Transcript 2010 Partners in Excellence Program –Primary Care

HealthPartners Communication Toolkit
HealthPartners is pleased to provide you with this communication toolkit
to assist in your efforts to disseminate clinical indicator results to your
providers. The toolkit consists of PowerPoint slide templates that you
can customize with your results.
Included in the toolkit:
– Clinical indicators overview
– Sample comparison graphs for Optimal Lifestyles, Preventive Services,
Healthy Behaviors and Optimal Depression Care
– Partners in Excellence measures and targets for 2009 and 2010
To use this as a PowerPoint document, click File, Save As and save it
to your system.
A technical supplement to the Clinical Indicators Report is available and
includes measurement detail, optimal component rates, trended plan
rates over time and external benchmarks. The report and supplements
are available at healthpartners.com/quality.
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2010 HealthPartners Clinical Indicators
Communication Toolkit
HealthPartners Clinical Indicators
18th Edition
Over seventeen years
of collaboration,
measurement
innovation and
performance
improvement
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2010 HealthPartners Clinical Indicators
Communication Toolkit
Clinical Indicators
2009 / 2010 Results
• The primary purpose is to provide valid and reliable information for providers
to use in their efforts to improve patient care and outcomes
• Rates are displayed for HealthPartners provider groups based on patient
volume, Partners in Excellence program participation, geographic location
and strategic relationship with HealthPartners
• Each graph displays provider performance, 95% confidence intervals,
average medical group performance and performance goals for Partners in
Excellence measures
• Results reflect claims data, chart audit results, patient survey and provider
self-reported data
• Clinical Indicators data is reported at the medical group level and supports the
HealthPartners Partners in Excellence program. This important initiative
provides financial recognition to medical groups for superior performance.
• HealthPartners uses this information to support internal quality improvement
initiatives which may include provider incentive and tiering programs
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2010 HealthPartners Clinical Indicators
Communication Toolkit
Clinical Indicators
2009 / 2010 Results
• Measure Title
• Description
• Methodology
– Products included
– Denominator/numerator definitions
– Attribution
– Sample size if applicable
• Results
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2010 HealthPartners Clinical Indicators
Communication Toolkit
Clinical Indicators
2009 / 2010 Results
Comparative provider performance on 67 measures
reported by primary care, specialty, pharmacy and
hospital related to:
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Behavioral Health
Diabetes Care
Healthy Behaviors
Medication Management
Musculoskeletal
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Obstetrics and Gynecology
Preventive Services
Safety
Tobacco Use & Cessation
Total Cost of Care
2010 HealthPartners Clinical Indicators
Communication Toolkit
What’s New?
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Diabetic Eye Exam
Generic Drug Use (Pharmacy Chains)
Optimal Care for Acute Low Back Pain (Primary Care)
Annual Monitoring for Patients on Persistent
Medications – Combined ACE/ARB and Diuretics
(Pharmacy Chains)
• Total Cost of Care
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2010HealthPartners Clinical Indicators
Communication Toolkit
What’s Coming?
Optimal Health Management for Severe Mental Illness
– On average, people with schizophrenia or bipolar disorders and on an
antipsychotic medication die 25 years earlier than people without these disorders
– Antipsychotic medications predispose people to Metabolic Syndrome, weight gain,
diabetes, hypertension and hyperlipidemia
Measure Description
The percentage of members ages 18 to 65 on December 31st of the measurement
year that have a diagnosis of schizophrenia or bipolar disorder and had at least one
fill of an antipsychotic or mood stabilizer medication and documentation of care is
optimal.
1.BMI assessment
2.Tobacco assessment
3.Alcohol use screening
4.LDL screening
5.Blood glucose screening
6.Blood pressure screening
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2010HealthPartners Clinical Indicators
Communication Toolkit
Optimal Lifestyles and Preventive Services
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
O ptimal
Life style Adult
O ptimal
Life style
C hildre n
Pre ve ntive
Se rvice s Adult
Your Rate 2009
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Pre ve ntive
Se rvice s C hild
C ombo #2
Avg Rate
2010 HealthPartners Clinical Indicators
Communication Toolkit
Healthy Behaviors
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Alcohol Asse ssme nt
Adult
BMI Asse ssme nt
Adult
Your Rate 2009
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BMI Asse ssme nt
C hild & Adol
Avg Rate
2010 HealthPartners Clinical Indicators
Communication Toolkit
Optimal Depression Care
100%
• Documented five or
more symptoms of
major depression
75%
• Documented symptom
follow-up within three
months
50%
• Antidepressant
medication for 180
days
25%
0%
Symptoms
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Follow Up
Medication
Your Group
Optimal Care
Average Optimal
Care
2010 HealthPartners Clinical Indicators
Communication Toolkit
How we compare to others
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
O ur rate
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Me dical Group Me dical Group
Ave rage
1
2
Me dical Group
2010 HealthPartners Clinical Indicators
Communication Toolkit
Partners in Excellence Program
• Forms the basis for HealthPartners financial and public recognition for
medical/specialty groups achieving either excellent or superior
performance in clinical quality, patient experience and affordability
measures.
• Rewards are based on medical group performance as measured by the
clinical indicators measurement set, Consumer Choice satisfaction survey
and other defined measurement tools.
• October 2010 Partners In Excellence provider group awards reflect
performance measured against targets outlined in the 2009 program
manuals (reflecting rates based on 2009 dates of service) with the exception of
generic drug use which are measured against targets outlined in the 2010
manuals. (Generic drug use rates reflect 2010 performance.)
