Julie Sonier, President of MN Community Measurement (MNCM), was the featured guest and fielded questions from callers during the January 10, 2018 edition of MPR News with Kerri Miller, a live call in radio program broadcast statewide on the stations of Minnesota Public Radio.
The cost of health care, with insight from MNCM, was the featured topic. Discussion began with a focus on a recently released report from the Minnesota Department of Health noting wide variation in the cost of certain medical procedures. The report, as Sonier noted, is similar yet different from “average cost per procedure” data produced and published annually by MNCM and posted online for the public to see at MNHealthScores.org.
The wide ranging, 60-minute discussion covered cost of specific procedures, reimbursement, health insurance and calls from listeners including numerous physicians. Want to hear the program? Click here to listen to the entire conversation.
“We sometimes focus too much on cost alone and we need to look at the bigger picture,” said Sonier.
“We need to look at Total Cost of Care and quality measurement to assess both the quantity and quality of health care services in addition to the price or cost of care,” added Sonier.
Read about this and other topics discussed on the daily radio program, MPR News with Kerri Miller, at this link https://www.mprnews.org/topic/kerri-miller
“Providing health care in rural regions presents unique challenges,” writes Allison Suttle, MD, in this article published October 18, 2017 in the Harvard Business Review. The article notes how data from MN Community Measurement is helping medical groups and providers to improve rural health care. Read the article here.
Minnesota is one of only three states that earned an “A” grade for transparency of physician quality measures in a recent report by Altarum’s Center for Payment Innovation and Catalyst for Payment Reform. Along with Washington and California, Minnesota earned an “A” grade for quality transparency that is based on the following criteria: independent and impartial; data are freely available; data are timely; data are available on large numbers of providers; quality measures used are meaningful; and information is easily found and understood by consumers.
The report also ranks states on price transparency, based on whether the state has a law requiring price transparency. Two states (Maine and New Hampshire) earned an “A” on this ranking. Although Minnesota does not have a law requiring a price transparency website, the pricing information that MNCM makes available through MNHealthScores.org is comparable to what is being published through those state-mandated websites.
The total cost of medical care increased 3.4 percent from 2015 to 2016 for commercially-insured patients according to a new report released by MN Community Measurement (MNCM).
The report shows an increase in average costs for commercially-insured patients per month from $474 in 2015 to $490 in 2016. Growth in 2016 was lower than the previous year (5.6 percent), but higher than the 3.1 percent growth recorded in 2014.
“Although cost growth in 2016 was moderate compared to historical averages, affordability continues to be a major concern. This problem affects just about everyone, and it is one that we must work together to solve,” said Julie Sonier, MNCM President.
“This report is one way that MN Community Measurement is bringing the power of data, measurement and transparency to the health care affordability discussion here in Minnesota,” said Sonier.
The 2017 Cost and Utilization Report provides the most current comparable and validated cost of health care information, at a level of detail that provides a unique view of health care cost and the drivers of cost in Minnesota.
The report includes several types of information on health care costs: average costs for 118 common medical procedures; the average total cost of care (TCOC); information on resource use and prices to provide insight and context for understanding variations or differences in total cost; and data on variations in utilization for specific types of services. These data are published at the statewide, regional and medical group levels.
Examples of findings in the 2017 Cost & Utilization Report include:
- Costs for common medical procedures: There is substantial variation across medical groups in the amounts that they are paid for the same procedure. For example, the amount that providers are paid for an ankle X-ray averages $72, but ranges from $26 to $201. Similarly, the average payment for reading an eye chart was $6 in 2016, but ranged from $4 to $46 across different medical groups.
- Total Cost of Care: Across the 122 medical groups included in this report, TCOC averaged $490 in 2016, with a range of $386 to $977 per patient per month on a risk adjusted basis. TCOC for men is lower than TCOC for women and lower for children than adults.
- Resource use and price: Across medical groups, the analysis finds about a 70 percent variation in resource use and 90 percent variation in price, after accounting for patient risk.
- Utilization of services: Analysis of emergency room use shows a three-fold difference in use after adjusting for patient illness.
“Better understanding of how much variation we have in our medical care system and what factors contribute to the variation is a starting point for strategies to make health care more affordable,” said Sonier. “The measures in this report provide unique insight for comparing and taking actions to manage and reduce health care costs.”
The report uses data from 2016 health insurance claims of more than 1.5 million commercially-insured patients (i.e. those with private health insurance, both individual and employer-sponsored) enrolled with four Minnesota health plans: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica and PreferredOne.
