All posts by Brian Strub

Health Care Quality Report Shows Increases in Teen Mental Health Screening and Immunizations for Adolescents

Health Care Quality Report Shows Increases in Teen Mental Health Screening and Immunizations for Adolescents

The number of Minnesota teens receiving a mental health screening increased between 2015 and 2016. Likewise, the number of Minnesota adolescents receiving recommended immunizations also increased from the previous year. These findings, and results of more than 30 individual clinical quality measures, are part of a new report published March 2 by MN Community Measurement (MNCM).

The annual MNCM Health Care Quality Report, now in its 13th edition, compares clinic, medical group and hospital performance on clinical measures related to preventive and chronic care, hospital care and health information technology. An objective of the Health Care Quality Report is to provide reliable information to support medical group quality improvement. An equally important objective is greater health care transparency by sharing results with the public at-large.

The report is at www.mncm.org/health-care-quality-report

“This report provides valid and reliable information to help consumers make informed decisions about their health care,” said Jim Chase, MNCM President. “This report also contains actionable, reliable and comparable information for providers to use in their efforts to improve patient care and outcomes.”

Examples of Health Care Quality Report results:

  • The statewide screening rate for Teen Mental Health Screening increased from 40 percent in 2015 to 64 percent in 2016. This is a 24 percentage point increase in adolescent patients receiving mental health and/or depression screening at a well-child visit. This means that 64 out of 100 youth ages 12 through 17 were screened for depression and other mental health conditions at their well child exams. The Teen Mental Health Screening measure notes how many patients age 12 through 17 were screened for social, emotional and behavioral disorders by their primary care provider at a well-child visit.
  • The statewide rate for Immunizations for Adolescents increased from 75 percent in 2015 to 85 percent in 2016. This is a 10 percentage point increase in adolescents receiving immunization. This means 85 of 100 adolescents had their meningococcal and either Tdap or Td vaccines by their 13th birthday. This measure is calculated both on a statewide basis as noted above, and also an average of all medical groups reporting. The rate of Immunizations for Adolescents by all reporting medical groups, and reported on MNHealthScores.org, is 87 percent. The Immunizations for Adolescents measure shows how well Minnesota health care providers performed in keeping adolescents current on meningococcal (meningitis) and either Tdap (tetanus, diphtheria and pertussis) or Td (tetanus and diphtheria) vaccines.

“These results show that when Minnesota providers focus on a particular area, there can be a substantial positive impact,” said Chase.

Additional Health Care Quality Report key results

Two clinical measures showed noticeable improvement in their statewide rates:

  • Pediatric Preventive Care: Overweight Counseling – The statewide rate increased from 85 percent in 2015 to 89 percent in 2016.
  • Optimal Asthma Control – Adults – The statewide rate increased from 52 percent in 2015 to 55 percent in 2016.

Thirteen other clinical measures showed some small improvements in their statewide rates. Measures with increases or noted improvement include Childhood Immunization Status (Combo 3); Chlamydia Screening in Women; Appropriate Testing for Children with Pharyngitis; Appropriate Treatment for Children with Upper Respiratory Infections; Colorectal Cancer Screening; Breast Cancer Screening; Use of Spirometry Testing in the Assessment of Chronic Obstructive Pulmonary Disease; Follow-up Care for Children Prescribed Attention Deficit Hyperactivity Disorder (ADHD) Medication; Total Knee Replacement pre-op and post-op; Spinal Surgery Discectomy/Laminotomy Functional Status; Spinal Surgery Discectomy/Laminotomy pre-op and post-op; Spinal Surgery Lumbar Fusion pre-op and post-op and Maternity Care: C-Section Rate.

Six medical groups achieved rates that were above average for a cluster of primary care measures. Julie Gerndt, MD, is Chief Medical Officer at Mankato Clinic and was not surprised that Mankato Clinic was among the high performing medical groups across Minnesota.

“We expected to do well based on the commitment we made as an organization several years ago to redesign our care model for better patient outcomes,” said Dr. Gerndt. “That work is paying off.”