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2010 HealthPartners Clinical Indicators
Communication Toolkit
2009 Partners in Excellence Program – Primary Care
Measures
Silver Target
Gold Target
MNCM Optimal Diabetes Care DDS
40%
50%
MNCM Optimal Vascular Care DDS
55%
60%
Optimal Depression Care
45%
50%
Evidence-based Cervical Cancer Screening
45%
55%
Preventive Services – Adult
93%
98%
Alcohol Assessment
93%
98%
Optimal Care for Acute Low Back Pain
15%
25%
Generic Drug Use – Adult
Generic Drug Use – Pediatrics
75%
70%
80%
75%
Breast Cancer Screening (small groups only)
80%
85%
Part 1: BMI Assessment – Pediatric
Part 2: Preventive Services Combo 2 – Pediatric
80%
75%
85%
80%
Pediatric Immunization Combo 3 – Pediatric
90%
95%
Top Band
Top Band
Top Performer
Top Performer
Top Performer
Top Performer
Top Performer
Top Performer
Patient Experience – Informed about care – Adult
Patient Experience – Talked about pros and cons – Adult
Patient Experience – Informed about care – Pediatric
Patient Experience – Talked about pros and cons – Pediatric
HealthPartners Innovations in Health Care Award
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2010 HealthPartners Clinical Indicators
Communication Toolkit
2009 Partners in Excellence –Specialty Care
Specialty
Measures
Silver Target
Gold Target
Cardiology
Generic Drug Use
Patient Experience – Informed about care
Patient Experience – Talked about pros and cons
75%
75%
Top Performer
80%
80%
Top Performer
OB/GYN
Generic Drug Use
Hysterectomy Post-Operative Complications
Alcohol Assessment
Patient Experience – Informed about care
Patient Experience – Talked about pros and cons
78%
93%
Top Performer
Top Performer
83%
≤ 0.5 of the index rate
98%
Top Performer
Top Performer
70%
55%
75%
60%
75%
71%
Top Performer
80%
76%
Top Performer
Initial 75%
Longitudinal 35%
Combined
75% Initial
35% Longitudinal
80%
Top Performer
85%
Top Performer
Behavioral Health
Generic Drug Use
Optimal Depression Care
ENT
Generic Drug Use
Patient Experience – Informed about care
Patient Experience – Talked about pros and cons
Physical Therapy
Oswestry Compliance
Orthopaedics
Patient Experience – Informed about care
Patient Experience – Talked about pros and cons
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2010 HealthPartners Clinical Indicators
Communication Toolkit
2010 Partners in Excellence Program –Primary Care
Measures
Silver Target
Gold Target
MNCM Optimal Diabetes Care DDS
40%
50%
MNCM Optimal Vascular Care DDS
55%
60%
Optimal Depression Care
45%
50%
Optimal Care for Acute Low Back Pain
15%
25%
Evidence-based Cervical Cancer Screening (pap test attribution)
60%
65%
Part 1: Preventive Services – Adult
Part 2: Preventive Services Combo 2 – Pediatric
Part 3: MNCM Childhood Immunization Combo 3
(Primary care will need to meet all three targets, Pediatric groups need to meet Parts 2
& 3)
90%
80%
90%
95%
85%
95%
Generic Drug Use – Adult
Generic Drug Use – Pediatrics
78%
73%
83%
78%
MNCM Avoidance of Antibiotic Use in Acute Bronchitis
40%
45%
MNCM Controlling High Blood Pressure
90%
95%
Initiation & Engagement of Alcohol & Other Drug Dependence Treatment - Initiation
Initiation & Engagement of Alcohol & Other Drug Dependence Treatment - Engagement
20%
10%
25%
15%
Annual Monitoring for Patients on Persistent Medications - ACE/ARB
Annual Monitoring for Patients on Persistent Medications - Diuretics
85%
85%
90%
90%
Patient Experience – Informed about care - Primary Care
Patient Experience – Talked about pros and cons - Primary Care
72%
70%
77%
75%
Patient Experience – Informed about care - Pediatrics
Patient Experience – Talked about pros and cons - Pediatrics
72%
75%
77%
80%
HealthPartners Innovations in Health Care Award
11.30.10
2010 HealthPartners Clinical Indicators
Communication Toolkit
2010 Partners in Excellence –Specialty Care
Specialty
Measures
Silver Target
Gold Target
Cardiology
MNCM Optimal Vascular Care
Generic Drug Use
Annual Monitoring for Patients on Persistent Medications ACE/ARB
Annual Monitoring for Patients on Persistent Medications - Diuretics
Patient Experience – Informed about care
Patient Experience – Talked about pros and cons
55%
78%
90%
90%
85%
85%
60%
83%
95%
95%
90%
90%
OB/GYN
Generic Drug Use
MNCM Chlamydia Screening
Evidence-based Cervical Cancer Screening (pap test attribution)
Patient Experience – Informed about care
Patient Experience – Talked about pros and cons
78%
70%
60%
85%
90%
83%
75%
65%
90%
95%
Behavioral Health
Generic Drug Use
Optimal Depression Care
78%
55%
83%
65%
ENT
Generic Drug Use
Patient Experience – Informed about care
Patient Experience – Talked about pros and cons
78%
85%
85%
83%
90%
90%
Orthopaedics
Functional Measurement for Knee Arthroplasty
Written
documentation AND
> 25% longitudinal
85%
90%
Written
documentation AND
> 75% longitudinal
90%
95%
Patient Experience – Informed about care
Patient Experience – Talked about pros and cons
HealthPartners Innovations in Health Care Award
11.30.10
2010 HealthPartners Clinical Indicators
Communication Toolkit