These FAQs accompany the Pilot program for the State Scorecard on Payment Reform 2.0 where Catalyst for Payment Reform issued a Request for Proposals in June/2017 seeking local sponsors to assist in carrying out state level Scorecards. The results of the three state level Scorecards are expected to be issued in August/2018.
Q—What does “sponsor” mean?
A—A sponsor is a local champion or local ambassador of the project. The opportunity to be a sponsor for the piloting of Scorecard 2.0 was open to any organization that has the mission, staffing, and relationships necessary. Preferably, sponsors have the ability to encourage health plans operating in the state to participate in a voluntary survey. These include, but are not limited to, business coalitions, multi-stakeholder health care improvement organizations, state-based health care data organizations, state employee and retiree agencies, state Medicaid agencies, state departments of health or insurance, and others. Two or more organizations can join together to submit a single application, so long as the organizations agree to be joint sponsors.
Q—How is the sponsor recognized for being the local champion?
A—CPR plans to announce the selected states and sponsors publicly. CPR is open to any suggestions regarding recognition. CPR understands the importance of the recognition and wants to support the effort in ways in which the sponsor feels comfortable.
Q—What are the responsibilities of the sponsor?
A—The primary responsibilities of the sponsor are to:
Q—Is the sponsor’s staff time covered by the grant?
A—No. The grant funding covers CPR’s labor for developing the design of the scorecard—from the metrics to the graphics—data collection, analysis, validation and training of health plans in how to provide data, etc.
Q—Are sponsors responsible for holding the trainings (finding meeting space, sending out invites, etc.)?
A—No. CPR will conduct the trainings via webinar. As noted under sponsor responsibilities, the sponsor will help identify appropriate contacts within the health plans, but the sponsor is not responsible for logistics. CPR will send emails, reminders, set up WebEx, prepare training slides, and conduct the training.
Q—How long will the health plan trainings be?
A—CPR expects the training to take 1-1.5 hours and CPR will handle all follow-up with individual health plans if there are subsequent questions.
Q—Is the sponsor able to post the final results on its website?
A—Yes. The sponsor will have electronic versions of the final work products and can post the information on its website or disseminate as is appropriate for the local situation. To the extent the information is disseminated in paper form, sponsors will have to cover any direct costs for promotional materials and printing.
Q—What percent participation by health plans in the survey is required to get to a “representative sample”?
A—Obtaining a representative sample is always tricky, because it is not likely that it will be representative in the statistical sense of the word. Based on CPR’s experience, we have set a minimum threshold of three health plans, representing a combined 60% of the covered lives in the commercial and Medicaid markets.
For example, if 5 plans are needed to get to the 60% threshold, then 5 plans need to participate. On the other hand, if only 2 plans are needed to get to the 60% threshold, CPR still requires a third plan to participate. This ensures that individual health plan data cannot be identified. All results will be reported in the aggregate.
Q—Do you anticipate CPR would use outcomes data collected from APCDs and other sources (if available) to meet the requirements for the evaluation?
A—If a state has APCD data that can be used to calculate some of the metrics, CPR would like to consider that source as an option.
Q—What are the expected responsibilities of each Scorecard sponsor?
A—Scorecard sponsors will be the primary champions of the project in their respective state. The Scorecard will capture the amount of value-oriented payments in the selected state, which will require the sponsor to encourage (or require) health plans to participate in a survey that gathers detailed information from them about the methods they use to pay health care providers. For representative findings, it’s important to engender sufficient participation by health plans. To this end, the Scorecard sponsor will help CPR identify the appropriate contacts at health plans to complete the survey. In addition, the sponsor will help identify health care leaders in the state for CPR to interview to assist with interpretation of the quantitative results as well as to gather their views on the future of payment reform in the state. CPR and the Scorecard sponsor would check in regularly to keep the project moving and trouble shoot as needed. The Scorecard sponsor will help promote and support the release of the results.
Q—How long will implementation of the Scorecard take?
A—Based on CPR’s experience in other states, the Scorecard process takes about 12 months. CPR anticipates beginning in September 2017 and completing the project by August 2018. The process involves: recruitment of state-specific health plans; training of the health plans to complete the survey; data collection, validation and analysis; outreach and interviews with health care leaders; construction of the Scorecard; and dissemination of the results.
Q—What is the difference between Scorecard 2.0 and CPR’s previous Scorecards?
A— By adding indicators of whether payment reform is correlated with better quality, efficiency, and lower costs, Scorecard 2.0 goes beyond just quantifying the amount of value-oriented payment in the state and evaluating what reforms are most prominent. While the health care system is too complex to draw causation between payment reforms and particular outcomes, CPR, with the help of an expert Advisory Committee, identified 12 metrics to serve as correlating indicators. Examples of these metrics include: percent of patients seeking care from high-value providers, comprehensive diabetes care (HbA1c testing), cesarean delivery rate in low-risk pregnancies, preventable hospital admissions, and more.