I was kind of down this week. I don’t know if the mellow mood was due to the end of vacation, the snow, or that I didn’t get a card from the White House this year. I got a card the previous two years after George and I bonded at our health reform meeting in 2006. I guess he was busy packing and cleaning behind the furniture, just like the rest of us when we have to move.

The health care community is also preparing for this big transition. This past month, several national organizations have developed recommendations for the new administration and Congress on the importance of performance measurement as a foundation for national health care reform. Several key themes are emerging:

• Controlling costs and increasing access to health care are national priorities, but these reforms will only succeed with effective performance measurement and quality improvement systems.
• We need national priorities for quality improvement and standardized methods for measurement of results; we need local initiatives to collect and use information that will drive improvement.
• For areas in which overuse of health care services is common, performance measures such as those proposed by the National Priorities Partners of the National Quality Forum should be developed and demonstrated by local communities.
• Federal support, in funding as well as in participation in local data collection and improvement initiatives, is necessary to increase the impact of health care reform.

Minnesota has been a great example of how participation in these activities can lead to real improvements in health care. Physicians, hospitals, and other providers are engaged in collecting performance information and using that information to improve results. We are working together as a community to establish priorities. The state is supporting this work with funding and participation of its own programs. And, as a result, Minnesota is seeing improved health care that benefits people across the state.

2009 marks an important year for health care quality. MNCM will embark on our new partnership with the state to expand our quality measurement and align incentive payment systems. MNCM will expand our measures to include patient experience and specialty care. We will also begin evaluating cost of care and overuse of care measures that will help providers improve value for their patients in these difficult economic times. We also hope to see an increase in federal support and interest in regional improvement initiatives.

This issue of Measurement Minute contains information on our new state contract, the collection of race and ethnicity data, a Direct Data Submission update, a discussion of how MNCM can support physician participation in the new Medicare pay-for-performance program, our approach to measurement alignment for local pay-for-performance programs, and MNCM’s new phone numbers. We will also introduce a new section with stories about how public reporting has improved patient care and ask for your help in collecting stories you may have heard.

Thank you again for your support this past year and I hope you all have a wonderful New Year.


Sincerely,



Jim Chase
President

MN Community Measurement has Switched Over to Direct Dial Numbers

Staff can now be reached at the following phone numbers:

Please note that our main business number - 612.455.2911 - and fax number - 612.455.2912 - remain the same.
 

MN Community Measurement Gets Involved in the State Health Reform

2009 will mark the year that Minnesota takes the lead among states in addressing the value side of the health care reform equation. Many states have focused their efforts on expanding access to health care; in Minnesota, policymakers recognized that Minnesotans already have fairly broad access, but that broad access without attention to the quality and cost of health care services will eventually be unsustainable.

In 2008, the Minnesota Legislature enacted and Governor Pawlenty signed a package of reforms that included several measures aimed at making both the cost and quality of care more transparent and relevant to consumers. Those measures include a provision directing the Minnesota Department of Health to expand the collection and public reporting of quality measurement information and to establish a state system of quality-based incentive payments. The Minnesota Department of Health awarded the contract for this effort to MN Community Measurement (MNCM) and the work is now well underway. Highlights of the work that we and our community partners will accomplish over the next three years include:

