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New Report Highlights Significant Increases in Immunizations for Children and Adolescents – MN Community Measurement’s Preventive Health Measures report shows several clinics and medical groups achieving noteworthy results

MN Community Measurement (MNCM), an independent nonprofit organization that empowers health care decision makers with meaningful data to drive improvement, has released a report highlighting quality measures for preventive health services in Minnesota. It includes information on cancer screening, infectious disease screening, and vaccinations for children and adolescents. The report, “2018 Preventive Health Measures,” presents data collected by MNCM in 2018, including an online appendix with comparisons by medical group and clinic. Medical group results for the immunizations for adolescents measure – now including the new HPV vaccine component – are also being publicly reported for the first time.

Key Findings:
Childhood and Adolescent Immunizations
Both immunization measures are improving and show statistically significant increases in statewide rates compared to last year. The statewide rate for the Childhood Immunization Status (Combo 10) measure is 60 percent, a six-percentage point increase compared to 2017. The statewide rate for the new version of the adolescent immunization measure, now including the HPV vaccine, is 26 percent. While there is ample room for improvement, the statewide rate improved by 11 percentage points compared to 2017.

American Cancer Society State Health Systems Manager Matt Flory applauds the inclusion of the HPV vaccination component in the adolescents measure. Flory says, “By giving boys and girls these shots, we can prevent six types of cancer. The American Cancer Society recommends this vaccination at age 11 or 12, which aligns perfectly with the new measure. In the future, we hope to see more 13-year-olds receive the HPV shot at the same time they are vaccinated for the other shots in the combo.”

Colorectal Cancer Screening
Although there was a decrease in the statewide colorectal cancer screening rate, this was due, at least in part, to changes to the denominator that were made to align with the national measure.

The changes removed relevant preventive service codes, reducing the size of the total population
included in the measure.

The Colorectal Cancer Screening measure uses data from clinics, which enables reporting of results by geography, age, gender, race, Hispanic ethnicity, language, and country of origin. Colorectal Cancer Screening rates are significantly higher for patients who live in metro areas,
are age 60 and older, or female. Notably, colorectal cancer screening rates for all populations of color are significantly below the statewide average.

Variation in Medical Group Performance
There is significant variation in medical group performance for all preventive health screening measures analyzed, but several medical groups and clinics are achieving noteworthy results for many of the measures. There were eight primary care or multi-specialty medical groups with rates significantly above the statewide average on at least 50 percent of the preventive health measures for which they were eligible. Seventeen primary care clinics received a top rating on the Colorectal Cancer Screening measure, after adjustment for different patient risk factors.

Allina Health President and CEO Dr. Penny Wheeler says, “Allina Health believes in measuring what matters to the people we serve and is grateful for MN Community Measurement as a trusted community resource to guide quality improvement. We are very proud of the quality outcomes our patients achieve as a result.”

The Importance of Preventive Health Screenings
MN Community Measurement has been collecting and publishing measures on preventive health since 2005. The topic continues to be an important focus for measurement because it can aid in preventing disease, detecting illness at an early state when treatment works best, helping people live healthier lives, and keeping health care costs down. Some of the most common preventive health services recommended include cancer screenings and immunizations.

Julie Sonier, president of MN Community Measurement, says, “Collecting and publishing data about how often recommended preventive services are being delivered is a powerful way for our community to focus on health care quality and improvement. We are especially encouraged this year by the improvement in immunization rates for children and adolescents.”

To see the full report, visit mncm.org/preventive-health-2018. In addition, detailed results by medical group and clinic are available on the online appendix or by visiting mnhealthscores.org.

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MNCM Welcomes New Measurement Reporting Committee (MARC) Co-Chair

MNCM is pleased to welcome Rahshana Price-Isuk, MD as the new co-chair of MARC. Dr. Price-Isuk is a board-certified practicing family physician and medical director at Neighborhood Healthsource, an urban primary care clinic system in Minneapolis organized as a Federally Qualified Health Center with a mission to provide affordable, quality health care to underserved communities. She has been an actively engaged MARC member for over six years. She joins Howard Epstein, MD, senior VP & Chief Medical Officer at PreferredOne who serves as the other co-chair.

