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16 Apr 2025

State-of-the-State Health Equity Report: A Snapshot of Hospital-Level Priorities, Barriers, and Opportunities in Michigan

April 16, 2025 | 0 Comments | birth outcomes, Cardiac Rehab, health equity, MVC, MVC Coordinating Center

Hospitals across Michigan are increasingly focused on using their available data to assess care delivery gaps, inefficiencies, and areas for improvement. The Michigan Value Collaborative (MVC) developed its 2024 Statewide Health Equity Report to provide a detailed summary of how hospitals across Michigan are approaching this process with a health equity lens. By analyzing MVC claims data along with survey responses from 52 hospitals and 11 health systems, the full report captures how hospitals are leveraging data to evaluate patient care, identify disparities in outcomes, and develop interventions that improve the overall value of care delivery.

Data Collection and Utilization

One of the key highlights of the report was the varied approach and capacity for collecting, measuring, and utilizing data on health equity. Many hospitals utilize readmission rates, clinical quality indicators, and demographic information to identify variations in care. However, the extent to which this data informs hospital-level decisions varies. While some hospitals remain in the early stages of collecting and organizing health equity data, others are beginning to analyze and apply these insights to shape their initiatives. Nearly a third of respondents indicated they were using data to guide funding and program priorities, while a smaller percentage integrated equity metrics into quality improvement strategies.

To further support hospitals in taking action, MVC used its robust medical insurance claims-based data to highlight established disparities for specific service lines. A notable finding was the difference in rates of birth complications by race (Figure 1). Women who identify as Asian and/or Pacific Islander had higher rates of postpartum hemorrhage than other race categories, and patients identified as Black had higher rates of hypertension and severe maternal morbidity (SMM) than the overall population.

Another notable finding was sex differences in cardiac rehabilitation enrollment (Figure 2). Women are significantly less likely to enroll in cardiac rehab within 90 days of discharge for eligible cardiac procedures, take longer to enroll in their first session, and attend fewer sessions on average than male patients. These patterns point to differences in how patients access and engage with follow-up care, and these gaps are present even among hospitals with strong cardiac rehabilitation enrollment rates.

These MVC claims-based investigations into healthcare outcomes across populations can assist hospitals in setting or enhancing their health equity goals.

Efforts to Improve Healthcare Access

Beyond data collection and analyses, the report summarized a range of efforts to improve healthcare access. Most hospitals have expanded telemedicine services, increased clinic hours, deployed mobile health units, support non-emergency medical transportation programs, and offer rideshare assistance to reach a variety of patient populations who struggle to access care in their community. Language accessibility has also been a focus, with nearly 90% of hospitals offering translated materials and on-site interpretation services. Financial barriers remain a concern, with 79% of hospitals reporting efforts to support patients dealing with medical debt or lacking insurance coverage.

There were also several hospitals implementing community-based programming and solutions in response to gaps for specific disease impacted communities or underserved groups. The most common types of solutions currently supported by hospitals across the state included:

Food Security Initiatives: Many hospitals are addressing food insecurity by screening patients for social needs, partnering with community food programs, and even launching hospital-based farms and Healthy Food Rx programs to encourage nutrition-based health interventions.
Community Health Workers (CHWs): Increasingly, hospitals are integrating CHWs into their care models to bridge the gap between clinical care and community-based support, particularly in rural and underserved areas.
Incorporating Patient Voices: Hospitals are utilizing Community Health Needs Assessments (CHNAs), patient experience surveys, and community advisory boards to ensure that patient perspectives inform quality improvement initiatives.

Looking Ahead

Although most hospitals have taken steps to improve care delivery across all patient populations, they face significant organizational barriers, such as insufficient funding for dedicated staff and programming, lack of staff training or expertise in community-focused challenges, and difficulty communicating the business case or return on investment of such efforts. These barriers and new ones will likely grow in the coming months and years as the field’s federal funding streams shift.

