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MN Community Measurement and DHS Release Health Care Report Highlighting Disparities

Report compares care delivered to patients with public and private insurance.

MN Community Measurement (MNCM), an independent non-profit organization that collects and reports health care data to drive statewide system improvement, today released the 2017 Health Care Disparities Report with the Minnesota Department of Human Services (DHS). The report shows significant room for improvement in closing health care gaps for patients enrolled in state health plans.

The Health Care Disparities Report provides health care performance rates for patients enrolled in the managed care component of Minnesota Health Care Programs (MHCP), including Medical Assistance and MinnesotaCare. As enrollment in these programs continues to increase, the Health Care Disparities Report helps the state and health care providers identify opportunities to improve health care and health outcomes for people served by state programs. DHS contracts with MNCM to produce the report.

Overall, patients enrolled in MHCP managed care received cancer screenings and immunizations less frequently than Minnesotans who have private or employer-based health insurance. Performance rates and health outcomes for MHCP patients who have asthma, depression or diabetes are also worse than privately insured patients. MHCP patients, when compared with the overall population of the state, are of lower socioeconomic status, include a disproportionate number of persons of color, and often experience barriers to care.

“The latest Health Care Disparities Report calls for community-wide action to ensure everyone has the opportunity to be healthy and get the care they need,” said Acting Human Services Commissioner Chuck Johnson. “This is the eleventh year of the report and, over time, statewide gaps in the care delivered to low-income Minnesotans have continued to narrow. We are hopeful that initiatives like the Integrated Health Partnerships – which encourage providers to work with one another and community organizations to address barriers to health – will continue to reduce the disparities identified in this report.”

This annual report reveals considerable disparities, highlighting three measures with the largest gaps – Childhood Immunization Status, Breast Cancer Screening and Colorectal Cancer Screening. The report includes medical group and clinic level results for 11 measures, as well as analysis by race/ethnicity and region.

Childhood Immunizations

Childhood Immunization Status rates, an updated measure this year, had a gap of 23 percentage points between patients with MHCP and other purchasers. This was the largest gap for any measure in this year’s report.

“While we can’t yet see trends for this Childhood Immunization measure, this large gap in childhood immunization rates between MHCP patients and others points to a need for close attention,” said Julie Sonier, MNCM President. “Immunizations by age two are vital to childhood health.”

Vaccination is safe, effective and can protect children from serious illness. Vaccine-preventable diseases are still a threat, resulting in hospitalizations and deaths every year. According to the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion, approximately 300 children in the United States die each year from vaccine-preventable diseases.

Eight medical groups had above average Childhood Immunization Status rates for MHCP patients, with HealthEast Clinics having the highest rate at 59 percent.

Disparities in Cancer Screenings

Colorectal Cancer Screening and Breast Cancer Screening also had large gaps in this year’s Health Care Disparities Report. There was a 20 percentage point gap between MHCP adult patients and patients with other insurance for Breast Cancer Screening and a 19 percentage point gap for Colorectal Cancer Screening.

The American Cancer Society website has specific recommendations for cancer screenings and guidelines for early detection of cancer. These cancer measures have had consistent gaps for many years between MHCP patients and patients with other forms of insurance.

Despite the gaps, MHCP patients have seen improved health outcomes in many areas measured since the first Health Care Disparities Report was issued over 10 years ago. Since 2011, for example, nearly 9,700 more MHCP patients have been screened for colorectal cancer.

Medical Group Highlights

There were five medical groups with above average ratings for the MHCP population in all three measures (Childhood Immunization Status, Breast Cancer Screening and Colorectal Cancer Screening):

  • Allina Health
  • CentraCare Health
  • HealthPartners Clinics
  • Mankato Clinic, Ltd.
  • Mayo Clinic

“Progress is being made, but gaps in many of these areas still exist,” said Sonier. “It’s encouraging to see improvements over time. As a community, we all have a role to play in closing these gaps and making sure that disparities between MHCP patients and patients with other types of insurance are diminished.”

For the full list of medical groups and more information on these measures, view the report online at http://mncm.org/health-care-disparities-report/.

