The 2019 MNCM Annual Seminar will be hosted on Thursday, September 12, at the Earle Brown Center in Brooklyn Center. Join your colleagues from across the region for a rich day of information sharing around innovations to improve health care quality and affordability.
Early bird registration is open until July. Register now. Watch for more details soon!
MNCM recognizes that all health care stakeholders have an important role to play in advancing improvement in health care cost and quality and we rely on the active engagement of stakeholders to help us deliver resources to the community that are timely, actionable, and relevant.
MNCM has recently launched an expanded supporting membership program with new membership benefits. Membership dues support MNCM’s efforts to drive health care improvement and to make quality measurement easier, more meaningful, and more actionable.
Please email Dina Wellbrock or call 612-454-4829 for information on how to become a supporting member of MNCM.
Data submission for Cycle B measures is underway! Measures include Adolescent Mental Health and/or Depression Screening, Spine Surgery (Lumbar Discectomy/Laminotomy and Lumbar Fusion), and Total Knee Replacement.
The submission deadline is May 10. Instructions are available on the MNCM Data Portal Resources tab for registered users or here.
MN Community Measurement (MNCM), an independent nonprofit organization that empowers health care decision makers with meaningful data to drive improvement, has released two reports that present information on disparities by insurance type and by race, ethnicity, language, and country of origin data for measures collected by MNCM in 2018, including online appendices with comparisons by medical group and clinic.
Disparities by Insurance Type
The report “2018 Minnesota Health Care Disparities by Insurance Type” summarizes quality measures for patients enrolled in Minnesota Health Care Programs (MHCP) and makes comparisons by insurance type. It also highlights high performing medical groups for the MHCP patient population. This report focuses on the managed care components of Minnesota’s Medical Assistance and MinnesotaCare programs. As enrollment in these programs continues to increase, the “2018 Minnesota Health Care Disparities by Insurance Type” helps the state and health care providers identify opportunities to improve health care and health outcomes for people served by state programs. The Minnesota Department of Human Services (DHS) contracts with MNCM to produce the report.
Statewide MHCP rates for the quality measures included in the report are consistently and significantly lower than other insurance types. The gap between MHCP and other insurance types has significantly narrowed over time for four measures but widened for two measures. One notable trend is that colorectal cancer screening for MHCP patients has increased by over eight percentage points since 2011.
“The annual disparities report helps highlight the need to continue efforts to advance equity in our state and achieve the goals of One Minnesota,” says DHS Commissioner Tony Lourey. “DHS embraces the role that we can play and is committed to building on the work with our partners and communities to reduce disparities and help ensure equitable health outcomes for all Minnesotans.”
Disparities by Race, Ethnicity, Language and Country of Origin
The report “2018 Minnesota Health Care Disparities by Race, Hispanic Ethnicity, Language and Country of Origin” features statewide and medical group performance rates stratified by race, Hispanic ethnicity, preferred language, and country of origin. In Minnesota, communities of color experience significantly higher rates of chronic and infectious diseases, illnesses, and premature death. According to the Minnesota State Demographic Center, populations of color are expected to continue to increase faster than the white non-Hispanic population, increasing to 25 percent of the total state population by 2035. As a result, the current challenge of addressing health disparities will become even more important over time.
This report illustrates that the range of quality measure results (lowest to highest) by preferred language has narrowed over time for colorectal cancer screening and for adolescent mental health and/or depression screening (see pages 19 and 21 of the report). In general, quality measures for American Indian, African American, and Hispanic Minnesotans are significantly below the statewide rate on most measures. For most measures, people who speak Hmong, Karen, Somali, and Spanish have rates that are significantly below the statewide average.
“Minnesota is unique in having this data that help us to identify disparities in health care quality measures,” says MN Community Measurement President Julie Sonier. “Understanding disparities is a necessary first step toward addressing them effectively. Monitoring disparities over time also gives us the ability to celebrate progress like the significant increases in colorectal cancer screening for African American patients.”
The March 2019 Measurement Minute is ready to view here.
Two new members have joined MNCM’s Measurement and Reporting Committee (MARC): Christopher Restad, MD and Lori Bethke, MD.
Dr. Christopher Restad
Dr. Restad is a doctor of osteopathy at Fairview Health Services. He has been the senior medical director of quality and patient safety at HealthEast primary care clinics and is currently serving in leadership roles in the Fairview ambulatory quality and safety departments. While serving in the Air Force, he participated in all levels of quality care metrics from local tracking to advisory councils with the Air Force surgeon general for ambulatory, surgical, and hospital settings. Chris will be serving on MARC as a large metro medical group representative.
