14 Jul 2021
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Introducing Carla Novak, MVC’s Administrative Assistant

Introducing Carla Novak, MVC’s Administrative Assistant

July 14, 2021 | 0 Comments

I am excited to be joining the MVC team as the Administrative Assistant. I was born in Ohio (Go Buckeyes!) and moved to Michigan when I was young. I have always had a desire to work on the clerical side of healthcare, which led me to several roles within Michigan Medicine.

Most recently, I worked as a Referral Coordinator for the U-M Division of Cardiovascular Medicine, where I obtained insurance authorizations for various procedures. Prior to this I worked as an Administrative Assistant on an inpatient unit within the hospital, providing support to roughly 90 employees and our management team. I also processed payroll, reimbursements, PTO requests, and more.

As MVC’s Administrative Assistant, I look forward to assisting with the day-to-day needs of the Coordinating Center. I am thankful for the opportunity to work with this great team and look forward to getting to know each and every one of you!

30 Jun 2021
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Introducing MVC’s Newest Analyst, Kristen Palframan, MPH

Introducing MVC’s Newest Analyst, Kristen Palframan, MPH

June 30, 2021 | 0 Comments

I am excited to have joined the Michigan Value Collaborative (MVC) this month as a data analyst. I’m really looking forward to working with the MVC team and using my experience in data management and analysis to support the goal of improving the quality and value of healthcare in Michigan.

My background is primarily in research and data analysis. I have a Bachelor of Science degree in Animal Behavior from Bucknell University. After conducting behavioral research and wildlife disease fieldwork with animals throughout and following college, I developed an interest in disease prevention and came to Michigan to pursue a Master of Public Health (MPH) degree from the University of Michigan School of Public Health. During my MPH program I took a variety of epidemiology and statistics courses, and I particularly enjoyed those that involved programming in SAS and SQL. After graduating from the University of Michigan with an MPH degree in Epidemiology in 2018, I worked for three years as an epidemiologist for the U.S. Department of Veterans Affairs (VA) in the Office of Mental Health and Suicide Prevention. At the VA, I worked on analyses, reports, dashboards, and manuscripts focused on supporting suicide prevention among U.S. Veterans. My work for the VA primarily used electronic medical record data from the Veterans Health Administration as well as mortality data from the Centers for Disease Control and Prevention’s National Death Index.

Now I am thrilled to use my experience in healthcare data analysis to support MVC’s mission and I’m looking forward to growing as an analyst and gaining experience working with claims data. If you have any questions or would like to contact me, please feel free to email me at kpalf@med.umich.edu.

17 Jun 2021
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Custom Hospital Analytics Result in Case Study for Collaborative

June 17, 2021 | 0 Comments | , ,

The Michigan Value Collaborative (MVC) Coordinating Center encourages its members to seek out custom analytics to inform and support ongoing quality improvement activities. These requests can help hospitals and physician organizations dig deeper into specific aspects of their administrative claims data and, as a result, better understand areas for improvement.

As custom analytics have been prepared and shared with respective members, the Coordinating Center has endeavored to learn the extent to which these analytics have been utilized. The resulting feedback has enriched MVC’s understanding of its members’ quality initiatives, and presents a great opportunity for MVC to educate its members about the successes and lessons learned of their peers.

In that spirit, the Coordinating Center has sought the permission of various hospitals to generate case studies based on this collaborative work. One such case study featuring McLaren Port Huron Hospital was created this past year and shared with the entire Collaborative via the MVC Newsletter (Figure 1). It features a custom analytics request about the rates and adherence of follow-up visits in their congestive heart failure (CHF) population as well as readmission rates for chronic obstructive pulmonary disease (COPD). The resulting custom analytics reports prepared by the Coordinating Center were also accompanied by best practice sharing sourced from other Collaborative members.

Figure 1.

The Coordinating Center plans to continue to generate shareable case studies about similar requests if those facilities have provided their permission. Similarly, MVC will continue to identify such opportunities for information sharing and networking across facilities in order to support its members.

If any members of the Collaborative are interested in pursuing custom analytics in the future or have ideas to share across hospitals, please contact the Coordinating Center at michiganvaluecollaborative@gmail.com.

