8:30

WELCOME AND INTRODUCTIONS

Denis A. Cortese, Mayo Clinic & Chair, IOM Roundtable on Value & Science-Driven Health Care

8:45

KEYNOTE: THE NEED TO IMPROVE VALUE IN HEALTH CARE

What are the key challenges facing the U.S. healthcare system in terms of costs, performance, and value? What are the implications of U.S. healthcare costs for the economic crisis, the nation’s ability to recover, and the welfare of the American people?

David M. Walker, Peter G. Peterson Foundation

SESSION 1: PERSPECTIVES ON VALUE

To provide context for the workshop discussions, this session will focus on reviewing how the concept of value is viewed from different sectoral perspectives.

Chair: J. Michael McGinnis, Institute of Medicine

• September 2008 Roundtable Panel Summary

• Reactor panel

(sanofi-aventis), Paul Ginsburg (Center for Studying Health System Change), Gail Griffith (FDA patient representative), Murray Ross (Kaiser Permanente)

DISCUSSION

[Break 10:30 to 10:45]

10:45

SESSION 2: APPROACHES TO ASSESSING VALUE – ILLUSTRATIVE EXAMPLES

Session 2 will feature presentations on the approaches taken to assessing value in various contexts. Speakers will highlight the analytic approaches and tools that are used to characterize and measure value—e.g., outcome measures, cost measures, time horizons, their use, limitations and needed refinements.

Chair: Ezekiel J. Emanuel, National Institutes of Health

• Physician evaluation and management services

L. Gregory Pawlson, NCQA

• Surgery and other procedures

Justin B. Dimick, University of Michigan

• Imaging technologies

Howard P. Forman, Yale University

REACTOR PANEL

Dan Campion (Outcome Sciences), Martha Sylvia (Johns Hopkins), Philip Wang (National Institute of Mental Health)

DISCUSSION

12:30

LUNCH PRESENTATION: PERSPECTIVES ON VALUE FROM THE UNITED KINGDOM

Sir Michael Rawlins, National Institute for Clinical Excellence, United Kingdom

SESSION 2

• Preventive services/wellness

David O. Meltzer, University of Chicago

• Pharmaceuticals/biologicals

Newell E. McElwee, Pfizer, Inc.

• Personalized diagnostics

• Devices

Parashar B. Patel, Boston Scientific Corp.

REACTOR PANEL

Elise Berliner (Agency for Healthcare Research and Quality), Steve Phurrough (Centers for Medicare & Medicaid Services), Paul Rudolf (Arnold & Porter, LLP)

DISCUSSION

[Break 3:45 to 4:00]

4:00

SESSION 3: APPROACHES TO IMPROVING VALUE – CONSUMER INCENTIVES

Sessions 3, 4, and 5 will present specific examples of current approaches to improve value in health care in three main areas. Each session will explore the nature of the efforts, and the best practices and results to date. Speakers will particularly focus on the evidence of impact and the future potential to improve value with each approach. The first session will focus on the use of a variety of consumer-oriented strategies to promote value. Each presentation will be followed by a reactor.

Chair: Michael E. Chernew, Harvard University

• Consumer-directed/high-deductible health plans

Melinda J. Beeuwkes Buntin, RAND

• Value-based insurance design

A. Mark Fendrick, University of Michigan

• Tiering

Dennis P. Scanlon, Pennsylvania State University

• Wellness

Ronald Z. Goetzel, Emory University

DISCUSSION

Initial post-presentation responses:

• Francois Sainfort (University of Minnesota School of Public Health)—Consumer-directed health plans

• Kavita Patel (United States Senate)—Value-based insurance design

• Caroline Rossi Steinberg (American Hospital Association)—Tiering

• Seth Serxner (Mercer)—Wellness

8:30

WELCOME AND RECAP OF THE FIRST DAY

Denis A. Cortese, Mayo Clinic & Chair, IOM Roundtable on Value & Science-Driven Health Care

9:00

SESSION 4: APPROACHES TO IMPROVING VALUE – PROVIDER AND MANUFACTURER PAYMENTS

Continuing from Session 3, this session will explore examples of approaches to improve value in health care, with a focus on the use of payment design and coverage and reimbursement policy to improve value. The first two presentations will each be followed by a reactor.

Chair: Samuel R. Nussbaum, Wellpoint, Inc.

• Pay-for-performance

Carolyn M. Clancy, Agency for Healthcare Research and Quality & Roundtable Member

• Coverage and reimbursement decisions

Steven D. Pearson, Institute for Clinical and Economic Review

• Incentives for product innovation

Donald A. Sawyer, AstraZeneca

Reed V. Tuckson, UnitedHealth Group

DISCUSSION

Initial post-presentation responses:

• Robert Galvin (General Electric)—Pay-for-performance

• Amy Miller (Personalized Medicine Coalition)—Coverage

[Break 10:45 to 11:00]

SESSION 5: APPROACHES TO IMPROVING VALUE – ORGANIZATION AND STRUCTURE OF CARE

Continuing from Sessions 3 and 4, the final session on approaches to improving value will focus on changing the organization and structure of care to improve value. Each presentation will be followed by a reactor.

Chair: John C. Rother, AARP & Roundtable Member

• Electronic health records

Douglas Johnston, Center for IT Leadership

• Patient-centered medical home

• Disease management

Tracey A. Moorhead, DMAA: The Care Continuum Alliance

DISCUSSION

Initial post-presentation responses:

• Ronald Paulus (Geisinger Health System)—EHRs

• Sarah Scholle (National Committee for Quality Assurance)—Medical home

• Linda Magno (Centers for Medicare & Medicaid Services)—Disease management

[Lunch 12:30 to 1:30]

1:30

SESSION 6: ALIGNING THE SYSTEM TO PROMOTE VALUE – NOW AND IN THE FUTURE

How could the health system be better aligned to promote value in all aspects of health care, both now and in the future?

Chair: Karen L. Smith, AstraZeneca

• On the horizon

Christine K. Cassel, American Board of Internal Medicine

• Panel discussion

Ezekiel J. Emanuel, National Institutes of Health

Samuel R. Nussbaum, Wellpoint, Inc.

John C. Rother, AARP & Roundtable Member

• Near term/quick hits

• Long term

• Political considerations

DISCUSSION