04 Jan 2024
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MVC Coordinating Center Looking Back at 2023 and Forward to 2024

MVC Coordinating Center Looking Back at 2023 and Forward to 2024

January 4, 2024 | 0 Comments

On behalf of the MVC Coordinating Center, I’d like to start by wishing you all a very happy and healthy new year! MVC had an outstanding 2023, which included celebrating our 10th anniversary and continued support of our hospital and physician organization members along with CQI partners.

Throughout 2023, MVC welcomed three new hospital members to the collaborative, distributed 17 push reports, grew its analytic offerings by adding ED-based episodes of care, delivered 24 custom analytic requests, hosted 24 virtual workgroups across six focus areas, advanced both of its value coalition campaigns, completed 37 member meet and greets, and hosted two collaborative-wide meetings. Additionally, several exciting improvements were made to the MVC registry, including new reports for payment and value metrics for Program Year (PY) 2024-2025 of the MVC Component of the BCBSM Pay-for-Performance (P4P) Program along with new measures and filters for long term acute care hospital utilization.

As MVC begins its 11th year, the Coordinating Center is excited to continue to advance the vision of more sustainable, high-value healthcare in Michigan. As highlighted in a recent blog outlining MVC’s refreshed strategy, there are a number of developments planned to advance our work in the areas of population health management, sites of care across the continuum, patient-centeredness, and equity. In addition to these strategic pillars, MVC has several operational plans for the coming year that I am excited to share with you.

New Engagement Point Menu for PY 2024

For hospital members participating in the MVC Component of the BCBSM P4P program, PY 2024 kicks off the new engagement point component of the program cycle’s scoring structure, which was developed as a mechanism for increasing and enhancing collaborative learning across the MVC network. Using MVC’s engagement point menu, participating members can choose the MVC engagement offerings that best meet the needs of their site to earn up to two points toward their PY 2024 score. Please visit MVC’s PY 2024 Engagement Point Menu for a complete list of offerings. For additional information on MVC’s PY 2024 engagement point component, you may access the MVC PY 2024 Engagement Point Webinar.

Actionable Data through MVC Push Reports

In 2024, MVC will continue to provide members with site-specific push reports to support quality improvement. Several new reports will be added to MVC’s suite of reporting in 2024, focusing on topics such as statewide health equity, pharmacy utilization, and alternative sites of care. The Coordinating Center will work closely with members, the broader CQI community, and other stakeholders to ensure the continued distribution of novel and valuable reporting.

Collaborative-Wide Meetings and Virtual Workgroups

The MVC Coordinating Center will host two collaborative-wide meetings in 2024. MVC’s spring 2024 meeting will take place on Friday, May 10 at the H Hotel in Midland, and the fall 2024 meeting will be held on Friday, October 25 at the VistaTech Center in Livonia. We are in the process of planning engaging agendas and are excited to see you in person at these events. Keep an eye on MVC’s blog as additional details are announced throughout the year.

Additionally, the Coordinating Center’s suite of peer-to-peer virtual workgroups will continue to provide a highly accessible online platform for hospital and PO members to come together, collaborate, and share practices. The 2024 workgroups will include series focused on MVC’s PY 2024-2025 P4P value metrics – cardiac rehabilitation, post-discharge follow-up, preoperative testing, and sepsis – along with a health in action series and a newly launched rural health series. To review the complete list and register for specific workgroup dates, please visit MVC’s 2024 Events Calendar.

Assessing Value and Site-Specific Opportunities

The MVC Coordinating Center continued its efforts in 2023 to help partners measure the impact of their initiatives from an investment and value perspective. MVC’s expertise in this area and its strong relationships throughout the CQI portfolio led to the commission and completion of three value assessment exercises last year with additional value assessments underway for 2024. Similarly, MVC continues to offer its members the ability to request custom analyses to better understand site-specific areas of interest and opportunity. If you are interested in a custom report, please submit a Custom Analytics Request and a member of the MVC team will follow up.

As we kick off 2024, I’d like to thank our hospital members, PO members, and CQI partners for their continued collaboration and support. We look forward to working with you throughout the coming year!

26 Oct 2023
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MVC Fall 2023 Collaborative-Wide Meeting Summary: Members Focus on High-Value Care for All

MVC Fall 2023 Collaborative-Wide Meeting Summary: Members Focus on High-Value Care for All

October 26, 2023 | 0 Comments |

The Michigan Value Collaborative (MVC) held its second collaborative-wide meeting of 2023 last Friday. A total of 98 leaders registered, representing 56 different hospitals, 9 physician organizations (POs), and 7 stakeholder organizations from across the state of Michigan. This meeting’s theme of “High-Value Care for All: Collaborative Approaches to Equitable Healthcare” focused on how interdisciplinary collaboration can support efforts to reduce disparities and provide equitable healthcare.