10 Jun 2021
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Virtual Site Visits Underway with MVC Members

June 10, 2021 | 0 Comments | , ,

The COVID-19 pandemic affected hospital operations in a myriad of ways, with many Michigan Value Collaborative (MVC) members experiencing circumstances that could impact their score on the MVC Component of the BCBSM Pay-for-Performance (P4P) program. In order to mitigate some of the effect of COVID-19, the MVC Coordinating Center introduced two extra bonus points to be earned for Program Year 2021 only. One bonus point can be achieved by attending both MVC semi-annual events; the first was held in May and the second will be held in October. The second bonus point can be earned by undertaking a virtual site visit with the MVC Coordinating Center.

To date, the Coordinating Center has completed 26 site visits, and a further 25 “visits” are scheduled with a variety of hospitals around the state. During these 90-minute virtual visits, MVC provides an overview of the collaborative, our data, and engagement activities. Hospitals receive a quality improvement slide (Figure 1) in advance that they complete and return prior to their scheduled date. These responses drive the main discussion of the site visit.

Figure 1.

Much has been learned about various quality improvement projects being implemented and what hospitals are focusing on for 2021 and 2022. MVC plans to use the information from these slides to connect hospital members with peers interested in implementing similar projects.

In addition, the Coordinating Center is interested in learning: who is utilizing the registry and any individualized reports, the types of MVC data that are most useful, and any challenges hospitals have with using the data. This feedback will help MVC make improvements to the registry and individualized reports to make them more actionable for members.

Finally, the hospital relationship with physician organizations (POs) is discussed. One of MVC’s goals is to help facilitate collaboration between POs that have patients attributed to each hospital, especially in the patient outcomes and quality of care arenas.

If you have not yet scheduled a site visit, please do so here. Slots are available between now and October. If you have any questions or would like further information on a site visit, please contact the MVC Coordinating Center at michiganvaluecollaborative@gmail.com.

27 May 2021
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Introducing Jana Stewart, MPH, MS Communication Specialist for MVC

Introducing Jana Stewart, MPH, MS Communication Specialist for MVC

May 27, 2021 | 0 Comments

I am excited to join the Michigan Value Collaborative (MVC) as Communications Specialist. This new position will help highlight MVC’s success stories, support MVC member events and engagement activities, and promote MVC services throughout the state of Michigan. I look forward to getting to know MVC members and hearing their feedback in the coming months.

I have worked in communications in various capacities over the past 10 years, and as a result my writing has been published in academic journals, newspapers, magazines, and K-12 curricula. I started out in journalism as a sports writer, copy editor, and then managing editor of a regional newspaper, during which I earned writing awards from the Michigan Press Association and the Society of Professional Journalists. My time as a journalist allowed me to write about a wide range of topics, from city government and local business to high school sports and crime.

When I left journalism for a position at the University of Michigan, I continued to provide broad communications support to administrative offices and research labs. Through this work I developed a strong interest in programs that sought to improve the long-term health of people and places. As a result, I also enrolled as a dual-degree master’s student in public health and environmental science. I have three degrees from the University of Michigan in total, including a Bachelor of Arts in Kinesiology, a Master of Science in Environmental Psychology, and a Master of Public Health (MPH).

Following the completion of my MPH program, I spent several years in the field working for primary prevention programs. I worked for a hospital-based farm in the St. Joseph Mercy/Trinity Health network, and then with Michigan Medicine’s Project Healthy Schools program. Implementing interventions in the field helped me to see first-hand the impact that such programs can have on a population or institution. Now I am truly excited to support the mission and vision of the MVC as I return to communications full-time. I know there are tremendous untold stories about the impact of MVC’s efforts on Michigan hospitals and patients. If you have a story to tell or a question to ask, please reach out to me at janaemil@med.umich.edu. I would love to hear from you!

13 May 2021
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MVC Semi-Annual Meeting May 2021 – Virtual Meeting Recap

MVC Semi-Annual Meeting May 2021 – Virtual Meeting Recap

May 13, 2021 | 0 Comments | , , , , ,

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.

29 Apr 2021
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MVC Launches New Physician Organization Reports

April 29, 2021 | 0 Comments | , , ,

The goal of the Michigan Value Collaborative (MVC) is to improve the health of Michigan through sustainable high-value healthcare. The primary focus at inception in 2013 was the development of hospital based metrics to improve patient outcomes, reduce healthcare costs, and encourage hospitals to collaborate in best practice sharing. With the knowledge that hospitals are not the healthcare entity capable of such changes, MVC invited Physician Organizations (POs) to join the collaborative towards the end of 2018.

