July 9, 2015
Survival of the Medicaid expansion
July 8, 2015
America’s Essential Hospitals
MetroHealth study shows value of Medicaid coverage.
Read more.
July 8, 2015
MetroHealth Care Plus Study Shows Prepared Safety Net Improves Care, Saves Money in Medicaid Expansion Population
July 8, 2015
New study shows prepared safety net improves care, saves money in Medicaid expansion population
July 8, 2015
A good omen for Georgia Medicaid waiver plan?
Ohio findings may significantly impact Georgia.
Read more.
July 7, 2015
MetroHealth featured in national journal for its Medicaid waiver (behind pay wall)
July 7, 2015
The benefits of Medicaid expansion
July 7, 2015
Good omen for Georgia Medicaid waiver plan?
July 7, 2015
Studies tout Medicaid expansion’s effects on patients, hospitals
Medicaid expansion has made patients and hospitals’ bottom lines healthier, according to two new Health Affairs studies focusing on Ohio and Connecticut (story behind paywall).
Read more.
New study shows prepared safety net improves care, saves money in Medicaid expansion population
A new study published July 7 in Health Affairs found that poor, uninsured patients who enrolled in a Medicaid-like insurance plan had better care and health outcomes than those who remained uninsured -- all achieved with total costs of enrollees' care that were 28.7 percent below the spending cap allowed by the federal government. The study examined the impact of MetroHealth Care Plus, which extended Medicaid coverage to 28,295 Cuyahoga County residents before the expansion of Medicaid took place in Ohio. "The results challenge recent reports and contribute to the ongoing debates on the value of expanding health care coverage to more poor Americans," said Randall Cebul, MD, President and CEO of Better Health Partnership and lead author of the study.
Read the news release.

Presentations from our 15th Community Health Checkup now available
90.3-WCPN highlights Better Health improvements in diabetes, high blood pressure
News report notes improvement of 60,000 Northeast Ohioans with diabetes and high blood pressure; work to eliminate disparities in care and outcomes.
Click here for more
February 7, 2015
Lake Health initiating new patient care model
A new partnership between local employers and Lake Health is hoped to improve the services and ultimately the health of thousands of area individuals. The initiative is a pilot collaboration with the Lubrizol Corp., Lake County Schools Council, the Progressive Group of Insurance Companies and Lake Health to provide coordinated, patient-centered care for employees who receive care from a physician in the Lake Health Integrated Physician Hospital Enterprise. Read more.
February 1, 2015
Lake Health partnering with major employers
Population health and accountable care are hot topics in the rapidly evolving health care industry, but Lake Health — one of the few independent hospital systems left in Northeast Ohio — believes it's taking those concepts to the next level with an experimental project involving three of the region's major self-insured employers.

Lubrizol Corp., Progressive Corp. and the Lake County Schools Council have teamed up with the health system to provide coordinated, patient-centered care for employees who receive care from one of 300 of Lake Health's primary care and specialty physicians. Also, as part of the arrangement, the employers are paying a monthly fee per member to Lake Health to manage their employees' care. Read more.
January 27, 2015
Healthcare Transformation Director Greg Moody to Speak at City Club – January 27 14th Annual "Community Health Check-Up"
A landmark step in health care transformation – payment reform – is here, paving the way for a major shift in how insurance companies pay health care providers in the near future.  Greg Moody, Director of the Governor’s Office of Health Transformation, will address The City Club on Tuesday, January 27, at 12:00 PM to present Ohio’s plan for change. Mr. Moody also will speak earlier at Better Health Greater Cleveland’s meeting to present its 14th report on the quality of health care in the region, also at The City Club. The Office of Health Transformation is resetting the rules so the incentive is to keep people as healthy as possible, pay for what works to improve and maintain health, and shift from fee-for-service payments to population- and value-based payments that reward patient- centered care coordination and better health outcomes. Read the full news.
August 5, 2014
Hospital Reboots Medicaid To Give Better Care For Less Money
MetroHealth's Medicaid waiver program delivered better care, better outcomes and better costs with population management approaches and care coordination. "All of the clinical outcomes are really amazing," said Randall D. Cebul, MD, in a 90.3 WCPN story featured on NPR August 5. Read or listen.
Sept. 30, 2013
Be Well: Choose Wisely
Amidst all the debate about healthcare in America are a couple of undeniable facts: We spend at least twice as much per capita as almost any other country; and countries that spend a lot less often have better health outcomes. One of the latest national efforts to address costs and benefits of medical treatments comes to Cleveland later this week. Read more or listen.
Sept. 25, 2013
Beyond Camden: In Ohio, Will Providing More Care to High Utilizers Save Money?
If a health system delivers more services to patients with chronic conditions, will it lose money or save money? To answer this question, the MetroHealth Medical Center, in Cleveland, is conducting a study of what it calls the Red Carpet Program. As the name suggests, MetroHealth is figuratively rolling out a red carpet for 150 patients with diabetes, hypertension, and heart failure and provide more care to these patients for 18 months. Then it will compare the before and after costs. Read more.
March 11, 2013
Internists should pursue innovative practice models
The patient-centered medical home and the accountable care organization allow internists to do a better job caring for patients, and there is at least some early evidence that they may reduce the costs of care.