Amid that uncertainty, MVC hopes to play the role of facilitator by supporting hospitals with actionable equity data, facilitating peer learning opportunities through dedicated meetings and sharing of success stories, and financial incentives through the MVC Component of the BCBSM P4P Program. In addition, the MVC Coordinating Center regularly consults with the Michigan Social Health Interventions to Eliminate Disparities (MSHIELD) team on best practices for data collection and equity-centered quality improvement. MVC will demonstrate this commitment via its quarterly MVC member spotlight blog—which will highlight successful initiatives across MVC’s membership—and via dedicated learning sessions at MVC’s Oct. 10 collaborative-wide meeting in Livonia.

If you are interested in pursuing a health equity initiative, MVC has a robust registry of claims data that can be utilized, as well as site specialists who can help facilitate connections with peers doing similar work. Please reach out to us by email if you have a success story to share or want to learn more about related MVC data.

02 Apr 2025

Chronic Disease Chronic Disease Management CKD MVC Coordinating Center MVC workgroup post-discharge follow-up

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March Workgroups Highlight Chronic Kidney Disease Detection in Primary Care and Population Health Program

April 2, 2025 | 0 Comments | Chronic Disease, Chronic Disease Management, CKD, MVC Coordinating Center, MVC workgroup, post-discharge follow-up

In March, MVC hosted two virtual workgroup presentations – the first, a rural health workgroup focused on enhancing early detection of chronic kidney disease (CKD) in primary care and the second, a post-discharge follow-up workgroup focused on the impact of launching a population health program. MVC hosts two virtual workgroups per month with topics rotating between post-discharge follow-up, sepsis, cardiac rehabilitation, rural health, preoperative testing, and health in action (ad hoc focused topics). Each month, the MVC Coordinating Center publishes key highlights from the past month’s presentations to provide resources and support best practice sharing across the state.

March Rural Health Workgroup: National Kidney Foundation of Michigan & Michigan Center for Rural Health

In support of National Kidney Month, MVC’s first rural health workgroup of 2025 featured a presentation by Mary Wozniak, Program Manager for the National Kidney Foundation of Michigan (NKFM) and Jill Oesterle, Director of Provider Solutions for Michigan Center for Rural Health (MCRH). The joint presentation focused on the partnership between NKFM and MCRH on a 2024 Medicaid Impact and Expansion grant.

Low recognition of CKD is a chronic health problem. Nearly 35.5 million Americans are projected to have CKD but according to the Centers for Disease Control and Prevention (CDC) up to 90% of patients are unaware of their CKD status. Additionally, among Medicaid beneficiaries with CKD, the average estimated healthcare costs per year is more than six times the average cost per person when compared to patients without CKD.

Despite the availability of diagnostic tests like estimated glomerular filtration rate (eGFR) and albumin: creatinine ratio (ACR), fewer than half of individuals with diabetes and less than 10% with hypertension receive annual CKD screenings, even though both groups face heightened CKD risk. For more information about testing, Wozniak recommended the guidelines for CKD screening and management from KDIGO and KDOQI.

Knowing that CKD can be diagnosed with two simple evidence-based laboratory tests, NKFM and MCRH teamed up to combat low CKD screening rates. To start, Wozniak and Oesterle explained that the partnership established a CKD Learning Collaborative Initiative made up of four rural health clinics: Cass City Family Practice, Cass City Medical Practice, St. Helen Mclaren Primary Care, and Clare McLaren Central. These sites were identified based on data indicating a high CKD prevalence or low CKD screening rates within their Medicaid patient populations.

The collaborative aimed to increase awareness of the importance of early detection and management of CKD among Medicaid eligible populations at Rural Health Clinics (RHCs) using a three-pronged approach:

Increase provider and clinical education
Promote referrals to evidence-based lifestyle change programming (through NKFM)
Provide support and guidance to implement screening into clinical workflows

Each pilot site participated in an initial assessment including the collection of baseline data. NKFM then provided one-hour tailored clinical education sessions on various CKD topics from diagnosis and staging to lifestyle and nutrition approaches for prevention and management. Wozniak and Oesterle attribute the collaborative’s ability to adapt these trainings to each clinic based on their identified needs, capabilities, and goals to the successes observed in increased screening and diagnoses made at these pilot sites when compared to baseline data.

