MVC Blog -

14 Jan 2026

MVC Welcomes Faculty Advisor and Physician Ryan Howard

January 14, 2026 | 0 Comments | MVC, MVC Coordinating Center

I am so excited to be joining the Michigan Value Collaborative as a Senior Faculty Advisor. I’ve worked closely with the Collaborative Quality Initiatives for the last decade and am thrilled to continue that work in this new role!

By way of introduction, I am a surgeon and healthcare researcher at the University of Michigan. I am Maize and Blue through and through, having completed my undergrad, medical school, residency, and fellowship at the University of Michigan. My clinical practice focuses on bariatric and hernia surgery, and I also specialize in comprehensive obesity treatment with medications and other non-surgical options. What I love most about my practice is partnering with patients to help them accomplish their goals and live their life to the fullest.

My research focuses on studying the quality and safety of surgical care. My passion is taking what we discover through research and turning it into real-world improvements for our patients. To that end, I conduct studies that identify opportunities to improve care, then I use those findings to inform quality improvement efforts to make those changes a reality. My research has explored post-operative opioid prescribing, abdominal wall hernia repair, and long-term health changes after bariatric surgery. I’ve also written a lot about the Collaborative Quality Initiatives, which really demonstrate what you can accomplish through statewide collaboration and partnership.

The Michigan Value Collaborative is such a critical engine for translating our research into real-world improvements for patient care, and I could not be happier to join such a talented and dedicated team. In my role at MVC, I’ll be engaged in studying the quality of surgical care in Michigan, collaborating on quality improvement initiatives, and helping identify new ways to enhance the care we deliver to patients.

I’m truly looking forward to the work ahead and to contributing to MVC’s mission of driving high-value, patient-centered care across the state.

07 Jan 2026

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December Workgroups Highlight RITE-Size Preoperative Testing and MVC Year End Reflections and Goals

January 7, 2026 | 0 Comments | MVC Coordinating Center, MVC workgroup, preoperative testing, quality improvement

In December, Michigan Value Collaborative’s (MVC) preoperative testing workgroup featured a co-presentation by Kelly Lewton, RN, BSN, Performance Improvement Coordinator for Lake Huron Medical Center, and 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. The presentation focused on the Right-Sizing Testing Before Elective Surgery (RITE-Size) trial; Dr. Mott was the lead author on a recently published paper in JAMA Network Open that described the components and impact of the trial, and Lewton shared her first-hand experience as the lead during Lake Huron Medical Center’s participation in the trial. RITE-Size works with hospitals to identify and right-size testing before elective surgery procedures. The second workgroup, health in action, featured MVC Site Engagement Coordinator Emily Bair, MS, MPH, RDN, CSP, and the Engagement team and focused on a year in review of quality initiatives across MVC members. The MVC Coordinating Center hosts one to two workgroup presentations per month covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehabilitation, rural health, preoperative testing, and health in action.

Preoperative Testing Workgroup - RITE-Size & Lake Huron Medical Center

The RITE-Size trial is a partnership among quality improvement teams in Michigan including the Michigan Program on Value Enhancement (MPrOVE), the MVC Coordinating Center, the Michigan Surgical Quality Collaborative (MSQC), and the Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE). Dr. Mott shared that the goal for RITE-Size participants is to lower unnecessary preoperative testing before elective outpatient cholecystectomy, inguinal hernia repair, and lumpectomy. Routine preoperative testing before these low-risk surgeries has shown no clinical benefit to the patient but has led to multiple downstream consequences such as increased spending, care cascades, and treatment delays (Dossett & Wilkinson, 2022).

Dr. Mott described that RITE-Size launched a pilot feasibility study 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% reduction in unnecessary testing at all participating sites (Figure 1).

Some barriers that impacted the study included lack of clarity about guidelines, a need for ongoing education due to the automated nature of testing processes, and coordination across a large healthcare system and/or within the limitations of institutional rules. Elements that led to success included strong leadership through key collaborators, incorporation of the initiative into policy, self-monitoring throughout, and team cohesiveness and communication. The pilot's success allowed RITE-Size to expand to other sites across Michigan.

Lewton from Lake Huron Medical Center (LHMC) followed the RITE-size presentation sharing first-hand experience of participating with the initiative in 2025. She described the site onboarding process, which included a RITE-Size site visit in July 2025 where her team worked with Dana Greene, Jr., Project Manager at MPrOVE, to discuss LHMC interventions and progress over the duration of the program and to schedule ongoing coaching sessions (Figure 2). After investigating preoperative testing rates, LHMC found that their biggest outlier was electrocardiograms (EKGs) ordered by a particular surgeon.

After the site visit, the lead anesthesiologist met with the surgeon, and they discovered he had been given outdated testing guidelines when he onboarded. With this discovery, their team was able to review their testing guidelines and begin the process of updating and educating team members. By November 2025, LHMC saw a notable decrease in preoperative testing for low-risk surgeries and began development for an updated version of their pre-admission testing (PAT) guidelines.

Health in Action Workgroup - MVC Coordinating Center

This month’s health in action workgroup was led by MVC Site Engagement Coordinator Emily Bair, MS, MPH, RDN, CSP, with support from other staff at the MVC Coordinating Center. The workgroup encapsulated a year in review for member QI work in 2025 as well as a look ahead at 2026.

Bair shared result highlights from the MVC QI survey that many MVC members completed in June 2025, noting several common QI efforts across the state (Figure 3). The top areas of focus were sepsis, readmissions, transitions of care, population health management, and emergency department care. Of the 88 survey responses, there were a total of 65 hospitals, 8 physician organizations, and 15 hospital systems represented.

Some of the common barriers identified by member sites in the survey included insufficient resources and funds, staff burnout, high turnover, and staff shortages.

