Provider Peer Grouping Monthly Updates

Transcription

1 Provider Peer Grouping Monthly Updates August 13, 2012 Stefan Gildemeister Director, Health Economics Program

2 Outline Background of Provider Peer Grouping Progress Update: Advisory committee update Announcement of committee members First Advisory committee meeting 2

3 What is Provider Peer Grouping? A system for publicly comparing provider performance on cost and quality a uniform method of calculating providers' relative cost of care, defined as a measure of health care spending including resource use and unit prices, and relative quality of care (M.S. 62U.04, Subd. 2) a combined measure that incorporates both provider riskadjusted cost of care and quality of care (M.S. 62U.04, Subd. 3) 3

4 What types of Provider Peer Grouping 1. Total care need to be developed? 2. Care for specific conditions The commissioner shall develop a peer grouping system for providers based on a combined measure that incorporates both provider risk-adjusted cost of care and quality of care, and for specific conditions (M.S. 62U.04, Subd. 3) 4

5 Stakeholder involvement Provider Peer Grouping Advisory Group Rapid Response Team Reliability Workgroup Feedback during review period & at public meetings Monthly conference calls Advisory Committee Data validation Work Group 5

6 Progress Update: Advisory Committee 6

7 PPG Advisory Committee As required by MN Laws, 2012, Regular Session, Chapter 164 SF1809, sec. 4, Commissioner of Health will convene an Advisory Committee Membership will include representatives of: Health care providers Health plan companies Consumers State agencies Employers Academic researchers Organizations that work to improve health care quality in Minnesota Call for nominations w/due date of July 11, 2012: 7

8 Advisory Committee, contd. Committee will meet no fewer than 3 times per year Committee will provide advice on developing and administering the Provider Peer Grouping System: Establishing peer groups Selecting quality measures Recommending thresholds for completeness of data and statistical significance Considering methods for risk adjustment, including whether certain provider characteristics should be included Including or excluding certain cost information in the analysis Adopting patient attribution Performing scoring on quality and costs

9 Advisory Committee Appointments Health Commissioner Dr. Ed Ehlinger last week appointed members to an advisory committee to provide recommendations as the Minnesota Department of Health (MDH) implements the Provider Peer Grouping system an initiative to provide consumers, payers and providers with greater transparency about value in health care. The Commissioner appointed a group of 24 representatives from health systems/hospitals, physician clinics, health plan companies, consumers, state agencies, employers, academic researchers, and organizations that work to improve health care quality in Minnesota. Commissioner Ehlinger stated, We're fortunate to have a group of people willing to step forward with this level of experience and expertise advising the Health Department as we make the decisions necessary to implement the Provider Peer Grouping system. I value their contribution to the community and look forward to their help in holding us to our goals of scientific rigor, actionable results and transparency of approach. 9

10 Representing health systems and hospitals: Allie Coronis, Allina Hospitals & Clinics Andy McCoy, Fairview Health System Bob Stevens, Ridgeview Medical Center Jim Naessens, Mayo Clinic System Sam Van Norman, Park Nicollet Todd Sandberg, Sibley Medical Center 10

11 Representing physician clinics: Daniel Trajano, Park Nicollet David Luehr, Integrity Health Network Julie Anderson, St. Cloud Medical Group Katie Lust, Boynton Health Center, University of Minnesota Linda Ridlehuber, MN Association of Community Health Centers William Davis, Winona Health

12 Representing health plan companies: Kristie Ruma, Medica Larry Lee, Blue Cross Blue Shield of Minnesota Sue Knudson, HealthPartners 12

13 Representing consumers and employers: Akhtar Chaudri, Vertelligence Patrick Irvine, consultant Peter Benner, retired, AFSCME Shawn Leavitt, Carlson Companies Stacie Weeks, Legal Services Advocacy Services 13

14 Representing academic researchers and organizations that work to improve health care quality: Bryan Dowd, University of Minnesota Tina Frontera, MN Community Measurement 14

15 Representing state agencies: Mark Hudson, MN Department of Human Services Nathan Moracco, State Employees Group Insurance Program (SEGIP) 15

16 Advisory Committee Meeting The first meeting of the Advisory Committee will be held Sept. 7, 2012, 1-4 p.m. at the Eagan Community Center. All meetings of the Advisory Committee will be open to the public. Facilitating the Advisory Committee s work will be Carrie Coleman, recently selected after MDH s informal solicitation for professional services related to project planning, meeting facilitation and communication planning work.

17 Resources For more information about the Advisory Committee and the Provider Peer Grouping system, see: Or contact: Stefan Gildemeister Carrie Coleman Director, Health Economics Program Consultant, MDH Health Economics