In addition to this report, MNCM publishes total cost of care and the average cost of 118 common medical procedures by medical group level on its consumer-oriented website, MNHealthScores.org.
View the current and previous MNCM cost of care reports here.
The role of measurement in overcoming health disparities, with insight from MN Community Measurement (MNCM), was the featured topic during the November 6, 2017 edition of Community Health Dialogues, a radio program on KMOJ FM.
Julie Sonier, President of MNCM, was joined by Gaye Adams Massey Co-Chair of the MNCM Health Equity Advisory Council (HEAC) and Anne Snowden Director of Performance Measurement & Reporting at MNCM.
Want to hear the Community Health Dialogues program again? Click here to listen to the entire conversation.
The weekly radio program is hosted by Clarence Jones. Jones participated at the MNCM Annual Seminar 2017 and spoke about the Clippers ‘N Curls program to reduce incidents of heart attack and stroke in the African American population. Jones invited MNCM to continue the panel discussion, titled In Pursuit of Health Equity, from the seminar, onto the air waves and directly with KMOJ listeners.
“There are so many things that impact good health,” said Adams Massey. She shared her insight as both the co-chair of the HEAC and also as CEO of the YWCA of Saint Paul.
The discussion touched on the importance of collecting health data in efforts to reduce health disparities. Definitions of health equity were shared, as well as the methods used to collect quality measurement data and the usefulness of this information in helping providers and patients to overcome barriers.
“This data is about getting Minnesota healthier,” said Sonier. MNCM works to not only collect the data, added Sonier, but also to disseminate it so that the public and health care professionals can better understand the result and take action based on the results.
The three panelists invited listeners to think of health broadly, more than doctors and nurses. The data, they added, is a tool to help come up with solutions to health disparities.
Sonier ended the program with an invitation for KMOJ listeners to visit MNHealthScores.org and to think of other ways that MNCM could work with community groups to reduce health disparities though quality measurement data.
In addition to the weekly radio program, Jones is outreach director of Southside Community Health Services and Q Health Connections which works with community partners to offer free, weekly blood pressure screenings.
In August 2016, MNCM’s Measurement and Reporting Committee approved recommendations that further align the Childhood Immunization Status HEDIS measure with CMS’s Merit-Based Incentive Payment System (MIPS) requirements.
In the 2017 report year, MNCM will report the Childhood Immunization Status Combo 10 measure. The Childhood Immunization Status measure evaluates children’s vaccination status, as of their second birthday. Evidence and national consensus support the recommendation for children to receive all vaccines encompassed in the HEDIS Childhood Immunization Combo 10 measure. Currently, MNCM reports results for the Childhood Immunization Status Combo 3 measure. Three additional vaccines are included in Combo 10: Hepatitis A, Rotavirus, and influenza, all of which are included in state and national preventive care guidelines, both from ICSI and the USPSTF.
In the 2018 report year, MNCM will report the Immunizations for Adolescents Combo 2 measure. The Immunization for Adolescents measure evaluates adolescents’ vaccination status, as of their thirteen birthday. Evidence and national consensus support the recommendation for adolescents to receive all vaccines encompassed in the HEDIS Immunization for Adolescents Combo 2 measure. Currently, MNCM reports the Immunization for Adolescents Combo 1 measure. In the 2017 report year, the National Committee for Quality Assurance (NCQA) will introduce Combo 2 for this measure – an update that will include the HPV vaccine for males and females. In the 2018 report year, NCQA has updated their specifications for this measure to reflect the most recent guidelines for HPV vaccine, namely, children aged 11-12 receiving two doses, instead of the previously recommended three doses. The addition of the HPV vaccine is supported by state and national preventive care guidelines. With recent changes in recommendations by the US Preventive Services Task Forces (USPSTF) and NCQA’s recent update of the measure, reporting this measure as a Combo 2 allows MNCM to be completely aligned with national and local guidelines.
In June 2017, MNCM’s Measurement and Reporting Committee (MARC) recommended the retirement of two quality measures starting in the 2018 report year:
- Pediatric Preventive Care Overweight Counseling – This is a process measure that is now topped out with a statewide rate of 90%.
- Maternity Care Cesarean Section Rate – Although Cesarean section rates have increased significantly over the past 20 years and may be medically necessary in many situations, an appropriate target rate is unknown. The statewide Cesarean section rate of 22% (lower is better) is 3.5 percentage points below the national rate of 25.7% and the statewide rate has been flat for more than three years.