The MVC QI survey also sought to consider the needs of its members and asked participants to provide suggestions for how MVC can best support them in the upcoming year (Figure 4). The top requests included data and report-specific training, recordings and summaries of workgroups for those unable to attend events, user-friendly reports, smaller and more frequent breakout sessions during virtual events, and data and QI topics that are helpful for all types of hospital sites.

Bair reminded participants that MVC uploads virtual workgroup recordings to MVC’s YouTube channel and shares the link with members in a post-workgroup summary email along with slides and resources from presentations. To support members in accessing additional training opportunities, MVC has launched its new new site coordinator education program in January 2026. The four-module training is designed to provide a more individualized approach to building knowledge as an MVC site coordinator. The MVC QI survey was also a helpful resource for presenter recruitment, developing 2025 workgroup content, and planning 2026 offerings.

Following the 2025 review, participants engaged in an interactive polling activity about QI progress from the past year (Figure 5), areas of focus, and their key accomplishments. Some of the successes shared included improving compliance with the sepsis bundle, maintaining a low readmission rate, increased senior/executive leadership engagement, and a department-led change to improve utilization.

Workgroup participants were asked to share some of their QI priorities for 2026, including ways that their sites are trying to align with other services or programs and how MVC can best support them. Several shared they will focus on the following priorities in 2026:

Sepsis compliance improvement
Streamlining order sets to reduce sepsis fallouts
Reducing readmissions
Building connections with primary care clinics
Reducing length of stay
Reducing unnecessary preoperative testing by participating in the RITE-Size trial
Reducing hospital acquired infections
Interviewing readmissions patients

Participants also shared different ways they are working to align with Collaborative Quality Initiatives (CQI) and Centers for Medicare & Medicaid Services (CMS) measures. Several sites noted that they are shifting to align their sepsis metrics with the Michigan Hospital Medicine Safety Consortium (HMS) sepsis initiative and the CMS Hospital Sepsis Program Core Elements.

Members expressed interest in learning more about local quality leaders, developing effective committee structures within their sites, and acquiring new resources that might be available. Additionally, there was great interest in MVC’s new site coordinator education program that kicked off this January with modules that support site coordinators via one-on-one tailored training. Registration for the education program is closed for Q1 – Q2, and a waitlist has been started for Q3 – Q4. If you are a site coordinator interested in participating, you can submit an interest form. [LINK]

MVC welcomes workgroup presenters from across Michigan to share their expertise, success stories, initiatives, and solution-focused ideas with MVC members. Please reach out to us by email or by submitting a presentation proposal here if you are interested in sharing your work in a presentation.

10 Dec 2025

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Celebrating 2025 Successes and Setting the Stage for 2026

December 10, 2025 | 0 Comments | collaborative-wide meeting, custom analytics, health outcome variation, MVC P4P, MVC registry, site visits, workgroups

On behalf of the MVC Coordinating Center, let me first start this end-of-year blog by thanking you all for your partnership and continued support throughout 2025. In case you blinked and its now December – don’t worry, you’re not alone! The last year has flown by with plenty of twists and turns along the way. Before we get caught up in the holidays and planning for 2026, we wanted to step back and celebrate the successes we achieved together over the last 12 months.

In writing my reflection piece last year, I highlighted that both our engagement participation and analytics utilization were far above previous years. While this gave us a hard act to follow, we are delighted to share that this trend continued upwards in 2025. Over the last year, we welcomed two new hospital members to the collaborative, delivered 23 virtual workgroups with an average attendance of 41, facilitated 24 different member presentations, completed 9 site visits, delivered 14 custom analytic requests, and supported 106 new users in gaining access to our online registry. On top of all of this, we held two collaborative wide meetings in Midland and Livonia, with 197 member representatives joining us to share stories, spotlight successes, and support one another in navigating all of the challenges which 2025 decided to bring.

These flagship numbers only tell one part of the story; the true value of each of the activities detailed above comes from the relationships and partnerships developed as a result of the time spent together. We hope you all have taken as much benefit from these collaborations as our group has during this time. Which brings me to another highlight…the MVC Coordinating Center. Let’s take a moment to celebrate the people who not only help make all of the above possible but that make this such a great place to work. Thank you to the entire MVC team for your hard work and commitment to supporting our members throughout 2025. I’m excited for what the next year will hold. Speaking of which, here’s a sneak peek of a few things that will be taking place in 2026.

Collaborative Wide Meetings, Networking Events, and Virtual Workgroups

MVC’s 2026 engagement events calendar is now live. Our spring collaborative wide meeting will take place on Friday, May 8 in Traverse City and we will be returning to Livonia for our fall meeting on Friday, October 9. These forums continue to be supported by virtual and in-person networking activities and dinners throughout the year, and dates for our regular suite of virtual workgroups can also be found on the 2026 calendar. Save the dates - we look forward to seeing you at each of these events!

MVC Site Visits

We visited a number of you in 2025, providing the opportunity to strengthen our understanding of member activities, priorities, and system-level practices. This effort will continue next year, and members can participate in these site visits in either a virtual or in-person capacity, with P4P engagement points on offer for taking part. If you are interested in getting on the calendar for 2026, please don’t hesitate to reach out.

MVC Site Engagement Coordinator Education Program

In response to member feedback, MVC will be launching a new Site Coordinator Education Program in 2026, designed to offer a flexible, individualized, rolling training curriculum to provide members with a stronger understanding of MVC data, share tools to help evaluate metric progress, and facilitate peer collaborations. This program is in high demand with capacity already met for the first round of registration. Additional opportunities to participate in this new education program will open throughout the calendar year – more communications to follow!

New MVC Component of the BCBSM P4P Program PY26/27 Registry Pages & Webinars

As with previous cycles, new P4P pages will be launched at the turn of the year to correspond with the changes implemented for PY26/27. These pages will look and feel similar to those currently available with a few important updates to reflect changes to our episode spending and value metric menu options and the introduction of MVC’s new Health Outcome Variation Measure. The latter reflects a new metric to the MVC Component, and to support members in navigating and utilizing these new registry pages, dedicated explainer webinars will be held in January.