Park Nicollet Health, HealthPartners Clinics, Mankato Clinic, Stillwater Medical Group, Fairview Health Services and Allina Health each achieved above-average rates on at least half of the primary care clinical measures.

“These results validate that if you keep working at this over time and make it a priority, you can have an impact,” said Dr. Gerndt.

The Health Care Quality Report is organized for ease of use to both the clinician and the public at-large. The report contains easy to read tables for specific conditions or procedures, grouped by large and moderate improvement, increase or decrease. Trends are noted where a trend exists. More than 300 medical groups and 1,600 clinics are registered to submit data to MNCM. The annual Health Care Quality Report is a compilation of all measures publicly reported by MNCM during the year. Individual medical group results are also available year-round at MNHealthScores.org.

About Us

MN Community Measurement is a non-profit organization dedicated to improving health by publicly reporting health care information. A trusted source of health care data and public reporting on quality, cost and patient experience since 2003, MNCM works with medical groups, health plans, employers, consumers and state agencies to spur quality improvement, reduce health care costs and maximize value. Learn more at MNCM.org.

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Additional Hospital Measures Released

MN Community Measurement (MNCM) recently published new results for two hospital-based health care quality measures and a refresh of five existing readmission measures. This information can be used to compare hospitals within Minnesota with state and national averages.

The results are available at MNCM’s public reporting website MNHealthScores.org.

The two quality measures are relatively new composites that are required by Centers for Medicaid and Medicare Services (CMS).

Value Based Purchasing Composite

The Hospital Value-Based Purchasing (VBP) composite measures the performance of acute-care hospitals on the quality of care they provide to Medicare beneficiaries, how closely best clinical practices are followed and how well hospitals enhance patients’ experiences of care during hospital stays.

The VBP measure combines results from different measure components into a single score for a hospital. A hospital score can range between 0 and 100. The statewide score is 46.0. A hospital’s performance rating is a comparison to the statewide score and is noted as “above average” (better), “below average” (worse) or “average” (the same). This information is from patients seen between January 1, 2015 and December 31, 2015.

Hospital Acquired Conditions Composite

One way to measure hospital quality is to see how many patients developed infections or other specific health issues as a result of their hospital stay, such as bloodstream infections, pressure ulcers, surgical complications, kidney damage, blood clots and other serious conditions.

The Hospital Acquired Conditions Composite measure combines results from different measure components into a single rating for the hospital. A hospital score can range between 1 and 10. The statewide score is 4.94. A hospital’s performance rating is a comparison to the statewide score and is noted as “lower than average” (better), “higher than average” (worse) or “average” (the same). This information is from patients seen between January 1, 2015 and December 31, 2015.

Refreshed Data

Additionally, MNCM refreshed data for five readmission measures for the period of July 1, 2012-June 30, 2015. Measures with refreshed data include Chronic Obstructive Pulmonary Disease (COPD), Heart Failure,    Acute Myocardial Infarction (AMI), Pneumonia and Knee or Hip Surgery.

Results for these and other health care quality measures are available at MNCM’s public reporting website MNHealthScores.org.

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Equity Report Shows Continued Gaps in Health Care for Many Minnesotans

For many Minnesotans, good health can be elusive, especially for people of color and new immigrants. Health care outcomes vary widely based on where a person lives, their race, preferred language or country of origin, according to a new report from MN Community Measurement (MNCM).

The 2016 Health Equity of Care Report pinpoints distinct differences in health care between numerous patient populations and geographic regions across Minnesota. Results in the 2016 Health Equity of Care Report clearly show that some racial, ethnic, language and country of origin groups have consistently poorer health care outcomes than other groups. The report also shows how those rates vary by medical group across the state and gives examples of what groups are doing to improve outcomes for their patients.

“Minnesota is one of the healthiest states in the nation, at the same time we have some clear and persistent inequities in health status,” said Jim Chase, MNCM President. “Patients from specific geographic regions and populations, including those in Greater Minnesota, people of color, people who identify as Hispanic, immigrants and people who do not speak proficient English are less likely to receive preventive screenings and more likely to suffer from negative health outcomes.”

