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The first change that Dr. Dupree discussed in detail is the change to MVC’s payer mix for PYs 2026/2027. Since April 2023, MVC members were given access to rates and spending for their Medicaid patients. Adding this patient population to the MVC P4P payer mix allows the collaborative to score a more comprehensive and diverse patient population. Medicaid data will be reflected in baseline measures provided in MVC participants’ PYs 2026/2027 selection reports.

Dr. Dupree also announced changes to the P4P episode payment condition menu for PYs 2026/2027. MVC will retire colectomy, pneumonia, and joint replacement, and will add percutaneous coronary intervention (PCI). Dr. Dupree summarized MVC’s decision-making and rationale behind each retirement or addition. As a result of these changes, the episode spending metric options for the upcoming cycle include CABG, CHF, COPD, and PCI.

A third change announced on Friday was a revision to the definition of MVC’s sepsis value metric. Dr. Dupree explained that this adjustment was being made to align with the Michigan Hospital Medicine Safety Consortium (HMS) initiative to increase post-discharge care coordination after sepsis. In PYs 2026-2027, MVC’s sepsis value metric will change from 30-day risk-adjusted readmissions after sepsis to 14-day follow-up after sepsis.

To close out the P4P presentation, Dr. Dupree announced the inclusion of a new health equity measure and the methodology behind it. This measure was developed with the goal of addressing common barriers that MVC member hospitals reported in the MVC health equity survey, such as insufficient data, no clear business case, and insufficient financial investments. With the introduction of MVC’s P4P health equity measure (Figure 2), MVC wants to quantify and drive improvement in all-cause readmission rates between payer groups at each hospital using an index of disparity (IOD). Dr. Dupree explained that similar index or composite measures have been utilized by health organizations already, and that this risk-adjusted measure can help identify hospital-level preventable differences in readmissions. Hospitals will earn the health equity point by improving relative to their own baseline IOD or by performing well relative to their peers (i.e., having an IOD at or below the median IOD across the collaborative).

Before closing the P4P session, Dr. Dupree reviewed the upcoming P4P timeline for various cycles. MVC selection reports for PYs 2026/2027 will be shared with members in early November. Following dissemination of these selection reports, MVC will accept selections until Dec. 13, 2024. Members may attend one of two webinars on Nov. 19 at 1 p.m. [REGISTER for 11/19] or Nov. 21 at 10 a.m. [REGISTER for 11/21] to support their selection process, as well as schedule one-on-one meetings with MVC staff as needed.

After the P4P session, MVC members and stakeholders presented posters highlighting their QI work on a wide variety of conditions and initiatives (Figure 3). The MVC Coordinating Center would like to thank all poster presenters for sharing their work. Electronic copies of the posters are available on the MVC website [LINK].

The poster session was followed by a presentation from the vice president of care coordination for Corewell Health System, Tricia Baird, MD, FAAFP, MBA. Dr. Baird leads inpatient, transitional, and ambulatory care coordination teams comprised of registered nurses, social workers, and community health workers. The presentation, “Readmission Reduction: Intelligent Targeting to Timely Intervention,” provided an in-depth look at how Dr. Baird’s team identified a subset of their Medicare patients with readmissions that were preventable [SEE SLIDES]. After identifying their complex patients, the Corewell team then designed interventions to target those discharge journeys, essentially providing an example of how to lower a payer-specific readmission rate.

After a networking lunch, attendees spent the afternoon participating in breakout sessions on two topics of their choice. A cardiac rehabilitation breakout session was led by Jodi Perdue, RN-C, BSN, who presented on Munson Medical Center’s multi-phase cardiac rehabilitation program [SEE SLIDES]. Her session was followed by an MVC unblinded data presentation by MVC site engagement coordinator Emily Bair, MS, MPH, RDN.

In the post-discharge follow-up breakout session, MVC project manager Jana Stewart, MS, MPH, guided attendees through a patient journey mapping workshop [SEE SLIDES]. Attendees learned the basics of patient journey mapping approaches and collaborated to draft patient journey maps for key patient populations in Michigan.

In the preoperative testing breakout session, Dana Green, Jr., MPH, a project manager and de-implementation specialist for the Michigan Program on Value Enhancement (MPrOVE), educated attendees on available resources, lessons learned, and upcoming opportunities related to the RITE-Size initiative [SEE SLIDES]. MVC engagement manager Jessica Souva, MSN, RN, C-ONQS, then showed participants their own sites’ performance on MVC’s preoperative testing metric using unblinded data.

The fourth breakout session on sepsis was led by Pat Posa, RN, BSN, MSA, CCRN, FAAN, a quality and patient safety program manager with the Michigan Hospital Medicine Safety Consortium (HMS). She outlined the complex impact of sepsis on patients and the motivations behind launching the HMS Sepsis Initiative, as well as details about HMS sepsis bundles and performance data [SEE SLIDES]. The session was closed out by MVC senior analyst Kim Fox, MPH, with an unblinded data presentation on 14-day follow-up after sepsis, MVC’s newest value metric.

The meeting closed with reminders about upcoming meetings, key dates for the PY 2026-2027 P4P metric selection process, and post-event survey information presented by Jessica Souva (Figure 4).