MVC Push Reports and Custom Analytics

As highlighted above, MVC’s push reports and offer of custom analytics were well utilized by members in 2025, and to reflect member feedback, efforts will be spent strengthening this offering for member benefit in 2026. Remember, if you are interested in working with the Coordinating Center on a custom build, reach out to us by email. [LINK]

Thank you again for your continued partnership throughout the last year and we look forward to more successes in 2026. Have a great holiday and a happy new year when it rolls around.

03 Dec 2025

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November Workgroups Highlight Mobile Health and Patient Storytelling

December 3, 2025 | 0 Comments | Cardiac Rehab, cardiac rehabilitation, CHF, Chronic Disease, HBOM, health outcome variation, Michigan Cardiac Rehabilitation Network, MiCR, non-medical drivers of health, post-discharge follow-up, rural hospitals

In November, MVC hosted two virtual workgroup presentations – the first, a rural health workgroup, featured Hillsdale Hospital’s mobile health unit initiative. The second, a post-discharge follow-up workgroup, continued a presentation started at MVC’s February 2025 health in action workgroup on patient journey mapping and introduced a joint patient storytelling project by Healthy Behavior Optimization for Michigan (HBOM) and Michigan Cardiac Rehab Network (MiCR). The MVC Coordinating Center hosts workgroup presentations twice per month covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehab, rural health, preoperative testing and health in action.

Rural Health Workgroup – Hillsdale Hospital

The first workgroup of the month provided a review of Hillsdale Hospital’s mobile health unit, which aims to deliver essential health services to patients living in rural communities who may otherwise struggle physically or financially to reach traditional care settings.

As Lindsey Crouch, Director of Outpatient Clinics, Home Care, and Durable Medical Equipment for Hillsdale Hospital explained, rural communities face higher health outcome variation, transportation issues, limited accessibility to primary care providers, and high unnecessary emergency department (ED) utilization (Figure 1).

During the Covid-19 pandemic, Hillsdale County’s health department purchased a mobile health unit in an effort to close the gap in healthcare access for their community. However, despite continued need, utilization of the mobile unit has waned in recent years.

Hillsdale Hospital aimed to revitalize the mobile health unit to:

Bridge access gaps in rural areas. For many rural residents, distance to hospitals or clinics, limited transportation, and infrastructure challenges can hinder timely access to care. A mobile health unit can bring services to patients rather than requiring patients to travel long distances. This helps to reduce one significant non-medical barrier to care.
Focus on preventive and ongoing care. The mobile unit’s design supports not just acute care, but preventive services — screenings, check-ups, chronic disease management — especially helpful for rural populations that may have higher chronic disease burden and less frequent access to routine care.
Address gaps in health outcomes between communities. By delivering care directly to underserved communities, this model aligns with broader efforts to ensure that where a person lives does not determine whether they receive high-value, quality healthcare.

Throughout this program, Hillsdale Hospital aimed to improve health outcome variation with a goal to achieve a 15% improvement in selected chronic disease metrics (e.g., blood pressure control) while also establishing partnerships with local organizations for sustainability.

Throughout the presentation and follow-up discussion, participants addressed several key considerations related to implementing and operating the mobile health unit including:

Logistical planning & scheduling. Which rural towns or areas will be served? How often do visits occur? How to communicate the schedule to residents to maximize utilization?
Service offerings. What mix of services beyond basic triage should be included? Considerations may include screenings, chronic disease management, preventive care, and referrals when needed to ensure the mobile unit meaningfully supplements local rural healthcare capacity.
Coordination with local providers. What existing local hospitals, clinics, and community health organizations should be involved to ensure continuity of care? Consider these, especially follow-up and referrals, for more advanced services.
Addressing rural-specific challenges. What unique barriers impact your community? Consider transportation, limited staffing, and supply chain constraints.

Hillsdale Hospital’s mobile health unit embodies a vision for bringing high-value, high-quality care to rural Michigan. By lowering access barriers and delivering preventive and ongoing services directly to patients in their communities, this initiative can help improve health outcomes, reduce reliance on emergency services, and foster trust in healthcare among rural residents.

Insights from this workgroup have several practical implications for other rural hospitals and provider organizations across Michigan:

Expansion is possible through mobile care. Rural hospitals can leverage mobile health units as an extension of their current clinical outreach, helping to connect with populations that may rarely visit brick-and-mortar facilities.
Support chronic disease management. By delivery of routine care and screenings, mobile units can help stabilize chronic conditions earlier, reducing acute exacerbations and potentially reducing avoidable ED visits.
Enhance care coordination. Partnering with mobile health teams and community resources can help coordinate follow-up appointments, testing, and specialty referrals to create a more continuous care experience for rural patients.
Advance population health goals. Mobile services can function as a tool within a hospital’s broader population health strategy, align with value-based initiatives, community health needs assessments, and provide the opportunity for all people to achieve optimal health goals.
Gather meaningful community insights. Regular presence in rural communities can help hospitals better understand local barriers, non-medical drivers of health, and other care gaps which may inform program planning, grant proposals, and collaborative partnerships.

Post-Discharge Follow-Up Workgroup – MVC and HBOM

The second MVC workgroup of November featured a joint presentation by MVC’s Associate Program Manager, Jana Stewart, MPH and HBOM’s Informatics Design Lead, Noa Kim, MSI. The workgroup kicked off with an overview of the rationale behind placing a greater emphasis on post-discharge follow-up – particularly how timely and effective follow-up care can reduce readmissions, improve patient outcomes, and ease transitions from inpatient to outpatient or home settings.

Next, as a continuation of the February 2025 health in action workgroup presentation on patient journey mapping, Stewart showed how mapping can be used to highlight key moments in a coronary heart failure (CHF) patient’s journey where there may be opportunities for post-discharge care coordination improvement – e.g., medication reconciliation, patient knowledge, frequent rehospitalization, low follow-up rates, and lack of social and community support.