Dr. Lori Bethke
Dr. Lori Bethke graduated from the University of Minnesota, Duluth School of Medicine and completed her residency at United Family Medicine Residency Program in 2003. Since then, she has worked at Entira Family Clinics practicing full spectrum family medicine, including obstetrics. She has served on Entira’s Board of Directors for the past eight years, as well as several other Entira committees. In addition, she sits on the HealthEast OB/GYN Peer Review and Clinical Council Committee. Dr. Bethke precepts residents at Phalen Village Family Medicine Program and enjoys hosting medical students in her medical practice from time to time. She was recently named Chief Medical Officer at Entira Family Clinics and is excited to serve in this new role. Outside of work, she enjoys spending time with her husband and two teenage sons – especially doing outdoor activities.
In November 2018, ICSI, StratisHealth, and MNCM facilitated an Affordability Summit attended by key community stakeholders interested in coming together to discuss affordability – currently a critical component impacting health care.
That day’s learnings and the three key priorities were summarized in an issue brief. This is the beginning of important collaborative work that Minnesota leads to address the high cost of health care.
Read The Issue Brief »
In February, MNCM released the “2018 Minnesota Health Care Quality Report.” This report summarizes all clinical quality measures collected by MNCM in 2018, including an online appendix with comparisons by medical group and clinic. Several medical groups are recognized for achieving high performance on at least 50 percent of the measures for which they were eligible. View the report.
The “2018 Minnesota Health Care Disparities Report by Insurance Type” and “2018 Disparities Report by Race, Ethnicity, Language, and Country of Origin” are expected to be released in early April. Watch for the press release soon!
The Minnesota Department of Health (MDH) recently submitted a report to the legislature on their work defining a quality measurement framework for the future of Minnesota. The report synthesizes the first phase of the project where information was collected from the community and workgroup regarding what the framework should contain and do.
You may access the report, a summary fact sheet, and other information by visiting the Quality Framework webpage. MDH will continue to provide updates on framework development – including opportunities for input – through the webpage and announcements.
See the Quality Measurement Framework »
In March, MNCM’s Measurement and Reporting Committee (MARC) approved several recommendations for the redesign of the spine surgery measures. Consideration of redesign was sparked by a request from the Centers for Medicare & Medicaid Services (CMS) who have adopted six MNCM spine measures into the Quality Payment Program. The evolution of these measures offered an opportunity for benchmarking capability and stability.
The spine measure redesign workgroup, led by Paul Huddleston from Mayo Clinic, reached consensus on several redesign recommendations that will enhance measure use and reporting.
The scope of work included three tasks:
- Consider a target-based measure construct for measures of functional status and pain
- Expand the denominator for the discectomy/laminotomy population
- Discuss the usability/value of the quality of life measures with PROMIS Global-10
After several meetings with thorough discussion, review of extensive data analysis and numerous constructs, the workgroup reached consensus on the following recommendations:
Modify the current measure constructs for functional status, back pain, and leg pain
Recalculation of existing data (no change in elements submitted).
- Functional status is less than or equal to 22 OR a change of 30 points or greater on the Oswestry Disability Index (ODI).
- Back pain is less than or equal to 3.0 OR a change of 5.0 points or greater on the VAS Pain scale.
- Leg pain is less than or equal to 3.0 OR a change of 5.0 points or greater on the VAS Pain scale.
- Patients who are not assessed remain in the denominator and are counted as not meeting the target.
- MARC requests additional monitoring of average pre-op scores as a proxy for appropriateness.
Expand the discectomy/laminotomy denominator population
It is very likely that medical groups are not using CPT codes to determine which patients to administer pre-operative assessments to; proceed forward with expanded denominator definition and delay public reporting.
- Expansion of denominator from single CPT code 63030 to include all the following discectomy/laminectomy CPT procedure codes: 63005, 63012, 63017, 63030, 63042, and 63047. No narrowing by diagnosis. Name changed to discectomy/ laminectomy to reflect expanded population.
- Add the same exclusions currently used for the lumbar fusion population; spine related cancer, fracture or infection and scoliosis (neuromuscular, idiopathic, or congenital).
- No submission for discectomy/laminectomy 2018 dates of procedure. Submit 2019 dates of procedure in 2020 for private reporting.
- Change in submission timeframe more appropriate for this measure with a shorter assessment period.
MARC, a subcommittee of the MNCM Board of Directors, approved these amended recommendations March 13, 2019. Measure changes pending final Board approval in May 2019.
For more information, please refer to the summary report and measurement specification example.
Feedback about these changes will be accepted at firstname.lastname@example.org until Friday, April 12, 2019. Questions can be directed to email@example.com.