As part of ongoing efforts to communicate health care performance results in a timely and user-friendly way, MNCM has created “snapshots” from the 2017 Cycle A and Cycle B measure reporting periods.
These snapshots include Optimal Diabetes Care, Optimal Vascular Care and Depression Care from Cycle A and Adolescent Mental Health and/or Depression Screening and Overweight Counseling from Cycle B that will be published in the Health Care Quality Report, which is anticipated to be released in January 2018.
This information can be used to aid decision making associated with quality improvement efforts.
In 2017 (2016 Dates of Service), the statewide rate for Optimal Diabetes Care is 45 percent and 62 percent for Optimal Vascular Care. The statewide rate for Depression Remission at Six Months is 8 percent. Overweight Counseling is 90 percent and 73 percent for Adolescent Mental Health and/or Depression Screening. Clinic and medical group level results are publicly reported on our consumer website, MNHealthScores.org. The site provides this information in convenient, sortable tables to view, download and/or print.
MNCM appreciates the significant contributions of clinics, medical groups, health plans, hospitals and other professional organizations that provide data to MN Community Measurement. Achieving our mission to accelerate the improvement of health by publicly reporting health care information relies on this collaborative, multi-stakeholder effort. MNCM strives to continue to be the trusted source for performance measurement, data sharing and public reporting locally and nationally.
MNCM has been named a Qualified Clinical Data Registry (QCDR) by CMS for the upcoming Merit-based Incentive Payment System (MIPS) under the Quality Payment Program (QPP). A QCDR is a CMS-approved entity that collects clinical data on behalf of clinicians for data submission.
MNCM is now able to assist clinician group practices in meeting MIPS (formerly PQRS) requirements for the 2017 reporting year. The MNCM QCDR service will seamlessly submit quality measures and improvement activities to CMS.
The proven MNCM Direct Data Submission (DDS) reporting platform is familiar to many and is currently used by clinics and medical groups for state reporting. The MNCM QCDR is an enhancement of the DDS to help you comply with federal MIPS and MACRA requirements.
Simplify your reporting needs with MNCM. For details on timing, list of approved measures and more, click here.
MN Community Measurement has announced that Shantanu Agrawal, MD, President and CEO of the National Quality Forum will be a featured keynote speaker at the MNCM Annual Seminar on Sept 13, 2017.
Registration is open through September 1. Early bird pricing for attendance us in effect until July 14. The full event agenda is found at seminar2017.mncm.org and online registration can be accessed at this LINK.
Shantanu Agrawal, MD, MPhil, is president and CEO of the National Quality Forum (NQF). A board certified emergency medicine physician who has worked in both academic and community settings, Dr. Agrawal is the former deputy administrator for the Centers for Medicare & Medicaid Services (CMS) and director of one of its largest centers, the Center for Program Integrity (CPI).
At CMS, Dr. Agrawal led an effort to improve the physician experience with Medicare by working to minimize the administrative tasks with which doctors contend. He also was one of the main architects of CMS’s strategy and action plan to address the national opioid misuse epidemic. His main focus at CPI was improving healthcare value by lowering the cost of care through the detection and prevention of waste, abuse, and fraud in the Medicare and Medicaid programs. From 2012 through 2014, CPI’s prevention efforts saved Medicare and Medicaid $42 million.
Dr. Agrawal previously served as CPI’s chief medical officer and was instrumental in launching new initiatives in data transparency and analytics, utilization management, assessment of novel payment models, and stewarding a major public-private partnership between CMS and private payers, the Health Care Fraud Prevention Partnership.
Dr. Agrawal has testified numerous times before Congress and is a frequent national speaker on healthcare and cost. He is a well-published author with articles in Journal of the American Medical Association, New England Journal of Medicine, Annals of Emergency Medicine, among others.
Prior to joining CMS, Dr. Agrawal was a management consultant at McKinsey & Company, serving the senior management of hospitals, health systems, and biotech and pharmaceutical companies on projects to improve the quality and efficiency of healthcare delivery. He also worked for a full-risk, capitated delivery system as its leader for clinical innovation and efficiency.
Dr. Agrawal completed his undergraduate education at Brown University, medical education at Weill Medical College of Cornell University and clinical training at the Hospital of the University of Pennsylvania. He has a master’s degree in social and political sciences from Cambridge University.