MVC Director Hari Nathan, MD, PhD, kicked off Friday’s meeting with an update from the MVC Coordinating Center (see slides). He welcomed MVC’s newest team members - Data Analysts Jiaying “Janet” Zhang and Kushbu Narender Singh, Senior Data Analyst Kim Fox, and Engagement Manager Jessica Souva – and highlighted the successes delivered by the Coordinating Center since May’s collaborative-wide meeting. One highlight was the release of MVC’s 2023 Qualified Entity Public Report with refreshed data for 30-day unplanned rehospitalization for patients discharged to home health after high-volume medical and surgical episodes, as well as measures of post-discharge outpatient follow-up for congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). To reflect MVC's ongoing commitment to providing meaningful data in a way that reflects best practices for diversity, equity, and inclusion, Dr. Nathan also shared MVC’s revised approach to race and ethnicity reporting, which lists racial and ethnic identities in alphabetical order, removes the categories of “other” and “unknown,” and includes two additional categories in MVC reporting. Finally, Dr. Nathan highlighted MVC’s recent push report offerings. Hospital and PO members received the new emergency department-based episode report as well as the new skilled nursing facility and home health utilization report. Hospital members received their Mid-Year Scorecard for Program Year 2023 of the MVC Component of the BCBSM Pay-for-Performance (P4P) Program, as well as refreshed versions of the CHF and COPD follow-up report, common conditions report, and sepsis report.

Following the MVC Updates, Dr. Nathan introduced its keynote speaker, Renée Branch Canady, PhD, MPA, who serves as CEO of the Michigan Public Health Institute (MPHI) and is a recognized national thought leader in the areas of health inequities and disparities, cultural competence, and social justice. Rooting the advancement of health equity in a systems-thinking approach, Dr. Canady encouraged attendees to address upstream change (Figure 1) by seeing differently, saying differently, and doing differently (see slides).

Figure 1.

Following Dr. Canady’s presentation, Senior Data Analyst Julia Mantey, MPH, MUP, led a presentation about combining MVC claims data and social determinants of health (SDOH) data sets for regional equity analyses (see slides). The session began with a review of statewide heat maps for the following MVC measures: 1) follow-up after hospitalization for CHF, 2) emergency department visits after CHF hospitalization, and 3) readmission after CHF hospitalization. Then, Ms. Mantey introduced the SDOH database managed by the Agency for Healthcare Research and Quality (AHRQ), a public database linkable to MVC data by county and Zip code (Figure 2).

Figure 2.

From the AHRQ SDOH database, MVC incorporated data from the American Community Survey (U.S. Census Bureau), Homeland Infrastructure Foundation-Level data (U.S. Department of Homeland Security), and Provider of Service Files (U.S. Department of Health & Human Services, Centers for Medicare and Medicaid Services) to illuminate potential barriers to care. Statewide heatmaps were presented for 1) the percentage of households with no internet access, 2) the percentage of households with no computing device, 3) the percentage of households with no vehicle available, and 4) the percentage of households with public assistance income or SNAP benefits. Following Ms. Mantey’s presentation, Nora Becker, MD, PhD, explained the value of area-level SDOH metrics and how such data can be used in partnership with healthcare utilization data to provide a more robust picture of factors influencing patient outcomes (see slides).

Following Dr. Becker’s remarks, a poster session began, providing an opportunity to highlight recent quality improvement successes and encourage networking across the collaborative. The MVC Coordinating Center would like to thank the poster presenters. Electronic copies of the posters are available in batches of four each here, here, and here.

Following a networking lunch, attendees participated in one of three breakout sessions (Group 1, Group 2, or Group 3). The breakout sessions were geographically based and focused on regional snapshots of the American Community Survey data along with unblinded data for readmissions after CHF hospitalization. In each breakout session, hospital and PO members discussed opportunities to support patients and explored how MVC could support hospital and PO members going forward (Figure 3).

Figure 3.

Following the breakout sessions, the group reconvened for roundtable discussions. During the session, attendees visited three tables of their choosing, where they learned about the work of the roundtable speaker, asked questions, and discussed the table topic with their peers. The MVC Coordinating Center would like to thank its roundtable speakers (Figure 4) for sharing their work and expertise: Nora Becker, MD, PhD, University of Michigan (association of chronic disease and patient financial outcomes); Diane Hamilton, BAA, CEP, Corewell Health Trenton (transportation barriers for cardiac rehabilitation patients); Noa Kim, MSI, HBOM (jumpstart grocery delivery program for patients with Type 2 diabetes); Matthias Kirch, MS, MSHIELD (best practices for anti-racist data collection and patient screening); Laura Mispelon, MHA, Michigan Center for Rural Health (supporting healthcare needs in rural communities); Thomas Pierce, LMSW, MPA, U-M Health West (SOGI data collection); Amanda Sweetman, MS, Trinity Health Michigan (hospital-based farm programs to support healthy food access); and Larrea Young, MDes, HBOM (tobacco cessation resources for providers and patients).

Figure 4.