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MNCM Adopts 2019 Slate of Measures for Public Reporting

In December, MNCM’s Measurement and Reporting Committee and its board of directors approved the slate of measures for public reporting in 2019. The measures listed on the 2019 slate are similar to last year with a few updates. First, the Controlling High Blood Pressure HEDIS measure will not be publicly reported in 2019 due to substantial changes to the measure specifications; public reporting will resume in 2020. In 2020, adolescents will be added to the suite of depression outcome measures reported in 2020 and the new Symptom Control During Chemotherapy measure will also be reported. To view the 2019 slate, click here.

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Clinic and Provider Registration and Direct Data Submission Deadlines

All eligible Minnesota clinics and providers are required to register and update their information in MNCM’s data portal before February 8, 2019. Registration instructions and a recorded webinar are available for download from the MNCM Data Portal Resources tab or MNCM.org. Registration is a prerequisite to submitting data for the clinical quality measures in 2019.

Clinical quality measures are submitted during two cycles:

  • Cycle A measures are submitted in January and February and include the asthma, colorectal cancer screening, depression, diabetes and vascular measures.
  • Cycle B measures are submitted in April and May and include the adolescent mental health and/or depression screening, total knee replacement, spine surgery lumbar discectomy/laminotomy and spine surgery lumbar fusion measures.
  • A detailed schedule is available for download from the MNCM Data Portal Resources tab for registered users.

Questions? Please check out the MNCM Knowledge Base and Help Desk. You can also contact MNCM at support@mncm.org or 612-746-4522.

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MNCM Releases Report on Quality of Care for Chronic Conditions; Preventative Care Report Coming Soon

In December, MNCM released the second in a series of topic reports, “Quality of Care for Chronic Conditions in Minnesota.” This report presents data collected in 2018 on quality measures for chronic disease care, including comparisons by medical group and clinic. While Minnesota has some of the best health indicators in the country, measurement results show a pattern of wide variation in health care quality overall and significantly different outcomes among some patient populations. View the report here.

The third in our new report series focuses on preventive health screening measures and is expected to be released at the end of January.

These reports bring together performance results on both quality and health equity for measures relevant in each category. The series is intended to provide a user-friendly view of measure results to highlight the wealth of data that MNCM collects, engage stakeholder audiences more effectively and catalyze improvement. Watch for the press release soon!

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MNCM is Seeking Workgroup Members for Cost Measure Development Group

MNCM is investigating the feasibility and value of adding an episodes of care cost measure to the current Cost and Utilization suite of measures that is produced annually and is convening a workgroup to advise this project. The scope of the workgroup’s discussion will include risk adjustment, attribution and reporting options. Recommendations will be delivered to the Cost Technical Advisory Group and to the Measurement and Reporting Committee (MARC).

We are looking primarily for medical group participants. No technical expertise in episodes of care is required.

The time commitment is 6-9 months with virtual monthly meetings. If you are interested or have questions, please contact Gunnar Nelson at nelson@mncm.org by February 7.

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MNCM in the News

MN Community Measurement’s second topical report – “Quality of Care for Chronic Conditions” – was featured on Minnesota Public Radio (MPR) in a piece titled Report: Treatment quality varies widely for expensive chronic conditions. The report was also featured in the Star Tribune in a piece titled Clinics’ grades go down slightly in Minnesota. The articles draw attention to the importance of measuring chronic conditions. With approximately 60% of adults in the U.S. struggling with a chronic condition, treating them makes up a vast majority of the nation’s health care spending.

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MNCM 2019 Leadership and Board Announcements

On December 13, the MNCM board of directors approved the election of Beth Averbeck, MD, Senior Medical Director of Primary Care at HealthPartners, as MNCM Board Chair. The board also approved the election of Mark Matthias, MD, Vice President of Medical Affairs and Acute Care Division at CentraCare to serve as MNCM Vice Chair. Both officers will serve in their appointed roles for two-year terms.