An important strategy for combating these challenges for CHF patients is engagement in cardiac rehabilitation. And yet, patients rarely optimize this opportunity. Patient storytelling can help patients recall details, model scenarios a patient may experience in the future, and reduce the burden of information provided during a visit and may be a strategy to optimize cardiac rehab enrollment.

Under the umbrella of Michigan Cardiac Rehab (MiCR), a collaboration between the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2), MVC, and HBOM, several initiatives have been developed aimed at optimizing guideline-directed medical therapy including the development of NewBeat materials and now the Heart-to-Heart storytelling campaign (Figure 2).

As Kim explained, the goals of the Heart-to-Heart project are to collect diverse first-person accounts of cardiac rehab in video, audio, and photo formats from patients and clinicians from across Michigan to produce a compelling, free, reusable story library for use by cardiac rehab advocates across Michigan and beyond.

For hospitals and health systems across Michigan seeking to improve post-discharge outcomes, insights from this workgroup offer the following next steps:

Use journey mapping and storytelling in quality improvement. By mapping patient journeys and capturing patient experiences, providers can better identify and address systemic barriers to safe discharge and recovery.
Adopt standardized discharge-to-follow-up workflows. Hospitals should ensure that discharge planning includes scheduling follow-up appointments, medication reconciliation, and clear communication of next steps before patients leave the hospital.
Prioritize high-risk patients for post-discharge support. Patients with chronic illness, limited social support, or social determinants that might hinder recovery deserve extra attention during discharge planning and follow-up scheduling.
Assign care coordinators or navigators. Especially for high-risk or complex patients, dedicated staff to oversee follow-up care – manage appointments, support communication, track adherence, and offer resources – may reduce readmissions and improve outcomes.
Leverage post-discharge care as part of value-based care strategy. Effective follow-up after discharge supports long-term patient health, reduces avoidable costs, and aligns with goals of high-value care frameworks.

19 Nov 2025

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Highlights from the 4th Annual Michigan Cardiac Rehabilitation Network (MiCR) In-Person Meeting in Troy, MI

November 19, 2025 | 0 Comments | BMC2, Cardiac Rehab, cardiac rehabilitation, CQIs, HBOM, Michigan Cardiac Rehabilitation Network, MVC

The Michigan Cardiac Rehab Network (MiCR) held its fourth annual in-person meeting at Corewell Health East in Troy, MI on Nov. 13, 2025. The full slide deck is now available [LINK]. Opening the meeting’s agenda was Mike Thompson, PhD, MPH, co-director of MiCR and senior advisor at MVC. He welcomed attendees to the Corewell Health Beaumont Troy campus, announced the finalization of MiCR’s two-year strategic plan (Figure 1), and shared that Henry Ford Hospital was receiving the final MiCR Cardiac Rehabilitation Utilization Award mini grant to support their QUASAR project, which pilots a hub-and-spoke telehealth model for cardiac rehabilitation (CR) delivery. He also highlighted renewed engagement of the MiCR Advisory Council and ongoing collaboration with the Healthy Behavior Optimization for Michigan (HBOM) team to collect patient stories.

Dr. Thompson described MiCR’s strategic initiatives in two key areas: telehealth and medication management. For telehealth, MiCR is employing a multi-pronged approach that includes surveys, qualitative interviews, and stakeholder outreach to understand the current state, implementation plans, and barriers to telehealth CR implementation in Michigan. This effort will also include an evaluation of the value and utilization of existing resources that support telehealth CR. In the realm of medication management, MiCR is using claims data to assess variability in medication adherence among CR participants and applying surveys, interviews, and outreach to identify gaps and opportunities for improvement. These efforts will lead to actionable plans designed to help stakeholders implement initiatives that elevate CR services across the state.

MiCR/HBOM Heart-to Heart Collaboration Update

Larrea Young, MDes, a human-centered design project manager at HBOM, announced the launch of Heart-to-Heart, a new initiative designed to inspire both patients and providers by collecting and sharing diverse stories of patient experiences with CR. The goal of this effort is to foster broader conversations about the life-changing impact of CR and encourage patient enrollment by providing strong peer endorsements. The HBOM and MiCR teams are gathering first-person accounts in video, audio, and photo formats to create an engaging, free, and reusable story library for CR advocates across Michigan and beyond. Progress so far includes 10 patient interviews at two sites, representing a wide range of demographics and experiences. HBOM previewed a clip from a patient interview at the meeting. Clinicians were also encouraged to contribute to the effort by sharing voice messages about cardiac rehabilitation through Speakpipe.

Leveraging National CR Quality Improvement (QI): Efforts, Updates, and Next Steps

Megan Gross, MPH, CHES, ACSM-CEP, EIM, clinical exercise physiologist at Holland Hospital and board director of the Michigan Society for Cardiovascular and Pulmonary Rehabilitation (MSCVPR), shared a summary of national CR QI efforts and discussed how her organization has leveraged these initiatives to advance local QI projects. She identified tools and resources, advocacy, and QI champions as the core “pillars” of quality improvement, all supported by a foundation of data. Gross highlighted nationally available resources such as the Million Hearts/American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) Cardiac Rehab Change Package and the Agency for Healthcare Research and Quality’s (AHRQ) TAKEheart initiative, as well as ongoing advocacy, research, and publications. Encouraging all CR program staff to view themselves as champions, she transitioned to describe how Holland Hospital has applied these tools in their own QI efforts, concluding with a description of their project to implement an inpatient liaison model aimed at increasing CR participation.

Understanding the Physiologic and Clinical Significance of Metabolic Equivalents (METS)

Barry Franklin, PhD, a director emeritus of preventive cardiology and cardiac rehabilitation at Corewell Health East, gave a presentation explaining the physiological and clinical significance of metabolic equivalents (METs). Dr. Franklin summarized key lessons from his 50-year career in clinical exercise physiology, highlighting topics such as energy systems for exercise, acute cardiorespiratory responses (VO2 max), METs, anaerobic (ventilatory) threshold, fitness and mortality, fitness in relation to surgical outcomes and health care costs, and clinical considerations for prescribing exercise intensity. Dr. Franklin’s key take home message related to his guidelines and recommendations for moving patients from achievement of lower to higher METs through CR participation.

