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Semi-Annual Summary: Turning Data & Collaboration into Action

Semi-Annual Summary: Turning Data & Collaboration into Action

The Michigan Value Collaborative (MVC) held its first semi-annual meeting of 2022 last Friday. A total of 158 leaders joined the MVC Coordinating Center’s virtual meeting, representing 68 different hospitals and 15 physician organizations (POs) from across the state of Michigan. “Turning Data and Collaboration into Action” was the theme of this year’s first semi-annual, putting the spotlight on quality initiatives that successfully leveraged data or collaboration to bring about improvements in healthcare.

MVC’s Director, Dr. Hari Nathan, kicked off Friday’s meeting with an update from the MVC Coordinating Center. He welcomed two new collaborative members, McLaren Caro Region and UP Health System - Bell, as well as MVC’s newest team member, Engagement Associate Chelsea Andrews. Dr. Nathan also highlighted the successes delivered by the Coordinating Center during the first six months of 2022. This included the incorporation of Medicaid data into MVC’s suite of push reports to provide a more complete view of the collaborative’s patient population, the launch of three new push reports (colectomy, pneumonia, and P4P), and the incorporation of additional demographic data into MVC's reporting.

MVC’s recent Qualified Entity accreditation was also highlighted, representing a breakthrough for the collaborative that will allow the relaxation of certain data use agreement regulations and improve the granularity of data available to members. As part of extending this improved access, the Coordinating Center will reach out to site coordinators to have authorized representatives at each institution complete a new data use form. To align with the security requirements of the Qualified Entity program, the MVC registry will also begin requiring multi-factor authentication for users upon login. More information on each of these elements will be shared with the collaborative in the coming weeks. Chelsea Abshire Pizzo, MVC’s Manager of Analytics, rounded off the meeting welcome by sharing some highlights from Program Year 2021 of the MVC Component of the Blue Cross Blue Shield of Michigan Pay-for-Performance (P4P) Program.

Showcasing opportunities where MVC data can drive change was a focal point for the meeting. Utilizing unblinded data from the collaborative, MVC Analyst Jessica Yaser led attendees through a data session focused on MVC’s two Value Coalition Campaigns (VCCs): Preoperative Testing and Cardiac Rehab. This allowed attendees to see their preoperative testing and cardiac rehab utilization rates compared to their peers. Hospitals performing well were invited to offer insights as to how this was achieved and what mechanisms other hospitals could adopt to improve performance levels. Jessica also announced new collaborative-wide goals around cardiac rehab utilization rates (see Figure 1), which will continue to be promoted and highlighted in the months ahead.

Figure 1.

With the scene set, MVC welcomed guest speakers Mary Pool and Holly Gould from McLaren Port Huron hospital. Mary and Holly provided attendees with an overview of how they have used MVC data to help tackle high readmission rates for the congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) patient populations at McLaren Port Huron. Specifically, data provided by the Coordinating Center helped confirm the suspicion that although follow-up rates were high across the institution, this wasn’t being translated into a reduction in readmissions. Stratifying these data further helped McLaren Port Huron introduce tailored initiatives in the form of their COPD and Heart Failure Navigator Programs, aimed at driving the effectiveness of follow-up visits (see Figure 2).

Figure 2.

After hearing from McLaren Port Huron, Michelle Marchese from BCBSM provided an overview of how their Physician Group Incentive Program (PGIP) platform supports value-based care. As part of this, Michelle provided a walk-through of the current state of BCBSM data and report sharing, outlining how these all fit together to provide valuable healthcare insights for physician organizations (POs) (see Figure 3). MVC’s ongoing partnership with BCBSM to identify PO-level opportunities for improvement was also highlighted – a collaboration that will continue moving forward to enhance the level of support available to POs across the state. Michelle then passed the baton to Dr. Shannon Martin from MyMichigan Health who shared how MyMichigan has used its internal data to develop, implement, and assess its “Health Aging Program.” This initiative is aimed at decreasing the use of high-risk medications in the elderly population, saving many seniors from the harm of adverse drug effects.

Figure 3.

The meeting concluded with a summary of the day and key upcoming activities, led by MVC Engagement Associate Chelsea Andrews. The recording from Friday’s meeting is available here. If you have questions about any of the topics discussed at the semi-annual or are interested in finding out more about MVC, please reach out to the Coordinating Center. MVC’s next semi-annual meeting will be in person on Friday, October 28 at the Radisson in Lansing – we look forward to seeing you all then!

