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Document Code No.: PHL 10-2 (AEO)
Department/Issuing Agency: Department of Executive Services
Effective Date: January 13, 2007
Approved: /s/ Ron Sims
Type of Action: New

Signed document (PDF, 1.13 MB)

This Order requires King County departments to employ strategies to support the transparency of health care information and value-based purchasing in alignment with the U.S. Department of Health and Social Service's "four cornerstones" to improve health care quality and control costs.

WHEREAS, King County is a self-insured employer providing benefits to over 35,000 employees and their families which has, based on the recommendations of the King County Health Advisory Task Force, put in place a highly innovative, market-based health reform initiative that encourages employees to engage in preventive health behaviors and to become better health care consumers; and

WHEREAS, King County, through its founding of and commitment to the Puget Sound Health Alliance is actively engaged with labor unions, private employers, local and state government, health plan sponsors and provider clinics and hospitals in implementing evidence-based reforms on a region-wide basis, including and especially through the enhancement of transparency of information related to the delivery of health care; and

WHEREAS, King County through the Department of Public Health provides health care services to the public through its 15 Public Health Centers throughout King County, as well as jail health services to incarcerated adult and juveniles; and

WHEREAS, King County through the Department of Community and Human Services, provides mental health care services to over 35,000 adults and 10,000 children and provides chemical dependency services to over 10,000 adults and children annually in King County; and

WHEREAS, U.S. Health and Social Services Secretary Mike Leavitt has called on both private and public employers throughout the nation to commit to "four cornerstones" to improve health care quality and reduce health costs by providing information in the health care sector; and

WHEREAS, the "four cornerstone" goals call for actions to improve:

1. Health information technology
2. Transparency of quality measurements
3. Transparency of pricing information
4. Promoting quality and efficiency of care; and

WHEREAS, King County is actively engaged in improvements to health information technology including: 1) employing member-managed secure on-line personal benefit records and wellness assessment tools; 2) implementing an interoperable Electronic Medical Record system in the county's correctional facilities; and 3) working to put advanced health information technology tools in the hands of health care providers in King County public health clinics; and

WHEREAS, King County in collaboration with the Puget Sound Health Alliance, is actively engaged in enhancing the transparency of quality measurements, including the development in 2007 of the first consolidated public comparison report based on nationally-vetted measured endorsed by Institute of Medicine (IOM), National Quality Forum (NQF) and Ambulatory care Quality Alliance (AQA), to compare the performance of and quality of care provided by local clinics and hospitals across the Puget Sound region, and to give patients necessary information to choose and receive effective care that leads to better health in the community; and

WHEREAS, King County, as the founder and active member of the Alliance, laid the early groundwork for the public comparison report effort by dedicating over $1 million to help the Alliance secure a data vendor to aggregate and analyze claims data from Medicaid, all major health plans and self-insured employers providing data, and Medicare data, when available, as Medicare data would greatly enhance the precision and accuracy of the comparison reports as well as inform the federal government on its quality initiatives and its payment strategies to provide incentives for quality health care; and

WHEREAS, King County is actively engaged in seeking new ways to unveil the transparency of pricing information by requiring our Pharmacy Benefit Manager (PBM) to practice "pass-through" pricing and full disclosure of contracts and rebates for all retail drugs; and

WHEREAS, King County's health reform initiative is actively engaged in promoting quality and efficiency of care by: 1) reducing health risks "upstream" with strategies based on prevention and early detection of illness, including working with area hospitals and health care providers to develop clinical guidelines and practices in keys areas of chronic illness to address problems earlier and more effectively; 2) implementing the Healthy IncentivesSM program, which provides financial incentives to employees and their spouse/domestic partners to complete a personal wellness assessment and enroll in action plans for better health; and 3) conducting a robust evaluation component to measure the effectiveness of all our benefit and workplace health strategies.

NOW, THEREFORE, I, Ron Sims, King County Executive do hereby commit this government to the "four cornerstone" goals for improving transparency in health care. I order and direct all King County departments that administer and support the delivery of health care to county employees, their dependents or other populations to take steps that will result in more comprehensive and open information and, most importantly, better health outcomes at reduced cost, while always protecting the privacy rights and confidentiality of those we serve.

Dated this 3rd day of January, 2007.

/s/ Ron Sims, King County Executive


/s/ Jim Buck, Interim Director

Records, Elections, and Licensing Services Division