To date, PO members have been able to see hospital level data for their attributed facilities. This has proved helpful for our PO members but we have heard consistent feedback that being able to view metrics that display a PO’s specific attributed patient population would be welcome. This value added request was appreciated by MVC, and so the Coordinating Center began a collaboration with representatives from the Blue Cross Blue Shield of Michigan (BCBSM) Physician Group Incentive Program (PGIP) to develop new PO patient specific metrics. MVC has also engaged other parties in the development of these new metrics, including the Michigan Data Collaborative (MDC) and hearing directly from our PO members.

As a result of this collaboration, the first MVC PO population level report, containing data for both BCBSM PPO Commercial (Comm) and BCBSM Medicare Advantage (MA) between 1/1/19 and 12/31/19, was sent out to all 40 MVC PO members on Tuesday, April 20, 2021. The report contains data on health care utilization and allows POs to benchmark themselves against all MVC participating physician organizations for the metrics listed in Table 1.

Table 1. Initial PO Reporting Metrics

Each metric was stratified by payer to account for differences in patient populations, as well as to serve as a proxy for age stratification (Figure 1).

Figure 1. Sample PO Metric: Percent of Attributed Members with at Least One Inpatient Stay

As engagement with our PO members builds, and further feedback and requests are processed, MVC plans to continue to build on the metrics highlighted in this report. As the most recent reports are at a population level, the Coordinating Center intends to delve further into the metrics for more granular level detail.

If you are interested in sharing feedback about the PO reports, have any specific analytic requests, and/or would like more information about the Michigan Value Collaborative,  please reach out to the Coordinating Center at michiganvaluecollaborative@gmail.com.

 

15 Apr 2021
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Cardiac Rehab Stakeholder Meeting Motivates Improvements in Care

April 15, 2021 | 0 Comments | , , ,

On Monday, March 22, 2021, a “stakeholder meeting” was hosted by the Michigan Value Collaborative (MVC) Coordinating Center with multiple key players in cardiac rehabilitation (CR) from around Michigan. As MVC has written about before, cardiac rehabilitation is a highly valuable but underutilized service and is the focus of one of MVC’s ongoing value coalition campaigns. The goal of the stakeholder meetings is to bring together key constituents to work towards solving the problem of underutilization. Attendees included managers of cardiac and pulmonary rehab facilities, quality improvement leaders and executives from  several MVC members, our payer partners from Blue Cross Blue Shield of Michigan, and representatives from the Michigan Society for Thoracic and Cardiovascular Surgeons (MSTCVS), the Michigan Society for Cardiovascular and Pulmonary Rehab (MSCVPR), and the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2).

The stakeholder meeting occurred the week after MVC distributed new Master Cardiac Rehab reports, which detail several metrics on cardiac rehabilitation after percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), transcatheter aortic valve replacement (TAVR), and surgical aortic valve replacement (SAVR) procedures. The collaborative-wide average cardiac rehab utilization varied by procedure: 52.6% for SAVR, 30.1% for TAVR, 56.3% for CABG, and 32.3% for PCI (see Figure 1). The mean days to first cardiac rehab visit also varied by procedure: 46 days for SAVR patients, 43 days for TAVR patients, 45 days for CABG patients, and 34 days for PCI patients (see Figure 2).

Figure 1

Figure 2

The Master Cardiac Rehab reports were also distributed by our partners at MSTCVS and BMC2. The aim is to increase awareness of hospital-level CR utilization and encourage as many players as possible (cardiologists, cardiac surgeons, cardiac rehab staff, quality improvement staff, and executive leadership) to work together to increase CR utilization at every hospital. These reports were well-received at the March 22nd stakeholder meeting, with one attendee emphasizing that the information contained in the reports was “the envy of other states,” speaking to the utility of MVC data and the success of BCBSM Value Partnerships. Attendees also provided excellent suggestions for improvement which will be taken into account during the next report refresh later this year.

The data is distributed, and the stakeholder meeting is over, but the value coalition campaign is just getting started.  There’s still a lot of work to do in order to equitably increase cardiac rehabilitation use in our state, including studying barriers to entry, exploring the intricacies of benefit design, and making various operational changes hospital by hospital, health system by health system. Nevertheless, that Monday afternoon showed that sometimes, when you have the right people around the same (virtual) table, everyone can walk away connected, motivated, and ready to carry out their respective roles to improve health care.