 About the Health Care Disparities Report

In 2016, more than 900,000 Minnesotans received health care coverage through Medical Assistance or MinnesotaCare programs overseen by the Department of Human Services (DHS). MNCM has partnered with DHS to produce the Health Care Disparities Report since 2007. This report supplies objective, transparent data that can be used to evaluate performance and identify improvement opportunities. To view the full report, visit: http://mncm.org/health-care-disparities-report/.

About MN Community Measurement

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.


Contact: Rachel Enerson, Neuger Communications Group

enerson@neuger.com, 612-664-0700 (office) or 507-696-9207 (cell)

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Health Care Quality Report Highlights Improvements in Care

MN Community Measurement (MNCM), an independent non-profit organization that collects and reports health care data to drive statewide system improvement, today released its 2017 Health Care Quality Report. This 14th annual report provides data related to preventive and chronic care comparing statewide, regional, medical group and clinic performance.Health Care Quality Report

A highlight of this year’s analysis is improvement in quality measures related to mental health. The rate of Adolescent Depression and/or Mental Health Screening increased by nine percentage points since last year’s report, from 64 to 73 percent. Since 2015, the rate for this measure has improved 33 percentage points resulting in over 45,000 more adolescents across Minnesota receiving screening for depression during this time period.

Improvements were also seen in measures for adult depression care follow-up and outcomes. Depression is a common and treatable mental disorder. According to a recent National Health and Nutrition Examination Survey (NCHS), it is estimated that over 8 percent of American adults had an episode of major depression in a given two week period. MNCM’s suite of depression measures was developed to increase follow-up and improve depression outcomes.

This year’s report shows improvement in three of the depression measures:

  • The depression follow-up rate at 12 months increased by nearly five percentage points, from 22.8 to 27.3 percent;
  • The depression response rate at 12 months (fewer symptoms after starting treatment) improved by nearly two percentage points, from nine to 11 percent; and
  • The depression remission rate at 12 months (no symptoms or very few symptoms after starting treatment) improved by over one percentage point, from five to six percent. This represents over 5,800 patients with depression symptoms in remission.

Entira Family Clinics – West St. Paul had the top depression follow-up rate at 69 percent, the top response rate at 44 percent and the top remission rate at 39 percent.

These improvements reflect better follow-up with patients and improved communication between patients and their primary care providers, and between primary care providers and behavioral health providers. Most importantly, these numbers reflect overall better outcomes for patients with depression.

“We still have a long way to go, but it’s encouraging to see progress in screening, follow-up and outcomes for depression,” said Julie Sonier, MNCM President. “While the statewide improvements may appear small, they reflect tangible improvements for real people with a very challenging chronic disease. The most important news is that the hard work of follow-up is showing progress, and patients are benefiting with improved depression outcomes. The fact that all of these measures are trending upward shows that Minnesota health care providers’ efforts in this area are paying off.”

Other notable improvements in quality measures and trends over time included:

  • In the Colorectal Cancer Screening measure, the rate has increased nine percentage points since 2011 from 64 percent to 73 percent representing over 116,000 more patients being screened for colorectal cancer. Three medical groups had colorectal cancer screening rates at 90 percent or higher: Obstetrics, Gynecology and Infertility – Maple Grove, CentraCare Health Plaza – Internal Medicine and Catalyst Medical Clinic in Watertown.
  • Since 2012, the rate for adolescent immunization increased 33 percentage points from 53 to 86 percent. This means that 9,400 more adolescents in Minnesota received recommended immunizations (one dose of meningococcal vaccine and one tetanus, diphtheria toxoids and acellular pertussis vaccine) before their thirteenth birthday. Wayzata Children’s Clinic and Southdale Pediatrics Associates had the top adolescent immunization rate at 98 percent.

The report also highlights fifteen medical groups with consistent high performance on three or more quality measures over three years and 17 medical groups with consistent improvement on three or more quality measures over the same time period.

To read the full report and explore other measures statewide, visit mncm.org/health-care-quality-report. The annual report is a compilation of all quality measures publicly reported by MNCM during the year. Individual clinic and medical group results are available at MNHealthScores.org and updated as new data become available.