Sustaining Cardiac Rehab Through Health System Integration

Brett Reynolds, MPH, ACSM-CEP, and Cindy Haskin-Popp, MS, ACSM-CEP, of Corewell Health East shared their multi-year journey to build a fully integrated CR service line after the Corewell Health merger. They detailed key phases from planning and collaboration, such as forming committees, aligning workflows, and engaging stakeholders, to implementation, which involved developing communication channels, Epic workflow training, and designating super users for consistency. Post-integration successes included cross-training, improved communication, standardized competencies, and better patient care (Figure 2), while ongoing challenges remain in areas like documentation and order set variation. Looking forward, the team aims to pursue AACVPR accreditation, standardize patient education, and create a centralized referral process to further improve care quality and patient experience.

Medication Management Breakout Session

Following lunch, MVC Project Manager Emily Woltmann, PhD, MSW, led attendees through an interactive breakout session that explored roles, responsibilities, and strategies related to medication management in CR. Participants met in small groups to discuss strategies and barriers to addressing medication management issues with their CR patients (Figure 3). The information gathered will be used by the MiCR team to help drive forward the MiCR medication management strategic initiative.

Data Presentation and Panel Discussion on CR Completion Rates

Dr. Thompson led a session utilizing MVC claims data, which shared aggregate and unblinded data on CR completion rates across Michigan. This included a summary of the proportion of participating patients who finished the widely recommended 36 sessions, as well as those who completed at least 12 or 24 sessions. The findings revealed substantial variability among cardiac rehabilitation programs based on both metrics, with completion rates for the full 36 sessions ranging from 0% to 50% at CR programs across Michigan.

A subsequent panel discussion moderated by Dr. Thompson included Amy Poindexter, BS, CEP, CR manager at Trinity Health Ann Arbor and Livingston Hospitals, Amber Steele, BS, ACSM-CEP, CR lead at McLaren Bay Region Hospital, and David Running, BS, ACSM-CEP, CEPA, supervisor of CR at University of Michigan Health-West. Both the panel and the audience voiced a variety of strategies they use to increase session attendance in CR, such as developing supportive relationships with patients, watching for plateaus in progress, and having completion rituals and celebrations when a patient graduates from CR. The most frequently cited challenges to patients completing an adequate number of sessions were barriers related to the travel distance to CR programs and medical insurance copays.

AACVPR President Stacey Greenway Presents Keynote on AACVPR Strategic Plan

Stacey Greenway, MA, MPH, MAACVPR, ACSM-CEP, the newly elected president of AACVPR, delivered the meeting keynote, highlighting AACVPR’s growing multidisciplinary membership, widely recognized training and certification programs, and enhanced data registry resources for cardiac and pulmonary rehabilitation professionals. She outlined the 2026–2028 strategic plan focused on increasing awareness and engagement, advancing innovative delivery models like telehealth, and strengthening research and outcomes through a national network. Greenway encouraged MiCR members to participate nationally via opportunities such as the AACVPR quality improvement cohort, day on the hill, and legislative advocacy, and she invited involvement in content submission and session proposals for the 2026 Annual Meeting in San Antonio, TX.

Conclusion and Next Steps

Dr. Jessica Golbus, MD, MS, Co-Director of MiCR, wrapped up the meeting with a summary of the day’s key points and next steps. She shared that a follow-up email will be sent in the coming weeks and announced the dates for MVC cardiac rehabilitation virtual workgroups scheduled for 12 p.m. on Feb. 10, June 9, and Oct. 20 in 2026. The date for MiCR’s spring webinar will be announced soon.

MiCR is a partnership between BMC2 and MVC, the purpose of which is to improve access to, utilization of, and delivery of cardiac rehabilitation services across the state of Michigan. MVC is proud to partner with providers, hospitals, and fellow CQIs in advancing quality initiatives that benefit patients in Michigan. If you have questions about any of the topics discussed at the MiCR annual meeting or are interested in following up for more details on other initiatives, email the MiCR leadership team [EMAIL] or the MVC Coordinating Center [EMAIL].

12 Nov 2025

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MVC Announces Meeting Dates, Workgroups, and Trainings Available in 2026

November 12, 2025 | 0 Comments | BCBSM P4P, MVC Coordinating Center, MVC P4P, MVC workgroup, Pay for Performance

As we head into the holiday season and final months of calendar year 2025, the MVC Coordinating Center has been planning for its 2026 engagement activities. At MVC's most recent fall collaborative-wide meeting in October, MVC first announced several key dates and updates related to next year’s engagement offerings.

MVC’s 2026 event calendar is available now [PDF]. Of note, MVC site coordinators can see the dates for 2026 collaborative-wide meetings (Figure 1) and workgroups, as well as the months in which MVC will offer in-person or virtual networking events. MVC will head to Traverse City for its spring collaborative-wide meeting on May 8, 2026. MVC will return to Vistatech in Livonia for its fall collaborative-wide meeting on Oct. 9, 2026.

Also available is MVC’s Program Year (PY) 2026 P4P Engagement Point Menu [PDF]. Engagement activities offered in 2025 will largely continue along with some minor changes and new additions.

Earning P4P Engagement Points in 2026

In PY 2026 of the MVC Component of the BCBSM P4P Program, members can continue to earn up to two engagement points by completing eligible MVC activities. Many of the engagement point activities from PY 2025 remain available, such as attending or presenting at eligible MVC events, participating in site visits, utilizing MVC custom analytics, and survey submissions (Figure 2). Some of these offerings will have minor adjustments to their allotted point values. For example, attending a collaborative-wide meeting will now be worth 0.4 points compared to 0.25 points in 2025, and worth 1 point in 2026 for attending both meetings versus 0.75 in 2025.

