02 Sep 2026
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MVC Publishes its 2026 QECP Annual Report as a Qualified Entity

MVC Publishes its 2026 QECP Annual Report as a Qualified Entity

September 2, 2026 | 0 Comments | ,

Recently, the MVC Coordinating Center published its annual Qualified Entity Certification Program (QECP) public report for 2026. This report was published on the QECP section on MVC’s Data/Registry webpage and is an annual requirement for MVC as a qualified entity with the Centers for Medicare & Medicaid Services (CMS). This was MVC’s fifth public QECP report, which continued to provide unidentified aggregated data about Michigan hospital performance on two measures: rates of 30-day rehospitalizations following start of home health care, and rates of outpatient follow-up received after hospitalization for congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD).

All measures in the report were created using data from MVC claims-based episodes of care initialized by inpatient hospitalizations or surgeries between Jan. 1, 2018, and Dec. 31, 2024. Claims were incorporated from all MVC payer sources, including Medicare Fee-for-Service (FFS), Blue Cross Blue Shield of Michigan (BCBSM), Blue Care Network (BCN), and Michigan Medicaid.

The reported overall risk-adjusted rate of 30-day unplanned rehospitalization after the start of post-acute home health care among episodes beginning at MVC hospitals in Michigan was 11.9% for 2018-2024. Risk-adjusted rates by index hospital ranged from 4.5% to 16.4% (Figure 1). By home health provider, risk-adjusted rates ranged from 2.4% to 23.9%. Patients whose episode of care began with an index event for endocarditis, COPD, or CHF were more likely than patients with other index conditions to experience an unplanned rehospitalization in the 30 days after they started home health care, with rehospitalization rates of 22.4%, 19.9%, and 19.9%, respectively (Figure 2). Patients with a joint replacement episode of care were least likely to have an unplanned rehospitalization following the start of home health care (3% rehospitalization rate).

Figure 1. Risk-Adjusted Rates of 30-Day Unplanned Rehospitalization from Home Health, by MVC Hospital

Line chart displays risk-adjusted rates of 30-day unplanned rehospitalization from home health by MVC hospital, with rates ranging from about 5% to 16%. Blue dots represent individual MVC hospitals with confidence interval bars, and an orange horizontal line marks the overall MVC average rate of 11.9%.

Figure 2. Unadjusted Rates of 30-Day Unplanned Rehospitalization from Home Health, by Condition

Bar chart showing unadjusted rates of 30-day unplanned rehospitalization from home health by medical condition. Endocarditis has highest rehospitalization rate at 22.4%, followed by COPD at 19.9%, while other spine surgery and knee/hip replacement have lowest rates at 5.4% and 3.0%, respectively.

Results for the outpatient follow-up metrics remained similar to findings from previous annual reports. Across episodes of care for index events in 2018-2024 at the 107 MVC hospitals in Michigan, the unadjusted rate of patients receiving outpatient follow-up within 7 days after hospitalization for CHF was 43.6% (Figure 3). Following index hospitalizations for COPD, 35.5% of patients received outpatient follow-up within 7 days (Figure 4). Looking at 30-day follow-up for both conditions, there was wide variation across hospitals in follow-up rates after hospitalization, with rates ranging between less than 20% to over 80%. MVC calculated follow-up rates after CHF and COPD hospitalizations using 3-day, 7-day, 14-day, and 30-day follow-up windows, with those rate and hospital-level rate distributions summarized in the full report. Rates of follow-up were steady over time. Overall, follow-up rates were lower for COPD episodes compared to CHF episodes across all evaluated follow-up windows.

Figure 3. 7-Day Follow-Up After CHF Hospitalization by MVC Hospital

Line chart showing 7-day follow-up rates after CHF hospitalization for MVC hospitals, with rates ranging from about 5% to 65%. Data points include confidence intervals, and an orange horizontal line marks the overall MVC average follow-up rate of 43.6%.

Figure 4. 7-Day Follow-Up After COPD Hospitalization by MVC Hospital

Line chart showing 7-day follow-up rates after COPD hospitalization for individual MVC hospitals, with rates ranging from about 5% to 60%. An orange horizontal line marks the overall MVC average follow-up rate at 35.5%, highlighting variation and hospitals performing above or below this benchmark.

For more information and the entire set of findings we invite you to read the full 2026 report.

QE certification status allows MVC to provide hospital members with additional data from Medicare FFS claims at a level of granularity not otherwise available under standard CMS data use agreements. Reports located under the “QE Medicare” icon on the MVC registry allow hospital registry users to see unsuppressed Medicare data including case counts <11 as well as utilization rates and average payments based on case counts <11. In addition, on any QE Medicare registry report, members can click on specific data points to load a list of all episodes underlying that data point. From that episode list it is possible to view drilldown information on individual episodes to learn more about the claims and price-standardized payments comprising that episode.

Members may contact the MVC Coordinating Center by email to learn more about data available through MVC’s QECP reports and to receive the forms necessary to gain access on the registry.

15 Jul 2026
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Share Your Success Story at MVC’s Fall 2026 Collaborative-Wide Meeting

Share Your Success Story at MVC’s Fall 2026 Collaborative-Wide Meeting

July 15, 2026 | Comments Closed | , , , ,

The Michigan Value Collaborative (MVC) is now accepting presentation proposals for its fall 2026 collaborative-wide meeting, taking place Fri., Oct. 9, at the VistaTech Center in Livonia, Michigan.

