All posts in Feature Articles

NRHI Affordability Summit

The strong work of Minnesota collaboratives to advance health care affordability was highlighted throughout the third annual National Affordability Summit, hosted by the Network for Regional Healthcare Improvement (NRHI) in Minneapolis in October. The conference focused on sharing national and regional actions underway to advance health care affordability. MNCM President Julie Sonier presented on the power of collaboration, describing the work of Minnesota stakeholders in partnership with MNCM, to illustrate how communities can leverage the power of data to address health, price, and waste. Efforts by Minnesota stakeholders were also highlighted during two panels that discussed how local partnership can be leveraged to address needs related to mental healthcare, and the critical connection between health equity and affordability.

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Reducing the Burden of Data Reporting: Introducing PIPE

MNCM is in the process of developing a new suite of software to alleviate the burden of provider quality reporting. The new approach will allow MNCM to implement an automated data extraction method to retrieve encounter data necessary for quality measurement from participating providers. This process can either be completed by an extraction by the clinic group or by utilizing the MNCM extraction technology. Once encounter data is extracted and retrieved, MNCM will then be able to apply measurement specifications centrally to determine the appropriate measure denominator. The new MNCM software suite is called Process Intelligence Performance Engine (PIPE).

More About PIPE

PIPE is a platform for application integration, process automation, data extraction, and clinical measurement analysis. PIPE can integrate applications that weren’t built to be connected and automate processes across such heterogenous systems; cloud/SaaS applications with premise systems, legacy systems with modern web applications, and back office systems. This aspect of the software suite is known as the Process Intelligence (PI). Clinic groups can choose to work with MNCM to utilize the PI to extract the necessary information, or they can manually extract the information from their EHR and other systems.

Once the data has been extracted, the information is moved into the MNCM Performance Engine (PE). The PE will be able to quickly analyze the data and provide real-time denominator and numerator reporting back to the clinic group. Unlike the current process, PIPE can retrieve clinic data monthly and report back to each clinic group on a monthly and quarterly schedule.

The initial pilot will begin the second quarter of 2019. Organizations that transition to PIPE can continue to use the new platform going forward. Organizations that are currently utilizing the existing process will be able to continue to do so. Additional organizations will be onboarded throughout 2019.

Organizations that are interested in reducing their reporting burden can contact Will Muenchow, Director of Technology and Data Integrity, at muenchow@mncm.org.

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MNCM in the News

This winter, MNCM has been featured in a variety of news stories in publications from throughout the state. Stories have covered a range of topics – from depression care in Minnesota to transparent price and quality comparisons. The articles highlight the importance of measurement and reporting for all health care stakeholders.

Click on the headlines below to read the articles:

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MNCM’s Sonier on MPR with Kerri Miller

Julie Sonier, President of MN Community Measurement (MNCM), was the featured guest and fielded questions from callers during the January 10, 2018 edition of MPR News with Kerri Miller, a live call in radio program broadcast statewide on the stations of Minnesota Public Radio.

The cost of health care, with insight from MNCM, was the featured topic. Discussion began with a focus on a recently released report from the Minnesota Department of Health noting wide variation in the cost of certain medical procedures. The report, as Sonier noted, is similar yet different from “average cost per procedure” data produced and published annually by MNCM and posted online for the public to see at MNHealthScores.org.

The wide ranging, 60-minute discussion covered cost of specific procedures, reimbursement, health insurance and calls from listeners including numerous physicians. Want to hear the program? Click here to listen to the entire conversation.

“We sometimes focus too much on cost alone and we need to look at the bigger picture,” said Sonier.

“We need to look at Total Cost of Care and quality measurement to assess both the quantity and quality of health care services in addition to the price or cost of care,” added Sonier.

Read about this and other topics discussed on the daily radio program, MPR News with Kerri Miller, at this link https://www.mprnews.org/topic/kerri-miller

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Minnesota Earns “A” Grade for Quality Measurement Transparency

Minnesota is one of only three states that earned an “A” grade for transparency of physician quality measures in a recent report by Altarum’s Center for Payment Innovation and Catalyst for Payment Reform. Along with Washington and California, Minnesota earned an “A” grade for quality transparency that is based on the following criteria: independent and impartial; data are freely available; data are timely; data are available on large numbers of providers; quality measures used are meaningful; and information is easily found and understood by consumers.

The report also ranks states on price transparency, based on whether the state has a law requiring price transparency. Two states (Maine and New Hampshire) earned an “A” on this ranking. Although Minnesota does not have a law requiring a price transparency website, the pricing information that MNCM makes available through MNHealthScores.org is comparable to what is being published through those state-mandated websites.

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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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MNCM on KMOJ FM

The role of measurement in overcoming health disparities, with insight from MN Community Measurement (MNCM), was the featured topic during the November 6, 2017 edition of Community Health Dialogues, a radio program on KMOJ FM.

Julie Sonier, President of MNCM, was joined by Gaye Adams Massey Co-Chair of the MNCM Health Equity Advisory Council (HEAC) and Anne Snowden Director of Performance Measurement & Reporting at MNCM.

Want to hear the Community Health Dialogues program again? Click here to listen to the entire conversation.

The weekly radio program is hosted by Clarence Jones. Jones participated at the MNCM Annual Seminar 2017 and spoke about the Clippers ‘N Curls program to reduce incidents of heart attack and stroke in the African American population. Jones invited MNCM to continue the panel discussion, titled In Pursuit of Health Equity, from the seminar, onto the air waves and directly with KMOJ listeners.

“There are so many things that impact good health,” said Adams Massey. She shared her insight as both the co-chair of the HEAC and also as CEO of the YWCA of Saint Paul.