Amongst the four pilot sites, the collaborative found CKD screening rates in patients with diabetes increased on average by 27%, while in patients with hypertension (HTN) screening increased on average by 17% (Figure 1). Overall, CKD diagnosis increased by an average of 6.5% when compared to baseline.

Figure 1. CKD Learning Collaborative Data Findings

Empowering the healthcare team and patients with actionable recommendations was another strategy identified to be especially helpful in moving the needle on screening rates. Ensuring laboratory representation from the beginning of the project was especially helpful in overcoming challenges related to laboratory test ordering and reporting. Moving forward, the presenters note that the project timeline may need to be adjusted to build in enough time to identify clinic champions and develop buy-in with clinic staff.

Throughout the project, NKFM and MCRH met monthly with all the pilot sites together, as well as separately. This allowed them the opportunity to collaborate on shared successes and barriers while also offering an opportunity to cater education and guidance of interventions to each site’s needs. While each pilot site ended the project with different next steps, all will continue to receive support from NKFM and MCRH as they progress on their journeys to diligently increase CKD screening, diagnosis, and referrals to lifestyle management programs.

Using the remaining funds from this grant, NKFM and MCRH built on their successes by developing a CKD toolkit for rural providers. The toolkit allows them to broaden the reach of the CKD Learning Collaborative’s impact to more clinics across Michigan. While the toolkit does cater to a rural health clinic audience, any clinic interested in learning more about enhancing CKD care can access the suite of provider and patient education resources, workflows, and screening tools on MCRH’s website.

March Post-Discharge Follow-Up Workgroup: Oaklawn Hospital

This month, MVC’s post-discharge follow-up workgroup featured a presentation by Morgan Albright, Director of Case/ Care Management and Population Health at Oaklawn Hospital and Zach Chapman, Executive Director of Oaklawn Medical Group. Their co-presentation centered on Oaklawn Hospital and Oaklawn Medical Group’s collaboration to integrate Medicare Annual Wellness Visits (MAWVs) into their population health program.

MAWVs focus on preventive care and health maintenance and include a health risk assessment, review of medical history, and development of a personalized prevention plan (Figure 2). Unlike a preventive physical exam (IPPE) or routine physical exam, MAWVs do not include a comprehensive physical exam. Albright explained that while MAWVs are a standard benefit for Medicare beneficiaries, these visits were infrequently completed due to the limited time available during a PCP visit. Additionally, since these visits are hands off assessments and previously stand-alone appointments, patient satisfaction following these visits was generally low.

Figure 2. Comparison of Medicare Physical Exam Coverage

In January of 2023, three population health nurses were integrated across Oaklawn’s outpatient offices with the goal of conducting dual and/or phone-prep MAWV appointments. Combining an MAWV with another regularly scheduled visit has helped to alleviate the barriers that existed for the Medicare patient population. Benefits of completing the MAWV include increased care planning, depression screening, and patient satisfaction.

An additional benefit to the integration of the population health nurses and MAWVs has been in the improvement of billing and revenue. Albright explained that while an initial MAWV does not necessarily generate revenue, any subsequent MAWVs, such as those focused on depression screening or social determinants of health (SDoH) concerns, are billable. Champman notes that in 2022, only 66 depression screenings were billed, compared to close to 4,000 in 2024. Similarly, billing for advanced care planning has increased from 94 cases in 2022 to 1,100 in 2024. Chapman estimates the return on investment is about 150% of the cost of a dedicated population health RN. He also noted the impact the introduction of population health support staff has had on reducing the primary care physician’s workload.

In addition to the MAWV assessments, Albright and Chapman note Oaklawn has initiated a chronic care management program. This program is a collaborative effort between Oaklawn’s care managers and a third-party chronic care management vendor. These check-ins take place between regularly scheduled appointments to ensure patients have the resources (access to medications, transportation, etc.) to be successful in management of their chronic conditions. The depth and breadth of the resources available between these two groups allows them to reach out to over 800 patients monthly. Identified downstream effects of this program have been reduced emergency department (ED) utilization and reduced length of stays (LOS).