Each collaborative-wide meeting provides an opportunity for members to learn directly from one another by sharing innovative approaches, practical lessons learned, and successful quality improvement strategies. MVC is seeking presentations that highlight quality improvement initiatives informed by MVC offerings, such as push reports, custom reports, registry data, or insights gained through participation in MVC events and peer learning opportunities.

Potential presentation topics include how your organization used MVC offerings to:

  • Benchmark performance against peer hospitals
  • Establish quality improvement goals and target metrics
  • Build leadership support for improvement initiatives
  • Identify variation in care across hospitals or communities
  • Measure the progress or impact of interventions
  • Inform the development of new workflows, programs, or best practices

We also welcome proposals showcasing other ways your organization has leveraged data to support quality improvement planning, implementation, or evaluation.

Partners may submit MVC's online presentation proposal form by Tues., July 28, to share their proposed topic. After proposals are reviewed, the MVC Coordinating Center will contact selected presenters to discuss their topic and provide guidance throughout the presentation development process.

As an added benefit, hospitals participating in the MVC Component of the BCBSM Pay-for-Performance (P4P) Program may earn 0.5 engagement points toward Program Year 2026 for presenting at an MVC event.

We hope you'll consider sharing your team's work and helping inspire improvement efforts across the MVC collaborative.

Presentation proposal deadline: Tues., July 28

Please reach out to the MVC Coordinating Center with any questions.

28 Apr 2026
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MVC Push Report Benchmarks Follow-Up Rates for CHF, COPD, Pneumonia, and Sepsis Patients

MVC Push Report Benchmarks Follow-Up Rates for CHF, COPD, Pneumonia, and Sepsis Patients

April 28, 2026 | Comments Closed | , , ,

The Michigan Value Collaborative (MVC) distributed hospital-level follow-up push reports recently intended to support the evaluation of long-term trends as well as the identification of gaps in follow-up care across differing patient demographics. This report focused on follow-up care after hospitalization for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), pneumonia, and sepsis—four of MVC’s value metrics for Program Years 2026-2027 of the MVC Component of the BCBSM Pay-for-Performance (P4P) Program.

While MVC also provides reporting on its P4P value metrics via scorecards and registry reports, this push report provided additional data on follow-up care at member hospitals by showcasing variability across a longer analytic timeframe and more detailed stratifications for its 30-day CHF, COPD, pneumonia, and sepsis episodes. MVC defined follow-up as episodes where a patient had an outpatient follow-up visit (in person or by telehealth) within 30 days or before a readmission, inpatient procedure, emergency department visit, skilled nursing facility admission, or visit for inpatient rehabilitation.

Contained in each hospital’s report was a page dedicated to follow-up following hospitalizations for each condition. On those report pages, MVC hospitals received comparisons to their peers on outpatient follow-up rates and 30-day risk-adjusted total episode payments, as well as their hospital’s outpatient follow-up rates stratified by payer.

The report also featured a patient population snapshot table that highlighted demographic data for patients in each condition cohort. These tables (see Figure 1) provided each hospital with information on race, mean age, common comorbidities, and several indicators of non-medical drivers of health.

Figure 1. Sociodemographic Overview of Patients Receiving Follow-Up Following Discharge for CHF, COPD, Pneumonia, or Sepsis at Hospital A

Table presenting sociodemographic overview of follow-up conditions at Hospital A, including CHF, COPD, pneumonia, and sepsis. It details age groups, race/ethnicity percentages, common comorbidities, and socioeconomic indicators such as diabetes prevalence and living conditions, with data organized in rows and columns for comparison across conditions.

*Patient zip codes categorized as prosperous, comfortable, mid-tier, at-risk, or distressed according to the Economic Innovation Group's Distressed Communities Index 2018-2022, which incorporates economic indicators such as education, employment, and income.

Each figure reflected index admissions between 1/1/2023-12/31/2024 in BCBSM PPO Commercial, BCBSM PPO Medicare Advantage, BCN HMO Commercial, BCN HMO Medicare Advantage, and Medicare Fee-for-Service claims, and between 1/1/2023-9/30/2024 in Michigan Medicaid claims. Individuals insured by both Medicare and Medicaid were categorized as dual-eligible in the payer-specific figures. Hospital reports included pages for each condition if they met the threshold of at least 11 qualifying episodes in each year of data for that condition.

There was wide variation in follow-up rates across the collaborative for all four conditions, with some member follow-up rates averaging less than 20% to greater than 60% among CHF, COPD, and pneumonia patients, and between less than 30% to greater than 70% among sepsis patients.

Among general acute care hospitals, there were consistent decreases in average follow-up rates across the collaborative compared to previous reporting; MVC provided reporting on these same follow-up measures in a Q1 2025 push report based on 2022-2023 claims. Using the updated 2023-2024 timeframe, the collaborative-wide average 14-day follow-up rate for patients hospitalized for COPD fell from 55.3% to 51%. A similar trend was observed for seven-day follow-up after CHF (decreased from 44.8% to 43.1%), seven-day follow-up after pneumonia (decreased from 42.7% to 41.6%), and 14-day follow-up after sepsis (decreased from 58% to 52.5%). Follow-up rates were often lowest among the Medicaid and dual-eligible patient populations (Figure 2), and are therefore a patient group that likely needs additional support and outreach. Additionally, across all four conditions the average risk-adjusted price-standardized total episode payment at general acute care hospitals was higher among patients who did not receive follow-up than among patients who received follow-up care (see COPD example in Figure 3).

Figure 2. 3-Day, 7-Day, and 14-Day Follow-Up Rate Among Patients Hospitalized for Sepsis by Payer for Hospital A

Bar chart comparing follow-up rates across five insurance categories with three time intervals: 3-day, 7-day, and 14-day follow-ups, represented by blue, gray, and orange bars respectively. Notable trends include consistently higher follow-up rates at 14 days, with Commercial insurance showing the highest rates.