The next cardiac rehab stakeholder meeting is scheduled for Monday, June 28, 2021 from 4:00-5:00pm. If you have an interest in joining this group, or if you have not received your Master Cardiac Rehab report, please email michiganvaluecollaborative@gmail.com.

01 Apr 2021
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Introducing Bradley Raine, MVC Analyst

Introducing Bradley Raine, MVC Analyst

April 1, 2021 | 0 Comments | ,

I am happy to join the Michigan Value Collaborative (MVC) in the role of Analyst and am looking forward to working with the MVC team to help improve the quality and value of healthcare provided in the state of Michigan.

I graduated from the University of Michigan with my Bachelors of Science in Biology in 2015, and spent nearly three years working in the prep lab for the Michigan Clinical Research Unit (MCRU) based at the Cardiovascular Center. There I developed an interest in research methodology and wanted to learn more about how research teams use their data to publish their findings. Therefore, I decided to pursue a degree in Statistics, and graduated from Central Michigan University in August 2020 with a Master’s of Science degree.

In order to complete my graduate degree, I worked on a visualization project for COVID-19 data using Tableau. I found this product to be a great tool for creating dashboards to tell stories about data, and am hoping to take the skills learnt and implement them in a professional setting.

As an analyst for MVC, I am excited to learn how to analyze data using medical claims information to identify areas for improvement in quality of care. This has been important to me ever since having worked at MCRU and seeing how much data can do towards improving patient outcomes.  I am looking forward to taking the knowledge and experience gained at Central Michigan University and using it for this purpose. If you have any questions or wish to get in touch, please feel free to email me at bjraine@med.umich.edu.

11 Mar 2021
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Michigan Value Collaborative Value Coalition Campaign. Introducing the Preoperative Testing VCC and Report Series.

March 11, 2021 | 0 Comments | , , ,

In 2020, the Michigan Value Collaborative (MVC) introduced the Preoperative Testing Value Coalition Campaign (VCC) with the aim of reducing the use of unnecessary preoperative testing for surgical procedures.  As part of this new campaign to improve quality, reduce cost, and improve the equity of care delivery in Michigan, the Coordinating Center developed and distributed preoperative testing reports to collaborative members earlier this week. The goal of these reports is to introduce the VCC and provide benchmarking data for some of the common preoperative tests to members.

Currently, the VCC is focused on three elective, outpatient, low-risk surgeries. This includes cholecystectomy, lumpectomy, and inguinal hernia repair. These surgeries were chosen to identify a population unlikely to require much, if any preoperative testing. Metrics included in the reports evaluate hospital testing rates for electrocardiography (EKG), trans-thoracic echocardiography (TTE), cardiac stress tests, chest X-ray (CXR), urinalysis, complete blood count (CBC), basic metabolic panel, coagulation tests, and pulmonary function tests (PFT).  As shown in Figure 1, there is wide variation across the collaborative for overall preoperative testing rates, ranging from 20% to 96%.

Whilst the report provides the MVC all and regional averages as benchmarks, the variation suggests that there is significant room for improvement among Michigan hospitals, and even facilities that are average likely have the possibility to reduce preoperative testing. Furthermore, to allow hospitals to identify areas of opportunity, a more granular grouping of laboratory testing including CBC, basic metabolic panel, coagulation tests, and urinalysis for the three low-risk surgeries is depicted in Figure 2.  To allow hospitals and physician organizations to view more comprehensive preoperative testing data, the MVC Coordinating Center is in the preliminary stages of developing a new preoperative testing report for the MVC registry.

Although many preoperative tests are relatively low cost, large-scale overuse when not necessary can increase episode costs. For these three low-risk procedures, an annual preoperative testing payment of $3.2 million dollars was noted in 2019 across MVC hospitals and according to MVC data, annual preoperative testing payments for these conditions has increased steadily over the last 5 years. In addition, overuse of preoperative testing has the potential to harm patients. Patients with borderline or false positive tests may be subjected to additional testing, have their surgeries postponed, or even experience unnecessary harm from invasive follow up tests.  Questions about appropriate preoperative testing  guidelines can be answered at the Choosing Wisely website.

Please provide us with your feedback on the utilization of these or any other MVC reports, or if you would be interested in joining the MVC Preoperative Testing Stakeholder Group, please reach out to MichiganValueCollaborative@gmail.com.