MNCM board members continuing to serve in 2019 include:

  • Joseph Bianco, MD, Director, Primary Care, Essentia Health
  • Cara Broich, RN, CPHQ, Senior Director, Quality and Clinical Advancement, Medica
  • Jon Christianson, PhD, James A. Hamilton Chair in Health Policy, School of Public Health, U of M
  • Kevin Croston, MD, Chief Executive Officer, North Memorial Health
  • Howard Epstein, MD, SFHM, Executive Vice President and Chief Medical Officer, PreferredOne
  • Bentley Graves, Director, Health Care and Transportation, Minnesota Chamber of Commerce
  • David Homans, MD, Minnesota Hospital Association Representative
  • Deb Krause, Vice President, Minnesota Health Action Group
  • Mariam Mohamed, Consumer Representative
  • Dan Trajano, MD, MBA, Senior Medical Director, BlueCross BlueShield of Minnesota
  • Mary Ellen Wells, FACHE, Consumer Representative
  • Brian Whited, MD, MBA, Vice Chair-Operations, Mayo Clinic Health System
  • Pam Houg, Office Manager, Minnesota Council of Health Plans (ex officio)
  • Lawrence Massa, President, Minnesota Hospital Association (ex officio)
  • Claire Neely, MD, President and Chief Executive Officer, Institute for Clinical Systems Improvement (ex officio)
  • Jim Schowalter, President and Chief Executive Officer, Minnesota Council of Health Plans (ex officio)
  • Janet Silversmith, Chief Executive Officer, Minnesota Medical Association (ex officio)
  • Julie Sonier, President, MN Community Measurement (ex officio)

The MNCM board of directors represents the breadth and depth of the many stakeholder groups we are proud to serve and we extend our thanks to them for their service to our community.

Beth Averbeck Beth Averbeck, MD
HealthPartners Medical Group
Senior Medical Director of Primary Care

Dr. Averbeck is an executive physician leader with extensive experience in organizational culture, clinical operations, governance, quality improvement, measure development, and physician resilience. She joined HealthPartners in 1992 as a practicing internist and is now responsible for HealthPartners primary care practice overseeing 400 clinicians in over 40 practice locations. She maintains a clinical practice in geriatrics.

Her leadership in redesigning ambulatory care has been recognized by the American Medical Group Association (AMGA) which named HealthPartners Medical Group the recipient of the Acclaim Award, its highest honor, in 2006 and 2012. In 2010, Dr. Averbeck and her team were honored with an Acclaim Award honoree for their work reducing health disparities.

Dr. Averbeck earned a bachelor’s degree at St. Olaf College in Northfield, Minnesota, and earned a Doctor of Medicine from the University of Minnesota Medical School. She serves on the boards of Minnesota Community Measurement, the Institute for Clinical Systems Improvement, and the American Medical Group Association.

 

Mark MatthiasMark Matthias, MD
CentraCare Health
Vice President of Medical Affairs and Acute Care Division

Mark joined St. Cloud Hospital in 2011 as Vice President of Medical Affairs and in October 2015 became Vice President of Medical Affairs and Acute Care Division.

He trained at the University of Minnesota Medical School and completed his residency in Family Practice and Community Health at Methodist Hospital in St. Louis Park. Mark has been a physician leader in Mankato, Hutchinson, and Willmar.

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MN Community Measurement Releases Report on Quality of Care for Chronic Conditions

MN Community Measurement (MNCM) has released a new report highlighting quality of care for chronic conditions. The report, “Quality of Care for Chronic Conditions,” presents data collected by MNCM in 2018 on quality measures for chronic disease care, including comparisons by medical group and clinic.

Key Findings of the Report

While Minnesota has some of the best health indicators in the country, measurement results show a pattern of wide variation in health care quality overall and significantly different outcomes among some patient populations. Key findings of the report include:

  • Statewide results for all chronic condition measures have been relatively stable over the last three years but show continued room for improvement. See page 8 of the report.
  • Rates are, on average, significantly better for patients with chronic conditions who live in metro areas. For example, patients with asthma who live in small town or rural areas have the lowest rates. See page 10 of the report.
  • In general, measures of how well chronic conditions are managed mostly improve with age. For example, the highest rates occur among people age 60 and older with ischemic vascular disease. See page 11 of the report.
  • Outcome rates vary by race and Hispanic ethnicity. In general, rates for diabetes vascular and asthma are lower for American Indians, African Americans, and Hispanics. See page 13 of the report.