Following the roundtable session, MVC Co-Director Michael P. Thompson, PhD, MPH, concluded the meeting with an update on the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program (see slides). It was noted Program Year 2023 bonus point surveys are due on Wednesday, November 15, 2023, and MVC will be hosting a Program Year 2024 engagement point webinar to review the new engagement point menu on Thursday, November 9, 2023, at 12 p.m.

If you have questions about any of the topics discussed at MVC’s fall 2023 collaborative-wide meeting or are interested in following up for more details, contact the Coordinating Center. MVC’s next collaborative-wide meeting will be in person on Friday, May 10, 2024, in Midland.

25 May 2023
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MVC Spring Collaborative-Wide Meeting Summary: Connecting the Dots for Value-Based Healthcare

MVC Spring Collaborative-Wide Meeting Summary: Connecting the Dots for Value-Based Healthcare

May 25, 2023 | 0 Comments

The Michigan Value Collaborative (MVC) held its first collaborative-wide meeting of 2023 last Friday. A total of 90 leaders registered, representing 52 different hospitals, 13 physician organizations (POs), and five stakeholder organizations from across the state of Michigan. This meeting’s theme of “Connecting the Dots: Celebrating 10 Years of Insights into Value-Based Healthcare” focused on interdisciplinary collaboration, care transitions, alternative sites of care, and MVC’s 10-year anniversary kickoff.

MVC Director Hari Nathan, MD, PhD, kicked off Friday’s meeting with an update from the MVC Coordinating Center (see slides). He welcomed MVC’s newest team members, Site Engagement Coordinator Kristy Degener and Senior Data Analyst Julia Mantey. Dr. Nathan highlighted the successes delivered by the Coordinating Center since October’s collaborative-wide meeting, including the release of MVC’s first Qualified Entity Public Report, which looked at 30-day unplanned rehospitalization for patients discharged to home health after high-volume medical and surgical episodes, as well as measures of post-discharge outpatient follow-up for congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). Dr. Nathan also announced Medicare Part D pharmacy claims as MVC’s newest data source and highlight recent push report releases – sepsis, joint replacement, cardiac rehabilitation, and preoperative testing – aimed at increasing the amount of meaningful, benchmarked data available to members. Rounding out the welcome address, Dr. Nathan showcased a 10-year anniversary video featuring members of MVC’s leadership team, past and present.

MVC Co-Director Michael P. Thompson, PhD, MPH followed Dr. Nathan with an update on the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program, noting that final scorecards for Program Year (PY) 2022 were distributed in March. For the 2022 - 2023 program cycle, hospital members selected two conditions to be measured for the 30-day episode spending component of the program - chronic obstructive pulmonary disease (COPD), colectomy (non-cancer), congestive heart failure (CHF), coronary artery bypass graft (CABG), joint replacement (hip and knee), pneumonia, or spine surgery - and are eligible to receive up to two bonus points for completing a survey on each of their episode conditions. Dr. Thompson presented a snapshot of the PY2022 evaluation (Figure 1), noting all participating hospitals scored at least two points and over a third of participating hospitals scored the maximum of 10 points (mean: 7.7 points, median: 8 points). Turning to PY2023, the group was reminded that mid-year scorecards will be distributed to participating hospitals in the summer of 2023 and bonus point questionnaires will be due in November.

Figure 1.

Following Dr. Thompson’s update on the MVC Component of the BCBSM P4P program, Senior Data Analyst Kristen Hassett, MPH, introduced MVC’s new Emergency Department (ED)–based episodes, which were developed in collaboration with the Michigan Emergency Department Improvement Collaborative (MEDIC). The new ED-based episodes are initialized by an ED visit for a set of high-volume, ED-relevant conditions, and capture both adult and pediatric patients who may not be captured through MVC’s traditional inpatient/surgery-based episodes of care. The new ED-based episodes (Figure 2) provide MVC members with information on care transitions and trajectory of care for patients visiting the ED, quality improvement opportunities to prevent excess ED visits and inpatient hospitalizations, and patterns in post-ED care (e.g., inpatient admissions, outpatient visits, home health care, skilled nursing facility care, etc.). Ms. Hassett presented unblinded hospital and PO data using ED-based episode payments for CHF patients. Members who are interested in seeing their organization’s ED-based episode data can contact the Coordinating Center to request a report. MVC also shared a link to a video interview of MEDIC Program Director Keith Kocher, MD, MPH, about how sites can utilize MVC’s new ED-based episode structure to improve care for patients treated in the ED as well as how MEDIC supports quality improvement in the ED.

Figure 2.

Following the ED-based episode presentation, Caitlin Valley, Senior Population Health Project Manager with Trinity Health IHA Medical Group, delivered a presentation (see slides) on their strategies and approach to caring for patients across the continuum. She began by providing insights about care transitions and why they are important. She also shared Trinity Health IHA Medical Group’s team-based approach to care transitions (see Figure 3), which includes the use of a transitional support call center and care team navigators for post-discharge follow-up outreach, screening for social influencers of health (SIOH), and comprehensive medication reviews with a clinical pharmacist, among other strategies.