• Creation of inventories of quality measures, pay-for-performance measures, and methodologies in use across the country. MNCM is contracting with the University of Minnesota’s School of Public Health to lead these tasks. Other community partners, such as Stratis Health and the Minnesota Medical Association, will assist with this task as well.
• Accelerated expansion of quality measures for both ambulatory and hospital care. MNCM will expand the current set of quality measures for ambulatory care by 11 new measures, including six new specialty care measures as well as measures of patient experience and use of health information technology. MNCM will also begin collecting race and ethnicity data on a couple of our measures. In addition, the legislation directed the Minnesota Department of Health to expand public reporting of quality information about hospital care. Under that directive, the Minnesota Hospital Association and Stratis Health will be partnering with MNCM to report 18 measures from the AHRQ Healthcare Cost and Utilization Project (HCUP) file. They will also assist MNCM in the continued development of a database of clinical laboratory data that will augment administrative data, resulting in the collection and public reporting of at least five new quality measures.
• Creation of a single, aligned set of quality measures and a methodology for payment incentives. Working with the Minnesota Hospital Association, Stratis Health, and the Minnesota Medical Association, MNCM will convene stakeholder groups. The stakeholder groups will select aligned sets of measures for payment incentives, one for hospitals and another for ambulatory providers. The University of Minnesota’s School of Public Health will use its expertise to assist MNCM in establishing an approach to risk adjustment.
• Provider education about quality reporting requirements. The contract requires MNCM to propose and implement strategies to educate physician clinics and hospitals about the state’s new quality reporting requirements and incentive payment system. MNCM has contracted with Stratis Health to develop and implement strategies for hospital education, while the Minnesota Medical Association will do so for physicians.
• Creation of a “one-stop” web site. In addition to an annual public report, MNCM will expand its Web site to display hospital quality information to consumers with the same search functions as found on its current web site. Stratis Health will advise and support MNCM in this effort.

MNCM is excited about this opportunity to build on Minnesota’s collaborative system of health care reporting and to be part of the state’s health reform efforts.

To monitor the state's health care reform efforts, subscribe to the Minnesota Department of Health's listserv for Health Reform Announcements at their site.

MN Community Measurement Develops Handbook for Collecting Race, Ethnicity, and Primary Language Data in Medical Groups

The collection of patient data - including race, ethnicity, and primary language - provides medical groups information that helps ensure equitable care is being delivered consistently to all its patients. In the fall of 2008, MN Community Measurement (MNCM) began developing a handbook for collecting race, ethnicity, and primary language data in medical groups. To develop this, MNCM first drew on the experience of five medical groups in Minnesota that already collect this information. MNCM is currently gathering feedback from a variety of interested organizations and medical groups that have indicated they are ready to set up a system to collect these data in 2009.

The handbook provides medical groups information on how to collect health equity data and why it is important. It also outlines MNCM’s expectation that race, ethnicity, and primary language be submitted through its Direct Data Submission process in the future. Medical groups will be encouraged to submit race, ethnicity, and language data along with their diabetes and cardiovascular disease data for 2009 dates of service in February of 2010. MNCM expects to release the handbook in the spring of 2009.

This is an exciting step for Minnesota because accurate patient level data on race, ethnicity, and language is an important step to improving health and health care. To receive a copy of the Handbook for Collecting Race, Ethnicity, and Primary Language Data in Medical Groups, please email Nate Hunkins. The handbook will also be posted on MNCM’s web site. Watch for more details on how to sign up for webinar educational sessions to take place in late spring and summer.

2009 Direct Data Submission Update
Optimal Diabetes Care and Optimal Vascular Care

Medical groups submitting data for this year’s Direct Data Submission are in the midst of preparing their submissions. Please keep in mind this year’s timelines:

Each medical group should be working on a document that outlines its method for identifying its denominator (or patient population). Page 13 in the Direct Data Submission guide outlines the elements to include in the methodology. Please submit the document via the data portal and MNCM will aim to respond within two business days.

Also, please refer to the 2009 Direct Data Submission guide throughout this process. The guide is intended to be a comprehensive resource.

Watch for further communications. Thank you to the medical groups for all your hard work! Send any questions to support@mncm.org.