David Bronson, current president of the American College of Physicians, writes about Better Health Greater Cleveland. Read more.
February 18, 2013
AMA details plan for cutting hospital readmissions
Outpatient physician practices can play a key part in ensuring that patients have safe transitions in care and avoid preventable hospital readmissions, according to an American Medical Association report released in February.  Read article.
January 30, 2013
Ohio's Better Health reports 10 percent drop in cardiovascular hospitalizations Healthcare Finance News
CLEVELAND – Better Health, a regional health improvement collaborative in northeast Ohio reported that hosptializations for cardiovascular conditions addressed by its programs fell by 10.7 percent in 2011, building on declines in 2009 and 2010. According to Better Health this is first time a decline in avoidable hospitalizations has been reported as a result of a regional health collaborative’s efforts. Read article.
December 18, 2012
Rolling Out the Red Carpet for ED "Super-Utilizers"? Taking a Patient-Centered Approach
"Super-utilizers" -- people who go to the emergency department frequently and often unnecessarily -- are often looked down upon, as they constitute a small percent of overall ED patients but account for the majority of costs. Some healthcare providers and the population at large perceive these "super-utlilizers" as nuisances -- people who make the ED crowded and contribute to long wait times and high costs. However, some healthcare organizations are taking a more patient-centered approach...

Click here to read more about Better Health Greater Cleveland's Red Carpet Care program, funded by Robert Wood Johnson Foundation, that is underway at MetroHealth and two of its health plan partners, Medical Mutual of Ohio and Buckeye.
October 25, 2012
Publicly Reporting Quality Data to Identify "Bright Spots," Motivate Improvement
In 2007, a group of healthcare providers and payors established Better Health Greater Cleveland, a quality improvement organization under Robert Wood Johnson Foundation's Aligning Forces for Quality initiative. The organization started in the outpatient setting with physician practices, but has recently expanded to include hospitals. Read the article, featuring Better Health's use of EHR data to identify "Bright Spots" in health care quality.
October 3, 2012
Regional Healthcare Improvement Collaboratives Needed Now More Than Ever: Program Directors' Perspectives
"If a national vision of value-driven, patient-centered care is to become a reality—one that results in better care, better health of populations, and lower costs—Regional Healthcare Improvement Collaboratives, such as those embodied by the RWJF’s AF4Q initiative, are a necessary part of the solution. Each collaborative represents a neutral common table for all stakeholders to discuss their unique concerns while recognizing their shared. Read the article.
August 29, 2012
Local Solutions Spark Readmission Reductions
With the Oct. 1 start of penalties for excessive readmissions looming, Hospital published a cover story featuring innovation solutions to reducing readmissions -- and featured Better Health Greater Cleveland, Aligning Forces for Quality, and William C. Cook, DO, a Kaiser Permanente hospitalist who co-chairs Better Health's Steering Committee for care transitions.

