MNCM News

"The two words ‘information’ and ‘communication’ are often used interchangeably, but they signify quite different things. Information is giving out; communication is getting through." -- Sydney J. Harris

MNCM Continues to Expand Risk Adjusted Measures

The Risk Adjustment Task Force was started in 2012 to discuss and make recommendations on risk adjustment, case mix adjustment and segmentation of quality measure results. The risk adjustment is done using an Actual to Expected methodology, which does not alter the result of a clinic or medical group. The actual rate remains unchanged but instead of comparing the rate to the raw market average, a unique expected rate based on the proportion of each risk category for each clinic or medical group is used for comparison. Over the last five years, we’ve made steady progress and by the end of 2016, the following measures will be risk adjusted:

  • Optimal Asthma Care – Children
  • Optimal Asthma Care – Adults
  • Optimal Vascular Care
  • Optimal Diabetes Care
  • Colorectal Cancer Screening
  • Depression Response at Six Months
  • Depression Remission at Six Months
  • PHQ-9 Follow-up at Six Months
  • Depression Response at 12 Months
  • Depression Remission at 12 Months
  • PHQ-9 Follow-up at 12 Months
  • Total Knee Replacement – Functional Status
  • Spinal Surgery: Lumbar Fusion – Functional Status
  • Spinal Surgery: Herniated Disc – Functional Status
  • Maternity Care – C-Section Rate

Socioeconomic and demographic variables, such as income, patient’s ability to finance and ability to communicate are considered important factors to delivery of care and MNCM is working with the University of Minnesota who is currently studying risk adjustment on socioeconomic factors. MNCM continues to review methodologies and variables each year as more data becomes available and as it’s feasible and considered appropriate by the multiple stakeholders who submit and use the data.