The discussion touched on the importance of collecting health data in efforts to reduce health disparities. Definitions of health equity were shared, as well as the methods used to collect quality measurement data and the usefulness of this information in helping providers and patients to overcome barriers.

“This data is about getting Minnesota healthier,” said Sonier. MNCM works to not only collect the data, added Sonier, but also to disseminate it so that the public and health care professionals can better understand the result and take action based on the results.

The three panelists invited listeners to think of health broadly, more than doctors and nurses. The data, they added, is a tool to help come up with solutions to health disparities.

Sonier ended the program with an invitation for KMOJ listeners to visit MNHealthScores.org and to think of other ways that MNCM could work with community groups to reduce health disparities though quality measurement data.

In addition to the weekly radio program, Jones is outreach director of Southside Community Health Services and Q Health Connections which works with community partners to offer free, weekly blood pressure screenings.

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HEDIS Reporting Changes: Childhood Immunization Status and Immunizations for Adolescents

In August 2016, MNCM’s Measurement and Reporting Committee approved recommendations that further align the Childhood Immunization Status HEDIS measure with CMS’s Merit-Based Incentive Payment System (MIPS) requirements.

In the 2017 report year, MNCM will report the Childhood Immunization Status Combo 10 measure. The Childhood Immunization Status measure evaluates children’s vaccination status, as of their second birthday. Evidence and national consensus support the recommendation for children to receive all vaccines encompassed in the HEDIS Childhood Immunization Combo 10 measure. Currently, MNCM reports results for the Childhood Immunization Status Combo 3 measure. Three additional vaccines are included in Combo 10: Hepatitis A, Rotavirus, and influenza, all of which are included in state and national preventive care guidelines, both from ICSI and the USPSTF.

In the 2018 report year, MNCM will report the Immunizations for Adolescents Combo 2 measure. The Immunization for Adolescents measure evaluates adolescents’ vaccination status, as of their thirteen birthday. Evidence and national consensus support the recommendation for adolescents to receive all vaccines encompassed in the HEDIS Immunization for Adolescents Combo 2 measure. Currently, MNCM reports the Immunization for Adolescents Combo 1 measure. In the 2017 report year, the National Committee for Quality Assurance (NCQA) will introduce Combo 2 for this measure – an update that will include the HPV vaccine for males and females. In the 2018 report year, NCQA has updated their specifications for this measure to reflect the most recent guidelines for HPV vaccine, namely, children aged 11-12 receiving two doses, instead of the previously recommended three doses. The addition of the HPV vaccine is supported by state and national preventive care guidelines. With recent changes in recommendations by the US Preventive Services Task Forces (USPSTF) and NCQA’s recent update of the measure, reporting this measure as a Combo 2 allows MNCM to be completely aligned with national and local guidelines.

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Retirement of Two Clinical Quality Measures

In June 2017, MNCM’s Measurement and Reporting Committee (MARC) recommended the retirement of two quality measures starting in the 2018 report year:

  • Pediatric Preventive Care Overweight Counseling – This is a process measure that is now topped out with a statewide rate of 90%.
  • Maternity Care Cesarean Section Rate – Although Cesarean section rates have increased significantly over the past 20 years and may be medically necessary in many situations, an appropriate target rate is unknown. The statewide Cesarean section rate of 22% (lower is better) is 3.5 percentage points below the national rate of 25.7% and the statewide rate has been flat for more than three years.
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Snapshots Provide Preview of Health Care Quality Report Results

As part of ongoing efforts to communicate health care performance results in a timely and user-friendly way, MNCM has created “snapshots” from the 2017 Cycle A and Cycle B measure reporting periods.

These snapshots include Optimal Diabetes Care, Optimal Vascular Care and Depression Care from Cycle A and Adolescent Mental Health and/or Depression Screening and Overweight Counseling from Cycle B that will be published in the Health Care Quality Report, which is anticipated to be released in January 2018.

This information can be used to aid decision making associated with quality improvement efforts.

In 2017 (2016 Dates of Service), the statewide rate for Optimal Diabetes Care is 45 percent and 62 percent for Optimal Vascular Care. The statewide rate for Depression Remission at Six Months is 8 percent. Overweight Counseling is 90 percent and 73 percent for Adolescent Mental Health and/or Depression Screening. Clinic and medical group level results are publicly reported on our consumer website, MNHealthScores.org. The site provides this information in convenient, sortable tables to view, download and/or print.

MNCM appreciates the significant contributions of clinics, medical groups, health plans, hospitals and other professional organizations that provide data to MN Community Measurement. Achieving our mission to accelerate the improvement of health by publicly reporting health care information relies on this collaborative, multi-stakeholder effort. MNCM strives to continue to be the trusted source for performance measurement, data sharing and public reporting locally and nationally.

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MNCM named CMS registry; can help with QPP/MIPS reporting requirements

MNCM has been named a Qualified Clinical Data Registry (QCDR) by CMS for the upcoming Merit-based Incentive Payment System (MIPS) under the Quality Payment Program (QPP). A QCDR is a CMS-approved entity that collects clinical data on behalf of clinicians for data submission.

MNCM is now able to assist clinician group practices in meeting MIPS (formerly PQRS) requirements for the 2017 reporting year. The MNCM QCDR service will seamlessly submit quality measures and improvement activities to CMS.

The proven MNCM Direct Data Submission (DDS) reporting platform is familiar to many and is currently used by clinics and medical groups for state reporting. The MNCM QCDR is an enhancement of the DDS to help you comply with federal MIPS and MACRA requirements.

Simplify your reporting needs with MNCM. For details on timing, list of approved measures and more, click here.

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