The CEO of The Leapfrog Group Speaks about Value, as the World Health Care Congress Gets Underway

April 30, 2018
As the 15th Annual World Health Care Congress got underway in Washington, D.C. on Sunday evening, the Leapfrog Group’s CEO Leah Binder discussed the current status of the concept of value in healthcare—after receiving a Health Value Award

As the 15th Annual World Health Care Congress got underway at the Marriott Wardman Park Hotel in Washington, D.C. on Sunday, April 29, judges drawn from the various segments of the U.S. healthcare industry named a variety of organizations winners in various categories of achievement in healthcare (see sidebar below).

One of those named a winning organization was The Leapfrog Group, the Washington, D.C.-based independent organization focused on value in healthcare. That group’s online description states that, "Founded in 2000 by large employers and other purchasers, The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American health care. The flagship Leapfrog Hospital Survey collects and transparently reports hospital performance, empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions.” The Leapfrog Group was named the silver winner in the “Lifetime Achievement: Public Leadership” category.

During the reception immediately following the announcement of the winners of the Health Value Awards, Leah Binder, The Leapfrog Group’s CEO, Leah Binder, who has been with Leapfrog for ten years, spoke with Healthcare Informatics Editor-in-Chief Mark Hagland regarding her organization’s current activities and aims, and how she sees the present and future of value in U.S. healthcare. Below are excerpts from that interview.

Congratulations on receiving this award. What does it mean for you?

I think that it honors thousands of people who have made Leapfrog a force in American healthcare. We have made every effort to change the way people seek out services, so that they weigh considerations of value before they go to a hospital or a doctor. And before you can even do that, you need information. Price is just one element. We need to know first about quality, before we send a loved one to a hospital or clinic or anywhere else. That’s where we started out in 2000. And we all still have a long way to go. It’s important for employers to continue to push on the healthcare industry to provide information. That’s what this award really honors: we made value possible.

Leah Binder

Just a week ago, I wrote a blog about the results of a study of Massachusetts health plan members that found that, even armed with data and information tools designed to help them decide between healthcare providers based on value, most often, consumers are still not making full use of such tools. Are consumers ready to be fully active in this emerging role?

Consumers are being jolted into readiness, because they are being pushed into high-deductible health plans. One in three workers now is in one, and many employers either only offer a high-deductible health plan, or make it extremely difficult to choose another option. So that changes the landscape for consumer. The first dollar is now coming out of your pocket. So people are having to ask, how much will this procedure cost me? And as you get more comfortable asking questions about price, you start asking other questions. The patient is becoming a payer. And when the patient is a payer—when the recipient of a service is also the payer of a service, we call that a consumer. Patients are becoming consumers, and are starting to think of themselves that way. And that’s a huge cultural shift. So I see payers starting to change rapidly in their treatment of patients. For example, in hospitals, there’s a whole new job category, that of the chief experience officer. Did we never need that before? Of course we did, but that role is emerging now as the whole economy is changing. I see a whole new response to patient engagement beginning to take place now. It’s not going to happen overnight, but it will happen, and any provider who thinks they can just put their head in the sand and think consumers won’t become activated, is deluded.

What should CIOs, CMIOs, and other senior healthcare IT leaders, who have a broad role to play in creating the data analytics and data performance architectures to help their clinician and operational colleagues improve care delivery performance, be thinking about and doing right now?

One thing they should be doing is listening very closely to clinicians—physicians and nurses—about what is happening in direct patient care. I think it is very concerning right now that so many physicians are complaining of being burned out, especially around electronic health records. If the physician is feeling burned out and the EHR [electronic health record] is interfering with the physician-patient interaction, that’s not good. So healthcare IT leaders need to listen to physicians and nurses as experts in the design and implementation of information and record systems.

What about the issue of physicians feeling burnout around having to respond to multiple outcomes measure processes sponsored by the different health plans they’re contracted to? I know that stakeholders have been collaborating for a decade and a half in California on harmonizing outcomes measurement programs statewide.

I think the responsibility that purchasers and payers have is to use measures well. The burnout factor happens when we collect measures and don’t use them. When consumers don’t pay attention, or when purchasers and payers don’t use those measures for contracting purposes. I don’t think it means measurement is a useless thing; indeed, we have to do measurement, to provide scorecards to know how healthcare is doing. It’s very important. So in my mind, our responsibility is to use the measurements appropriately and well.

What should the leaders of employer-purchasers and health plans be doing right now?

