Colorado Business Group on Health The Colorado Business Group on Health (CBGH) is an innovative non-profit organization that educates Colorado employers about what really matters in health care. Through programs, pilot projects and studies, CBGH is the voice of market-based, employer driven approaches to lowering costs and improving quality. They are also taking the initiative in improving the health and wellness of their employees which is what they are a Certified Healthy Business! Health Links Colorado Certified Businesses ...

  Fairly recently one of Longmont's most respected and popular family practice physicians said, in several forums, "You know, I've been a primary care doc in this town for 25 years and I'm afraid I can't tell you, with any real certainly, who the best specialists in town are." Now - at least with regard to surgeons - he and everyone else can have a much better idea which physician to use for which procedure. On Monday, CBS News shared a release called "It's Complicated: ProPublica Surgeon Scorecard Gives Patients Doc Data" about a publically available, free resource. As stated on the Surgeon Scorecard website: "Guided by experts, ProPublica calculated death and complication rates for surgeons performing one of eight elective procedures in Medicare, carefully adjusting for differences in patient health, age and hospital quality. Use this database to know more about a surgeon before your operation." Focusing on outcomes for eight of the most common surgical procedures, the website allows users to search for a specific surgeon, search all surgeons at a given hospital (that do a threshold number of the specific type of surgery), or by zip code. We found the results fascinating. To be certain, measuring outcomes in healthcare can be a tricky business. Risk factors and behaviors that vary from patient to patient certainly effect outcomes. But surgical complication rates seems like a fair metric and ProPublica takes a number of reasonable steps to adjust for factors outside the surgeon's control. They specifically exclude trauma and other high-risk cases. They also exclude procedures done on patients who came through emergency department from another healthcare facility. Finally, they apply "accepted statistical methods to adjust for age, the health of each patient, luck, and the overall performance of each hospital." We're encouraged by the availability of such a tool for use by patients. We think it's availability to the public, perhaps more than anything else, will ultimately reduce avoidable surgical complications. As a physician friend of ours says, "Sunshine is the best disinfectant." Please check out the Surgeon Scorecard and consider sharing this free resource with your employees.  

We shared, at a recent monthly meeting, a copy of Paul Keckley’s excellent article, The Biggest Challenge in US Healthcare – Becoming a Retail Industry. Because this is such an important article, addressing perhaps the most foundational issue in healthcare today, we wanted to point it out once more and highlight it in case you missed it. As Keckley so appropriately points out (and we’ve argued strenuously).... Ours is a B2B industry. It’s great business for manufacturers and middlemen who successfully access capital markets to create their newest and best parts and facilities, especially if they’re able to align with frontline workers to use them as much as possible.....It’s big business and profitable for most. In other words, it’s a system working pretty well for the big (and getting bigger) players. The simple and straightforward problem, of course, is that it’s not working so well either for the people whom it’s supposed to serve – patients – or for the organizations that fund most of (e.g., the employers). And while we can give lip service to "patient-centered care" until the gurneys all come back to central supply (and it feels as though we have already), the system won’t transform until the market shifts to a B2C (e.g., business to consumer) model.   What will that require? Two things: First and foremost, it will require employers who insist that payment models bundle services as they do in other industries. Your employees or your procurement department buy complete computers – not separate keyboards and screens and hard-drives that they then have to put together. And, in Colorado, Colorado PERA is leading the way in this regard. But it was PERA, not a health plan, that forged the way. The second prerequisite will be tools to make quality and price not only transparent, but user friendly. While, in this regard, the plans do seem to be trying to move forward, our members tell us that outsiders like Castlight and Healthcare Bluebook provide the most appealing applications. As Keckley points out, it’s not that the B2B model hasn’t served us well. It did - for a period of time. But change comes particularly glacially to healthcare and, in this case, the model has not only outlived its usefulness, it’s now hurting our families and our companies. It’s time for an employer-led transition to a B2C market. Don’t expect the B2B stakeholders to set the pace. The market's working pretty well for them.

  The Leapfrog Group just released its final report on the results of the 2014 Leapfrog Hospital Survey. As well as summarizing the results of our previous reports, this report explores hospital-acquired conditions, ICU physician staffing, Never Events and more. 39% of hospitals nationwide report to the Leapfrog Hospital Survey, demonstrating their commitment to transparency. But there's more work to do. Last year, just over 1,500 U.S. hospitals voluntarily completed the Leapfrog Hospital Survey, the highest recorded participation to date. These hospitals are committed to transparency--for the benefit of their patients and their communities. But more hospitals need to be on board. "We're excited to see a growing level of commitment from hospitals and I applaud those who have taken the steps to provide this level of transparency," said Leah Binder, president and CEO of The Leapfrog Group. "As a result, we've seen a continued decrease in the national rate of early elective deliveries, as well as a number of strong improvements in key areas, including hand hygiene compliance and ICU staffing practices. Still, more work is needed. It's essential we see this level of improvement in all areas of the health care system."

  This may come as no surprise if you spend any time at your local grocery store or fast food restaurant, but according to a June 22nd, Time Magazine article, a recent report in JAMA Internal Medicine, 67% of American women are overweight or obese, while 75% of men are of a similar bulk. Now, what would you say is the single biggest health risk factor for employers? How about the primary risk factor for developing type 2 diabetes? As they used to say when you were a kid - "Three guesses and the first two don't count." This epidemic of overweight American workers explains why one-third of Coloradans are considered pre-diabetic, according to the American Diabetes Association. It is also why CBGH advocates for targeted risk reductions strategies in general, and particularly for sponsorship of a Diabetes Prevention Program as a covered benefit. Developed under the guidance of the Centers for Disease Control, the DPP is a nationally recognized, evidence-based lifestyle change program for preventing type 2 diabetes. The program encourages people to increase physical activity to 150 minutes a week and adopt modest behavior changes that can lead to a 5-7% body weight loss. The DPP can help people cut their risk of developing type 2 diabetes in half. It may be the single most effective risk-reduction strategy an employer can put in place. Under a grant from the Colorado Department of Public Heath and Environment, CBGH can assist public, self-funded employers in implementing a DPP in their workplace. And, we can help employers utilize a tool we're developing to project the economic impact of doing so. While we can't actually pay the nominal cost for the program, we can support the development of strategies for employee outreach and communications, benefit design, provider and cost identification, and potential ROI. If you're interested, give us a call. We need to talk!