Figure 3.

Ms. Valley also shared several barriers to scheduling hospital follow-up appointments observed by Trinity Health, and the interventions they implemented in response, such as patient education, transportation resources, and creative scheduling solutions. She concluded her presentation by discussing post-acute care collaboration among providers, citing the use of a post-acute transitional care manager and the expertise of partners specializing in the post-acute care space.

Following Ms. Valley’s presentation, a poster session began, providing an opportunity to highlight recent quality improvement successes and encourage networking across the collaborative. The MVC Coordinating Center would like to thank the poster presenters:  Holland Hospital, MSU Health Care, Henry Ford Health System, Michigan Medicine, McLaren Port Huron, MARCQI, BMC2, and the Michigan Cardiac Rehabilitation Network.

Following a networking lunch, attendees participated in one of four breakout sessions: cardiac rehabilitation; post-discharge follow-up for CHF, COPD, and pneumonia; preoperative testing; and sepsis readmissions. In each breakout session, hospital and PO members reviewed unblinded data and shared strategies to address each of the topic areas.

The group reconvened after the breakout sessions for a closing presentation from Michael Sjoding, MD, MSc, Associate Professor of Internal Medicine in Michigan Medicine’s Division of Pulmonary and Critical Care Medicine, and Co-Director of the Inspiring Health Advances in Lung Care (INHALE) team, one of the newest population health CQIs in BCBSM’s Value Partnership program. Dr. Sjoding’s presentation (see slides) centered around how INHALE has leveraged MVC data to plan and implement the INHALE collaborative.

The meeting concluded with a summary of the day and upcoming MVC activities, led by MVC Program Manager Erin Conklin, MPA. The slides from Friday’s meeting have been posted to the MVC website. If you have questions about any of the topics discussed at the spring 2023 collaborative-wide meeting or are interested in following up for more detail, contact the Coordinating Center. MVC’s next collaborative-wide meeting will be in person on Friday, October 20, 2023, at the Radisson Hotel at the Capitol in Lansing.

05 Jan 2023
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MVC Coordinating Center Looking Back at 2022 and Forward to 2023

January 5, 2023 | 0 Comments

On behalf of the MVC Coordinating Center, I’d like to start by wishing you all a very happy and healthy new year! MVC had a stellar 2022 with a wide range of successful activities, all while continuing to support hospitals, physician organizations, and CQI partners.

Over the course of 2022, MVC welcomed three new members to the collaborative, distributed 21 push reports, grew its analytic offerings by adding pharmacy administrative claims as well as race and equity-related data sets, delivered 23 custom analytic requests, hosted 33 virtual workgroups across six focus areas, advanced both of its value coalition campaigns, and returned to in-person events for the first time since 2019. Additionally, a number of exciting improvements were made to the MVC registry: the creation of three new conditions (endocarditis, small bowel obstruction, and nephrectomy), new filters for patients with a diagnosis of chronic kidney disease or venous thromboembolism, and new comparison groups allowing member hospitals to compare their data to other general acute care hospitals or Critical Access Hospitals.

Additionally, a key MVC accomplishment in 2022 was achieving accreditation as a Qualified Entity (QE) through the Qualified Entity Certification Program (QECP), also known as the Medicare Data Sharing for Performance Measurement Program. As a QE, MVC was able to launch 20 new QE reports on the MVC registry, which give authorized users the ability to drill down into patient-level Medicare data, and recently released its first Qualified Entity Public Report following the completion of MVC’s QECP phase three application.

The Coordinating Center is excited for what’s to come in the new year, with MVC celebrating 10 tremendous years advancing its vision of more sustainable, high-value healthcare in Michigan. MVC looks forward to continuing this work and growth into 2023. There are a number of plans for the coming year that I am excited to share with you.

New Push Reports

A number of new reports will be added to MVC’s suite of reporting in 2023, focusing on topics such as transitions of care, health equity, and the revised Program Year (PY) 2024-2025 metrics of the MVC Component of the BCBSM Pay-for-Performance (P4P) Program. The Coordinating Center will work closely with members, the wider CQI community, and other stakeholders to ensure the continued distribution of novel and valuable reporting.

New and Returning MVC Workgroups

The Coordinating Center’s suite of peer-to-peer virtual workgroups will continue to provide a highly accessible online platform for hospital and PO leaders to come together, collaborate, and share practices. MVC will continue offering regular sessions focused on chronic disease management, diabetes, health equity, and health in action. In addition, MVC is looking to host collaborative learning communities for the PY 2024-2025 P4P value metric cohorts, such as the sites that selected cardiac rehabilitation.

Collaborative-Wide Meetings & Reimagined Engagement Events

The MVC team will continue to hold two flagship semi-annual collaborative-wide meetings. These will take place on Friday, May 19 at the VistaTech Center in Livonia and on Friday, Oct. 20 at the Radisson Hotel in Lansing. The MVC team also plans to test new approaches for peer networking to better support practice sharing, such as bringing together sites with similar patient populations and partnering with members to develop impact stories about their quality improvement efforts. Stay tuned for additional details.