Paired together, the addition of MAWVs and the chronic care management program have robustly increased Oaklawn Hospital and Medical Group’s ability to reach their aging Medicare patients. Overall, roughly 50% of Oaklawn’s eligible population completed MAWVs in 2024, compared to just 11% in 2021. This translates to about 1,800 wellness visits in 2021 versus 5,500 in 2024. Oaklawn’s next steps include intentionally working to engage with the remaining 50% of eligible Medicare patients to ensure they do not miss out on valuable healthcare resources.

To learn more about Medicare Wellness Visits including coding and billing requirements, visit the Centers for Medicare and Medicaid Services education website.

12 Mar 2025

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MVC Welcomes Its Newest Senior Analyst, Steven Ellinger

March 12, 2025 | 0 Comments | Michigan Value Collaborative, MVC, MVC Coordinating Center

I’m ecstatic to join the MVC team as a senior analyst and bring my passion for healthcare analytics to the table! I am joining the team with over a decade of experience in healthcare analytics, pricing adjudication, reimbursement analysis, and provider network management. I’ve spearheaded projects to optimize network-level claims reporting and streamline data processes in every role. My background in economics and finance from Western Michigan University has helped me develop a strong analytical mindset, which I’ve applied in roles at Michigan Medicine-Sparrow, IBM Watson Health, McLaren Health Plan, and beyond. Healthcare large data manipulation is a passion of mine and you’ll see me smile each time a question is asked, as I am eager to find the answer.

Prior to joining the MVC team, I enjoyed five years as a pricing analyst at University of Michigan Health Plan (formerly Physicians Health Plan). I was responsible for establishing and maintaining provider fee schedules, ensuring competitive and compliant compensation across a vast provider and facility network. My expertise in SQL, Microsoft Excel, claims processing, and financial reporting have been instrumental in automating adjudication processes and enhancing financial forecasting. I also worked closely with provider relations, contract negotiations, and system configuration, making data-driven decisions to enhance efficiency.

Outside of work, my two kids under five keep me very busy with not a lot of free time. When I do find that time, I love staying active—backpacking, running marathons, and formerly teaching swing dancing. You will find me every year at the Indycar Detroit Grand Prix, at the paddock, pit line, or at the box suites, wishing the race was back at Belle Isle. I am thrilled to be on board and look forward to working with MVC’s members to make an impact on healthcare.

22 Jan 2025

MVC Coordinating Center MVC registry preoperative testing

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MVC Introduces Multi-Payer Preop Testing Registry Reports

January 22, 2025 | 0 Comments | MVC Coordinating Center, MVC registry, preoperative testing

MVC recently added three new multi-payer reports to its online registry focused on preoperative testing use prior to low-risk surgery. MVC has been tracking measures of this low-value practice since 2021, and previously shared biannual static push reports with its members on their testing rates. Now, MVC registry users can access these metrics under the multi-payer reports tab on MVC’s online data registry [LINK].

Similar to previous reporting, these new multi-payer reports provide interactive figures to assess a site’s opportunities to reduce unnecessary testing prior to three low-risk procedures: outpatient cholecystectomy, inguinal hernia repair, and lumpectomy. MVC hopes to add additional low-risk procedures in the future. For each of these procedures, preoperative testing is assessed in the 30 days prior to the surgery according to CPT codes identified in claims data. Each report reflects the most up-to-date available claims data from Blue Cross Blue Shield of Michigan (BCBSM) PPO Commercial, BCBSM PPO Medicare Advantage (MA), Blue Care Network (BCN) HMO Commercial, BCN MA, Medicare Fee-for-Service (FSS), and Medicaid insurance plans.

Multi-Payer Report Filters

Users can dynamically select the procedure(s), payer(s), and date range (i.e., the span of the episode start dates) to meet their data needs. Users may also filter by patient characteristics such as age and the presence of certain comorbidities that may place a patient in a higher risk category. Additional patient-level characteristics related to the episode of care that can be filtered include gender, race/ethnicity, and a diagnosis of chronic kidney disease (CKD) or venous thromboembolism during the index event or within 90 days. Up to five comparison groups can also be applied to each figure: the average across all MVC member hospitals, a cohort of hospitals located within the user’s MVC region, hospitals of the same type as the user (i.e., general acute care hospital or Critical Access Hospital), hospitals of the same trauma center level, and, if applicable, other rural hospitals in MVC's membership. A full listing of MVC member hospitals and their GACH, CAH, and rural hospital status can be referenced on the MVC website [LINK].