Figure 3. Average 30-Day Risk-Adjusted, Price-Standardized Total Episode Payment Among Patients Hospitalized for COPD by 14-Day Follow-Up Status for Hospital A

Bar chart comparing 30-day total episode payments for 14-day and no 14-day follow-up periods across three categories: Your Hospital (blue), Your Region (gray), and GACH Average (orange). No 14-day follow-up shows higher payments overall.

MVC member hospitals who classify as Critical Access Hospitals (CAHs) received alternate versions of the report, which used the averages of other CAHs as their comparison group in addition to MVC region. Similar to general acute care hospitals, the collaborative observed decreases in average follow-up rates among its CAH members for patients hospitalized for CHF (decrease from 39% to 38.2%), pneumonia (37.4% to 32.5%), and sepsis (44.7% to 43.9%). Among patients hospitalized for COPD at a CAH, however, there was an observed increase in the average 14-day follow-up rate from 44.9% to 47.2%. CAHs also observed similar trends of lower follow-up rates among Medicaid and dual-eligible patients.

Members can similarly benchmark the values and data provided in their recent report pages to the previously distributed follow-up push report from Q1 2025.

In addition to providing data on follow-up care, the MVC Coordinating Center offers a regular post-discharge follow-up workgroup series where members and partners share strategies and insights to help improve follow-up performance. The next workgroup will take place on Thurs., July 23, from 12-1 p.m. More information about upcoming MVC events can be found on the MVC events page.

If you have any suggestions on how these reports can be improved or have additional data requests to help support your quality improvement projects, please reach out to the MVC Coordinating Center.

18 Mar 2026
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Reducing Unnecessary Preoperative Testing: Progress on RITE-Size Partnership

Reducing Unnecessary Preoperative Testing: Progress on RITE-Size Partnership

March 18, 2026 | Comments Closed | , , ,

For many patients preparing for surgery, the process begins long before they enter the operating room. Blood tests, lab visits, and diagnostic screenings often become routine steps in preoperative care—even for patients undergoing low-risk procedures. In many cases, these tests add extra appointments and costs without changing how care is delivered.

Research suggests that as many as one in three patients evaluated for low-risk surgery receive tests that are not clinically necessary, and those results rarely influence clinical decisions. Improving the appropriateness of testing is therefore an important opportunity to improve the patient experience while reducing inefficiencies in surgical care.

For the last few years, the Michigan Value Collaborative has engaged its suite of offerings – from dedicated registry pages and push reports to workgroups and performance-based incentives – to support hospitals across the state in aligning their preoperative protocols with evidence-based guidelines.

Progress on the RITE-Size Trial

Another key component in the success of improved preoperative testing appropriateness in Michigan is the Right-Sizing Testing Before Elective Surgery (RITE-Size) trial, supported by the Michigan Program on Value Enhancement (MPrOVE), the Michigan Surgical Quality Collaborative (MSQC), the Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE), and MVC.

RITE-Size is an Agency for Healthcare Research and Quality (AHRQ)-funded, multi-institutional quality improvement trial. RITE-Size launched a pilot in March 2024 at three hospitals in Michigan. The study aimed to meet criteria in several areas such as feasibility (implementation in the appropriate amount of time), testing rates (reduction), and acceptability and appropriateness (results from interviews). By August 2024, the desired milestones had been achieved, showing a 68% average reduction in unnecessary testing by the three participating sites (Figure 1). All three sites saw significant decreases in their testing rates following implementation of the multi-component intervention.

Figure 1. MVC RITE-Size Pilot Program Testing Rates Over Time Across All Three Sites from March-April 2024 to July-August 2024

line graph depicting reduction in unnecessary preoperative testing at three pilot sites

This was followed by a larger trial in 2025 with six new hospitals. Each site participated in a site visit, personalized coaching, and evaluation of their data in consultation with the RITE-Size team to guide on-site efforts to improve the appropriateness of their preoperative testing. In 2026, the RITE-Size partners are looking to enroll 12-15 hospitals and ambulatory surgery centers (ASCs) across Michigan.

Along the way, some of the successes, tools, and challenges from sites participating in the trial have been featured in MVC’s preoperative testing workgroups, where clinical and quality leaders have come together to learn from one another and share best practices. In one of those recent workgroups, for example, Lake Huron Medical Center shared insights into their experience in the trial and its impact on their preoperative protocols. A collated list of MVC’s preoperative testing workgroups can be found on MVC’s YouTube channel.

The work is also contributing to the broader evidence base on reducing low-value care. Nicole Mott, MD, MSCR, a National Clinician Scholar at the University of Michigan supported by the Veterans Administration and a general surgery resident at the University of Colorado, was the lead author on a recently published paper in JAMA Network Open that described the components and impact of the trial.

Leveraging Partner Operations for Recruitment

Over the past year, the RITE-Size partnership has worked to strengthen alignment between the trial’s activities with those operational activities of the partner organizations.

For instance, participation in the RITE-Size initiative is now tied to MSQC’s BCBSM P4P scorecard for preoperative testing, allowing hospitals to receive credit toward their scorecard by engaging in the initiative. MVC is also leveraging its new ambulatory surgery center (ASC) dataset to identify additional sites beyond the hospital setting that may benefit from participating in the initiative, with recruitment efforts under way with six eligible ASCs. Three new hospitals joined the trial at the start of 2026, and additional sites are engaged in conversations and related information sessions as they consider participating.