"From the hospitalist perspective, our role is to make care transitions safe and predictable," Dr. Cook told the magazine. "The way I can contribute most to these transitions is by thinking ahead about what's going to happen next—and how do I prepare the patient and the next provider." Read the article.
December 11, 2011
Greater Cleveland should grab the chance to shift to medical homes: editorial
What if health insurers, employers and health care providers banded together to help consumers buy smarter medicine? Don't rule it out. The idea -- the "patient-centered medical homes" model of care -- is beginning to take hold. The next step is to get it off the drawing board and into examining rooms, human resource departments and benefits managers' offices in a much bigger way. In Northeast Ohio, a group called Better Health Greater Cleveland has been at the task for several years now, advocating among the various stakeholders in both medical care and payment for a shift to medical homes supported by electronic health records. Read more.
September 6, 2011
EHRs Beat Paper in Head-to-Head Competition
Electronic health records (EHRs) show promise to improve quality of care and patient outcomes—that’s why the federal government is investing billions of dollars in them. he more than 500 primary care physicians in 46 practices who took part in the study are all members of Better Health Greater Cleveland, a nonprofit healthcare alliance made up of providers, health plans, employers, and government agencies focused on improving the health of chronic disease patients in Northeast Ohio. Read more.
September 6, 2011
The Cleveland Experiment
There have been a number of research studies published that question the value of Electronic Health Records (EHRs), particularly as it pertains to improving quality of care and ultimately outcomes. Chilmark has always viewed these reports with a certain amount of skepticism. Simple logic leads us to conclude that a properly installed (including attention to workflow and thorough training) of an enterprise software system such as an EHR will lead to a certain level of standardization in overall process flow, contribute to efficiencies and quality in care delivery and ultimately lead to better outcomes. But to date, there has been a dearth of evidence to support this logic, that is until this week. Read more.
September 6, 2011
Tech That Powers Quality Standards
A study published in the New England Journal of Medicine is among the first to put hard numbers on the benefits of electronic health records. Researchers looked at four national quality standards, including: 1) Eye exams, 2) pneumonia vaccinations, 3) outcome measures such as blood sugar, blood pressure, and cholesterol control, and 4) patient- driven issues such as obesity and smoking. Nearly 51% of patients in EHR practices received care that met all four quality standards, compared to just 7% of patients at paper-based practices. Nearly 44% of patients in EHR practices met at least four of five outcome standards, compared to about 16% of patients at paper-based practices.

The study is among the first to put hard numbers on the benefits of electronic health records. But as the study's lead author, Randall Cebul, MD, said in an interview this week, "51% is 49% short of ideal."

So what are the next steps? And how can health information technology get us there? Read more.
September 1, 2011
New England Journal of Medicine Study Shows Benefits of EHRs Office of the National Coordinator's Buzz Blog
Yesterday the New England Journal of Medicine (NEJM) published a study, which looks at care delivered to diabetic patients in physician practices that use electronic health records compared to physician practices that do not. The results should not come as a surprise to those of us who are working to speed the adoption and meaningful use of health IT: Practices that use EHRs -- especially in conjunction with collaborative efforts to improve quality -- delivered measurably better care than practices which rely on paper records. Read more.
September 1, 2011
Q&A: Between the lines of NEJM EHR report - 'Trust trumps technology' for EHR success, authors say
Distinguishing itself from previous efforts to prove the viability of EHRs and meaningful use, a study published Wednesday in the New England Journal of Medicine shed light on just what can be accomplished by using electronic medical records rather than paper records. The finding: A survey of 27,000 adult diabetics spanning 500 primary care physicians across 46 practices in the Cleveland area found that those practices employing EHRs earned “annual improvements in healthcare that were 10 percent greater than their paper-based counterparts,” and their patients were “significantly more likely to have healthcare and outcomes that align with accepted standards than those where doctors rely on paper records.” Read more.
August 31, 2011
Study finds higher clinical quality compliance at practices using EHRs
Researchers from Case Western Reserve University, Cleveland, report that provider practices using electronic health-record systems had higher rates of compliance with clinical quality improvement measures for diabetic patients than did their clinical counterparts using paper-based record systems. 

