AUGUST 29, 2019 – Minnesota Community Measurement (MCNM) is a nonprofit, multi-stakeholder collaborative organization that empowers the community by providing data and information to drive improvement in health care cost and quality. Founded in 2005, MNCM’s collaboration includes health care providers, health plans, employers, consumers, and state government.
Recently, the Minnesota Medical Association – a founding member of MNCM – notified us that they have decided to resign as a dues-paying member of MN Community Measurement. While this is unfortunate, MNCM will continue its work of bringing all stakeholders together to drive quality improvement that improves health and health care for all Minnesotans.
One of the most pressing issues in health care today is affordability of care, such as rising costs that are an increasing burden for employers, consumers, and taxpayers. At the same time, the Institute of Medicine estimates that as much as 30 percent of total U.S. health care spending is wasted – due to factors including missed opportunities for prevention and management of chronic disease, preventable complications, care fragmentation, overuse of certain services, high administrative costs, and others. Many strategies will be needed to solve this problem, and it is widely agreed that making sure our health care dollars are paying for value must be part of the solution. This means that we have to have good, evidence-based, and objective measurement of value.
MNCM has been a national leader in developing and using meaningful measures of health care quality – with an emphasis on measuring outcomes of care, including from the patient’s perspective. In order to truly transition to a health care system where payment is based on value rather than volume of services, it’s essential that this work continue. Indeed, it is spreading nationally. The federal government has prioritized exactly the types of measures that MNCM uses in developing the national Merit-based Incentive Payment System (MIPS). In fact, several MNCM-developed measures have been adopted into this national program. Minnesota health care providers are ahead of the curve nationally in their ability to measure and report on health care outcomes, in part because of the work of MNCM.
We know that measuring and reporting on health care quality makes a difference. Health care providers tell us they use our data extensively to understand how they compare to others and where they have the biggest opportunities for improvement. And we know that data drives change. Here are just four examples of how MNCM is making an impact in a relatively short period of time:
- In 2004, only 12 percent of diabetic patients in Minnesota were receiving optimal care. Today, that number stands at 45 percent. That represents more than 100,000 additional Minnesotans with diabetes whose risk of major complications – such as heart attack, stroke, limb amputation, and blindness – is lower due to better management of their condition.
- Depression is a costly condition, both in terms of medical costs and through its impacts on quality of life and workplace productivity. MNCM’s depression outcome measures have raised awareness throughout Minnesota about the importance of follow-up care and monitoring for patients who have depression. Since MNCM began measuring depression outcomes, rates of follow-up at 12 months have improved from 17% to 30%, representing nearly 15,000 more patients receiving this important care. Despite slow progress, the number of patients whose depression is in remission at 12 months has nearly doubled.
- Since MNCM introduced its measure for adolescent mental health screening in 2015, the percentage of adolescents who receive screening at well-check visits has increased from 40 percent to 86 percent, representing an additional 68,000 teens who received this important screening.
- Finding colon cancer at an early stage increases the rate of survival and is less costly to treat. Rates of screening for colorectal cancer in Minnesota have increased from 58% in 2006 to 71% today, which means that over 160,000 more Minnesotans are up to date on this important screening as a result of this improvement.
These are just a handful of positive outcomes that have resulted from our community being able to measure value and care. There is an axiom that says, “You can’t improve what you can’t measure.” With the help of many people and organizations, we have played an effective measurement and analysis role for the health care community.
It takes a lot of work for providers to report quality measures, and so MNCM is careful to make sure that the measures we use are meaningful and valuable. Measures are recommended by a committee that includes representation from health care providers, health plans, employers, consumers, and state government. Criteria for measure selection include whether the measure is meaningful (e.g., it affects a large number of people), evidence-based, whether there are opportunities for improvement (e.g., there is a known gap in care and/or high variability among providers), whether it is actionable, and whether it is feasible. Every year, MNCM reviews its list of measures to determine whether these criteria continue to be met – and retires measures that are no longer useful.
MNCM is particularly proud of work that it has launched in the past two years to make quality measures more timely and actionable while substantially reducing the burden on health care providers. In addition, we are working with health plans and health care providers on a new project to standardize and streamline data flows in ways that will make data less fragmented and more actionable – and set Minnesota up for success in value-based care.
These new initiatives came about as the result of listening to our stakeholders and asking what they need, and how MNCM can build on its strong foundation as a convener and as a trusted source of data to support them in achieving better quality and value in health care. We will continue to engage, listen, and respond to our stakeholders, welcoming all who wish to join us in this important collaborative work.
We thank our many partners, members and supporters for their continued contributions and participation. The more people we can have engaged in the process the better, but we will continue to advance our mission of improving the affordability, value, quality and access to health care with the countless partners who remain committed to that mission.