Supporting Hospitals in Practice Change

Participating hospitals are approaching preoperative testing improvement from a variety of starting points. For some, the initiative has helped validate practices that were already evolving. For others, it has created an opportunity to revisit long-standing protocols and bring them in line with current evidence.

At Lake Huron Medical Center, participation in the RITE-Size initiative helped uncover an important opportunity for improvement. While staff had already begun reducing unnecessary preoperative testing in practice, the hospital discovered that its formal documentation had not kept pace with these changes. The pre-anesthesia testing protocol used by staff still included outdated materials and handwritten updates accumulated over time.

Through the collaborative work of the RITE-Size initiative, the hospital was able to review and modernize its protocol, ensuring that documentation reflects current practice and provides clear guidance for clinical teams. This type of operational refinement—aligning written protocols, data reporting, and frontline practice—is a common step for organizations working to improve the appropriateness of preoperative testing.

Kelly Lewton, RN, BSN quote

The collaborative structure of the initiative has also proven valuable. Participating hospitals are able to share implementation strategies, learn from peers facing similar challenges, and access guidance from project partners as they refine their approaches.

Looking Ahead

As this work continues, MVC is also using its claims-based data to examine the broader impact of reducing unnecessary testing. The MVC Coordinating Center is currently partnering with MSQC to explore the impact and value of MSQC’s preoperative testing metric since its inclusion in their scorecard. The aims of this analysis are to better understand the statewide improvement in the measure as well as the potential financial and operational benefits associated with improvements.

Insights from this analysis will help the RITE-Size partners better understand the impact of an incentive-based measure on testing outcomes as well as related cost savings that may accompany on-the-ground improvements.

As the RITE-Size trial continues into its next phase, the trial partners remain committed to supporting hospitals through shared data, collaborative learning, and practical implementation resources. Together, these efforts aim to ensure that preoperative testing is used when it adds clinical value.

Hospitals interested in learning more about their preoperative testing rates and opportunities can contact the MVC team.

25 Feb 2026
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Cardiac Rehabilitation Awareness Week Spotlighted Resources and Tools Improving Cardiac Rehab Enrollment

Cardiac Rehabilitation Awareness Week Spotlighted Resources and Tools Improving Cardiac Rehab Enrollment

February 25, 2026 | Comments Closed | , , , , ,

MVC and BMC2 took to LinkedIn recently to celebrate Cardiac Rehab Awareness Week, spotlighting the importance of cardiac rehabilitation for patients recovering from cardiovascular events. MVC and BMC2 collaborate to lead the Michigan Cardiac Rehab network (MiCR) and its related offerings. Across multiple posts, both teams highlighted stories, tools, collaborations, and insights designed to support providers, patients, and programs working to improve cardiac rehab outcomes in Michigan.

One of the central themes of the week was the voice of the patient. MiCR shared the first completed patient story from a new storytelling initiative called Heart-to-Heart, developed with the Healthy Behavior Optimization for Michigan (HBOM) team. This initiative amplifies real patient experiences, bringing to light why cardiac rehab matters — not just clinically, but personally — for those considering participation. Cardiac rehab week marked the launch of the first available patient story about a patient named Margaret from Covenant Healthcare.

Cardiac Rehab Week also offered opportunities for networking and knowledge exchange. MVC hosted a virtual cardiac rehab workgroup [view video] focused on optimizing congestive heart failure (CHF) follow-up and increasing rehab enrollment in this especially vulnerable patient population. Featuring panelists from Corewell Health, Holland Hospital, Michigan Medicine, MyMichigan Health, and University of Michigan Health-Sparrow, this session highlighted real-world strategies and insights for improving care transitions and referral practices.

Throughout the week, both organizations also shared posts featuring practical tools to strengthen cardiac rehab engagement, such as:

  • NewBeat Resources: BMC2 highlighted NewBeat materials — engaging, evidence-based education and referral tools designed to help care teams talk with patients about the benefits of cardiac rehab and support meaningful discussions that lead to enrollment (Figure 1). A new round of no-cost printing for MiCR sites was announced, offering flexible, ready-to-use materials that programs can request.
  • Cardiac Rehab Center Finder: Knowing “where to go” is a crucial earliest step. MVC and BMC2 reinforced the MichiganCR.org searchable directory that allows patients and providers to locate nearby rehab programs. This simple tool reduces a key barrier to engagement by connecting patients with access points across Michigan.
  • Resource Library Spotlight: The MiCR Resource Library was featured as a one-stop hub for tools — from evidence-based products to collaborative resources developed with partners throughout the state — supporting both providers and patients as they plan, refer, and participate in cardiac rehab sessions.

Figure 1. Cardiac Rehab Resource Materials

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Recognizing the evolving landscape of cardiac rehabilitation delivery, MiCR also took the opportunity to highlight its newest strategic efforts throughout cardiac rehab week, including its explorations into the role of telehealth in cardiac rehab as well as medication management opportunities. Updates on these efforts and more were summarized and linked in a summary blog to the MiCR website. To learn more, read the MiCR summary.

As the week wrapped, the MiCR teams thanked everyone for their role in advancing cardiac rehab throughout Michigan, and invited their active participation going forward—either by trying a MiCR tool in their daily work or sharing their experiences and stories. As MiCR continues its work, the momentum from this week sets the stage for meaningful improvement in patient outcomes and program engagement statewide.

