Statewide Programs

Minnesota Statewide Quality Reporting and Measurement System (SQRMS)mdh_healthreform

Minnesota’s 2008 Health Reform Law required the Minnesota Department of Health (MDH) to establish a standard set of quality measures for health care providers across the state. MDH developed the Minnesota Statewide Quality Reporting and Measurement System (SQRMS) to collect and report quality measurement data. As of January 1, 2010, all hospitals and clinics are required to collect and report annually on a uniform set of measures.

MDH has contracted with MNCM for the past six years to collect these data and assist clinics and hospitals in meeting the measure requirements. As part of this contract, MNCM subcontracts with the Minnesota Hospital Association and Stratis Health to assist with key activities.

Under this contract, MNCM:

  1. Facilitates data collection, validation and management of information collected from physician clinics and hospitals, including customer service support to assist clinics and hospitals with the data collection process.
  2. Develops and implements provider education about measures and the data collection process.
  3. Works with community stakeholders to review existing measures and develop new measures, including measure specifications.
  4. Develops recommendations annually of the uniform set of quality measures for the state’s consideration.
  5. Holds public meetings to present and obtain feedback on the recommended uniform set of measures.
  6. Manages implementation of a standardized statewide patient experience of care survey process.
  7. Submits both risk-adjusted and unadjusted final clinic-level results to MDH.
  8. Conducts data analyses.

Physician clinics in Minnesota have two acceptable options to submit data under the MDH requirements:

  • Direct Data Submission – MNCM manages this process through the MNCM Data Portal. To be eligible for numerous pay-for-performance programs in Minnesota, clinics must submit data using this method.
  • Summary Data Submission – Groups must contact MDH for the requirements of this method to submit summary data only.

Additional background information includes:

Minnesota Bridges to Excellence (MN BTE)

The Minnesota Bridges to Excellence (MN BTE) program advances both care delivery and outcomes by rewarding clinics for meeting or exceeding a strict set of care standards for patients with diabetes, depression and vascular disease. These conditions are known to be primary drivers of health care costs.

Introduced by Minnesota Health Action Group in 2006, MN BTE is a purchaser-led pay-for-performance program in Minnesota. It is tailored for the Minnesota marketplace and uses measures developed and publicly reported by MN Community Measurement.

The goals of MN BTE are to:

  • Improve the quality of care for patients
  • Raise the level of purchaser and consumer awareness about the variation in health care quality
  • Encourage provider competition based on quality outcomes

How You Can Benefit

MNCM’s Optimal Diabetes Care, Optimal Vascular Care and Depression Remission at Six Months measures form the basis for a quality-focused, pay-for-performance program administered by MN BTE. By working through MNCM, MN BTE has achieved measure alignment with Minnesota’s health plans and others who are using these measures in the community.

To be eligible for a MN BTE reward, clinics must achieve specific targets that are determined by MN BTE’s Guiding Coalition and/or make substantial improvements over the previous year:

  • Optimal Diabetes Care: This is an all-or-none composite measure that includes five components including levels of blood sugar, cholesterol, and blood pressure, along with non-smoking status and daily aspirin use for patients at risk for cardiovascular disease.
  • Optimal Vascular Care: This is an all-or-none composite measure that includes four components including levels of cholesterol and blood pressure, along with non-smoking status and daily aspirin for all patients.
  • Depression Remission at Six Months: This outcome measure demonstrates improvement in a patient’s PHQ-9 score within a six month period of time. The PHQ-9 is a standardized set of nine questions that helps the doctor and patient understand the degree of a patient’s depression.

Quality Incentive Payment System (QIPS)

Minnesota’s 2008 Health Reform Law directed the Commissioner of Health to establish a system of quality incentive payments. Under the Quality Incentive Payment System (QIPS), providers are eligible for quality-based payments that are, in addition to existing payment levels, based on a comparison of provider performance against specified targets as well as improvement over time.

Payers interested in implementing QIPS are encouraged to select some or all of the approved measures to send common signals about priority health conditions to the marketplace and to maximize incentives for health care quality improvement. This approach allows payers to use QIPS in a way that best meets their needs, while setting a common set of priorities for improvement. Using consistent conditions and measures as the basis of a broadly used incentive payment system will help stimulate market forces to reward excellent and improved performance by providers and enhance the prospect of improved performance by treating priority health conditions.

The quality measures and methodology used in QIPS will continue to be adjusted and refined in future years.

Read more about QIPS and view a list of the current and prospective physician clinic and hospital quality measures. >>

 

How MNCM Can Help

MNCM is under contract with the Minnesota Health Action Group as the designated vendor to provide services related to the Action Group’s administration of MN BTE and QIPS. These services include, but are not limited to, rewards calculation and the delivery of performance rates (risk adjusted and unadjusted) for measures included in both programs.

If you have questions, please contact support@mncm.org.