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MVC Coordinating Center Looking Back at 2021 and Forward to 2022

Let me begin the first MVC blog of 2022 by wishing you all a very happy new year on behalf of everyone at the MVC Coordinating Center. I’ve started my last two recaps with this line and ended with the hope of seeing you all in-person sometime soon. Since we still haven’t quite managed to get together in-person yet, I’d like to reiterate our thanks and gratitude to each of our collaborative members and those hospitals and physician organizations across the country who have continued to work tirelessly against the ongoing pandemic.

The MVC team has remained remote throughout 2021 and not only have we mastered the Zoom mute button, but we’ve continued to provide support to help MVC’s 100 hospital members and 40 physician organizations during this time.  In 2021, the MVC team held two virtual collaborative wide meetings, conducted 62 tailored registry webinars, undertook 58 virtual site visits, delivered 56 custom analytic requests, facilitated 34 workgroups, disseminated 21 push reports, and held five virtual regional networking events. As a result of this activity, the collaborative has welcomed 13 new hospital members to the collaborative.

In addition to these efforts, the MVC Coordinating Center has continued to adhere to our commitment to provide hospitals and POs with increased access to meaningful benchmarked performance data. In May of this year, MVC’s data portfolio grew with the addition of Michigan Medicaid data, and this was recently refreshed in early October. The data range for this data source currently covers 1/1/2015 – 9/30/2020, reflecting index admissions from 1/1/2015 – 6/30/2020. MVC Medicaid claims (Fee-for-Service and Managed Care) account for a total of 319,140 episodes (19.4% of all MVC episodes) and cover 256,889 beneficiaries. Overall, MVC data sources now comprise over 80% of Michigan’s insured population.

We look forward to continuing this growth in 2022 as we strive to improve the health of Michigan through sustainable high-value healthcare. There are a number of new developments in the pipeline for the coming year and I excited to be able to share some of these with you.

New Hospital Push Reports

A number of new reports will be added to MVC’s suite of reporting in 2022, focusing on topics such as COVID-19, Pneumonia, and Health Equity. The Coordinating Center will work closely with members, the wider CQI community, and other stakeholders to ensure the introduction of other new and novel approaches to sharing our data.

New Physician Organization Reporting

Driven by continued communication with members, the Coordinating Center disseminated its first PO-specific report focused on joint replacement towards the end of last year and has identified two new conditions of interest for future development (gastroenterology and hysterectomy). The Coordinating Center will also be working closely with PO members to inform the development of new metrics for the MVC online registry.

Increased Custom Analytics

Over the last year, the MVC team has devoted effort to raising awareness of MVC’s custom analytic offering to members. This has proved successful, with 56 custom projects undertaken for members in 2021 alone. This support will continue into 2022 – if you are interested in learning more, please contact the MVC Coordinating Center (michiganvaluecollaborative@gmail.com).

Emphasizing Equity in Healthcare

Most measures of overall health are worse in the US compared to any other developed country. The state of Michigan in particular ranks poorly in measures of population health, including tobacco use and the inter-related issues of inactivity, poor nutrition, and obesity. The relationship between these poor health behaviors and social determinants of health are closely interlinked and represent a huge opportunity to improve health and healthcare outcomes for targeted patients. In the coming year, MVC will be exploring how best to use its data and engagement platforms to emphasize equity in healthcare.

Collaborative Wide Meetings

The MVC team will continue to hold two flagship semi-annual collaborative wide meetings. These will take place on Friday, May 13th and on Friday, October 28th. The MVC team will also be holding five regional networking events throughout the year and plans to pilot a new ‘Northern Meeting’ in Summer 2022. More details to come.

New 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. In addition to MVC’s Chronic Disease Management, Sepsis, Joint, and Diabetes workgroups, two new groups will be added in 2022. This includes forums focused on ‘Health Equity’ and ‘Health in Action’.

As these activities and other planned developments come to fruition, we will be sure to share updates with you through our various engagement platforms. If you have any questions in the meantime, please do not hesitate to contact the MVC Coordinating Center at michiganvaluecollaborative@gmail.com. Happy New Year, and we look forward to a great 2022 together.

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October 2021 MVC Semi-Annual: Virtual Meeting Recap

October 2021 MVC Semi-Annual: Virtual Meeting Recap

The Michigan Value Collaborative (MVC) held its second virtual semi-annual meeting of 2021 on Friday, October 22nd. A total of 221 leaders from a variety of healthcare disciplines attended Friday’s virtual meeting, representing 70 different hospitals and 23 physician organizations (POs) from across the state of Michigan. These participants came together to hear about the planned adjustments to the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program for Program Year 2021 in light of COVID-19 and to discuss “the social risk and health equity dilemma” - a growing priority within the healthcare system generally, as well as within the MVC Coordinating Center.