MNCM’s goal with the Health Care Quality Report and other initiatives is to provide reliable information to support both quality improvement in the medical community and health care transparency with the public. According to the 2017 Price Transparency and Physician Quality Report Card from Altarum Institute and Catalyst for Payment Reform, Minnesota was one of only two states that earned an “A” for our outstanding work in physician quality websites through MNHealthScores.org.

About MN Community Measurement

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 and MNHealthScores.org.

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Equity Report Highlights Continued Gaps in Health Care Outcomes in Minnesota

A new report from MN Community Measurement (MNCM) provides a unique source of information on disparities in health care outcomes by race, ethnicity, language and country of origin.

The report includes data for 12 measures reported to MNCM in 2017 with analysis at the statewide, regional and medical group levels, and features interviews that highlight efforts to reduce the gaps in outcomes especially for populations of color in Minnesota.

“Our data show that outcomes for chronic disease and preventive care screening rates vary substantially by race, ethnicity, language and country of origin,” said Julie Sonier, MNCM President. “It is important to highlight these differences so that we can raise awareness, focus resources on reducing these inequities and track progress.”

New in the 2017 Health Equity of Care Report is trending information on the Colorectal Cancer Screening measure. The statewide colorectal cancer screening rate was 70 percent in 2014 and 73 percent in 2017. Examined by race, ethnicity, preferred language and country of origin, colorectal cancer screening is trending up for most groups. The largest increase was among patients whose preferred language is Spanish; for this group, the screening rate increased from 44 percent in 2014 to 54 percent in 2017. This represents over 2,200 more Spanish-speaking people in Minnesota getting screened for colorectal cancer.

Much of this progress can be attributed in part to local and national coordinated efforts by primary care clinicians, community organizers, cancer coalitions and others – all focusing on a shared public health goal of reaching an ambitious 80 percent screening rate for colorectal cancer. The National Colorectal Cancer Screening Roundtable leads this effort with a strong emphasis on health equity. In fact, Hispanics are a priority audience due to their low screening rates and African Americans are a priority audience due to their high incidence of colorectal cancer. One of the key messages that resonates with these audiences is that there are several screening options available, including simple take-home options. They are also encouraged to talk with their doctor about getting screened.

“It is good news that we’re making gains in colorectal cancer screening rates for most groups,” said Sonier. “However, we still have large disparities between groups that indicate the need for sustained efforts to reduce the gaps.”

The 2017 report also includes survey data that show variations in patient experience across population groups. One finding is that African American patients rated their experiences above average in four out of five patient experience categories, yet had below average results for five out of seven clinical quality measures. In contrast, despite mostly higher than average clinical quality measure outcomes, Asian patients evaluated their experience of care below the statewide average in all five categories.

“These differences highlight the fact that health care quality is multidimensional,” said Sonier. “It’s hard to know exactly why patient experience and clinical quality diverge for some population groups, but it’s our goal that these data will be used by health care providers and others to better understand the gaps and identify opportunities for improvement.”

The report includes several stories highlighting ways that these data are being used for improvement.

MNCM’s data by race, ethnicity, language and country of origin are a valuable resource that resulted from years of collaborative work to define these elements and validate best practices for collecting them. The report features information on seven clinical quality measures:

  • Adolescent Mental Health and/or Depression Screening
  • Pediatric Preventive Care: Overweight Counseling
  • Optimal Diabetes Care
  • Optimal Vascular Care
  • Optimal Asthma Care for Adults
  • Optimal Asthma Care for Children
  • Colorectal Cancer Screening

The patient experience ratings include the following five categories, in terms of whether patients:

  • Got care when needed (“Access to Care”)
  • Received understandable information and instructions (“Provider Communication”)
  • Received coordinated care defined by how often providers knew patient’s medical history, gave results of tests and asked about medications (“Care Coordination”)
  • Experienced courteous and helpful office staff (“Office Staff”)
  • Were satisfied with their provider (“Provider Rating”)

The fourth annual Health Equity of Care Report is at www.mncm.org/health-equity-of-care-report

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 and MNHealthScores.org.

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New Report Highlights Minnesota Health Care Cost Trends and Variation, with Overall Modest Increase in Cost Last Year

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.