Another minor change is the number of virtual workgroups offered. MVC will offer 18 virtual workgroups in 2026; these workgroups will continue to focus on similar topics and themes, including cardiac rehabilitation, preoperative testing, post-discharge follow-up, rural health, health in action, and sepsis.

New Engagement Offering

MVC is excited to introduce one new offering in 2026: site coordinator education modules. These modules will support site coordinators via one-on-one tailored training that covers a variety of topics (Figure 3). Site coordinators can receive 0.2 engagement points per module and may participate in as few as one module or all four within the performance year. Each quarter of 2026, MVC will offer limited registration to participate in a module. Registration to begin participating in 2026 Q1 will start in December 2025. Training topics provide a review of:

Overview of MVC’s mission, history, P4P program, and site coordinator role
Training on MVC claims data, metrics, and reports
Introduction to MVC’s value-based initiatives and the CQI model
Meeting with other site coordinators to collaborate and discuss practices

As part of the online training, site coordinators will complete a structured education plan with individualized guidance to deepen understanding of how to get the most value out of MVC’s offerings.

Earn Engagement Points by Being a Presenter

For those sites participating in the MVC Component of the BCBSM P4P Program, being a presenter at an MVC event is an opportunity to earn 0.5 points toward your hospital’s PY26 engagement points. By sharing successes, lessons learned, and helpful tools with members from across the state, presenters play an important role in improving outcomes for all Michigan patients. MVC’s Engagement team is here to support you every step of the way, making the experience of presenting as easy and comfortable as possible. Presentation proposals are accepted on a rolling basis through MVC's online form.

MVC offers a variety of opportunities to engage with the Coordinating Centers and other members of the collaborative to support peer learning, best practice sharing, and networking. These activities and events foster a collaborative learning environment that enables providers to learn from one another in a cooperative, non-competitive space, and is therefore core to MVC’s efforts to support sustainable, high-value healthcare delivery across the state. We look forward to engaging with you and your teams next year. Please contact the Coordinating Center with any questions [EMAIL].

05 Nov 2025

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October Workgroup Highlights Food FARMacy Program for Chronic Disease Management

November 5, 2025 | 0 Comments | Chronic Disease Management, diabetes, Michigan Value Collaborative, MVC, MVC workgroup, non-medical drivers of health

In October, MVC’s health in action workgroup featured Hurley Medical Center’s Amanda Escalera-Torres, RD, Director and Nutrition Specialist for their Food FARMacy program. The presentation shared how the program helps support patients with chronic diseases by providing healthy food and nutrition education. The MVC Coordinating Center hosts workgroup presentations twice per month, covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehabilitation, rural health, preoperative testing, and health in action.

Health in Action Workgroup: Hurley Medical Center

Hurley Medical Center’s Food FARMacy initiative was founded in 2017 to address Genesee County’s higher food insecurity rate of 13% (compared to the state average of 11%). It was funded by several grants and the Hurley Foundation to provide support services such as grocery access and nutrition education for Hurley patients. According to a 2024 MVC member survey, programs such as this are becoming more common in health systems across the state to address non-medical drivers of health such as food insecurity, economic and housing instability, and other factors. Food insecurity and being unable to access nutritious food has been linked to an increased risk of chronic diseases such as diabetes, cardiovascular disease, and certain types of cancer (Odoms-Young, 2024).

Patient Eligibility and Enrollment

Escalera-Torres shared that patients are eligible to enroll in the Hurley Food FARMacy program if they are both food-insecure and have a chronic diet-related condition (Figure 1). Patients are referred to the program through avenues such as Hurley Medical Center inpatient or outpatient services, community health clinics, or primary care clinics throughout Genesee County. Once enrolled, patients receive monthly grocery support, meal kits, and nutrition classes for up to six months (Figure 2).

Food Distribution Process

Each month, Hurley’s Food FARMacy program provides 300–400 patients with food access and education. Groceries are acquired through established contracts with local farmers and vendors and include locally sourced fresh fruits, vegetables, grains, meat, and more.

Program and Participant Success

Hurley Food FARMacy expanded their food resources by increasing their farmer and vendor contracts to 11 this past year. This provides more accessibility for food and helps boost the local Michigan economy. The program also established 12 referral partnerships across Genesee County’s community health centers and primary care providers, allowing the program to serve over 5,500 individuals in the last year. Among the population served, only 5% of those who completed six or more Food FARMacy visits in the last year had an inpatient admission (Figure 3).

Reducing Barriers

Following the presentation, Escalera-Torres answered questions about the ways the program has been able to reduce barriers to access, including how food supply was managed during the off-season and how they accommodated patients with transportation limitations. Escalera-Torres explained that the program did experience some difficulty acquiring fresh produce during the off-season but recently partnered with Great Lakes Farm to Freezer to ensure availability of a robust selection of nutritious foods year-round. To address patient transportation barriers, Hurley Food FARMacy partnered with Door Dash earlier in the year for a trial run of delivering food to participants. The program was well received but ended due to lack of continued funding. Patients with transportation barriers are now able to assign a proxy to pick up their groceries, which has helped reduce accessibility barriers.

The Food FARMacy program will continue to adapt and serve Genesee County patients providing quality food and improving nutritional awareness for chronic diet-related illnesses.

22 Oct 2025

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

October 22, 2025 | 0 Comments | BCBSM P4P, MVC, MVC Coordinating Center, MVC P4P, P4P, Pay for Performance

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.

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.

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.