18 Feb 2026
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MVC and MSSIC Impact Assessment Quantifies $73M in Cost Savings from Reduced Surgical Complications

MVC and MSSIC Impact Assessment Quantifies $73M in Cost Savings from Reduced Surgical Complications

February 18, 2026 | Comments Closed | , , , , ,

Over the past several years, the Michigan Value Collaborative (MVC) has partnered with clinical quality collaboratives across the state to better understand how improvements in care delivery translate into value—for patients, providers, and payers alike. By pairing robust clinical data with claims-based cost and utilization data, these partnerships allow us to move beyond reporting improvement to quantifying its real-world impact.

The MVC Coordinating Center is excited to announce the completion of two new impact and value assessments conducted in partnership with the Michigan Spine Surgery Improvement Collaborative (MSSIC). These analyses examined statewide improvements in postoperative urinary retention (POUR) complications and surgical site infections (SSI) following spine surgery.

Although focused on different complications, both assessments followed a shared framework: pairing MSSIC’s clinically abstracted registry data with MVC’s claims-based episode data to quantify the impact of declining complication rates on episode-level spending and utilization.

Background and Approach

MSSIC has led statewide efforts to reduce preventable surgical complications following spine surgery through surgeon engagement, performance feedback, alignment of incentive-based measures, and implementation of evidence-informed practice changes. Over time, MSSIC-participating hospitals demonstrated measurable declines in both urinary retention and surgical site infections.

To assess the value implications of these improvements, MSSIC provided MVC with a dataset of lumbar and cervical spine patients that included the presence or absence of complications as abstracted from medical records. Spine patients were matched to MVC’s analytic tables and spine cohort for Medicare Fee-For-Service (FFS), Medicaid, Blue Cross Blue Shield of Michigan (BCBSM) Commercial, BCBSM Medicare Advantage (MA), Blue Care Network (BCN) Commercial, and BCN MA claims. MVC then evaluated the matched population for readmission status and price-standardized facility payments associated with POUR and SSI. MVC and MSSIC used the rates of adverse events pre- and post-QI to estimate the number of events averted. MVC payment data was then used to calculate cost savings from averted events.

Postoperative Urinary Retention (POUR)

While postoperative urinary retention may not always be perceived as a high-cost complication, the analysis demonstrated that it is associated with meaningful differences in episode spending and utilization. Episodes involving POUR were linked to higher total payments and greater downstream healthcare use compared to episodes without urinary retention.

The analysis conducted revealed that there were statistically significant reductions in the rates of POUR and readmissions between 2016-2024 from which to estimate cost savings. Specific to POUR, MVC and MSSIC estimated there were 5,197 POUR events averted. Using the MVC-based estimate of 21.7% of POUR events also involving readmission, MVC and MSSIC estimated there were 1,128 readmissions averted.

To estimate cost savings from averted POUR events, MVC completed a comparative analysis of diagnosis-related group (DRG) and post-discharge payments among lumbar and cervical spine patients with no POUR compared to those with POUR events. The results of the analysis of higher inpatient DRG payments (Figure 1) show that the weighted average DRG payments for patients without POUR were $25,743.40; the weighted average payments for those with POUR was $27,603.20, a difference of $1,859.80 per patient. Looking at post-discharge payments (Figure 2), MVC found that the average payment for a patient without POUR was $1,691. The weighted average payment for those with POUR (21.7% with readmission and 78.3% without readmission) was $12,684.65, a difference of $10,993.65 between patients with and without POUR.

Figure 1. Calculation of Additional Inpatient Diagnosis-Related Group (DRG) Payments Based on Complications and Comorbidities (CC) by POUR Status

Table outlining the differences in inpatient average episode payments for patient with and without urinary incontinence complications

Figure 2. Calculation of Post-Discharge Price-Standardized Payments Associated with POUR

Table outlining differences in outpatient costs between patients with and without urinary incontinence

This amounted to an estimated total direct cost savings to payors of $66,799,380 from POUR rate reductions. On this finding, Senior MSSIC QI Lead Kari Jarabek, BSN, RN, said, “The analyses here show how decreasing rates of what some may consider to be a ‘minor complication’ of surgery can have profound consequences in terms of cost savings for patients, employers, and other payers.”

View the complete summary of the December 2025 MSSIC urinary retention assessment on MVC’s CQI collaboration page.

Surgical Site Infections (SSI)

The association between surgical site infections and higher costs is well established, and the MVC–MSSIC assessment reinforces this relationship within Michigan hospitals. Episodes complicated by SSI were associated with significantly higher total episode payments and increased post-discharge utilization.

The analysis revealed statistically significant reductions in the rates of SSI and readmissions from the 2019 baseline year to the 2020-2024 post-intervention period. MVC and MSSIC estimated 301 SSI events were averted. Using the MVC-based estimate of 62.6% of SSI events also involving readmission, MVC and MSSIC estimated that 188 readmissions were averted.

To estimate cost savings from averted SSI events, MVC completed a comparative analysis of diagnosis-related group (DRG) and post-discharge payments among patients with no SSI compared to those with SSI events. The results of the analysis of higher inpatient DRG payments (Figure 3) showed that weighted average DRG payments for patients without SSI were $25,823; the weighted average payments for those with SSI was $26,483, a difference of $660 per patient. Looking at post-discharge payments (Figure 4), MVC found that the average payment for a patient without SSI was $1,801. The weighted average payment for those with SSI (62.6% with readmission and 37.4% without readmission) was $23,274, a difference of $21,473 between patients with SSI and those without. This amounted to an estimated total direct cost savings to payors of $6,662,033 from SSI rate reductions.

