September Lessons Learned on Primary Care Quality Reporting

Patient-Centered Primary Care Collaborative of Central Ohio Lessons Learned: Primary Care Quality Reporting September 2012 Coordinated by:

Lead Support

Major Support

Additional Support

100% Access HealthColumbus Board & Staff

Strategic Partners:

SPREAD PRIMARY CARE QUALITY REPORTING: PCMH Improvement Dashboard • Access Measures • Capacity to Schedule Same Day Appointments • Continuity of Care with Personal Physician • Patient Experience • Provider and Staff Job Satisfaction • Diabetes Patient Self-Health Management • Diabetes Management Screenings • Diabetes Management Testing Outcomes • Utilization Outcome Measures • Emergency Department Visits • Hospitalizations • Re-Hospitalizations • Prescriptions Filled by Generics

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SPREAD PRIMARY CARE QUALITY REPORTING: PCMH Improvement Dashboard Observations and Lessons Learned - Compilation & Use Labor intensive and semi-manual for practices, health plans, and Access HealthColumbus. Measures are sourced from a large variety of records. System and staff changes effect the data and timing of content availability, even with a repeat request.

Based on feedback from the primary care practices and health plans, the experience of sourcing data and review of the values is providing an unusual look at practice level information. This can enable (even encourage and inspire) quality improved clinical practice and payment transformation over time.

Review and use of reports requires a primary care practice to allow time for key providers and staff to review the information, create and execute projects to improve patient care and experience.

Review and use of reports requires a health plan to allow time for staff and resources to review, create and execute projects to improve alignment of incentives.

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SPREAD PRIMARY CARE QUALITY REPORTING: PCMH Improvement Dashboard Observations and Lessons Learned - Measures & Values Payer Mix data, obtained for the first time, shows a wide variety of proportions of payer types, thereby patient types, among participating practices (Commercial, Medicaid, Medicare, Self-Pay) Access measures have a mix of positive and negative change values.

Diabetes screenings (tests performed) have a mix of positive and negative change values.

Significant improvements are reflected in Diabetes management outcomes (test results) from 2010 to 2011 (most measures, most practices).

Staff satisfaction has generally worsened. Does this reflect the difficulty transformational change initially presents?

Re-Hospitalization rates (one of the utilization measures) have modestly worsened.

Modest utilization improvements are reflected in Emergency Departments, Hospitalizations, and Generic Rx use. Variations between and within practices are high.

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SPREAD PRIMARY CARE QUALITY REPORTING: PCMH Improvement Dashboard Observations and Lessons Learned – Next Steps

Another PCMH Improvement Dashboard update is planned for fall 2012. This report will be more robust, including updates and refreshes to all developed measures.

It is becoming widely recognized that it is important for Primary Care organizations to invest in documenting service and care, capturing data, and demonstrating increased value by measuring service performance and care outcomes.

Looking forward, Access HealthColumbus intends to coordinate the work of a multi-stakeholder collaborative to design and guide the implementation of a Primary Care Quality Reporting project. Quality improvement, demonstrating value, aligned incentives, and benefit design can be better supported by improved Primary Care Quality Reporting in our community.

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SPREAD PRIMARY CARE QUALITY REPORTING: New project starting 2013

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WHY? In every community across America, health care delivery can be improved to yield better outcomes, reduce unnecessary utilization, and advance high value services. That's why it is important for leaders from business, government, health care, and the social sector to have access to accurate, objective information on the quality of health care.

WHAT can become available to provide this information?

Based on nationally endorsed measures, local comparative quality of care data can be compiled and reported. Awareness and knowledge of the measures and what their values reflect about the quality of health care in our community can be increased and utilized.

What VALUE can this reporting provide?

Physicians and providers have accurate information to identify areas for quality improvement

Primary care teams improve quality of care and demonstrate increased value by measuring performance and care outcomes

Payers can provide incentives to high-value primary care teams to accelerate transformation of care

Purchasers can promote utilization of high-value primary care teams via value-based insurance/benefit design