The Measurement and Reporting Committee (MARC) of MN Community Measurement in September approved a recommendation in favor of public reporting of all measures within the Total Cost of Care (TCOC), Relative Resource Use and Utilization measure suite. The MARC decision reflected a recommendation based in previous research and consideration by the Cost Technical Advisory Group (TAG) and could take effect later in 2016.
The TAG was formed to develop a cost/efficiency/value measure for public reporting. Within the TCOC and Average Cost per Procedure measures, there was a desire to understand whether or not the cost differences were due to variation in utilization or pricing structures.
MNCM has published the Total Cost of Care measure for three years, the Relative Resource Use and Utilization measures are meant to examine the cost drivers of price and utilization
The TAG felt both the process and data have been thoroughly vetted, analyzed and validated through the health plans. No major discrepancies raised by provider groups during the comment period. There was discussion in the TAG about whether or not this series of measures should be made public the first year (in calendar year 2016 for report year 2015 measure results) or have a one year private reporting to the medical groups since this is new reporting to some of the medical groups. A majority of the TAG members expressed that waiting another year would prevent consumers from having this information available to begin to make value-based purchasing decisions, and further may prevent MNCM from realizing the potential of this data at the state and national level. The TAG members also noted the methodology used in this effort, developed by HealthPartners, has been thoroughly vetted and has been endorsed by NQF.
Currently, all of the above mentioned measures are for commercial patients only. The TAG is investigating the capability and feasibility of expanding the measures to include Medicare programs. Data sources and significantly different patient risk and benefit designs will require a variety of solutions to including government programs.