Figure 3. Calculation of Additional Inpatient Diagnosis-Related Group (DRG) Payments Based on Complications and Comorbidities (CC) by SSI Status

Table outlining differences in inpatient episode costs for patients with and without SSI

Figure 4. Calculation of Post-Discharge Outpatient Payments Associated with SSI

Table outlining the differences in post-discharge payments for patients with and without SSI.

View the complete summary of the December 2025 MSSIC SSI assessment on MVC’s CQI collaboration page.

Advancing Value Through Collaboration

Taken together, these two assessments demonstrated that MSSIC efforts delivered significant net savings for its BCBSM sponsor and healthcare providers in Michigan, and that targeted practice changes—such as early ambulation and updates to existing protocols to reflect best practices—not only improved patient recovery but also contributed to improved value at the episode level.

These two assessments also demonstrated a consistent pattern: fewer complications were associated with lower episode spending and reduced downstream utilization. By linking clinical registry data with claims-based cost analysis, MVC and MSSIC were able to move beyond reporting improvements in complications to quantifying its broader impact.

As MVC continues its partnerships with the BCBSM Value Partnership CQIs, this work provides a replicable model for understanding how collaborative clinical improvement translates into measurable value for patients and the healthcare system.

22 Oct 2025
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Hospitals Receive PY25 Mid-Year Scorecards for MVC Component of BCBSM P4P Program

Hospitals Receive PY25 Mid-Year Scorecards for MVC Component of BCBSM P4P Program

October 22, 2025 | Comments Closed | , , , , , ,

Last month the Michigan Value Collaborative (MVC) distributed mid-year scorecards for Program Year (PY) 2025 of the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program. This report provided hospitals with their current standing for PY 2025. It also included a preview of measure scoring for the new health outcome variation measure that will be worth one point in PYs 2026-2027.

Each hospital received a mid-year score out of a total of 10 points, including 0 to 4 points for their selected total episode payment metric, 0 to 4 points for their selected value metric, and 0 to 2 points for completed eligible engagement activities. PY 2025 scores achievement and improvement points for each hospital’s selected episode spending conditions and value metrics using index admissions from 2024 performance year data against admissions in 2022 as the baseline year. Hospitals are awarded the higher of their achievement and improvement point scores.

The performance data timeframes included in mid-year PY 2025 scoring were index events 1/1/2024 – 12/31/2024 for BCBSM PPO Commercial, BCBSM Medicare Advantage (MA), BCN HMO Commercial, BCN HMO MA, and index events from 1/1/2024 – 6/30/2024 for Medicare FFS. The engagement points accrued represent all completed activities from 1/1/2025 – 7/31/2025. All scores are subject to change in the final scorecards as the remaining 2024 performance data becomes available and additional 2025 P4P engagement activities are completed and recorded for this year.

Figure 1 illustrates the current distribution of total points out of 10 across the collaborative. The average points scored across the mid-year scorecards was 6.3 out of 10. This average is 0.3 points lower than the average points scored at the conclusion of PY 2024.

Figure 1.

dot graph

Figure 2 illustrates the breakdown of scoring on average by each program component (i.e., episode spending metric, value metric, engagement points). Hospitals could earn up to four points for their episode spending and value metric selections, and up to two points for engagement activities completed in 2025. Across the collaborative, the average points scored for both episode spending and value metrics was 2.6 points, and 1.2 points for engagement activities.

Figure 2.

vertical bar chart of average score across hospitals for episode spending metric, value metric, engagement points

Figure 3 illustrates the breakdown of the average points by episode spending conditions. Coronary Artery Bypass Grafting (CABG) was the highest scoring episode spending condition with an average of 3 points, and this was closely followed by joint replacement with 2.7 points. The lowest scoring episode spending condition was pneumonia with hospitals earning less than 2 points on average.

Figure 3.

vertical bar chart of average points by episode spending conditions

Figure 4 illustrates the breakdown of average points by value metrics. Consistent with PY 2024, the highest scoring value metric was preoperative testing with 3.9 points followed by 30-day inpatient readmissions after sepsis with 3.2 points. The lowest scoring value metric was 7-day follow up after pneumonia and follows the same trend as that of PY 2024 with 1.8 points.

Figure 4.

vertical bar chart of average points by value metrics

This is the second year of a two-year (PY 24-25) P4P cycle. The full methodology for this program cycle can be found in the PY2024-2025 technical document.

In addition to the PY 2025 mid-year scorecard summary, this report also included a preview of the new health outcome variation measure scoring, which will be worth one point in PY 2026-2027 (Figure 5). The table presents the hospital’s payer-specific risk-adjusted readmission rates in the performance year, the baseline and performance indexes for the hospital, and the target indexes required to score a point via improvement or achievement. This table’s scoring is based on PY 2025 data (i.e., 2024 performance year data and 2022 baseline data). Please note that this table was included to help orient members to the scoring methodology for this new measure and does not impact PY 2025 scores. For detailed information about this measure, please refer to this introductory video and PY 2026-2027 P4P technical document.

Figure 5.

Table presents the hospital’s payer-specific risk-adjusted of readmission rates in the performance year, the baseline and performance indexes for the hospital, and the target indexes required to score a point via improvement or achievement.

These PY 2025 P4P mid-year scores are subject to change as new data is added. The final scores will be distributed after all 2024 claims are incorporated into the calculations. Hospitals can track their score via the P4P PY 2024-2025 dashboard reports on the MVC registry, which provides all relevant scoring information for both improvement and achievement points. These registry reports can be filtered by selected conditions/metrics to make tracking of P4P points easier. You can also contact the MVC Coordinating Center [EMAIL] for a walkthrough of your hospital’s PY 2025 mid-year scorecard or P4P registry reports.

