Marc's Weblog

Sunday, June 16, 2002

Systems Dynamics Modeling of Diabetes and Congestive Heart Failure in Whatcom County

Sunday 6/16/02; 10:29:16 PM by MP (notes by Mary Minniti)

This serves as documentation of the work of a small team scoping the systems dynamics work ahead. Attendees as the conference call were: Marc Pierson, Mary Minniti, Marcy Hipskind, Mark Donaldson and our consultants - Gary Hirsch and Jack Homer.
The main focus of Phase 2 is to model the financial impact of changes in care to the various organizations and community. We will model both diabetes and congestive heart failure. The purpose is to define the reimbursement issue and provide information useful to impact policy decisions. Work will begin in July and conclude by Jan 2003. It will be used by GHC [and hopefully others] to make changes in policy for reimbursement.
Two new areas of focus will be to model the effect of patients changing insurance companies and the % of patients who stay or leave the county as we are interested in the impact to each organization as well as the community. We will integrate into our model two concepts from John Wennberg's proposal to CMS (Medicare) - use of effective care and the effect of patient choice on the model.
The remaining time was spent identifying data needs and next steps:
The modelers will be in our community July 15 - 18th.
Individual meetings will be set up with each organization. A overall meeting with all partners to summarize their work, will occur on the last day. Mary/staff to coordinate
Individual phone interviews will occur with each organization's knowledge expert who has a broad view of the data in each system. Each site is asked to provide names and numbers of those individuals to Mary Minniti - who will forward to Jack and Gary by June 18th.
A listing of the cost assumptions in the Phase 1 model will be provided and each organization is asked to review it for accuracy.
A list of articles will be provided about CHF to Jack and Gary. These are review articles about the disease, best evidence and outcomes with various treatments and current thinking about disease management in this area. Roland Trenouth is providing the list.
Contact with the other organizations (especially CMS and DSHS) on the call will be made to get the appropriate names of people to participate in the Systems Dynamics F2F and phone interviews work between now and July 15th. Mary and/or Marc will make these contacts.
Marc and Mark will conference with Lynda Parton to share the approach of targeting appropriate folks in the insurance arena to provide information in this effort: Medical Director, Administrator/Operations person and Provider Relations person
Marc will contact Kristen Crosby about CMS and her involvement in the modeling work.
Data needs: [each organization will provide this information below to Gary and Jack for the modeling]
- understanding cost structure - what are fixed vs. variable cost at the practice/insurance level for care to patients.
Understanding revenue stream- understanding the different payment models for clinics/hospital. How do provider revenues changes if volumes change? What % of revenue are covered by different payment mechanisms?
Mark Donaldson will do some follow-up to see if GHC could share the above data information from their clinic practices
Mary will gather some information from HealthPartners regarding their % gain of efficiency or % cost savings from IDCOP so it can be placed into model as one gross variable.

10:43:43 PM

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