Preoperative Testing Table

The first of the three new report pages includes a table summarizing the testing rates for each type of preoperative test, overall and by procedure. Rates are shown for a user’s selected hospital and the comparison group of their choosing. The filters as described above allow users to determine which episodes to include or exclude based on their needs.

Preoperative Testing Trends

The next report shows the preoperative testing rates for the user’s hospital(s) over time alongside a comparison group of their choosing, as well as a trend graph demonstrating the magnitude of a site’s rate changes over time (Figure 1). The trend figures provide data points for a time interval of the user’s choosing, either monthly, quarterly, or annually, along with any additional filters as described. If these trend graphs appear to have missing data points, there is likely suppression occurring due to insufficient eligible episodes for that time period. In those instances, MVC recommends modifying the time interval to include more episodes. For all multi-payer reports, MVC suppresses data points with denominators of less than 11, and also suppresses denominators of rates that can be used to back-calculate to a numerator of less than 11.

Preoperative Testing Utilization Rankings

Lastly, the third and final report provides a visual representation of hospital preoperative testing rates for the user’s site(s) alongside all other peer hospitals from a selected comparison group, such as MVC All, hospital type, or hospital region. This style of figure can be used to help benchmark a site’s performance by showcasing how their utilization compares within a larger group. Since both this report and the trend graphs are interactive, users can hover their cursor over a specific data point to view additional details such as the exact testing rate and the number of episodes included in that rate's denominator.

Accessing the Registry Reports

All report pages can be exported into a variety of file types, such as PDFs or JPGs, for ease of sharing or adding to other materials. All MVC registry users will have access to these reports to view the data for their site(s). If you do not have registry access and are interested in using the registry to view these reports, you may complete MVC’s user access request form [LINK].

MVC hosted its first webinar to demonstrate the functionality and features of these new multi-payer preoperative testing reports on Jan. 21 and will host a second webinar on Tues., Jan. 28 from 12-1 p.m. Please RSVP if you are interested in attending this second webinar [LINK].

If you have any additional questions or feedback about the new registry reports, please contact the Coordinating Center by email [LINK].

15 Jan 2025

MVC Coordinating Center

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MVC Welcomes New Senior Analyst, Tanima Basu, MA, MS

January 15, 2025 | 0 Comments | MVC Coordinating Center

I am thrilled to introduce myself to the MVC team. As a senior analyst at MVC, I will contribute analytic skills and past claims related working experience to improve the overall health of MVC member hospitals and their patients.

I am a senior statistician who has worked at Michigan Medicine for the past decade. My journey in the world of biostatistics began at the University of Michigan School of Public Health, where I earned a Master of Science in biostatistics in 2014. I also have an M.A. in applied statistics from Eastern Michigan University and a B.S. in physics (honors) from India.

Following my graduation from SPH, I began my professional career as a guest researcher at the Centers for Disease Control and Prevention (CDC) in Atlanta. At the CDC, I had the opportunity to work closely with epidemiologists on public health projects.

In 2014, I joined Michigan Medicine, initially contributing analytic expertise to the School of Nursing. After a few years, my career path led me to the Institute for Healthcare Policy and Innovation (IHPI) at Michigan Medicine, where I was first exposed to data analysis using claims data.

Currently, I have a partial appointment as a senior statistician in the department of cardiology for WIRED-L Center (Wearables in Reducing Risk and Enhancing Daily Lifestyle Center), which designs and tests mHealth apps. In this role I analyze clinical trial data to evaluate whether a mobile phone app and smartwatch notifications can help patients lower their blood pressure or improve their heart health.

In my free time I enjoy sketching, painting, and photography (nature). I also practice yoga and love to explore naturals trails. I look forward to working with the diverse group of analysts and team members at MVC.