They need to pay close attention to outcomes and safety data, and use it in their contracting and tiering and identification of centers of excellence, and communications with employees and families. Fundamentally, they’re investing in healthcare, to make their employees’ lives better. And in the area of patient safety, that’s a critical aspect of that. You can get an excellent outcome at an excellent price, but if there’s an infection or error that disables or, God forbid, kills the patient, you’ve nullified the value. So we see it as a three-legged stool: quality, price, and safety.

What will be happening at The Leapfrog Group in the next couple of years?

One thing we’re planning is, in addition to collecting data on inpatient care and hospital safety grades, we’re going to roll out outpatient surgery center and outpatient surgical units (day surgery) outcomes, soon. We’ll be rolling it out later this year… sometime in the fall. Soon.

On a spectrum from pessimism to optimism, how optimistic or pessimistic are you regarding the progress of the U.S. healthcare industry as it evolves forward into a value-based delivery and payment system?

I’m optimistic, because we’re seeing the engagement of new people in healthcare. We’re seeing consumers, who never really paid much attention to the details of where they got healthcare before, now closely scrutinizing every aspect of their care. That’s a new thing. And I’ve never seen the employer-purchasers more active in healthcare. And new technology is making things very exciting, including artificial intelligence and telemedicine. Whole new ways of doing things. I feel very excited by the possibilities. As long as we have the right kind of market, things will move forward; if we go back down the road of fee-for-service payment, with the wrong incentives, things could go in the wrong direction. But I don’t think that will happen.

How might new disruptive arrangements in healthcare, such as the proposed CVS/Aetna merger, the announcement of the collaboration among Amazon, Berkshire Hathaway, and JP Morgan Chase, and the potential Walmart-Humana deal, impact all of this? Could these new disruptions help push forward the concept of value in U.S. healthcare?

Yes. I think the CVS-Aetna merger—I think that’s actually a very innovative merger that potentially could have an enormous influence on a new direction for healthcare. Potentially, it aligns incentives to the benefit of patients, if it goes the way it should. And if it does, we’ll see more pressure on pharmacy prices and medical prices. So we’ll see how it goes. There’s potential there, in any case. It’s promising. And what we don’t often see very often in healthcare is the merger of two different types of organizations. That’s what got me excited about the CVS-Aetna announcement.

Is there anything else you’d like to add?

We have strong belief in looking at measures around CPOE and barcoding. We actually pay a lot of attention to the information systems of hospitals and believe that that’s a really important element of quality. You have to look at the infrastructure of a hospital to really see its quality.

Sidebar: Health Value Awards 2018

Healthcare industry leaders were asked to evaluate a wide variety of submissions to the Health Value Awards program. The following winners were announced on Sunday, April 29, in a ceremony during the first session of the 15th Annual World Health Care Congress, being held at the Marriott Wardman Park Hotel in Washington, D.C.:

Third-Party Administrators:

Diamond: Continental Benefits
Gold: Group Pension Administrators

Direct Care Provider:

Diamond: Aravind Eye Hospitals
Gold: Integrated Musculoskeletal Care
Silver: Health City Cayman Islands

Product/Program Provider:

Diamond: Zero Card
Gold: Access Net

Silver: Quantum

Small Employer:

Diamond: The Phia Group, LLC
Gold: Access Net
Silver: Palmer Johnson Power Systems

Mid Sized Employer:

Diamond: CHG Health Care
Gold: City of Kirkland
Silver: Globaltranz

Large Employer:

Diamond: Intel Corp. HR Benefits Team
Gold: Metro Nashville Public Schools
Silver: Rosen Resorts & Hotels

Outstanding Benefits Provider 2018:

Diamond: David Hoke, Walmart
Gold: Todd Bisping
Silver: Adam Russo

Outstanding Benefits Broker or Consultant Leadership:

Diamond: RE Sutton & Associates, a Division of Brown & Brown
Gold: Don Reiman, Echelon
Silver: Scott Haas, USI Insurance Sales

Lifetime Achievement, Clinical Care:

Diamond: John Wennberg, Dartmouth Atlas
Gold: Dr. Devi Shetty, Narayanna
Silver: John Noseworthy, Mayo Clinic

Lifetime Achievement, Health Benefits Innovation:

Diamond: Harris Rosen, CEO, Rosen Hotels & Resorts
Gold: David Hoke
Silver: Barbara Barrett

Lifetime Achievement, Public Leadership:

Diamond: Harris Rosen, CEO, Rosen Hotels & Resorts
Gold: Dr. Devi Shetty, Narayanna
Silver: Lea Binder, The Leapfrog Group

source: World Health Care Congress