Return-on-Investment Analyses

The MVC Coordinating Center made an active effort in 2022 to help its partners measure the impact of their initiatives from an investment and value perspective. MVC’s expertise in this area and its strong relationships throughout the CQI portfolio led to the commission and completion of four ROI exercises last year with additional ROIs in progress in 2023. Similarly, MVC continues to offer its members the ability to request custom analyses using metrics, payers, and date ranges that they specify in order to better understand areas of opportunity. If you are interested in learning more, please submit a Custom Analytics Request and a member of the MVC team will follow up.

As we kick off 2023, I’d like to thank our hospital members, PO members, and CQI partners for their continued collaboration and support. We look forward to working with you throughout the coming year!

03 Nov 2022
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MVC Fall Semi-Annual Summary: Prescribing Health in Michigan

MVC Fall Semi-Annual Summary: Prescribing Health in Michigan

November 3, 2022 | 0 Comments | , ,

The Michigan Value Collaborative (MVC) held its second semi-annual meeting of 2022 last Friday, marking MVC’s first in-person collaborative-wide meeting since 2019. A total of 90 leaders registered for the meeting, representing 25 different hospitals, seven physician organizations (POs), and five stakeholder organizations from across the state of Michigan. This meeting’s theme of “Prescribing Health in Michigan” showcased strategies to drive evidence-based medication utilization and support patient access to medications through the implementation and evaluation of quality improvement projects.

MVC Director Hari Nathan, MD, kicked off Friday’s meeting with an update from the MVC Coordinating Center. He welcomed one new collaborative member, Bronson Lakeview (Paw Paw), as well as MVC’s newest team members, Associate Program Manager Erin Conklin and Statistician Lead Usha Nuliyula. Dr. Nathan also highlighted the successes delivered by the Coordinating Center since May’s Semi-Annual Meeting. For instance, MVC launched its Qualified Entity registry pages to provide authorized users with more granular data than is available in the Medicare FFS reports, incorporated Distressed Community Index data into push reports as part of MVC’s commitment to emphasizing equity in healthcare, and distributed three new push reports (chronic obstructive pulmonary disease for POs, emergency department and post-acute care utilization for acute and critical access hospitals, and a hysterectomy report for hospital members).

Dr. Nathan also provided an update on the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program, noting that final scorecards for Program Year 2022 will be distributed in quarter one of 2023. Attendees also learned about P4P changes coming with Program Years 2024 and 2025 (see Figure 1).

Figure 1.

Based on member feedback, MVC will be rolling out an updated methodology to improve the actionability of the program. Along with the existing 30-day episode of care component, MVC is introducing new value metrics and engagement metrics for PYs 2024 and 2025. The value metrics will incentivize evidence-based and actionable high-quality services, such as increasing cardiac rehabilitation utilization after percutaneous coronary intervention (PCI), increasing follow-up rates after hospitalizations for pneumonia, or decreasing preoperative testing prior to low-risk procedures. The engagement metric will award points to hospitals for attending and contributing to MVC engagement activities, such as attending both semi-annual meetings or presenting at a workgroup. Stay tuned for additional details on PYs 2024 and 2025; informational webinars on the program changes are coming soon.

Showcasing MVC’s new pharmacy claims data from BCBSM and Blue Care Network was a focal point for the meeting. MVC Senior Analyst Monica Yost led attendees through an overview of MVC’s current pharmacy claims data along with an unblinded data session focused on opioid overprescribing after joint surgery (see Figure 2 for a blinded version of utilization across the collaborative). Leveraging opioid prescribing recommendations from the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI), the data session allowed hospitals and POs to see their opioid prescribing rates in the 30 days following hip and knee replacements compared to their peers. Hospitals and POs performing well were invited to offer insights as to how this was achieved and what mechanisms other members could adopt to improve performance levels.

Figure 2.

With the scene set, MVC welcomed keynote speaker Lindsey Kelley, Associate Chief of Pharmacy at Michigan Medicine. Dr. Kelley provided attendees with an overview of the challenges patients face accessing high-cost, complex medications as well as opportunities to improve access and patient experience through integrated health system specialty pharmacy. Walking through Michigan Medicine’s model, Dr. Kelley noted that simplifying the workflow for specialty pharmacies reduces strain on clinic staff (i.e., physicians, nurses, medical assistants) and eliminates the instances of prescriptions being sent that cannot be filled, thereby reducing gaps in therapy starts. Sharing the model’s evaluation strategy, Dr. Kelley highlighted the project’s collaboration with MVC, which led to a larger proportion of all target specialty medication prescription fill data being tracked and extended the evaluation’s reach.