24 Sep 2025
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Fall Collaborative-Wide Meeting Agenda, Speakers Announced

Fall Collaborative-Wide Meeting Agenda, Speakers Announced

September 24, 2025 | Comments Closed | , , ,

The MVC Coordinating Center is excited to announce the agenda for its fall collaborative-wide meeting on Fri., Oct. 10, 2025, from 10 a.m. – 3 p.m., at the Vistatech Center in Livonia, MI. This meeting’s theme is “Adapting Together in 2025 and Beyond: High-Value Care for All in a Changing Landscape.” This meeting will highlight the various ways in which MVC's members identify gaps in outcomes, adapt to ensure all patients receive the highest quality care, and establish partnerships and programs that mitigate non-medical drivers of health outcomes. Those interested in attending MVC's fall 2025 collaborative-wide meeting must register here by Thurs., Sept. 25.

MVC Director Mark Bradshaw, MSc, will kick off the day with Coordinating Center updates as well as announcements about the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program. This will be followed by updates about 2026 engagement offerings presented by MVC Engagement Manager Jessica Souva, MSN, RN, C-ONQS.

MVC will then invite its first guest speakers of the day to the podium: Julia Weinert, MPH, MSHIELD Program Manager, and Brad Iott, PhD, MPH, MSHIELD Content Expert in Health Informatics and Social Care Integration. The MSHIELD team will lay the foundation for the day by discussing non-medical drivers of health and related implications for quality improvement teams, including examples of metrics that help evaluate care across all patients and interventions that can help reduce gaps in patient outcomes.

The event keynote will follow with a presentation by Gloria Rey, PA-C, MPH, Director of Post-Acute Care, Henry Ford Health. She will present on Henry Ford’s post-acute care (PAC) transition program, and the ways in which their team partners with PAC groups to ensure effective, individualized handoffs and care delivery for all patients.

Following lunch and networking, MVC Medical Director Hari Nathan, MD, PhD, will co-present with MVC Analyst Kushbu Narender Singh, MDS, MPH, for MVC’s Data in Action presentation. This data presentation will focus on MVC’s newest health outcome variation measure, including how it was developed, its use cases and benefits, a timeline for related data sharing, and unblinded data. This measure was a new addition to the MVC Component of the BCBSM P4P Program, with scoring on this measure beginning in Program Years 2026-2027.

Attendees will then transition into the afternoon breakout sessions, all led by guest hospital presenters. To showcase how members are addressing variation in outcomes, MVC invited presenters to discuss recent initiatives and successes across a range of focus areas, such as partnerships with community-based organizations, systematic approaches to referrals, and predictive analytics and assessment tools in EPIC. View a summary of all five breakout presentations here. Attendees will attend two breakout sessions before returning to the main ballroom for closing remarks and next steps.

The deadline to register for MVC’s fall 2025 collaborative-wide meeting is tomorrow, Sept. 25. We look forward to seeing you there!

10 Sep 2025
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Push Report Details New MVC Measure that Quantifies Gaps in Patient Outcomes

Push Report Details New MVC Measure that Quantifies Gaps in Patient Outcomes

September 10, 2025 | Comments Closed | , , , , ,

MVC distributed a new push report on Aug. 28, highlighting the components and methods for MVC’s newest measure: health outcome variation for all-cause readmissions. The goals of the recently distributed push reports are to familiarize hospital members with the measure methodology as well as provide a first look at their hospital’s performance.

This measure was developed with the goal of addressing common challenges by MVC’s members in identifying and addressing gaps in health outcomes within their patient populations. A survey distributed to the MVC collaborative in 2024 identified barriers such as insufficient data and insufficient financial investments as key causes for lingering variation across their patient population. With the introduction of MVC’s health outcome variation measure, MVC seeks to quantify the magnitude of hospital-level variation in all-cause readmission rates between payer groups using an index of variation calculation. Readmission rates are risk adjusted for patient demographic and comorbidity data, as well as for non-medical drivers of health.

The first two pages of the push report provide a step-by-step walkthrough of the index calculation, beginning with the calculation of absolute differences in hospital-level readmission rates by payer group compared to the hospital-level average readmission rate. The five payer groups included in these calculations are BCBSM and BCN Commercial, BCBSM and BCN Medicare Advantage, Medicaid only, Medicare FFS only, and patients dual-eligible for Medicaid and Medicare; dual-eligible patients have been pulled out of the Medicaid only and Medicare only categories. This initial step helps to highlight which payer group(s) have a higher readmission rate than the hospital’s average rate (Figure 1).

Figure 1.

vertical bar chart of calculation of absolute differences in hospital-level 30-day readmission rates by payer group compared to the hospital-level average readmission rate

The next step in the methodology is to calculate a hospital’s index of variation using absolute differences in payer-specific risk-adjusted readmission rates compared to the hospital’s risk-adjusted average readmission rate. These payer-specific absolute differences are multiplied by the respective payer population proportion to yield weighted differences (Figure 2). The sum of those weighted differences across all five payer groups yields the hospital’s index of variation. This index calculation indicates the magnitude of payer-specific differences in risk-adjusted readmission rates within a hospital. A higher value indicates a larger spread in a hospital’s payer-specific risk-adjusted readmission rates as well as opportunities to develop strategies that reduce gaps in care across patient groups. A lower value is desired and indicates less variation in a hospital’s risk-adjusted readmission rates across payers.

