This month the Michigan Value Collaborative (MVC) Coordinating Center distributed the final scorecards for Program Year (PY) 2023 of the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program. The 2023 program year was the second year of a two-year cycle for which hospitals were evaluated using MVC data. Hospitals were scored on two conditions that they selected from seven options: 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 the two-year program cycle. Joint replacement was the most commonly selected condition, and colectomy was selected the least.
Figure 1. Distribution of Hospital Condition Selections for PY 2023
The MVC Component of the BCBSM P4P Program evaluates each participating hospital’s risk-adjusted, price-standardized, average 30-day episode payments for their two selected conditions through two methods. Hospitals can earn points by reducing their payments from the baseline period (which included index admissions in 2020) to the performance period (which included index admissions in 2022). 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 the 2023 program year.
Figure 2. Distribution of Total P4P Scores for PY 2023
On average hospitals earned 7.4 points total, a decrease of 0.3 points from PY 2022’s average of 7.7 points. The majority (90.7%) of hospitals earned at least one of the two possible bonus points. As shown in Figure 3, the condition with the highest average point total was joint replacement (4.5 points) followed by spine surgery (4.3 points).
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 performance, please contact the Coordinating Center at Michigan-Value-Collaborative@med.umich.edu. The Coordinating Center will evaluate and release mid-year scorecards for PY 2024 in the summer of 2024.