18 Dec 2024

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Reflecting on Successes in 2024 and Looking Ahead to 2025

December 18, 2024 | 0 Comments | celebrations, MVC Coordinating Center

Over the years, it’s become somewhat of a tradition for me to use our final blog of the year to step back and reflect on what we have achieved together over the last 12 months, as well as look ahead to all the exciting things in the pipeline for 2025. December has well and truly snuck up on us but what a year it’s been.

In 2024, MVC’s engagement with our 105 hospital and 33 physician organization members reached new heights. During this time, we held two flagship collaborative-wide meetings and delivered 22 virtual workgroups, incorporating 33 different member presentations as part of these events to foster continued information and best practice sharing. It’s therefore no surprise that are our average attendance numbers at each of these engagement touchpoints were far above previous years.

Our new cardiac rehab pages and other registry developments also led to a rise in the number of people accessing our online platform, with a total of 121 new registry users over the course of 2024. These new registry pages have helped increase engagement with MVC’s cardiac rehab value improvement initiative and we just launched similar pages for our preoperative testing initiative. MVC’s data analytic offerings continue to go from strength to strength as well, with 18 different sites taking advantage of MVC’s one-on-one custom analytic reports and all hospital members continuing to benefit from MVC’s refreshed suite of push reports.

The MVC Component of the BCBSM P4P Program kept us busy this year too, with end-of-year scorecards for PY23, mid-year scorecards for PY24, and program selections for PY26/27. In looking at PY26/27 in particular, the Coordinating Center worked in partnership with members and the BCBSM Hospital P4P Quarterly workgroup to develop and implement a number of changes for this future program cycle. As MVC continues to ensure that this program is truly representative of the patient populations that members serve, Michigan Medicaid will be added to the program come 2026. This represents a big win and means the MVC Component is now inclusive of all MVC data sources. Elsewhere, changes have been made to MVC’s episode condition and value metrics menus, and a new health equity measure has been introduced. We’re pretty excited about this new addition in particular so please feel free to reach out if you want to get in the weeds and learn more.

In addition to all this great work, a personal highlight of mine has been the continued evolution of the MVC Coordinating Center and more specifically, the continued growth of those people that make it such an enjoyable place to work. We have welcomed a few new faces to our team this year and with fresh eyes comes fresh perspectives; we’re excited to leverage these insights as we move into 2025. Speaking of which, we have a number of new developments for the coming year that I’m excited to be able to share with you.

New Preoperative Testing Registry Pages

In June of this year, we launched four new multi-payer reports on our online registry. These reports evaluate cardiac rehabilitation utilization and encompass all metrics previously provided annually in MVC’s hospital-level cardiac rehab push report for acute myocardial infarction (AMI), percutaneous coronary intervention (PCI), heart valve repair or replacement (SAVR or TAVR), coronary artery bypass graft (CABG), and congestive heart failure (CHF).

Following the success of these multi-payer registry reports, we worked to add equivalent pages for MVC’s preoperative testing measures. Those registry pages went live on our registry at the end of last week, and will allow members to select specific preoperative conditions and payers, customize date ranges, and filter by patient characteristics. MVC will hold educational webinars in January to help increase familiarity and improve user experience with these new multi-payer reports.

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

Another addition to the MVC registry in 2025 will see new P4P pages added to reflect the recent changes shared for PY26/27. While these pages will look and feel very similar to those currently available for PY24/25, the main update here will be the launch of a dedicated page for MVC’s new health equity measure. We understand the importance of making sure that members have time to become familiar with this new part of the MVC Component; therefore, in addition to reporting on it for informational purposes in 2025 P4P scorecards, this new page will be live for member use towards the end of Q2.

MVC Push Reports and Custom Analytics

MVC’s suite of push reports will continue to be refreshed throughout 2025 and, in response to member requests, we will launch a new quarterly push report calendar. This is designed to inform members of which reports will be delivered when and therefore help strengthen internal organizational planning. As mentioned above, MVC has seen great engagement this year relative to our custom analytics, and we will be looking to share examples of such outputs with the collaborative in 2025 to increase awareness of their value and possible scope.