Following Dr. Kelley’s presentation, Troy Shirley, PharmD, MBA, System Director of Pharmacy for Bronson Healthcare, presented Bronson’s efforts to improve health equity through pharmacy-supported discharge initiatives. One initiative focused on medication reconciliation at discharge, which leveraged unit-based pharmacists to complete medication reconciliation for patients hospitalized with chronic obstructive pulmonary disease, pneumonia, heart failure, and acute myocardial infarction. Additionally, Bronson’s “Meds to Beds” program engaged a multi-disciplinary team that included a retail pharmacist, pharmacy, technician, unit nurse, and care manager to hand-deliver patients’ medications at the bedside and provide medication counseling prior to discharge.

Next on the agenda was a presentation from Tiffany Jenkins, PharmD, BCACP, Director of Population Health Pharmacy at Trinity Health Alliance of Michigan, who shared insights about population health pharmacy initiatives within a physician organization, including a diabetes medication management initiative focused on evidence-based diabetes management to improve quality of care, reduce inappropriate use of pharmaceuticals, and lower cost of care; a pharmacy tech-led medication adherence monitoring strategy to engage patients, providers, and care teams in appropriate medication use; an obesity medication management initiative focused on evidence-based utilization of chronic weight management medications to lower cost of care; and a comprehensive medication management project that leverages pharmacist-care team collaboration to support medication management.

Closing out the morning session, Mark Bicket, MD, PhD, Co-Director of the Opioid Prescribing Engagement Network (OPEN) and Assistant Professor with the Division of Pain Research, Department of Anesthesiology at the University of Michigan, presented information on shifts to prescribing recommendations after surgery to decrease opioid use, techniques to promote the adherence of non-opioid medications and non-pharmacological approaches to pain management, and strategies to maximize safe storage and disposal of controlled substances.

In the afternoon following a networking lunch, the presenters participated in a panel discussion moderated by MVC Co-Director Michael Thompson, PhD, MPH. The group discussed strategies to change provider behavior and navigate the challenges of pharmacy-related improvement initiatives. The meeting concluded with a summary of the day and upcoming MVC activities, led by MVC Associate Program Manager Erin Conklin. The slides from Friday’s meeting have been posted to the MVC website. If you have questions about any of the topics discussed at the fall 2022 semi-annual meeting or are interested in finding out more, please reach out to the Coordinating Center at Michigan-Value-Collaborative@med.umich.edu. MVC’s next semi-annual meeting will be in person on Friday, May 19, 2023, at the Vistatech Center in Livonia.

06 Oct 2022
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Welcoming Fall with Quality Improvement Week

October 6, 2022 | 0 Comments | , , , , , ,

October brings celebrations of Fall – with pumpkins, trips to the orchard for apple picking, and Halloween - and also Healthcare Quality Week (October 16 – 22), a time for healthcare teams to highlight their efforts to improve the quality of care for patients and families.

Over the years, various improvement methodologies have been applied in healthcare settings to advance the quality of care, reduce costs, and improve patient outcomes. Here is a look at some of the models and how they could bring value to your organization.

Six Sigma uses statistics and data analysis to reduce errors and improve processes. Originally developed in the 1980s, Six Sigma has grown over the years into an industry standard, with training and certification programs too. The Six Sigma methodology leverages the DMAIC (Define, Measure, Analyze, Improve, Control) approach (Figure 1). Following the five steps of DMAIC provides teams with a framework for identifying, addressing, and improving processes.

Figure 1: The Six Sigma DMAIC

Lean, a methodology borrowed from the automobile industry, optimizes an organization’s people, resources, and effort to create value for customers (Figure 2). Lean’s focus is on sustaining improved levels of quality, safety, satisfaction, and morale through a consistent management system. With a goal to promote, evaluate, and implement ongoing process improvements, Lean uses Value Stream Mapping (VSM) to create a visual map of each step in a workflow, allowing teams to identify opportunities for efficiency.

Figure 2: Lean Process Improvement

Additionally, Lean encourages teams to focus on continuous improvement through the Plan Do Check Act (PDCA) model, an interactive form of problem-solving used to improve processes and implement change. In a PDCA cycle, teams work through four key steps: 1) identify the problem and create a solution plan (Plan), 2) implement a small-scale test (Do), 3) review the test performance (Check), and 4) decide to adjust or implement the test on a larger scale or adjust (Act/Adjust).

Figure 3: PDCA Cycle

Total Quality Management (TQM) is a management approach for long-term success through customer satisfaction. Originally used by the Naval Air System Command, TQM is based on the principles of behavioral sciences; qualitative and quantitative analysis; economic theories, and process analysis. Using the TQM methodology allows organizations to be customer-focused, with all employees participating and engaging in continual improvement. By utilizing strategy, data, and effective communication, TQM becomes integrated into the organizational culture and activities (Figure 4).

Figure 4: Total Quality Management

With a goal to optimize activities that generate value and reduce waste, the Kaizen approach is based on the belief that continuous, incremental improvement adds up to substantial change over time (Figure 5).

