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Opportunity to Share your Perspective in Institutional Participation in the MVC Component of the BCBSM P4P Program

Opportunity to Share your Perspective in Institutional Participation in the MVC Component of the BCBSM P4P Program

MVC Senior Advisor and former Director, Dr. Scott Regenbogen recently received funding from The Donoghue Foundation to lead a team of investigators to learn more about institutional participation in the MVC Component of the BCBSM P4P Program.

As part of this study, Dr. Regenbogen is interested in conducting virtual interviews with lead administrators who were involved with selecting service lines for performance year 2017-2018

What is the value of participating? While participation in this study is completely voluntary and does not carry any bearing on P4P scoring, the insights gleaned from this work will help us to continue improving the MVC measure for the benefit of our members, and improve our understanding of successful strategies in commercial episode-based payment incentives.

What is The Donoghue Foundation? The Foundation supports a diverse portfolio of research projects, from understanding the mechanisms of disease, to improving clinical treatments, to public health initiatives that prevent illness – all founded on excellent science. To learn more about the organization and their mission, please visit https://donaghue.org/

Meet the Key Study Personnel

  • Scott Regenbogen, MD, MPH.  Dr. Regenbogen is an Associate Professor of Surgery and Chief of the Division of Colorectal Surgery at the University of Michigan (UM), and a Senior Advisor of the Michigan Value Collaborative (MVC). His research has focused on the role of perioperative care protocols in the costs, outcomes, and value of care around episodes of inpatient surgery, with a particular focus on older adults.
  • Shelytia Cocroft, PhD.  Dr. Cocroft is an applied medical sociologist and mixed-methodologist (qualitative and quantitative research designs).  She is currently a qualitative research analyst at the University of Michigan’s Center for Healthcare Outcomes and Policy (CHOP) and is collaborating on qualitative centric projects designed to identify systemic and structural mechanisms within surgical care that perpetuate inequalities in access, quality, and delivery of care.
  • Ashley Duby, MS.  Ms. Duby is the Research Director for the Division of Colorectal Surgery within the Department of Surgery and has been working with Dr. Regenbogen for the past 6 years. She has extensive experience in development and deployment of fieldwork protocols in diverse settings – including patient and provider populations.

If you have any questions or would like further information related to this project, please contact Ashley Duby, Research Director at agay@med.umich.edu.

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MVC Component of the BCBSM P4P Program: PY20 in Review

MVC Component of the BCBSM P4P Program: PY20 in Review

In early January, the Michigan Value Collaborative (MVC) distributed 2020 Program Year (PY) scores to hospitals for the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay for Performance (P4P) program. This marked the completion of the first year of a two-year cycle for which hospitals have selected two service lines (out of seven) to be scored on their episode spending using MVC data. These service lines include chronic obstructive pulmonary disease (COPD), colectomy, congestive heart failure (CHF), coronary artery bypass graft (CABG), joint replacement, pneumonia, and spine surgery. Figure 1 shows the frequency of hospital service line selections for the two-year program cycle.

Figure 1.

The program evaluates hospital’s risk-adjusted, price standardized, average 30-day episode payments for their two selected conditions through two methods. One way that hospitals earn points in the program is by reducing their payments from the baseline period (index admissions in 2017) to the performance period (index admissions in 2019). These are termed ‘improvement points’. Alternatively, hospitals are able to earn points by being less expensive than the other hospitals in their cohort. These are referred to as ‘achievement points’. The MVC cohorts are groups of hospitals determined to be peers using bed size, case mix index, and teaching status.

While participants are scored on both improvement and achievement, members receive the higher of the two scores for each service line. Hospitals are also eligible to earn a bonus point for each service line provided all hospitals in their respective cohort who selected the same condition reduce spending by five percent. A maximum of ten points can be awarded for participating members. Figure 2 shows the distribution of total points earned by hospitals for Program Year 2020.

Figure 2.

On average, hospitals earned six points, an increase of around one point from the 2019 program year average. Twenty-four hospitals received bonus points within the COPD, colectomy, joint replacement, and pneumonia service lines. Consistent with previous years, joint replacement had the average points, with pneumonia coming in a close second (see Figure 3).

Figure 3.

If you have any questions regarding the MVC Component of the BCBSM P4P program, please refer to the P4P Technical Document for Program Years 2020 and 2021 and the MVC P4P FAQ PY 2020-2021 . If you would like to set up a meeting to review your hospital’s performance, please contact the Coordinating Center at MichiganValueCollaborative@gmail.com.


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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.