MVC’s Director, Dr. Hari Nathan, started Friday’s meeting with an update from the MVC Coordinating Center, welcoming new collaborative members Munson Healthcare Manistee and Paul Oliver Memorial Hospital, and MVC’s newest Coordinating Center team members: Jana Stewart, Kristen Palframan, and Carla Novak. Dr. Nathan also highlighted some of the recent successes achieved by the Coordinating Center, including the launch of MVC’s new health equity report, increased custom analytic reporting, and the completion of over 50 virtual site visits with members this year.

Dr. Mike Thompson, MVC’s Co-Director, then shared information on the MVC Component of the BCBSM P4P Program with attendees. In investigating the impact of COVID-19 throughout the state in 2020, the MVC Coordinating Center found that 223 of the 25,627 (0.9%) episodes included in the P4P conditions from the first half of 2020 had a code for confirmed COVID-19 infection in the index event or other inpatient settings. The MVC Component of the BCBSM P4P program rewards hospitals for either making improvements over their baseline episode payment or for being less expensive than peer hospitals. The MVC team found that episodes of COVID-19 patients are generally more expensive than typical episodes. In addition, COVID-19 was not present in the baseline year of 2018 that hospitals stand to be evaluated against. Therefore, with approval from BCBSM, Dr. Thompson announced that, for Program Year 2021 only, the Coordinating Center will be removing any 2020 episode with a COVID-19 diagnosis on an inpatient facility claim during the 30-day episode if the COVID-19 ICD code is one of the first three diagnosis codes on the claim (see Figure 1). Looking ahead, a summary of participant selections for Program Years 2023 and 2024 were also shared, showing joint replacement as the most common condition selection, closely followed by congestive heart failure (CHF).

Figure 1. MVC Slide on Updates to MVC Component of BCBSM P4P Program for PY21

At MVC’s last semi-annual meeting in May, the Coordinating Center announced that Michigan Medicaid data had been added to MVC data sources and that the MVC Coordinating Center would be spending the subsequent months validating the data and getting it ready for member use. This work has now concluded and MVC’s Manager of Data Analytics shared what this new data source looks like. Michigan Medicaid now represents MVC’s third-largest data source, accounting for over 319,000 episodes since 2015, covering 256,889 beneficiaries, and making up 19.4% of all MVC episodes.  With this new addition, MVC data sources now comprise over 80% of Michigan’s insured population, all of which are available for members to utilize on the MVC registry.

To set the scene for our guest speakers, MVC Analyst Bonnie Cheng provided an overview of MVC’s recent health equity report (see Figure 2), highlighting racial, ethnic, and dual-eligibility variation across Michigan. The MVC Coordinating Center will look to build on this new report and undertake new activities in this area to support member activity moving forward. This will be supported by the Michigan Social Health Interventions to Eliminate Disparities (MSHIELD) collaborative – a new group recently launched as part of the Collaborative Quality Initiative (CQI) portfolio. With this in mind, MVC was joined by MSHIELD Program Manager Carol Gray to introduce this new collaborative and describe how MSHIELD will seek to interface with the health system and local communities to drive change (see Figure 3).

Figure 2. MVC Slide on New MVC Health Equity Report

Figure 3. MSHIELD Slide on MSHIELD's Role as a CQI

After hearing from MSHIELD, MVC welcomed guest speaker Dr. Nicole J. Franklin from McLaren Flint hospital. Dr. Franklin provided insight as to how McLaren Flint has devoted time and effort to bridge the gap between health and social care. This placed particular emphasis on the use of six representative sub-committees (employee resource, patient outcomes, community outreach, employee education, talent acquisition, and cultural calendar) to achieve McLaren Flint’s commitment to creating an inclusive and equitable environment where everyone is valued and empowered for success. Representing the Integrated Health Association (IHA), Leah Corneail shared how IHA has worked to actively screen and address patient social influencers of health (SIOH). This emphasized the importance of collecting actionable data through IHA’s SIOH questionnaire and the use of these data through an interactive population health dashboard (see Figure 4). The last guest speaker of the day was Melissa Gary, Community Liaison for Great Lakes Physicians Organization (GLPO). As well as providing an overview of GLPO, Melissa detailed how the organization has used a social determinants of health questionnaire and monthly tracking log to address the needs of over 2000 patients in 2020 alone.

Figure 4. IHA Slide on Social Influencers of Health Dashboard

To conclude Friday’s meeting, MVC Communications Specialist Jana Stewart provided a synopsis of the day and highlighted key upcoming activities. The slides from Friday’s meeting are available here and a recording of the meeting is available here. If you have questions about anything that was discussed at the semi-annual or are interested in finding out more about MVC’s offerings, please reach out to the MVC Coordinating Center (michiganvaluecollaborative@gmail.com). In the meantime, we look forward to seeing you all in person again soon.

