PH II       Title: Giving Credit Where Credit is Due--The Science and Art of Calculating Clinical and Financial Outcomes Based Upon the Methods Evaluation Process (tm) (MEPtm) Date: Thursday, June 19, 2008 Time: 08:00 AM - 12:00 PM Type: ANCILLARY-PUBLIC Level: ADVANCED Track: - Sponsor(s): - Speaker(s): Joel V. Brill; Garry Carneal; Vicki Darlington; Mary Beth Newman; Thomas Wilson Registration: Please register at CMSA's online conference registration or call 513–349-5846. Full CMSA conference attendees can attend for no additional charge, but they must register. For individuals who wish to attend the PHII workshop without attending the CMSA conference, the registration fee is $95. For additional information, please contact Kristin Solomon, PHII Project Coordinator at or 513–349-5846. This workshop will teach attendees the principles and standards behind credible, transparent, standardized, and replicable methods to evaluate the efficacy of population-based health management programs. These health management programs include a wide range of case management interventions. In addition, the workshop will provide an overview of the new MEP Accreditation Program. Attendees will receive a PHII certificate of attendance. This workshop will provide attendees with the tools and knowledge to calculate clinical and financial outcomes of case management, disease management, and other medical management programs. Whether you work in a health plan, clinical practice, business, academic or other setting, this is a must attend event! Workshop Background & Overview Quality improvement is founded on the framework of structure, process, and outcomes. However, without a credible and meaningful way to “attribute” the source of positive (or negative) outcomes based on specific structures and processes, the health care system and the people it serves suffers. The “attribution challenge” is very similar to the need to establish as a “cause-effect “relationship in science. From a financial standpoint, this challenge can be characterized as the “Return on Investment” (ROI) question. In the ROI metric, the “investment” is in the denominator, the “cause”, while the “return” on that investment, the “effect”, is in the numerator. In the clinical world, the classic example of cause and effect attribution is the randomized clinical trial (RCT). In the RCT, the cause is an intervention, but the effect (financial or clinical) is only attributed to that cause if one or more of confounding variables are taken into account through the use of an equivalent referent that did not get the intervention. In the RCT, dealing with confounding variable is by design; however, when calculating ROIs, addressing confounding variables is often an afterthought or ignored altogether. There are a plethora of methods and principles of attribution between the simple ROI and the complex RCT. The goal of each is to give credit where credit is due. None are perfect and these science-based processes must also be linked to the art of attribution (see Wilson, Carneal, and Newman’s article in the February/March 2008 issue of Case-in-Point Magazine). This workshop, Giving Credit Where Credit is Due — The Science and Art of Calculating Clinical and Financial Outcomes Based Upon the Methods Evaluation Process™ (MEP™), addresses the attribution problem with a tested and vetted set of principles and standards developed by a group of volunteer stakeholders representing purchasers, payors, providers, methodologists and others assembled by the non-profit Population Health Impact Institute. The workshop will teach each attendee the fundamentals of the Method Evaluation Process™ (MEP™) Program that is being developed by PHII. Attendees will receive a MEP certification of attendance from PHII. The MEP Principles are: Personal Accountability (Trust, but Verify) Transparency of Metrics and Methods Arithmetic Confirmation Logical Coherence of the Pathway. Defining Expectations (The Equivalence Principle, Use of Referents) Evidence-based Accountability (Attribution) Attendees also will learn about PHII’s MEP Accreditation Program. This Accreditation program focuses on both the transparency and the quality of the methodology that lies behind the health and wellness outcome claims made by health plans, disease management companies, case management entities, medical management organizations, and others. The standards are based on the generally accepted evaluation principles of transparency and scientific validity and well accepted decision support concepts used in business.