Updates to MVC’s Suite of Virtual Workgroups

In response to member feedback and recent surveys, MVC’s schedule for virtual workgroups has been updated for 2025. Over the course of next year, members will be able to hear directly from peers and the Coordinating Center on the following topic areas: cardiac rehabilitation, health in action (ad hoc topics), preoperative testing, post-discharge follow-up, rural health, and sepsis. More information can be found here.

Site and System-Level Visits

Over the course of 2024, the Coordinating Center conducted a number of virtual and in-person site visits, both at individual sites and in partnership with systems. These visits are designed to provide members with a more in-depth understanding of MVC and its offerings, as well as providing an opportunity for the Coordinating Center to strengthen its understanding of member activities, priorities, and system-level practices. Sites are able to earn P4P engagement points for participating in such visits; if you are interested in getting on the calendar for 2025, please don’t hesitate to reach out.

Thank you again for your continued partnership throughout the last year and we look forward to more successes in 2025. Have a great holiday and a happy new year when it rolls around.

30 Oct 2024

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MVC Fall 2024 Meeting Summary: Data-Driven Strategies for Success in Quality Improvement

October 30, 2024 | 0 Comments | collaborative-wide meeting, MVC Coordinating Center, quality improvement

The Michigan Value Collaborative (MVC) held its fall 2024 collaborative-wide meeting on Fri., Oct. 25, in Livonia. A total of 99 attendees representing 54 hospitals, 6 physician organizations, 2 Collaborative Quality Initiatives (CQIs), and 8 healthcare systems from across the state of Michigan came together to discuss innovative approaches to data-driven quality improvement. The theme of this meeting was to provide MVC members with new data use strategies to support their QI initiatives.

MVC program manager Erin Conklin, MPA, kicked off Friday’s meeting with an update from the MVC Coordinating Center [SEE SLIDES]. She welcomed MVC’s newest team member, site engagement coordinator Rachel Folk, MHA. Conklin also announced phase 2 of recruitment for the RITE-Size preoperative testing initiative, and provided details for the Michigan Cardiac Rehab Network (MiCR) meeting planned for Fri., Nov. 8 in Midland [register here by 10/31]. She concluded by highlighting recent MVC reporting, including refreshed versions of MVC’s common conditions and procedures push reports, a new statewide diabetes report, PY 2024 P4P mid-year scorecards, and MVC’s 3^rd annual QECP public report.

Senior Advisor Jim Dupree, MD, MPH, presented on the MVC Component of the BCBSM P4P Program [SEE SLIDES]. He reviewed MVC’s guiding principles, timeline, and historical program structure, announcing four key changes to the PY 2026-2027 cycle (Figure 1). The addition of a health equity measure is one of four key areas that MVC modified for the upcoming cycle.

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).

12 Jun 2024

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MVC Introduces New Multi-Payer Cardiac Rehab Registry Reports

June 12, 2024 | 0 Comments | Cardiac Rehab, Michigan Cardiac Rehabilitation Network, MVC Coordinating Center, MVC registry

The MVC Coordinating Center added four new multi-payer reports to its online registry in April. These new reports evaluate cardiac rehabilitation utilization and encompass all metrics previously provided annually in MVC’s hospital-level cardiac rehab push report for acute myocardial infarction (AMI), percutaneous coronary intervention (PCI), heart valve repair or replacement (SAVR or TAVR), coronary artery bypass graft (CABG), and congestive heart failure (CHF). Each report reflects the most up-to-date available claims data from Blue Cross Blue Shield of Michigan (BCBSM) PPO Commercial, BCBSM PPO Medicare Advantage (MA), Blue Care Network (BCN) HMO Commercial, BCN MA, Medicare Fee-for-Service, and Medicaid insurance plans. Users may select any combination of cardiac conditions and insurance plans to assess in each report.

In addition to allowing dynamic selection of cardiac conditions and payers, the reports allow for customization of report date range (the span of episode start dates), episode length (the time period following each index event), and index place of service (e.g., inpatient, outpatient, emergency department). Users may also filter by patient characteristics including gender, age, and comorbidities (diagnoses prior to the index event). Other patient-level characteristics related to the reflected episode can also be filtered, including whether the patient was transferred during their index event, was diagnosed with COVID-19 during the index event or within 30 days post-discharge, and by certain diagnoses during the index event or within 90 days. Up to four comparison groups are offered for each figure: the collaborative-wide measure, MVC All; the measure among other hospitals in the region, Hospital Region; the measure among only hospitals of the same type, Acute Care/Critical Access Cohort; and the measure among other rural hospitals (if applicable), MHA Rural Hospital Cohort.