The third annual Health Equity of Care Report released by MNCM provides a new benchmark in understanding health inequity in Minnesota. The report is at http://mncm.org/health-equity-of-care-report/

The report’s major findings include:

  • White patients generally had better health care outcomes across most measures and most geographic areas.
  • Patients in Greater Minnesota overall had poorer health outcomes than patients in the 13-county Metro area.
  • Patients born in Asian countries tend to have better outcomes across multiple quality measures and geographic regions than patients in other country of origin groups.
  • Generally, patients from large medical groups in the Metro area had higher rates of optimal care.
  • Across measures and geographic areas, American Indian or Alaska Native and Black or African American patients generally had the lowest health outcomes both statewide and regionally.
  • Hispanic patients generally had poorer health care outcomes than non-Hispanic patients across all quality measures and most geographic regions.
  • Patients born in Laos, Somalia and Mexico generally had poorer outcomes than other groups.
  • Patients who preferred speaking Hmong, Somali and Spanish generally had lower screening and care rates compared to other preferred language groups.

Despite the somewhat stark results, examples of success exist and several such examples are featured in the 2016 Health Equity of Care Report. South Lake Pediatrics is highlighted in the report as one such example for their positive results for numerous populations for the Optimal Asthma Control for Children measure.

“We are very proud of our asthma work,” said Laura Saliterman MD, with South Lake Pediatrics. “A great deal of effort has gone into our asthma program and it has produced great results for our patients.”

The 2016 Health Equity of Care Report contains information collected from patients seen for appointments at medical groups throughout Minnesota, and evaluates health care quality in seven areas. Results for the seven health care quality measures were segmented by race, Hispanic ethnicity, preferred language and country of origin. These measures are further reported at statewide, regional and medical group levels. The seven measures are: Adolescent Mental Health and/or Depression Screening, Adolescent Overweight Counseling, Colorectal Cancer Screening, Optimal Asthma Control for Adults, Optimal Asthma Control for Children, Optimal Diabetes Care and Optimal Vascular Care. The Adolescent Mental Health and/or Depression Screening and Adolescent Overweight Counseling measures are new in the 2016 Health Equity of Care Report.

“To reduce and eliminate the barriers to health equity, we must understand where they exist and their scope,” said Chase.

Background

This report is unique because medical groups across the state report the data in a standardized format, which allows MNCM to compare results across medical groups and regions.

MNCM released The Handbook on the Collection of Race/Ethnicity/Language Data in Medical Groups in 2008. This handbook defined and standardized the information that is to be collected from patients by clinics and medical groups, as well as set best practices for collection and reporting. Since then, Minnesota providers have steadily improved their collection and reporting of race, ethnicity, language and country of origin (REL) data. In 2016, nearly all Minnesota providers submitted REL data to MNCM and most did so using best practices. Only data from medical groups who have successfully demonstrated to MNCM that they follow these best practices is included in the Health Equity of Care Report.

Understanding why the gaps exist from one group to another and what can be done to reduce the barriers to optimal health are the reasons behind the MNCM effort to collect and report this information. Specific questions of why, and what is being done, according to Chase, are questions best answered by the state’s medical groups and others health equity advocates.

“We share this report with the community so that advocates, policymakers, public health professionals, communities of color and medical groups can take the necessary steps toward addressing the unique health concerns of their patients, stakeholders and constituents,” said Chase.

About Us

MN Community Measurement is a non-profit organization dedicated to improving health by publicly reporting health care information. A trusted source of health care data and public reporting on quality, cost and patient experience since 2003, MNCM works with medical groups, health plans, employers, consumers and state agencies to spur quality improvement, reduce health care costs and maximize value. Learn more at MNCM.org.

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New report seeks to better understand the cost of care at Minnesota medical groups

New report seeks to better understand the cost of care at Minnesota medical groups

A new report from MN Community Measurement (MNCM) highlights the significant variation of costs across medical groups in Minnesota and examines the drivers that impact and influence health care costs.