Figure 5: Kaizen (Continuous Improvement) Principles

The MVC Coordinating Center supports hospital and physician organization members across the state in identifying opportunities for improvement and facilitating a collaborative learning environment for members to exchange best practices. If you are interested in discussing improvement opportunities for your site, please contact the MVC Coordinating Center at michiganvaluecollaborative@gmail.com.

18 Aug 2022
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Roll Up Your Sleeve to Save a Life

August 18, 2022 | 0 Comments | , ,

After declaring the nation’s first-ever blood crisis in early 2022 and the worst shortage in over a decade, the American Red Cross and other blood donation organizations continue to plea for blood donors. In Michigan, blood donations fell with the start of COVID-19 and continue to lag pre-pandemic levels.

Based on data from the Red Cross, someone in the United States needs blood or platelets every two seconds, resulting in approximately 29,000 units of red blood cells, 5,000 units of platelets, and 6,500 units of plasma required daily. And, while an estimated 6.8 million people in the U.S., or 3% of eligible individuals, donate blood each year, more donors are always needed!

Figure 1.

According to the Association for the Advancement of Blood and Biotherapies, donating blood is a safe, simple, and rewarding experience that usually only takes 45-60 minutes. During a typical whole blood donation, approximately 0.5 liters of blood is collected. For donations of other blood products, such as platelet or plasma, the amount collected is based on the donor’s height, weight, and platelet count.

Along with helping others in need, blood donation also has some surprising health benefits, including:

  • A free mini health screening: before donating, potential blood donors receive a brief physical exam that includes taking blood pressure, body temperature, and pulse to ensure they are fit for donation.
  • A healthier heart and vascular system: in hypertensive individuals, regular blood donation has been linked to lower blood pressure and may lower the risk for heart attacks.
  • A happier, longer life: people usually donate because it feels good to help others and altruism has been linked to positive health outcomes, including a lower risk for depression and greater longevity.

Figure 2.

Alternatively, to help protect the limited supply of blood, reduce costs associated with the collection and administration of blood products, and reduce patient complications of allergic, febrile, and hemolytic reactions, restrictive transfusion practice or conservative blood use can be considered. This practice, recommended by the National Institute for Health and Care Excellence and the Choosing Wisely campaigns, uses the two major clinical decision points of hemoglobin concentration when transfusion should be considered and the number of units being transfused.

Whilst evidence suggests there is no increase in morbidity or mortality by following restrictive transfusion practices, outcomes related to the quality of life, symptoms of anemia, and length of hospital stay are not as well studied.

Some examples of multimodal interventions to reduce unnecessary blood transfusions include the START (Screening by Technologists and Auditing to Reduce Transfusions) study which produced guideline development, education for clinicians, prospective order screening, and immediate feedback to physicians for potentially inappropriate orders, and monthly feedback to the clinical teams on appropriateness. Secondly, an Australian system-wide initiative focusing on education, practice audits, and feedback for individuals and a policy promoting single-unit red blood cell transfusions showed success. Other blood management approaches including anemia prevention, iron supplementation for iron deficiency, and a reduction in blood loss during procedures are other methods that can be used.

To implement strategies for reducing the unnecessary use of transfusions, individuals should assess their own practice against evidence-based standards. Additionally creating a multidisciplinary team to discuss and set guidelines and protocols based on evidence, auditing practices against identified evidence-based standards and tailoring interventions to the institutional setting and context can help with the implementation of restrictive transfusion practices.

Until we can find an alternative source or increase supply, we will continue to need people to step up and donate.

If you plan to donate blood, a few helpful tips can make for a better experience:

  • Drink plenty of water. Staying hydrated makes it easier to find your veins and prevents you from becoming light-headed after donating
  • Eat well beforehand and be sure to eat snacks offered to you.
  • Get a good night’s sleep and, if you are planning to exercise, do so before donating, not after.
  • Take iron tablets. The American Red Cross recommends individuals who donate blood frequently take an iron supplement or a multivitamin with iron.

Typically, donors are eligible to donate blood every 56 days or up to six times per year. To find a blood donation site near you, visit the American Red Cross or your local donation center. Every drop helps!

14 Jul 2022
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Reflecting on MVC’s Accomplishments: January-June 2022

July 14, 2022 | 0 Comments

As we start the second half of 2022, the MVC Coordinating Center is taking a moment to pause and reflect on the tremendous work that has been accomplished over the past six months. Here is a look back at some of the highlights.

JANUARY

MVC Workgroups consist of a diverse group of representatives from Michigan hospitals and POs that meet virtually to collaborate and share ideas related to various topics. January kicked off with the launch of MVC’s new Health Equity Workgroup! The inaugural meeting featured speakers from the Michigan Social Health Interventions to Eliminate Disparities (MSHIELD) Collaborative. The Health Equity Workgroup has two more meetings in 2022 and we’d love to see you there! Visit the MVC 2022 Events Calendar to register and check the calendar for additional Workgroup offerings focused on Chronic Disease Management, Diabetes, Health in Action, Joint Replacement, and Sepsis.