15 Oct 2025

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MVC 2025 Fall Collaborative-Wide Meeting Summary – Adapting Together in 2025 and Beyond: High-value Care for All in a Changing Landscape

October 15, 2025 | 0 Comments | collaborative-wide meeting, health outcome variation, Michigan Value Collaborative, MVC Coordinating Center, outcome variation, Semi-Annual Event

The Michigan Value Collaborative (MVC) held its fall 2025 collaborative-wide meeting on Friday, Oct. 10, in Livonia. A total of 91 attendees representing 64 hospitals, three physician organizations, and 13 healthcare systems from across the state of Michigan came together to share strategies for mitigating the impact of non-medical drivers on health outcomes.

MVC Director Mark Bradshaw, MSc, kicked off Friday’s meeting with updates on the MVC Coordinating Center [See slides]. He introduced MVC’s newest team members, Manager of Data Analytics Ian Raxter, MPH, and Project Manager Emily Woltmann, PhD, MSW, as well as announced the promotion of Julia Mantey, MPH, MUP, to Lead Analyst. Bradshaw encouraged sites to register for the 2025 Michigan Cardiac Rehab network (MiCR) fall meeting at Corewell Health Troy Hospital by the Oct. 31 deadline. He also provided an update on Phase II of the RITE-Size preoperative testing trial and recent MVC reporting since MVC’s spring meeting, including refreshed common conditions push reports, the new health outcome variation push report, and the P4P Program Year 2025 mid-year scorecards. Bradshaw provided insights on the content included in the health outcome variation push report and the P4P Program Year 2025 mid-year scorecards before reviewing Program Year (PY) 2026-2027 cycle changes and member selections (Figure 1 and Figure 2).

Following Bradshaw’s announcement that MVC’s 2026 engagement point menu is now posted on MVC’s P4P webpage, MVC Engagement Manager Jessica Souva, MSN, RN, C-ONQS, highlighted the differences from previous versions of MVC’s engagement point menu. Souva noted that most of the changes to the engagement point menu were adjustments to the point values; however, Souva introduced the addition of a site coordinator education modules offering (Figure 3). Details on these modules will be shared with MVC site coordinators in the coming months via email.

The meeting then featured a presentation from the MSHIELD CQI, including Program Manager Julia Weinert, MPH, and Bradley Iott, PhD, MPH, on implications of non-medical drivers of health for quality improvement. Weinert and Iott presented research evidence on the importance of addressing upstream drivers of health outcomes, MSHIELD implementation toolkits, and resources available on the MSHIELD website.

MVC’s keynote presentation was delivered by Gloria Rey, PA-C, MPH, Director of Post-Acute Care for Henry Ford Health/Populance. Her presentation detailed Henry Ford Health’s approach to developing and maintaining strong relationships with post-acute care providers [See slides]. Rey went on to demonstrate how these relationships have improved patient outcomes and cost savings (Figure 4).

After a networking lunch, MVC Medical Director Hari Nathan, MD, PhD, and MVC Analyst Kushbu Narender Singh, MDS, MPH, delivered an MVC data presentation focused on MVC’s new health outcome variation measure [See slides]. During the presentation, Narender Singh supplemented Dr. Nathan’s explanation of the measure definition (Figure 5), benefits, and rollout timeline with MVC member unblinded data and case scenarios. An introductory video for the health outcome variation measure is available on MVC’s P4P webpage.

The meeting closed with a reflection of the day spent together and reminders about upcoming meetings and events [See slides].

What are the attendees saying about the meeting?

“I gained a lot of insight and ideas to take back to my organization to review with others.”

“I learned that patients can be in home care and cardiac rehab at the same time which is a game changer for us.”

“Enjoyable to see the multi-faceted approaches that are being used throughout the state's regions for decreasing readmissions.”

“I really enjoyed the breakout sessions and discussions!”

“Loved the ability to talk with other groups and learn from each other. Like the unblinded data, it was more meaningful to what was being discussed.”

If you have questions about any of the topics discussed at MVC’s fall collaborative-wide meeting or are interested in following up for more details, email the MVC Coordinating Center. MVC’s next collaborative-wide meeting will be in person on Fri., May 8, 2026, in Traverse City.

08 Oct 2025

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September Workgroups Highlight Sepsis ED Triage Process and MVC’s Common Conditions and Procedures Report & Registry Review

October 8, 2025 | 0 Comments | Emergency Department Utilization, MVC Common Conditions Report, MVC Coordinating Center, MVC registry, sepsis

In September, MVC hosted two virtual workgroup presentations – the first, a sepsis workgroup focused on Henry Ford Health Macomb’s efforts to build a structured emergency department (ED) triage process specifically for patients diagnosed with sepsis. The second, a health in action workgroup focused on the recent MVC Common Conditions and Procedures Report and included an overview of how to combine this push report with MVC registry data. The MVC Coordinating Center hosts workgroup presentations twice per month covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehab, rural health, preoperative testing and health in action.

Sepsis Workgroup September 9, 2025

As Brandie DeVos, RN, MSN, Sepsis Coordinator explained at the beginning of the presentation, sepsis continues to challenge hospitals due to its time sensitive nature. Delays in recognition or treatment can lead to worse outcomes. Henry Ford Macomb Hospital’s ED sepsis team – composed of Michigan Hospital Medicine Safety Consortium (HMS) coordinators, internal sepsis program, and ED leadership – was established to combat just this issue. Their mission, to build a structured ED triage process, with specific attention to patients suspected of sepsis who present with abnormal vital signs to ensure the rapid identification, prioritization, and early intervention in suspected sepsis cases (Figure 1).

Co-presenters, DeVos and Errin Couck, BSN, RN, HMS Sepsis Coordinator, emphasized that having a consistent, structured triage process has helped to ensure cases of sepsis are not missed in the chaos of the ED. They recognized that prior to the initiation of a triage process directed at identifying sepsis, patients were being placed throughout the ED regardless of the presence of symptoms, vital signs indicating organ dysfunction, or indications of systemic inflammatory response syndrome (SIRS) criteria.

