22 Jan 2025
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MVC Introduces Multi-Payer Preop Testing Registry Reports

MVC Introduces Multi-Payer Preop Testing Registry Reports

January 22, 2025 | 0 Comments | , ,

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. 

Figure 1.

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]. 

12 Jun 2024
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MVC Introduces New Multi-Payer Cardiac Rehab Registry Reports

MVC Introduces New Multi-Payer Cardiac Rehab Registry Reports

June 12, 2024 | 0 Comments | , , ,

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.

Figure 1. Cardiac Rehab Utilization Rates Report

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.

Figure 2. Cardiac Rehab Utilization Rankings Report

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.

23 Jun 2022
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MVC Registry to Soon Include Patient-Level Medicare Data

MVC Registry to Soon Include Patient-Level Medicare Data

June 23, 2022 | 0 Comments | ,

In the coming weeks, MVC registry users will receive communications outlining several required steps related to implementing the Coordinating Center’s new data use agreement (DUA) as a qualified entity (QE) with the Centers for Medicare and Medicaid Services (CMS). The QE DUA permits MVC to display Medicare Fee-For-Service (FFS) claims data with fewer data suppression limitations than its research DUA within its online registry. As a result, authorized users of the MVC registry may gain access to identifiable Medicare beneficiary data.

These changes are the result of years of work by the MVC team to earn its QE status through the Qualified Entity Certification Program (QECP), which is also known as the Medicare Data Sharing for Performance Measurement Program. The QE application includes multiple phases before an entity is permitted to show patient-level data. The MVC Coordinating Center has been working through the final phase (see Figure 1) of the application, which involves developing and documenting measures for public reporting.

Figure 1.

The QE Medicare data will be contained in a separate tab on the MVC registry. Authorized users will have access to both the existing Medicare FFS reports as well as the QE reports. The QE data will be available for the most recent 18 months of index admissions only and will not have any case count suppression, allowing users to see the more granular data that is censored in the Medicare FFS reports.

The QE reports also have additional patient population filters to view the data by patient comorbidities, patient age, and more granular date options. These reports also feature trend graphs that can be viewed monthly, quarterly, or annually. In addition to uncensored data, the QE data will allow for patient-level drill-down as is currently available in the Blue Cross Blue Shield of Michigan data. The drill-down includes detailed information on the patient’s comorbidities, price standardized episode payments, and claim level walk-through. Although patient drill-down is available, the provider identifiers have been removed in conjunction with the QECP regulations. Additionally, the skilled nursing facility report is not available in the QE reports to avoid identifying providers.

For those with access, the QE reports should be used when evaluating the most recent years of data. The Medicare FFS reports can still be useful for historical trends and the Coordinating Center may be able to provide custom reports to fill in information that isn’t available through the registry. The patient-level drill-down can be used in conjunction with a hospital’s clinical information to understand what led to high-cost patients. The QE data should make Medicare data more useful to hospital members. However, QE data is only to be used for quality improvement rather than for marketing purposes. Additionally, authorized users are prohibited from disclosing or redistributing data provided in these reports outside of their institution.

Next week MVC member hospitals will receive a new QE DUA to be reviewed and signed by an authorized representative from their institution. This signed DUA is a prerequisite for receiving access to the new QE pages once they are available. MVC’s current CMS research DUA will remain in effect on non-QE registry pages and will continue to utilize data suppression for fewer than 11 episodes to protect patient identities. The MVC registry will also implement multifactor authentication (MFA) upon login for all registry users regardless of QE access in order to comply with the new DUA's security and data privacy requirements.

In the coming weeks, MVC members and registry users are encouraged to be attentive to any communications containing additional details or requests. In the meantime, please contact the MVC Coordinating Center with any immediate questions at michiganvaluecollaborative@gmail.com.