FEBRUARY

MVC launched two new push reports in February, with the release of the new Physician Organization (PO) Colectomy Report, shared with 35 of MVC’s PO members, and the first-ever Pneumonia Push Report, distributed to 89 MVC hospital members[1]. To meet the needs of MVC’s growing hospital members, a subset of the Pneumonia Push Reports was tailored to meet the specific data needs of our Critical Access Hospital members.

MARCH

After completing 58 hospital site visits in 2021, MVC announced the creation of a robust quality improvement (QI) initiatives database, developed to track QI initiatives across the collaborative. The database, searchable by QI focus area and project status, allows MVC to understand common themes and challenges among all its members as well as within subgroups such as hospital size or region. In 2022, the MVC team is hosting site visits with our PO members and will be gathering QI initiatives to add to the QI initiatives database. The database is being used as a resource for custom analytic requests and a library of practice standards for members. If you are an MVC PO interested in participating in a virtual site visit, please contact the MVC Coordinating Center to schedule.

APRIL

In April, MVC distributed a refreshed Sepsis Push Report, developed in collaboration with the Michigan Hospital Medicine Safety Consortium. These customized reports provide hospitals with new insight on demographics for their sepsis patients, including the percentage of COVID-positive patients to illustrate how COVID has impacted their sepsis data, along with race, top comorbidities, and most common zip codes, stratified by payer.

MAY

MVC held its first collaborative-wide meeting of 2022 in May, with a focus on “Turning Data into Action.” Held virtually, a total of 158 leaders representing 68 different hospitals and 15 physician organizations (POs) from across the state of Michigan participated in the event. Save the Date for our next in-person collaborative-wide meeting, scheduled for Friday, October 28th at the Radisson Hotel Lansing!

JUNE

In June, the MVC Coordinating Center hosted its first in-person event since 2019, with a Regional Networking Dinner for our Eastern Michigan sites (Region 3). The dinner provided an opportunity for MVC hospital and PO members to come together to network, share ideas and discuss key priorities, including health equity initiatives. MVC’s next Regional Networking Event for Southeast Michigan (Region 4) is scheduled for Tuesday, September 27th. For identification of your MVC designated region, please see the MVC Regions Map here.

AND COMING SOON…

Along the way, the MVC team has been hard at work preparing for two new exciting developments:

  • MVC’s first Northern Summer Meeting (RSVP here) is scheduled for Thursday, August 18th at Traverse City’s Great Wolf Lodge. The agenda is tailored to highlight unique opportunities and challenges facing the Northern Michigan healthcare community. Interested MVC members serving Northern Michigan, the Upper Peninsula, and small/rural communities are encouraged to The University of Michigan Medical School designates this live activity for a maximum of 3.75 AMA PRA Category 1 Credit(s)™.  This meeting will feature presentations from:
    • Michigan Center for Rural Health
    • MyMichigan Medical Center – Sault
    • Munson Healthcare Grayling Hospital
    • Region 9 Area Agency on Aging

To learn more about these initiatives and other MVC happenings, visit the MVC blog!

Footnote

[1] Hospitals and POs not meeting case count thresholds did not receive a report.

02 Jun 2022
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MVC Welcomes Associate Program Manager Erin Conklin

MVC Welcomes Associate Program Manager Erin Conklin

June 2, 2022 | 0 Comments |

Inspired by the Michigan Value Collaborative’s (MVC) vision and mission, I am thrilled to join the team as Associate Program Manager. In this newly created role, I will be responsible for supporting the management, performance, and daily operations of the MVC Coordinating Center.

After receiving my Master of Public Administration degree from the University of Michigan-Flint, I began my first role in the healthcare space at the Greater Flint Health Coalition (GFHC), a collaborative, cross-sector organization dedicated to improving the health status of Genesee County residents. This experience provided me with a unique opportunity to learn about a wide range of public health issues, such as the impact of social influencers, the complexity of care navigation for patients with mental health and substance use disorders, and the role of systemic racism and racial disparities in care. I gained valuable skills in project management, strategic planning, sustainable implementation, and partnership development.

Following my tenure with the GFHC, my career focused on managing quality and operational improvement initiatives that aimed to improve health outcomes through patient-centered, value-based care at leading institutions, including Michigan Medicine and Massachusetts General Hospital. This work included implementing new payment and service delivery models, such as the Pioneer ACO Model initiative and the Innovation Advisors Program, in partnership with the CMS Innovation Center. I also had the opportunity to support provider engagement and the expansion of evidence-based care delivery models across Michigan with the Centering Healthcare Institute and Michigan Opioid Partnership.

I am excited to serve as MVC’s new Associate Program Manager. I look forward to learning and collaborating with members, key stakeholders, and partner organizations to advance the mission, vision, and values of MVC. If you have any questions or wish to get in touch, please feel free to email me.