The report also presents results by gender and language.

The measures were developed or selected for their potential to reduce the modifiable risks and complications associated with these conditions. National and state statistics illustrate the need for improvement in care.

  • Roughly 151 million adults in the United States are physically, emotionally, and financially affected by chronic disease.
  • 60 percent of adults in the United States have a chronic disease and 40 percent of adults have two or more. This number is predicted to increase rapidly in future years.
  • Chronic diseases such as diabetes, heart disease, stroke, or cancer are leading causes of death and disability in the United States.
  • In Minnesota, those diagnosed with chronic conditions accounted for 83 percent of all medical spending in the state in 2012, with an average of $12,800 in health care spending per person.

Although statewide rates have been relatively stable, the report also illustrates substantial variation across health care providers (page 9 of the report). MN Community Measurement President Julie Sonier says, “The reason we do this work is to provide health care decision makers with information that can be used to improve health outcomes. Many health care providers in Minnesota have been very successful in this effort, and we should look to spread these stories of success.”

Measurement Matters

Andrea Walsh, president and chief executive officer of HealthPartners, one of the highest performing medical groups across most measures in Minnesota, says that data drives progress.

“High quality care doesn’t just happen. It’s a continual process that’s guided by data to drive improvement and innovation across our system so that we can better serve patients,” she explains. “This report recognizes the work we’ve done to improve treatment of chronic conditions and pushes us to do better, especially our focus in reducing health disparities among diverse racial and ethnic communities.”

Read the full report.

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MNCM, ICSI, and Stratis Health Joint Convening on Health Care Affordability

On November 29, MNCM, the Institute for Clinical Systems Improvement (ICSI), and Stratis Health hosted a community event about health care affordability, supported by funding from the Network for Regional Healthcare Improvement and the Robert Wood Johnson Foundation. The purpose of the event was to call attention to the problem of health care affordability, and how to improve affordability as a community.

The event began with a presentation by MNCM President Julie Sonier on health care affordability drivers and recent cost trends, followed by a panel discussion led by Jennifer Lundblad from Stratis Health that included panelists representing a variety of perspectives: consumer, employer, provider, and health plan. Dr. Charles Fazio from HealthPartners gave a presentation on envisioning a more affordable health care system, and Dr. Claire Neely from ICSI provided context and led a small group exercise and discussion on barriers to a more affordable system. Participants were asked to identify collaborative action steps toward improving health care affordability in their own environments.

The engaging and energetic event was attended by about 75 local health care leaders.

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Clinic and Provider Registration and Direct Data Submission

MNCM’s Data Portal is open for annual clinic and provider registration. All eligible Minnesota clinics and providers are required to register and update their information. Registration instructions and a recorded webinar are available for download from the MNCM Data Portal Resources tab or MNCM.org. Registration is a prerequisite to submitting data for the clinical quality measures in 2019.

Clinical quality measures are submitted during two cycles:

  • Cycle A measures are submitted in Jan/Feb 2019 and include the asthma, colorectal cancer screening, depression, diabetes, and vascular measures.
  • Cycle B measures are submitted in April/May 2019 and include the adolescent mental health and/or depression screening, total knee replacement, spine surgery lumbar discectomy/laminotomy, and spine surgery lumbar fusion measures.
  • A detailed schedule is available for download from the MNCM Data Portal Resources tab for registered users.

Questions? Please check out the MNCM Knowledge Base and Help Desk. You can also contact MNCM at support@mncm.org or 612-746-4522.

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Report on Quality of Care for Chronic Conditions to Be Released Soon

In mid-December, MNCM will publish a report on quality of care for chronic conditions, the second in a new report series organizing quality measures by measurement focus area. These reports bring together performance results on both quality and health equity for measures relevant in each category. The series is intended to provide a more in-depth, user-friendly view of measure results that can more effectively draw attention to the wealth of data that MNCM publishes, engage stakeholder audiences, inform discussions, and catalyze improvement. The new reports present content more concisely using design, context, and streamlined visual displays.

The first report in the series is on depression measures and was released on October 29. The full report can be found here.

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