MN Community Measurement Now Accepts Data from Medical Groups for the Physicians Quality Reporting Initiative

MN Community Measurement (MNCM) is proud to announce that it is moving ahead with supporting groups that are interested in submitting 2008 Medicare data for the Physicians Quality Reporting Initiative (PQRI) through the MNCM registry based system! In 2007, the Medicare, Medicaid, State Children's Health Insurance Program (SCHIP) Extension Act gave qualified registries permission to submit PQRI measurement data to the Centers for Medicare and Medicaid Services (CMS) on behalf of PQRI participants. As a result of the SCHIP Extension Act, MNCM will submit data on five PQRI measures in February 2009 for 2008 dates of service:

• Measure #1: Hemoglobin A1c Poor Control in Type 1 or 2 Diabetes Mellitus
• Measure #2: Low Density Lipoprotein Control in Type 1 or 2 Diabetes Mellitus
• Measure #3: High Blood Pressure Control in Type 1 or 2 Diabetes Mellitus
• Measure #119: Urine Screening for Microalbumin or Medical Attention for Nephropathy in Diabetes Patients
• Measure #114: Inquiry Regarding Tobacco Use

Eligible physicians who participate in PQRI may earn an incentive payment of 1.5 percent of their total allowed charges for Medicare Physician Fee Schedule covered services. If groups are still interested in submitting PQRI data for 2008, it is not too late. However, since deadline for this year’s data submission is February 15, 2009, please notify MNCM today of your interest at support@mncm.org. For those groups who are not able to participate in 2008, MNCM is in the beginning stages of developing the 2009 program.

Patient Perspective

Note: MN Community Measurement (MNCM) is starting a new section of the newsletter in which we will share any anecdotes we hear about how patients or health care providers are using measurement information to inform their health care decisions. These stories are a valuable way for us to illustrate the impact that your efforts and ours are having on health care quality. If you have used MNCM’s data to make decisions about your health or know of patients who have done so and wouldn’t mind sharing their stories, we would love to hear your story! Please email Liz Hoelscher with any stories or questions.

Patient Recounts Her Experience Using MN Community Measurement’s Data

My name is Melinda and my son has asthma. His asthma doctor’s office used to be about 30 minutes away, which was not convenient. He needed a new doctor closer to home, but I didn’t want to just pick one out of the yellow pages. I wanted an asthma doctor who was outstanding.

I heard that MN Community Measurement has reports comparing health care quality of care for asthma (my daughter works there). So, I went to its web site and found the provider with the highest overall rating, clicked on the affiliated clinics, and found one near our home.

My son’s new doctor was very thorough and the new clinic scheduled enough time to allow him to be this thorough. We are extremely pleased with the new doctor!

MNCM Measure Matters
Measure Alignment in Minnesota

This past summer, MN Community Measurement (MNCM) participated in a collaborative endeavor that aimed to reduce the administrative burden and costs associated with measurement and to provide better information for consumers. To accomplish this, a workgroup was convened by the Minnesota Medical Association and the Minnesota Council of Health Plans to identify how to align measures used in pay-for-performance. The workgroup included physicians, employers, and health plans.

The workgroup recommends that payers use MNCM measures as the standard for pay-for-performance initiatives, if MN Community Measurement measures are available. The workgroup also recommends alignment of new measures in the future, where appropriate. These recommendations will be incorporated into preliminary recommendations to the Minnesota Department of Health on a quality incentive payment system, as required by health reform legislation passed last year.
 

Institute for Clinical Systems Improvement to Offer Free Seminar on Shared Decision Making

On February 25, the Institute for Clinical Systems Improvement (ICSI) will offer a seminar on shared decision making. The seminar - Improving Decision Quality Through Shared Decision Making - is the last in a three-part series addressing methods in patient activation and funded by the Robert Wood Johnson Foundation’s Aligning Forces for Quality initiative. The seminar will focus on how to engage patients in becoming active members of the health care team and feature general approaches and specific tools to assist health care professionals in moving their efforts forward locally. This is a free seminar and open to both ICSI members and non-members. Registration is required and seats are limited. Click here to learn more and register online.
 

Upcoming Calendar Items:

• February 15: Deadline for PQRI data submission
• February 16: DDS deadline for data submission
• February 25: ICSI’s free seminar

MN Community Measurement
Broadway Place East #455
3433 Broadway Street NE
Minneapolis, MN 55413
Telephone: 612.455.2911
Fax: 612.455.2912
www.mnhealthcare.org

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