The research work was conducted in the Cleveland area, one of 16 communities the Robert Wood Johnson Foundation selected to receive funding for the foundation's Aligning Forces for Quality program. Through the program, office-based physician practices report on quality-of-care and outcomes measures for patients who have chronic medical conditions. Some of the participating Cleveland practices use paper-based recordkeeping systems; other use EHRs. All were members of the Better Health Greater Cleveland, a RWJR-funded collaborative for practice improvement. Read more.
August 31, 2011
Study: E-Records Keep Patients Healthier

Electronic health records can help doctors give their patients the best care, at least when it comes to diabetes, U.S. researchers reported on Wednesday.

The findings are a boost to the Obama administration’s electronic health-records program, which offers doctors and hospitals financial incentives if they set up electronic health records. The program will start penalizing providers in 2015 by cutting Medicare reimbursement by 1 percent if they don’t use an electronic medical record.

Randall Cebul, a professor of medicine at Case Western Reserve University, and colleagues found that more than half of diabetes patients got the best care as measured by four standards if their providers used electronic health records. This compares to just 7 percent of patients whose providers used old-fashioned paper, they reported in this week’s New England Journal of Medicine. Read more.

August 31, 2011
EHR Incentives Likely to Improve Quality
Healthcare is one of the last industries in the United States to universally incorporate technological advancements. While most sectors have made significant investments in information technology to improve efficiency and consumer relationships, America’s health care system is still largely paper-driven. As a result the healthcare system is plagued by inefficiency and poor quality. Delivery is slower, more prone to errors, and harder to measure and coordinate than it should be. Investments in health information technology can help improve this situation. Research published in the New England Journal of Medicine (FREE FULL TEXT) gives cause for optimism that efforts to increase adoption of electronic health records (EHRs) will provide major benefits in better patient care and health outcomes. Perhaps we can finally move away from using a dead tree medical recod system in this country.

To start with take a look at this video from a 1961 study that concluded that one day it is going to be possible to relieve the nurses and doctors of some of their paperwork, and it is going to be possible to have correlation of diseases which we have not had before, it is going to be possible to eliminate errors in medications and tests which would have been harmful to the patient:

“We were not surprised by these results,” said Randall D. Cebul, M.D., a professor of medicine at Case Western Reserve University and the study’s lead author who I was able to speak with earlier today. “They were influenced by several factors, including our public reporting on agreed-upon standards of care and the willingness of our clinical partners to share their EHR-based best practices while simultaneously competing on their execution.”
April 4, 2011
Enact social policies to improve Clevelanders' health
On Wednesday, Plain Dealer Reporter Ellen Kleinermen reported on the release of the Robert Wood Johnson Foundation's "county health rankings." These indicators shine a light on the multiple dimensions of our lives that influence our health, such as access to healthy foods, education, income, teen pregnancy rates, smoking rates and quality of health care.

Overall, Cuyahoga County ranked 69th of Ohio's 88 counties. Simply put, place matters -- where you live influences your health, wealth and life expectancy. State and local policies can help to make Greater Cleveland a healthier place to live while simultaneously reducing the costs of health care.

Promoting the availability of fresh fruits and vegetables in corner stores and creating safe opportunities for physical activity in neighborhoods can make a difference. Our statewide smoke-free law, community programs and the Tobacco Quit Line have reduced smoking rates and saved lives and money. Increasing Ohio's cigarette taxes would generate additional revenue for the state, reduce smoking rates and enjoy the support of a majority of Ohioans. Adopting a penny-per-ounce tax on sugar-sweetened beverages would significantly reduce obesity rates and generate almost half a billion dollars for Ohio's General Revenue Fund.

