin Carman, Ph.D., American Institutes of Research

A community blueprint for hospital quality improvement

Hospitals are the most expensive setting in which to provide care, and inpatient and outpatient costs together account for over 50% of total health care spending. Hospitals also vary widely in the safety, quality and outcomes of care, as measured by patient mortality rates, complications, hospital-based infections, medical mistakes, and compliance with professional treatment guidelines. The session will present a case study of how Modesto purchasers joined together to negotiate a quality improvement program with Doctor’s Medical Center that has supported dramatic improvements in the quality and costs of hospital care in that community. Based on this success, we will outline and propose a similar strategy of purchaser-hospital collaboration in Fresno and other Central Valley communities to improve the safety, clinical quality, outcomes and costs of hospital services in Fresno and other Central Valley counties.

Moderator: John Glynn, J. Glynn & Company
Presenters: Maurice Hodos, UFCW National Health & Welfare Fund
Denny LItos, CEO, Doctors Medical Center
Michael O’Neil, Blue Shield of California
Keith Doram, MD, Chief Medical Director, Adventist Health

Provider perspectives on health care quality, costs and access

Providers in the Central Valley confront many challenges in helping patients maintain and improve health, not least of which is a growing uninsured and underinsured population, the growing prevalence of chronic diseases, a physician shortage, and substantial cultural diversity, with 105 languages spoken in the region. Representatives from Fresno and Central Valley physician organizations and hospitals will each outline what they consider to be the most daunting challenges in the region and offer their thoughts about how we can best address them together. The session moderator will then pose questions, followed by the audience.

Moderator: Phil Polakoff, MD, Claremont Partners
Panelists: Varoujan Altebarmakian, MD, Kaiser Permanente Medical Center - Fresno
Russell Judd, President, Mercy Hospital Bakersfield

Vendor accountability: Knowing and measuring what you pay for

The delivery of health care services is often fragmented and uncoordinated, increasing the likelihood that health plan beneficiaries and especially patients will “fall through the cracks,” with adverse consequences for patients, their families and those who pay the bill. The Fresno Unified School District in implementing a new labor-management strategy to measure and improve the performance of the District’s contracted vendors. Representatives from the FUSD Joint Health Management Board will review this data-driven strategy that requires vendors to share information and work across “service” silos for patient benefit and cost stabilization. The session will help purchasers know how to get the most out of their health care vendors by measuring performance, establishing improvement benchmarks, and coordinating across programs for higher quality and more cost-effective health care.

Presenters: Ruth F. Quinto, Fresno Unified Associate Superintendent/CFO and Joint Health Management (JHBM) Co-Chair
John Stallsmith, CSEA 143 Labor Relations Representative and JHMB Co-Chair
Viola Mellela, Fresno Teachers Association
Vincent Harris, Fresno Unified Executive Officer for Accountability
Andrew De la Torre, Fresno Unified Director, Benefits/Risk Management