Last month the Michigan Value Collaborative (MVC) distributed final scorecards for Program Year (PY) 2022 of the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program. PY 2022 was the first year of a two-year cycle for which MVC data was used to evaluate hospitals on two of seven selected episode spending conditions. These P4P condition options included chronic obstructive pulmonary disease (COPD), colectomy, congestive heart failure (CHF), coronary artery bypass graft (CABG), joint replacement, pneumonia, and spine surgery. Figure one shows the frequency of hospital condition selections for this two-year program cycle. Joint replacement was the most commonly selected condition, while colectomy was selected by the fewest hospitals.
Figure 1. Distribution of Hospital Condition Selections for PY 2022
The MVC Component of the BCBSM P4P Program evaluates each participating hospital’s average 30-day, risk-adjusted, price-standardized episode payments for their two selected conditions through two methods. One way that hospitals earn points is by reducing their payments from the baseline period (which included index admissions in 2019) to the performance period (which included index admissions in 2021). These are termed “improvement points.” Alternatively, hospitals can 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 and case mix index.
While participants are scored on both improvement and achievement, members receive the higher of the two scores for each condition. Hospitals were also eligible to receive a bonus point for each condition by completing a questionnaire designed to inform MVC of member hospital quality improvement practices. While 12 points were available, a maximum of 10 points were awarded to participating members. Figure 2 shows the distribution of total points earned by hospitals for PY 2022.
Figure 2. Distribution of Total P4P Scores for PY 2022
On average, hospitals earned 7.7 points total, a nearly one-point increase from the average of 6.8 points in PY 2021. A majority (98.7%) of hospitals earned at least one of the two possible participation bonus points. The condition with the highest average point total was joint replacement at 4.6 points with spine coming in second at 3.4 points (Figure 3).
Figure 3. Average Points by Condition
If you have any questions regarding the MVC Component of the BCBSM P4P Program, please reference the P4P Technical Document for Program Years 2022 and 2023 and the MVC P4P FAQ PY 2022-2023. If you would like to set up a meeting to review your hospital’s scorecard, please contact the MVC Coordinating Center at Michigan-Value-Collaborative@med.umich.edu. MVC plans to evaluate and release mid-year scorecards for PY 2023 in the summer of 2023.