Figure 2.

table: demonstration calculation a hospital’s index of variation using absolute differences in payer-specific risk-adjusted readmission rates compared to the hospital’s risk-adjusted average readmission rate

MVC first announced this measure at its fall 2024 collaborative-wide meeting, where Senior Advisor Jim Dupree, MD, MPH, announced its inclusion in the next cycle of the MVC Component of the BCBSM Pay-for-Performance (P4P) Program. Scoring on this measure will be offered in the Program Year (PY) 2025 scorecards with no points attached and thereafter will be worth one point in the PY 2026-2027 cycle.

Similar index or composite measures have been utilized by other health organizations, and MVC’s risk-adjusted measure can help identify hospital-level preventable differences in readmissions. Hospitals will earn the health outcome variation point by improving relative to their own baseline index or by performing well relative to their peers (i.e., having an index at or below the collaborative-wide median index).

As hospitals review their provided push report and become familiar with this new health outcome variation measure, they are encouraged to reach out to MVC with any questions.

13 Aug 2025
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MVC’s Updated Common Conditions Report Now Available to Hospital Members

MVC’s Updated Common Conditions Report Now Available to Hospital Members

August 13, 2025 | Comments Closed | , , ,

Last week, the Coordinating Center distributed a refreshed version of MVC’s common conditions report. This report delivers a comprehensive analysis of care episodes for eight prevalent medical and surgical conditions frequently targeted for quality improvement initiatives within MVC hospitals. It assesses hospital performance and highlights potential areas for growth. The report’s current conditions include atrial fibrillation (A-Fib), chronic obstructive pulmonary disease (COPD), colectomy (non-cancer), congestive heart failure (CHF), coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), pneumonia, and sepsis. Notably, total knee and hip (joint) replacement, which was previously included, has been replaced by A-Fib in the latest report.

MVC generated reports for 96 eligible hospitals. General acute care hospital (GACH) and Critical Access Hospital (CAH) members received tailored versions of the report, which included benchmark data specific to their respective hospital categories and tailored comparison groups. A blinded version of the general acute care hospital report is available here.

Although the provided metrics and figures vary by condition and case count, report pages generally focus on 30-day total episode payments, post-acute care and post-discharge ED utilization, readmission rates, and common reasons for readmissions. The report has been updated to feature data covering the period of January 1, 2023, through December 31, 2024, for Blue Cross Blue Shield of Michigan (BCBSM)/Blue Care Network (BCN) Commercial, BCBSM/BCN Medicare Advantage (MA), and Michigan Medicaid; Medicare FFS data covers the period of January 1, 2023, through June 30, 2024.

Upon opening the latest report, MVC members will first find a summary of patient population demographic data for each condition/procedure category their hospital was eligible to receive, facilitating a comprehensive and effective comparison across service lines for a variety of non-medical drivers of health.

On subsequent condition or procedure pages, most hospitals will have a figure displaying the breakdown of 30-day risk-adjusted, price-standardized post-acute care payments by payer categories (see Figure 1). The categories available included BCBSM/BCN Commercial, BCBSM/BCN Medicare Advantage, Medicare Only, Medicaid Only, and Dual Eligible; hospitals received data points for those payer categories with at least 11 episodes during the reporting period. As a reminder, the “Dual-Eligible” category represents patients eligible for both Medicare and Medicaid coverage, and the separate Medicare and Medicaid categories do not include those patients when the separate Dual-Eligible category is included.

Figure 1.

Bar graph of breakdown by payor of 30-day risk adjusted, price standardized, total post-acute care payments among patients hospitalized for COPD at a hospital

**Information is presented only for those payer categories that have at least 11 episodes during reporting period. Missing data labels represent less than 9% of the total.

Beyond offering insights into payments by payer and post-acute care categories, this figure can offer additional insights and context compared to the report figure that follows it for post-acute care utilization rates (see Figure 2). The two figures together serve to provide a clearer understanding of the relationship between rates of utilization and percent of episode spending for each post-acute care category, illustrating whether spending aligns with utilization frequency. The post-acute care categories for both figures includes home health care, skilled nursing facility (SNF) care, inpatient rehab, outpatient rehab, emergency department care, long-term acute care hospitals (LTACH) and outpatient services.

Figure 2.

Dot matrix of 30-day post acute care utilization among patients hospitalized for COPD

The remaining figures focus largely on ED utilization and readmissions, with some service line pages including figures for common reasons for readmission. Readmissions were generally observed to be highest across the collaborative at about 20% for patients hospitalized for CHF, followed by patients hospitalized for sepsis or COPD. Readmission rates were lowest across the collaborative at about 6% among patients who underwent a PCI procedure. There is also a visible decrease over time in 30-day readmission rates across the collaborative for all eight common conditions (see Figures 3 and 4); however, it is important to note that the 2024 Q3-Q4 data point does not include Medicare FFS patients, which is likely impacting the rate for that time interval.

Figure 3: 30-Day Readmission Rate Among Patients Hospitalized for Atrial Fibrillation, COPD, Colectomy, and CHF*

Line graphs of 30-Day Readmission Rate Among Patients Hospitalized for Atrial Fibrillation, COPD, Colectomy, and CHF

Figure 4: 30-Day Readmission Rate Among Patients Hospitalized for CABG, PCI, Pneumonia, and Sepsis*

Line graph of 30-Day Readmission Rate Among Patients Hospitalized for CABG, PCI, Pneumonia, and Sepsis

*Data points are only shown for six-month intervals with 11 or more episodes. Data from 2024 Q3-Q4 excludes Medicare episodes.

MVC is dedicated to regularly updating its commons conditions report, aiming to equip collaborative partners with insightful data that can drive and reinforce meaningful advancements in healthcare quality. We hope these reports prove beneficial and welcome MVC members to contact MVC with any questions or analytic requests.