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MVC Semi-Annual Meeting May 2021 – Virtual Meeting Recap

MVC Semi-Annual Meeting May 2021 – Virtual Meeting Recap

The Michigan Value Collaborative (MVC) held its first virtual semi-annual meeting of 2021 on Friday, May 7th. A total of 221 leaders from a variety of healthcare disciplines attended Friday’s virtual meeting, representing 74 different hospitals and 30 physician organizations (POs) from across the State of Michigan. These participants came together to hear about the planned adjustments to the MVC Component of the BCBSM P4P Program for Program Years (PY) 2022/23 and to discuss variations in transitions of care and ED utilization practices across Michigan.

MVC’s Director, Dr. Hari Nathan, started Friday’s meeting with an update from the MVC Coordinating Center, welcoming the eleven new hospital members who have joined the collaborative since the turn of the year and highlighting recent improvements to MVC data sources and push reporting. This included the “soft launch” of Medicaid data. MVC has now added Medicaid data to our data portfolio, meaning that MVC data sources now comprise over 80% of Michigan’s insured population. The Coordinating Center is in the final stages of validation and will have this new data source live for use by members in the coming months.

Dr. Mike Thompson, MVC’s Co-Director, then shared information on the MVC Component of the BCBSM P4P Program with attendees. An overview of PY20 was first provided, showing that participants earned an average of six points during this program year, an increase of around one point from the 2019 program year average. In an effort to continually improve the MVC Component, the Coordinating Center has introduced two methodological changes for the next two-year cycle (PY22 & PY23). Dr. Thompson walked through each of these changes, which include placing “Improvement” and “Achievement” on the same scoring scale, and introducing a new qualitative questionnaire for earning bonus points. The MVC Coordinating Center will be sharing further information on these changes and disseminating service line selection reports for the next program cycle with members in early June. Two dedicated P4P webinars will also be held around this time to assist members with selection.

Attention was then turned to looking at transition variations in Michigan hospitals, highlighting payment and ED utilization differences across MVC members, as well as the top reasons for readmission within the collaborative. To expand on this further, we were joined by guest speakers from the hospital, physician organization, and CQI setting to share their insights and learning. Dr. Robert Nolan and Michael Getty from Spectrum Health Lakeland were the first guest speakers of the day, discussing their organization’s efforts to reduce the cost of ED utilization and readmission rates. This highlighted the importance of real time data visuals, integrating documentation tools with best practices, and ensuring an effective longitudinal plan of care that is blended into natural work flows to enable physician buy-in. Dr. Nolan and Mike Getty were also able to spotlight the use of MVC data in these efforts, a custom option available to all MVC members.

Representing Professional Medical Corporation (PMC) and the Consortium of Independent Physician Associations (CIPA), Dr. Kyle Enger then shared how both entities have worked to promote appropriate emergency care in recent years. Again, this emphasized the importance of monthly data report cards to provide physicians with actionable data to guide activity, as well as the need to continue promoting urgent care as a viable alternative in certain situations. Our last guest speaker of the day was Dr. Keith Kocher, Director of the Michigan Emergency Department Improvement Collaborative (MEDIC). As well as providing a brief overview of the purpose of MEDIC and sharing some vital statistics relating to ED utilization across the US, Dr. Kocher discussed how best to approach the “ED readmission problem” and how local solutions can be used to minimize its impact.

To conclude Friday’s meeting, MVC’s Site Engagement Coordinator, Jeff Jameel, provided a synopsis of the day and highlighted key upcoming activities. The slides from Friday’s meeting are available here and a recording of the meeting can also be viewed here. If you have any questions on anything that was discussed at Friday’s semi-annual or are interested in finding out more about MVC’s offering, please reach out to the MVC Coordinating Center (michiganvaluecollaborative@gmail.com.) In the meantime, we look forward to seeing you all in-person again soon.

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MVC Coordinating Center

MVC Coordinating Center

First of all, let me begin by wishing you all a happy new year on behalf of everyone at the MVC Coordinating Center. I started my last recap in January last year with the same line and proceeded to share what the MVC team had in store for the year ahead…little did we all know what was just around the corner. The year 2020 has been one like no other and the whole MVC team is truly grateful to each of our collaborative members, and those hospitals and physician organizations across the country who have worked tirelessly to tackle the current pandemic.