Report Highlights

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.

 

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Minnesota Patients Pleased with Their Providers, Indicate Room for Improvement in Getting Timely Care in 2017 Patient Experience Survey

2017 Patient Experience Survey Results Released

In the nation’s largest and most comprehensive view of patient experience, 81 percent of Minnesota patients gave their health care provider a top rating of 9 or 10 on a 10-point scale. Two-thirds (66 percent) of patients said they experienced a top level of access to care, defined as patients who say they were able to get appointments, health care and information when they needed it.

“This information is collected directly from patients and based on their own experiences,” said Julie Sonier, President of MN Community Measurement.

Survey results for 767 clinics, separated into five categories, are included in the 2017 Patient Experience of Care Survey published by MN Community Measurement (MNCM). These clinic level survey results are available for the public online at MNHealthScores.org.

“Sharing these results can help patients make quality decisions about their health care and help clinics and medical groups learn what they can do to improve the results,” added Sonier.

The survey measures patient experience in five categories, in terms of whether patients were:

  • getting care when needed (“Access to Care”)
  • receiving coordinated care defined by asking patients how often providers knew their medical history, followed up to give results of tests and asked about prescription medications being taken (“Care Coordination”)
  • satisfied with their provider (“Provider Rating”)
  • experiencing courteous and helpful office staff (“Office Staff”)
  • being listened to and receiving understandable information and instructions (“Provider Communication”)

“Since MNCM unveiled the state’s first patient experience results in 2013, many clinics have used this information to focus on improving experiences for their patients,” said Sonier. “These results are also used to recognize outstanding service and health care satisfaction for clinics and medical groups.”

Though patients are generally reporting positive experience, the latest survey does show significant differences between clinics. Here are some highlights from the survey:

  • 66 percent of respondents said they had top-level Access to Care. Individual clinics have results ranging from 33 to 91 percent.
  • 73 percent of respondents gave their clinic the most positive rating possible when asked about Care Coordination. Across individual clinics, the low score was 49 percent and the high score was 87 percent.
  • 81 percent of respondents gave their provider a top rating of 9 or 10 on a 10-point Provider Rating scale. Individual clinics ranged from 46 to 94 percent of providers receiving a top rating.
  • 83 percent of respondents gave the office staff at their clinics top marks for being respectful and helpful. A 35 percentage difference is noted between the highest and lowest rated clinics.
  • 86 percent of respondents described communication from their providers as top-level. Across individual clinics, the low score was 59 percent and the high score was 96 percent.

One clinic, Surgical Consultants in Edina, MN ranked in the top 15 performers across 4 of 5 survey categories. Three clinics, Gunderson Health System in La Crescent, MN, Minnesota Oncology in Fridley, MN and Essentia Health Pillager Clinic in Pillager, MN ranked in the top 15 performers across 3 of 5 survey categories. For additional information on top performers, click here.

Results by Region

A regional analysis, based on the patient’s zip code, shows that among the five categories, patients in Northeast Minnesota rated all five categories significantly above the statewide average. Conversely, patients in Minneapolis rated all five categories significantly below the statewide average. Patients in the Twin Cities area are less satisfied with Care Coordination as this category was rated significantly below the statewide average for patients in Minneapolis, St. Paul, West Metro and East Metro.

Further analysis of the five categories within the 2017 Patient Experience of Care Survey examining race, ethnicity and region will be published in the forthcoming Health Equity of Care Report scheduled to be released by MNCM in December 2017.

About the Survey

Results are from the more than 180,000 patient-completed surveys on patient experience of care, known as the Clinician & Group Surveys Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS® 3.0) survey. This is the third time that MNCM has conducted the Patient Experience of Care Survey. Twenty-nine percent of the patients surveyed responded, which is a similar response rate compared to previous years. Although the survey was completed previously in 2013 and 2015, trending and direct comparisons to previous year results are not recommended due to modifications to the questionnaire.

The data are collected as part of Minnesota’s Statewide Quality Reporting and Measurement System. The Minnesota Department of Health partners with MNCM to collect the data, and MNCM reports results on MNHealthScores.org. Individual clinics are also given access to more detailed analysis on their survey results to see where they are performing well, and identify areas for improvement. A small number of clinics in border communities in Iowa, North Dakota and Wisconsin that see Minnesota patients also chose to voluntarily submit results to MNCM.