“The continued rise of health care costs and the burden this places on families, businesses and the community makes it critical for medical groups and the community to work together,” said Jim Chase, MNCM President. “This is our endeavor in this new report.”

The 2016 Cost & Utilization Report features analysis and comparative data on medical group performance in Total Cost of Care (TCOC), which includes all costs associated with treating commercially-insured patients, including professional, facility inpatient and outpatient, pharmacy, lab, radiology, behavioral health and ancillary costs. MNCM posted total cost results in the fall on MNHealthScores.org. New in this report is information that breaks out the total cost into price and utilization.

This report shows the variation or difference in total cost by medical group. Further, the report shows how much of the variation was due to the amount medical groups were paid relative to others and how much was due to the utilization or use of services. The report also contains more detailed utilization measures such as the rate of admissions, emergency room visits, office visits and pharmacy use, using the same patients and time period as TCOC.

For example, the 2016 Cost & Utilization Report shows that depending on where you go for care:

  • A strep test can range from $8 to $101
  • Total Cost of Care can range from $365 to $914 per month on a risk adjusted basis
  • Amount of resource use for a patient ranges from 22 percent below average to 33percent above average, after accounting for patient risk
  • Emergency room use (utilization of ER as a health care service) ranges from 37 percent less than expected to 104 percent more than expected, after accounting for patient illness

A goal of the 2016 Cost & Utilization Report is to help medical groups better identify opportunities to reduce costs for their patients. The report helps evaluate the categories of care that are driving the majority of providers’ costs and the medical groups can then take actions to reduce their costs and provide more efficient care. The report helps consumers make informed decisions on where to receive care. Further, the report can be used by health plans, employers, and policy makers, all of whom have a stake in addressing the challenges of rising health care costs.

The 2016 Cost & Utilization Report includes a suite of measures which encompasses 119 separate measures of cost and utilization to give a comprehensive view of the drivers of health care costs.

The 2016 Cost & Utilization Report provides insight into individual procedure costs (Average Cost per Procedure chapter), statewide and regional views into total cost of care (TCOC chapter), along with newly published perspective on the resources used (Resource Use and Price Index chapter) and the utilization of health care (Utilization Ratios chapter). When possible, this report displays information on these measures statewide, regionally, and by medical group for ease of analysis.

Reviewed and considered as a whole or individually by chapter, these measures provide unique insight into tracking, comparing and taking actions to manage and reduce health care costs.

The results of these measures are based on 2015 health insurance claims of more than 1.5 million commercially-insured patients enrolled with four Minnesota health plans: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica and PreferredOne.

View the current, and previous MNCM cost of care reports here.

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New Data Shows MN Hospitals On Par With, Or Better Than, National Averages

MN Community Measurement (MNCM) today announced the availability of new results for five hospital-based health care quality measures. This information can be used to compare hospitals within Minnesota with state and national averages. The results are available at MNCM’s public reporting website MNHealthScores.org.

“These measures are relevant for patients seeking health care and also have value for hospitals as they strive to improve their quality of care,” said Jim Chase, MNCM President. “Hospitals have been submitting outcome data for years, and it’s important to draw attention to what they are reporting and to put it into context for patients.”

Three of the measures are based on mortality or death rates that occur within 30 days following hospitalizations for heart attack (acute myocardial infarction), heart failure and pneumonia. For these measures, lower rates of death are better. On all three measures, the statewide average was the same or lower than the national average. These results show that Minnesota hospitals had average or better than average performance compared to hospitals in other parts of the nation.

National Average/Minnesota Average

Heart attack      14.1%/13.5%
Heart failure      12.1%/12.1%
Pneumonia         16.3%/15.9%

For the heart attack measure, Mayo Clinic Hospital in Rochester performed significantly better (lower), at 11.6 percent, than the national average of 14.1 percent. Mayo Clinic Hospital was the only Minnesota hospital different than the national average. All other Minnesota hospitals were similar to the national average for the heart attack measure.