However, the triage system does more than mechanically screen vitals; it incorporates clinical judgement and risk indicators to prioritize patients with abnormal temperatures, elevated heart rate, hypotension, or altered mental status (Figure 2). The optimized identification of at-risk patients increases adherence to evidence-based sepsis bundle elements such as early labs, cultures, antibiotics, and fluid resuscitation within the defined time windows, a crucial step to improving performance in quality metrics.

However, in practice, the sepsis program requires the support of a multidisciplinary team. DeVos and Couck note the most common roadblocks to this initiative were staff push back, untrained RNs in the triage area, and RN fatigue. They encourage aligning all stakeholders early and sustaining communication channels. They also noted great success with positive encouragement (i.e., celebrating the small wins), requiring triage RNs to have at least one year of ED experience, and routine triage RN rotations (every four hours).

Since initiating the new triage process, the presenters noted the following positive outcomes:

A 36% increase in antibiotics given within three hours of arrival for septic shock patients
For emergency medical services (EMS) patients, vital signs are obtained, triage completed, and patients roomed appropriately in an average of 12 minutes
90% of lobby patients have vital signs obtained within 5-10 minutes
Overall, less patient triage complaints

The presenters ended the presentation by discussing a challenge they have experienced when attempting to expand their sepsis ED triage process to other sites within their own system. Hospitals differ – in size, resources, patient volume, and staffing. DeVos and Couck encouraged participants to pilot, learn, and iteratively refine their workflows locally.

This workgroup session served as both a practical guide and a rallying call – a structured ED triage for suspected sepsis should not be optional. It’s a critical defense against delays that cost lives.

Health in Action Workgroup September 25, 2025

The September health in action workgroup featured a presentation by MVC’s Site Engagement Coordinator Emily Bair, MS, MPH, RDN, CSP. The presentation focused on the recent MVC Common Conditions and Procedures Report and included an overview of how to utilize the MVC registry to compliment analyses included in this push report.

The Common Conditions and Procedures Report was developed as a structured data tool aimed at providing individualized, comprehensive, high-impact trends in commonly seen chronic conditions and a selection of procedures across participating hospitals. The most recent version of this report was shared with members in July. Two previous versions of the report were shared in 2024 and 2023.

Similar to previous iterations of the report, the most recent Common Conditions report included 30-day inpatient or surgical episodes created from two years of index admissions between January 2023 – December 2024. Exclusions included patients who had an inpatient hospital transfer, died in the hospital during their index hospitalization, or were discharged to hospice. Payors included Blue Care Network HMO Commercial and Medicare Advantage, Blue Cross Blue Shield of Michigan PPO Commercial and Medicare Advantage, Medicare Fee-for-Service, and Michigan Medicaid.

Within each report each site has an individualized patient population overview table that displays the patient population for each common condition (Figure 3). This table illustrates the distribution pattern of the population within each common condition but is not necessarily indicative of the distribution of patient demographics for the outcome of interest. In addition to age, gender, and race/ethnicity categories, the table includes zip code level data based on the Economic Innovation Group’s Distressed Communities Index (DCI) 2015-19, dual-eligible status, and common comorbidities.

In an effort to continue to support hospitals to move from simply viewing data to implementing quality improvements, Bair outlined a few key MVC engagement strategies:

Outreach and coaching: MVC offers one-on-one coaching to support members with data interpretation and connections to peers
Custom analytic report development: MVC may facilitate the development of deeper data analyses
Peer learning and collaboration: MVC aims to catalyze dialogue across sites, encouraging sharing cross-hospital learning
Iterative feedback: MVC welcomes feedback from members to support the evolution of data tools

Once a registry request is received, the MVC team will confirm your request with your specified site’s MVC Site Coordinator (primary contact). Once confirmed, you will be sent an MVC website confidentiality agreement (WCA), and upon receiving the completed WCA, MVC will provide you with a username and directions to login via email.

If you are interested in pursuing a healthcare quality improvement project, MVC has data specialists available to help you navigate our data resources and create custom analytics reports to support your efforts. Please reach out to us by email if you would like to learn more about MVC data or engagement offerings!

Preoperative Testing Workgroup - RITE-Size & Lake Huron Medical Center

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

Figure 2. LHMC Timeline of RITE-Size Pilot Work

MVC Preoperative Testing Workgroup: Dec. 2, 2025

Health in Action Workgroup - MVC Coordinating Center

Figure 3. Statewide QI Initiatives in 2025

Figure 4. MVC Member Suggestions for Future Offerings

Figure 5. MVC Participants QI Progress Word Cloud

MVC Health in Action Workgroup: Dec. 18, 2025

Rural Health Workgroup – Hillsdale Hospital

Figure 1. Hillsdale County Community Health Needs Assessment (CHNA) Survey Data: Difficulty Finding or Getting Transportation to a Doctor in 2024, 2022, 2019, and 2016

MVC Rural Health Workgroup: Nov. 4, 2025

Post-Discharge Follow-Up Workgroup – MVC and HBOM

Figure 2. Examples of MiCR Guideline-Directed Medical Therapy Campaigns

MVC Post-Discharge Follow-Up Workgroup: Nov. 20, 2025

Figure 1. 2025-2027 MiCR Operational and Strategic Framework

Figure 2. Corewell Health System CR Post-Integration Outcomes

Figure 3. MiCR Co-Director Mike Thompson facilitating a medication management breakout discussion

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Health in Action Workgroup: Hurley Medical Center

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MVC Health in Action Workgroup, Oct. 23, 2025

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Sepsis Workgroup September 9, 2025

Figure 1. Walk-In Triage Process for Sepsis

Figure 2. Code Sepsis Activation Process

MVC Sepsis Workgroup Sept. 9, 2025

Health in Action Workgroup September 25, 2025

Figure 3. Common Conditions Patient Population Snapshot for Hospital A (Blinded Data)

Figure 4. Common Conditions Report Page for Atrial Fibrillation for Hospital A (Blinded Data)

Figure 5. Summary of Relevant Reports on MVC Data Registry

MVC Health in Action Workgroup Sept. 25, 2025

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