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 Shows Health Care Disparities Persist, Changes Deliver Improved Health Outcomes to Some

Adults and children enrolled in Medical Assistance and MinnesotaCare receive certain cancer screenings, immunization and care for asthma, depression and diabetes less frequently than Minnesotans who have private or employer-based health insurance, according to a report published by MN Community Measurement (MNCM) with the Minnesota Department of Human Services (DHS). A difference between populations, or groups of people, in either access to care or health outcomes indicates that there is disparity.

The 2016 Health Care Disparities Report shows public program enrollees were 19 percent less likely to receive colorectal cancer screening; 16 percent less likely to be screened for breast cancer; 15 percent less likely to receive optimal diabetes care; 12 percent less likely to achieve childhood immunization status and children age 5-17 were 12 percent less likely to receive optimal asthma control when compared to those with private health insurance.

“This report highlights that there is still significant room for improvement to reduce health care disparities,” said Jim Chase, MNCM President.

The 2016 Health Care Disparities Report provides health care performance rates for patients enrolled in Minnesota Health Care Programs (MHCP) including Medical Assistance and MinnesotaCare. Patients enrolled in MHCP represent a population considered at-risk and include a high number of persons of color, American Indians, persons with disabilities and elderly adults. By using MHCP enrollment as a proxy for socioeconomic status, this report evaluates health care disparities that exist as a result of socioeconomic status.

The 2016 Health Care Disparities Report link: mncm.org/health-care-disparities-report

Improved Health Outcomes

Despite the gaps, Minnesota patients have seen improved health outcomes in most areas measured since the first Health Care Disparities Report was issued ten years ago.

The statewide average for public program enrollees receiving childhood immunization is now 71 percent and has increased 22 percent since first reported in 2007. The statewide average for public program enrollees receiving appropriate testing for pharyngitis, commonly called sore throat, is now 90 percent and has increased 18 percent since first reported in 2007.

Five measures showed statistically significant improvement between 2015 and 2016, including Optimal Asthma Control for Children; Childhood Immunization Status; Colorectal Cancer Screening; Appropriate Testing for Children with Pharyngitis and Appropriate Treatment for Children with Upper Respiratory Infections.

Above Average Medical Groups

All 12 measures in the report are examined at a statewide and medical group level. Medical groups with rates greater than the state average for MHCP patients are noted as above average. For example, Fairview Health Services is listed above average on nine separate measures.

“Fairview is committed to quality health care for all,” said Valerie Overton, DNP, FNP-BC, Vice President Quality and Innovation at Fairview. “We have a two-pronged approach to reducing disparities. The first is to ensure highly reliable processes that deliver quality to every patient with every interaction. The second is to continue our journey to fully understand various populations and individuals. We are using this understanding to customize care approaches when needed to deliver great health care outcomes for all our patients.”

 

“Both the journey to ensure highly reliable processes and to thoroughly understand our various populations takes time and growth for us as an organization,” added Overton. “MN Community Measurement has been a great partner by bringing clarity on health disparities through this report.”

Report Context

In 2016, more than 900,000 Minnesotans received health care coverage through Medical Assistance or MinnesotaCare programs overseen by DHS.

Due to the at-risk nature of the MHCP patient population, the Minnesota State Legislature directed DHS in 2005 to establish a performance reporting and quality improvement system for medical groups and clinics providing health care services to patients enrolled in the managed care component of MHCP. The inaugural Health Care Disparities Report was released in 2007, evaluating care provided in 2006, and was the first in the nation to include local level information that was actionable for medical groups and clinics.

This report supplies objective data and brings accountability to medical groups and clinics, allowing them to reflect on their own results and identify areas for improvement within their systems.

“Our mission is to drive substantial health care improvement and reduce gaps in care more quickly for Minnesota’s most vulnerable patients,” said Chase. “Measures help us understand where we are, and where we want to be.”

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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Julie Sonier named new President of MN Community Measurement

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.

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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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