BTE, Leapfrog Group, and PROMETHEUS Payment support NBCH's eValue8 health plan evaluation program

Bridges to Excellence, the Leapfrog Group and PROMETHEUS Payment encourage health plans and health care purchasers to participate in national assessment program

As the U.S. moves forward with health reform, health care purchasers are working to eliminate waste, overuse, and misuse in the health care system at the point of care. To that end, several of the nation's foremost quality and measurement organizations – Bridges to Excellence (BTE), the Leapfrog Group, and PROMETHEUS Payment® – announced their support of eValue8™, a program of the National Business Coalition on Health (NBCH). eValue8 is the leading, evidence-based health plan evaluation program widely used by business health coalitions, their purchaser members, and national employers to assess and manage the quality of their health care vendors.

To encourage purchasers to focus on similar issues and to ensure common "evidence-based standards," many of the measures used by BTE, Leapfrog and PROMETHEUS Payment are integrated into eValue8. At the core of the eValue8 assessment, is a standardized request for information (RFI) tool used by purchasers to gather health care data from HMO and PPO health plans. More than 96 million Americans, or about two-thirds of those insured by employers, are members of health plans that respond to eValue8.

"To move the market and make significant changes to the quality and cost of our health care providers, it's important that all stakeholders use a common standard and language to communicate and measure," said Leah Binder, president and CEO, The Leapfrog Group.

eValue8 determines not only whether plans are participating in BTE and Leapfrog programs in the community, but examines which specific measures plans are using to assess and reward the performance of doctors and hospitals. The tool encourages and assesses the level of collaboration among plans in establishing and communicating a common set of measures for providers in the community. Examples of these measures include whether a doctor's patients have been properly advised about how to maintain their health and whether they are following those guidelines. On the hospital side there are measures on both adherence to clinical guidelines and the presence of structural investments like technology that prevent errors from occurring. Questions for PROMETHEUS Payment (a new model for health care payment that rewards hospitals and physicians for providing coordinated high-quality care) center on potentially avoidable costs related to chronic conditions such as diabetes and cardiovascular disease.

"eValue8 addresses a well thought out set of operating principles for patients receiving behavioral health care, and the process encourages health plans, delivery systems and local communities of purchasers to work together," said Michael Quirk, PhD, director of behavioral health services, Group Health Cooperative, a Puget Sound-based HMO. "Reducing fragmentation at all levels and improving results for people who suffer from chronic conditions, which can be remedied when identified and systematically addressed – results in healthier people who lead fuller lives."

Francois de Brantes, executive director, Health Care Incentives Improvement Institute (HCI3™), the umbrella organization for BTE and PROMETHEUS Payment, commented, "eValue8 incorporates the PROMETHEUS Payment ECR® (Evidence-informed Case Rate) Analysis Tool to enable participating health plans to report potentially avoidable costs in management of diabetes and cardiovascular disease, and is expanding to include all ECRs for the 2011 review process. This type of collaboration is critical to the success of payment reform."