Although Cuyahoga County ranked third in care quality, it's very low rankings on "social determinants of health" must be addressed by actions outside the doctors' office. Prevention is the best buy, and we are all stakeholders in a healthier community.
Terry Allan and Diane Solov, Cleveland
Allan is the health commissioner of the Cuyahoga County Board of Health.
Solov is the program manager for Better Health Greater Cleveland.
March 31, 2011
Universal adoption of electronic health records will pay dividends
One year ago this weekend, Congress passed far-reaching legislation to overhaul the U.S. health care system. Regardless of your personal views about the law, there are provisions in it about which most people, as patients, should agree. These provisions provide incentives for your doctor and her colleagues to adopt and use electronic health records (EHRs) in a meaningful way. The incentives encourage your doctor to use EHRs to improve the quality of your care and to increase communication with you and with other doctors who share responsibility -- with you -- for your health. The goal is that "meaningful use" of EHRs will help to improve health and blunt increases in health care costs. Cuyahoga County is ground zero for much of this work. Physicians and hospitals in our region have jumped into EHR adoption with both feet. The region is a leader of EHR adoption nationally, and lessons we are learning are improving care in our community and helping to guide the rest of the country. Read full article.
June 25, 2009
Greater Cleveland diabetes patients show improvements in treating the disease, but insurance cuts threaten progress
Greater Cleveland diabetes patients are showing health improvements in areas such as blood sugar control, but the gains are threatened by a growing number of people losing insurance coverage. A nonprofit collaborative called Better Health Greater Cleveland began examining medical records of more than 25,000 diabetes patients in 2007. The program is the first large-scale effort locally to report on how patients and their doctors are managing the chronic diseaseRead full story.
June 15, 2009
Better Health Director receives Saltzman Award
Better Health Director Randall Cebul, MD, a MetroHealth internal medicine physician and director of the Case Western Reserve University Center for Health Care Research and Policy at MetroHealth, was presented with the Mt. Sinai Health Care Foundation’s prestigious Maurice Saltzman Award for 2009. Dr. Cebul was recognized at the Foundation’s annual meeting on June 15 for his efforts in establishing and leading Better Health Greater Cleveland, a community-wide collaboration of those who get care, give care and pay for care that is dedicated to improving the health and value of health care for people in Northeast Ohio with chronic medical conditions.

The Hon.Dan A. Polster, chair of the award selection committee, said the award has become one of the most prestigious honors in Cleveland, which made the selection process both a privilege and a challenge. “As director of the Better Health Greater Cleveland initiative, Dr. Cebul has brought together community-wide stakeholders from all facets of the health care industry to address chronic illnesses in a manner never before attempted,” said Polster. “Because of his leadership, Greater Cleveland now has the infrastructure necessary to change the quality of care and reduce the economic and personal burden of chronic disease. His uncompromising drive for high-quality care and measurable outcomes has helped his colleagues move the needle toward better care and better outcomes for 25,000 patients currently served by this initiative.”

Dr. Cebul said he was “tremendously honored and thankful to the Mt. Sinai Health Care Foundation,” but the award was “not about me.” He said it was about themes that are playing out nationally in the dialogue about health care reform, including improving access to care for those who are disadvantaged, improving health outcomes and reducing costs of care for those with chronic conditions, and about the intelligent use of health information technology to monitor, coordinate and improve care. But mostly, he said, it was about building effective partnerships of leaders in primary care across the region. The award was established in 1983 to honor the late Maurice Saltzman, who was involved in human service causes for more than 30 years and demonstrated a special interest in health, medicine and collaboration.
January 27, 2009
Doctors, patients doing better at managing diabetes
Better Health Greater Cleveland, a health-quality group that began examining Cleveland-area diabetes patients in 2007, says in its latest report that doctors and patients are doing slightly better at managing the chronic disease. Read the full story.
June 18, 2008
Local project tackles diabetes complications
If you've been diagnosed with diabetes, you've got a better chance than the rest of us of going blind, losing a leg, having a stroke. A group of health-care experts from around Cleveland want to whittle away those complications. Read the full story.
June 12, 2008
Working together to cut the health care gap
Cleveland's diabetes rate is almost twice the state's rate and far higher than the national rates. Health care providers are working with a national foundation to figure out which best practices will narrow the gap, and close other health care inequities nationwide. Read / listen.