Frequently Asked Questions

What is the Michigan Value Collaborative (MVC)?

The Michigan Value Collaborative, or MVC, is a partnership between Michigan hospitals and Blue Cross and Blue Shield of Michigan/Blue Care Network. Like other BCBSM/BCN-funded collaborative quality improvement programs , the program aims to improve healthcare quality across Michigan through rigorous performance feedback, empirical identification of best practices, and collaborative learning.

Who is being invited to participate in MVC?

As with other Collaborative Quality Initiative (CQI) and Physician Group Incentive Program (PGIP) programs, the consortium is open to all clinically relevant providers. Because MVC is focusing on a wide range of conditions and procedures, almost all acute care hospitals in Michigan will be invited to participate.

What does participation require?

Your hospital is asked to send at least one or two leaders with hospital-wide responsibilities for managing cost and quality to each semi-annual MVC meeting, where we will review new performance data, empirical analysis of best practices, and collaborative strategies for improving quality and efficiency. Unlike other CQI programs, participating hospitals are not required to collect and submit data.

Is participation voluntary?

Attendance at MVC meetings and participation in its improvement activities is voluntary. Regardless of whether hospitals actively participate, however, performance will be assessed on all Michigan hospitals and updated and disseminated to the hospitals three times a year.

Why should my hospital participate in MVC?

Aside from helping Michigan provide the safest, most effective and most efficient healthcare in the nation, MVC will provide your hospital with actionable data on both quality (not initially) and cost and ultimately help you prepare for the new landscape of value-based reimbursement. This business intelligence is provided at no cost to hospitals.

What happens if my hospital doesn’t participate?

There is currently no direct financial incentive or disincentive to participate in MVC. However, in the future BCBSM expects to include MVC-generated measures in its hospital-based incentive models. To perform well on future incentive opportunities, hospitals will benefit by becoming familiar with MVC efficiency measures and participating early in the improvement process.

Which individual(s) should represent my hospital?

We leave that to each hospital, but the activities of MVC might be most relevant to Chief Medical Officers, Chief Quality Officers, P4P Administrators or others with similar responsibilities. Given the financial nature of the performance data, and the increasing focus by government and commercial payers on the overall effectiveness and efficiency of care on a population basis, MVC’s work will also be of interest to CFOs and/or CEOs.

What data will be used in assessing hospital performance?

In the immediate-term, we will be using Michigan-wide, BCBSM commercial claims data, which includes information about hospital-based care, professional services and post-acute care. Measures will be based on utilization and payments for different services, not actual hospital costs. Fee-for-service Medicare data will be incorporated in early 2014. We are also exploring the possibility of incorporating claims from Medicaid and other private payers.

How are episode costs determined?

Hospitals will receive risk and price-adjusted measures of 30-day and/or 90-day episode payments around hospitalizations for common conditions and procedures. Episode costs will be risk-adjusted to account for differences in case mix across hospitals. They will also be “price adjusted,” so measures will reflect utilization rates rather than negotiated prices/rates. Clinical services unrelated to the index admission will be excluded.

How will the data be reported?

In additional to viewing overall episode costs against their peers, hospitals will be able to drill down through their data and understand their comparative utilization of specific services, trends over time, and root causes of variation. In many specialty areas supported by CQI programs, hospitals will be able to view cost data alongside information reflecting clinical quality.

Will the performance data be kept confidential?

A hospital will be able view its own performance data against statewide averages. Its performance data will not be accessible by other hospitals, but hospital-specific data on utilization and cost derived from BCBSM-paid claims will be available to BCBSM.

What are the expectations of hospitals, with regard to using these data?

We hope that hospitals will use these data to help MVC target improvement opportunities, identify and share best practices, and design, implement, and evaluate statewide interventions. At the local level, we encourage hospital leaders to use these data to understand and improve their comparative efficiency, both overall and across individual specialties. For conditions or procedures where hospitals have “room to move,” we expect that hospital leaders will use both MVC cost data and clinical quality data from the other CQI programs as guides to their internal improvement activities.

Are high episode costs “good” or “bad?”

The overarching goal of MVC is to help Michigan hospitals achieve the best possible patient outcomes at the lowest reasonable cost. Taken alone, the financial and utilization measures provided by MVC cannot establish “optimal” practice for any given condition or procedure. By considering such data in the context of credible measures of clinical performance from other sources, including the CQI programs, however, the goal is to identify and share best practices and benchmarks for quality and cost.

Does participation in this project require Institutional Review Board (IRB) approval?

No. The MVC is a quality improvement initiative, not a research program. Moreover, all analyses and reports will be based on de-identified claims data.

How do we schedule meetings with MVC leadership to further discuss the data reports?

The MVC Coordinating Center is available to meet with you and others from your hospital to review your data and suggest areas where quality can be improved. Simply contact the Program Manager, Andrea McVeigh, to schedule a meeting time.

Which facilities are included in the on-line reporting application?

Michigan acute care facilities with more than 40 total cases during the specified time frame provide the sufficient sample size to be included in the on-line reporting application. As more data become available, more sites will be added.