Like many organizations around the world, the MVC team has now been working remotely for over ten months. During this time, we have adapted to new ways of working, wrestled with the zoom mute button on a daily basis, and got to know each other’s families and pets very well. However, the one thing that has remained constant during this time is the support on offer to each of our member sites.

Over the past ten months, the MVC team has used our current infrastructure to help MVC hospitals and physician organizations navigate the pandemic. This included the creation of a new statewide and hospital level Resource Utilization Report, providing historical resource utilization metrics for 17 different elective surgical procedures to inform surgical ramp-up at member facilities. The MVC Coordinating Center has also been working closely with the wider CQI community on the Mi-COVID19 initiative - a joint CQI venture collecting extensive clinical data on COVID-19 patients to provide insight into best practices in treating patients with the virus.

In addition to these efforts, MVC Coordinating Center activity has continued to expand. In 2020, the MVC team held two virtual collaborative wide meetings, facilitated 32 workgroups, delivered 30 tailored registry webinars, undertook 18 virtual site visits, disseminated

We look forward to continuing this growth in 2021 as we strive to improve the health of Michigan through sustainable high-value healthcare. There a number of new developments in the pipeline for the coming year and I excited to be able to share some of these with you.

Data Expansion: Medicaid Data

The MVC Coordinating Center is committed to expanding patient populations on the MVC registry to increase the level of meaningful, timely, benchmarked performance data that is available to aid our member’s quality improvement activities. Over the last two years, the MVC team has been working to add Medicaid claims data to the MVC registry. This dataset was received in late November 2020 and will add approximately 1.8 million covered lives to the MVC registry. As a result, this means that MVC data sources now comprise over 80% of Michigan’s insured population. It is projected Medicaid data will be available on the MVC registry for members to access by the end of Q1 2021.

New Push Reports

A number of new reports will be added to MVC’s portfolio in 2021, focusing on topics such as COVID-19, Preoperative Testing, and Social Determinants of Health. The Coordinating Center will work closely with members, the wider CQI community, and other stakeholders to ensure the introduction of other new and novel approaches to sharing our data. As always, the Coordinating Center is here to help so please let us know if you have any custom data requests or reports you would like to see.

New Physician Organization Metrics and Reports

As part of MVC’s organizational strategy and planned growth, Jeffrey Jameel (MD, MHA) joined the MVC team in the role of Site Engagement Coordinator in early November. In the coming year, Jeff will be working closely with each of our physician organization members to develop new measures and metrics to support ongoing activities.

Value Coalition Campaigns

In October 2020, the MVC Coordinating Center launched two new Value Coalition Campaigns (VCCs) focused on Cardiac Rehabilitation and Preoperative Testing. These VCCs can essentially be thought of as specific focus areas in which member collaborations are concentrated to drive improvement. By using our 90-day episode claims data to provide time-specific hospital-level information on CR enrollment and completed visits, and partnering with the Blue Cross Blue Shield Cardiovascular Consortium (BMC2), the Coordinating Center is aiming to equitably increase participation in cardiac rehabilitation for all eligible individuals in Michigan. In addition, the MVC team also plans to use claims data and engagement with MVC members to reduce the use of unnecessary preoperative testing for surgical procedures to improve quality, reduce cost, and improve the equity of care delivery in Michigan.

The MVC team will develop these new campaigns further in the coming year, sharing new push reports and launching new reports on the MVC registry to support member activity in this area. If you are interested in taking part in the development of MVC’s new VCCs, please reach out to the MVC Coordinating Center (michiganvaluecollaborative@gmail.com).

Collaborative Wide Meetings

The MVC team will continue to hold two flagship semi-annual collaborative wide meetings. These will take place on Friday, May 7th and on Friday, October 29th. As part of the MVC Component of the BCBSM P4P Program, hospitals will now be awarded an additional bonus point for attending BOTH semi-annuals in 2021. More details on each of these meetings will follow in the coming months.

Virtual Site Visits

MVC site visits are designed to provide members with a more in-depth understanding of MVC and its offering, as well as providing the opportunity to learn about best practices in operation at Michigan hospitals to share with the rest of the collaborative. Feedback is also sought from sites to ensure the Coordinating Center is able to continually improve the data, analytic support, and engagement resources available to members. This offering will continue in 2021.

As with attending both collaborative wide meetings, hospitals will now be awarded an additional bonus point for undertaking a virtual site visit with the Coordinating Center as part of the MVC Component of the BCBSM P4P Program. If you are interested in setting up a virtual site visit, please let us know (michiganvaluecollaborative@gmail.com).

If you have any questions on the above, please do not hesitate to contact the MVC Coordinating Center at michiganvaluecollaborative@gmail.com. Happy New Year, and we look forward to a great 2021 together.