For the heart failure measure, Mayo Clinic Hospital in Rochester performed significantly better (lower), at 9.4 percent, than the national average of 12.1 percent. Mayo Clinic Hospital was the only Minnesota hospital different than the national average. All other Minnesota hospitals were similar to the national average for the heart failure measure.

For the pneumonia measure, Park Nicollet Methodist Hospital (13 percent) and Mayo Clinic Hospital (12.3 percent) performed significantly better (lower) than the national average of 16.3 percent. Park Nicollet Methodist Hospital and Mayo Clinic Hospital were the only two Minnesota hospitals different than the national average. All other Minnesota hospitals were similar to the national average for the pneumonia measure.

The remaining two measures are composites, meaning they combine two or more components of care and wrap them into one comparable result. This is a common way health care is analyzed nationally and in Minnesota.

Readmission Reduction Program (RRP) results
The RRP measure is a hospital’s readmission ratio. The goal is to avoid readmissions for the same condition within 30 days of discharge from the hospital. Two examples include pneumonia and Chronic Obstructive Pulmonary Disease. A ratio of less than 1.0 means there were fewer readmissions across conditions than the national average. A ratio greater than 1.0 means there were more readmissions than the national average. For this measure, lower readmission ratios are better.

The statewide readmission average is .97 or 3 percent below the national average. Four hospitals performed significantly better than the statewide average in readmissions: Mayo Clinic Hospital in Rochester, Lakeview Memorial Hospital in Stillwater, Mayo Clinic Health System in Mankato and HealthEast Woodwinds Hospital in Woodbury.

Emergency Department Transfer Communication (EDTC) results
One element of hospital quality can be seen in how hospitals communicate when transferring patients. The EDTC measure was developed to track communications and facilitate care coordination. It measures the percentage of patients with complete medical record documentation communicated to another healthcare facility prior to the patient being transferred. For this measure, higher results are better.

One hospital, Essentia Health in Fosston, scored 100 percent on this measure. The statewide EDTC average was 62 percent. This means that 62 percent of patients transferred from hospital emergency departments to another health care facility had the required documentation forwarded within 60 minutes of leaving the hospital.

Thirteen Minnesota hospitals performed significantly better than the statewide EDTC average, including: Bigfork Valley Hospital in Bigfork, CentraCare Health in Sauk Centre, CHI St Gabriel’s Health in Little Falls, CHI St Joseph’s Health in Park Rapids, Cuyuna Regional Medical Center in Crosby, Essentia Health in Fosston, Mayo Clinic Health System in Cannon Falls, Pipestone County Medical Center in Pipestone, Redwood Area Hospital in Redwood Falls, Riverwood Healthcare Center in Aitkin, Sanford Jackson Medical Center, Sanford Tracy Medical Center and Windom Area Hospital in Windom.

Hospital-based health care quality measures are available at MNCM’s public reporting website MNHealthScores.org.

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Total Cost of Care Results Released: Total Cost Increased Nearly 6 Percent from Previous Year

New information published by MN Community Measurement (MNCM) allows consumers to compare the cost of care at medical groups across the state. The total cost of medical care in Minnesota increased 5.6 percent from 2014 to 2015 for commercially-insured patients, according to the latest data released by MNCM. View complete results for 2014 and 2015 in the 2016 Cost & Utilization Report 

“This increase is more than the previous year and greater than the average increase in people’s income in Minnesota,” said Jim Chase, MNCM President.

The MNCM data shows an increase for commercially-insured patients per month from $449 in 2014 to $474 in 2015. The increase was 3.2 percent between 2013 and 2014.

This is the third release of overall total cost of care (TCOC) information by MNCM. The first TCOC report occurred in 2014 and reported a TCOC in 2013 of $435 per commercially-insured patient per month. The data is available at MNCM’s public reporting website MNHealthScores.org.

“This data not only informs consumers,” said Chase, “the availability of these results provide useful information for our community about what is driving cost increases by medical group and by region.”

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