MN Community Measurement (MNCM) today announced that Julie Sonier has been named President of MNCM. Sonier is only the second person to lead MNCM and will succeed current MNCM President Jim Chase who announced in October 2016 that he would step down in 2017.
“Julie Sonier is very familiar with our work, having served on the Board, and she comes to MN Community Measurement with a wealth of strong relationships and immense respect within the community,” said MNCM Board Chair Tim Hernandez, MD. “Julie will lead MN Community Measurement into its next decade and bring new vitality to our efforts to accelerate the improvement of health at an important time of change in our health care system. We are excited about having Julie join us, and at the same time we will miss Jim.”
Sonier is scheduled to begin May 1. Chase will continue to serve MNCM through April 28.
“I look forward to this opportunity to deliver and demonstrate value to our partners and the community,” said Sonier. “MN Community Measurement is one of the best examples nationally of the power of collaboration among stakeholders from across the health care spectrum to achieve results that none could achieve alone.”
Sonier brings nearly 20 years of experience working to improve health care in Minnesota. She has in-depth knowledge of the health care financing and delivery systems, as well as the state and federal policy landscapes and their associated challenges and opportunities. She has a reputation as a knowledgeable, trustworthy, creative and thoughtful leader in Minnesota’s health policy community.
Prior to MNCM, Sonier served as Director of Minnesota’s State Employee Group Insurance Program, where she worked with labor unions, health plans, other employers, state agencies, state policymakers and others on initiatives to improve health and health care through the design of insurance benefits and value-based health care purchasing. She served as lead staff for Governor Tim Pawlenty’s Health Care Transformation Task Force in 2007-2008 which brought together stakeholders from across the health policy community in Minnesota to develop nation-leading initiatives aimed at improving health care cost, quality and access. She has served as Deputy Director of the State Health Access Data Assistance Center at the University of Minnesota and as State Health Economist/Health Economics Program Director for the Minnesota Department of Health. Sonier has a MPA in economics and public policy from the Woodrow Wilson School of Public and International Affairs at Princeton University in Princeton, NJ and a BA in economics from Amherst College in Amherst, MA.
MNCM started as a pilot project in 2003 to share diabetes care outcomes at medical groups across the state. In 2004, MNCM released its first public quality report. The report provided information about care in areas such as asthma, diabetes, breast and cervical cancer and well child visits. In 2006, MNCM became the first in the nation to use electronic medical records to collect health care quality measures from clinics across the state.
“MN Community Measurement is in a strong and respected position because of the leadership of Jim Chase for more than a decade,” said Dr. Hernandez.
During his tenure at MNCM Chase has led numerous initiatives, including development of more than 70 measures used by health plans, medical groups, consumer organizations and policy makers across the state. MNCM collects information on quality and patient experience from more than 1,500 clinics, 500 medical groups and 135 hospitals and reports on health care quality, cost, health equity, and health care disparities through its public reporting website MNHealthScores.org. MNCM has led the country in use of patient reported outcome measures. The National Quality Forum, considered the gold standard for health care measurement in the United States, has endorsed nine MNCM measures for conditions including knee replacement, spine surgery and care for diabetes, depression, asthma and heart and arteries.
“MN Community Measurement has a solid foundation to continue to lead towards better value in health care especially as organizations move towards greater transparency around quality and cost,” said Dr. Hernandez.
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.
On January 3, 2017, MinnPost published an article titled, “Minnesota health and medical experts cite greatest concerns — and hopes — for 2017.” In the article, several health and medical experts including Jim Chase, MN Community Measurement President, were asked to answer the following question: With a new administration taking over the White House, what is your greatest concern for your particular corner of the health/medical field in the coming year? What is your greatest hope?
“2017 will be a time of great opportunity to improve our health system. We can adopt a more efficient enrollment and purchasing system for people with high risks and those who need subsidies. We can expand payment methods that focus on patient outcomes and encourage less waste on treatments with marginal benefits. We can agree on better performance metrics across payers so we reduce the administrative burden on doctors while expanding transparency about their results. We can do more to reduce health disparities by race and income by providing more information that helps address both the social and care difference that cause these disparities. The greatest risk is people waiting to see what happens in Washington and not taking the actions we know have worked to give Minnesotans better care: focusing on patient and community needs, testing new processes and partnerships to improve outcomes, and sharing information on results.” — Jim Chase, president of Minnesota Community Measurement
The full MinnPost article can be read at this link.