Cardiac Rehab Utilization Rates

The first of the four new report provides data on cardiac rehab utilization rates (Figure 1). This report includes a description of cardiac rehab benefits followed by two figures reflecting utilization rates among episodes of the desired condition and payer combinations after all selected filters have been applied. The first figure shows the overall rate of cardiac rehab compared to utilization goals set by the Michigan Cardiac Rehab network (MiCR) and Million Hearts®. The second figure shows utilization trends over time at the user’s hospital(s) and a selected comparison group. This full report and all other reports can be downloaded as a ready-to-print PDF or image file.

Cardiac Rehab Utilization Rankings

The next report provides data on cardiac rehab utilization rankings, showcasing the ranked order of hospital-level utilization rates for a selected comparison group. For example, in Figure 2 there are data points for cardiac rehab utilization rates during AMI, CABG, PCI, SAVR, and TAVR episodes originating at MVC Hospitals A, B, and C between December 1, 2018, and November 30, 2023 compared to all other MVC general acute care hospitals. The average rate across all comparison hospitals is about 31%, and each point outlined in orange represents the rate at an individual comparison hospital. Again, this report and all others may be downloaded in a ready-to-share format.

The remaining new cardiac rehab registry reports provide visual hospital rankings in the same format as the utilization rankings report, but for two other measures: 1) mean days to first cardiac rehab visit, which ranks the average number of days from index discharge to patients’ first cardiac rehab visit (up to 365 days); and 2), mean number of cardiac rehab visits, which ranks the average number of cardiac rehab visits completed within a selected episode length. These reports offer the same dynamic filters and output capabilities.

All MVC registry users will have access to these reports to view the data for their site(s). If you do not have registry access and are interested in using the registry to view these data, you should complete MVC’s user access request form. If you have any questions or feedback about the new registry reports, please contact the Coordinating Center.

07 May 2024

MVC Coordinating Center

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MVC Welcomes Emily Bair, MS, MPH, RDN as Site Engagement Coordinator

May 7, 2024 | 0 Comments | MVC Coordinating Center

I’m excited to be joining the Michigan Value Collaborative (MVC) as a Site Engagement Coordinator. As a new member of MVC, I am looking forward to learning and working alongside this talented team of forward-thinking coordinators, administrators and analysts in their efforts to improve the health of Michigan through accessible, high-value healthcare.

Throughout my training I have always been fascinated by the intersection of physical and social sciences. Specifically, how healthcare and medical practices are influenced by social constructs such as race, education and economic stability. I was first introduced to this during my undergraduate education when I pursued a Bachelor of Arts in Anthropology & Biology at Kalamazoo College. I then continued in this vein of study earning a Master of Science in Biomedical Anthropology at SUNY Binghamton University and then a Master of Public Health (MPH) in Nutrition Sciences at the University of Michigan School of Public Health.

Following this portion of my educational journey, I decided to additionally train to become a registered dietitian and was honored in being selected for a Michigan Leadership Education in Neurodevelopmental and Related Disabilities (MI-LEND) fellowship. Through these experiences I developed a greater understanding of the barriers to accessing healthcare for specific populations, namely women, children and the disabled, as well as a passion for educating both patients and providers in these issues.

For the last 5 years I have practiced as a clinical registered dietitian specializing in pediatric gastrointestinal disorders, surgical recovery, and developmental disabilities. I’ve also engaged with projects spanning simulated medical education, hospital volunteer program development, and clinical research writing. This collection of experiences has provided me with a unique lens through which to observe and drive future healthcare efforts.

As Site Engagement Coordinator, I look forward to working with MVC and its members to continue to identify equitable health practices and opportunities for improved health outcomes. If you have any questions or wish to get in touch, please feel free to email me at baire@med.umich.edu.

10 Apr 2024

MVC Coordinating Center

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