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MVC Fall Semi-Annual Summary: Prescribing Health in Michigan

MVC Fall Semi-Annual Summary: Prescribing Health in Michigan

The Michigan Value Collaborative (MVC) held its second semi-annual meeting of 2022 last Friday, marking MVC’s first in-person collaborative-wide meeting since 2019. A total of 90 leaders registered for the meeting, representing 25 different hospitals, seven physician organizations (POs), and five stakeholder organizations from across the state of Michigan. This meeting’s theme of “Prescribing Health in Michigan” showcased strategies to drive evidence-based medication utilization and support patient access to medications through the implementation and evaluation of quality improvement projects.

MVC Director Hari Nathan, MD, kicked off Friday’s meeting with an update from the MVC Coordinating Center. He welcomed one new collaborative member, Bronson Lakeview (Paw Paw), as well as MVC’s newest team members, Associate Program Manager Erin Conklin and Statistician Lead Usha Nuliyula. Dr. Nathan also highlighted the successes delivered by the Coordinating Center since May’s Semi-Annual Meeting. For instance, MVC launched its Qualified Entity registry pages to provide authorized users with more granular data than is available in the Medicare FFS reports, incorporated Distressed Community Index data into push reports as part of MVC’s commitment to emphasizing equity in healthcare, and distributed three new push reports (chronic obstructive pulmonary disease for POs, emergency department and post-acute care utilization for acute and critical access hospitals, and a hysterectomy report for hospital members).

Dr. Nathan also provided an update on the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program, noting that final scorecards for Program Year 2022 will be distributed in quarter one of 2023. Attendees also learned about P4P changes coming with Program Years 2024 and 2025 (see Figure 1).

Figure 1.

Based on member feedback, MVC will be rolling out an updated methodology to improve the actionability of the program. Along with the existing 30-day episode of care component, MVC is introducing new value metrics and engagement metrics for PYs 2024 and 2025. The value metrics will incentivize evidence-based and actionable high-quality services, such as increasing cardiac rehabilitation utilization after percutaneous coronary intervention (PCI), increasing follow-up rates after hospitalizations for pneumonia, or decreasing preoperative testing prior to low-risk procedures. The engagement metric will award points to hospitals for attending and contributing to MVC engagement activities, such as attending both semi-annual meetings or presenting at a workgroup. Stay tuned for additional details on PYs 2024 and 2025; informational webinars on the program changes are coming soon.

Showcasing MVC’s new pharmacy claims data from BCBSM and Blue Care Network was a focal point for the meeting. MVC Senior Analyst Monica Yost led attendees through an overview of MVC’s current pharmacy claims data along with an unblinded data session focused on opioid overprescribing after joint surgery (see Figure 2 for a blinded version of utilization across the collaborative). Leveraging opioid prescribing recommendations from the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI), the data session allowed hospitals and POs to see their opioid prescribing rates in the 30 days following hip and knee replacements compared to their peers. Hospitals and POs performing well were invited to offer insights as to how this was achieved and what mechanisms other members could adopt to improve performance levels.

Figure 2.

With the scene set, MVC welcomed keynote speaker Lindsey Kelley, Associate Chief of Pharmacy at Michigan Medicine. Dr. Kelley provided attendees with an overview of the challenges patients face accessing high-cost, complex medications as well as opportunities to improve access and patient experience through integrated health system specialty pharmacy. Walking through Michigan Medicine’s model, Dr. Kelley noted that simplifying the workflow for specialty pharmacies reduces strain on clinic staff (i.e., physicians, nurses, medical assistants) and eliminates the instances of prescriptions being sent that cannot be filled, thereby reducing gaps in therapy starts. Sharing the model’s evaluation strategy, Dr. Kelley highlighted the project’s collaboration with MVC, which led to a larger proportion of all target specialty medication prescription fill data being tracked and extended the evaluation’s reach.

Following Dr. Kelley’s presentation, Troy Shirley, PharmD, MBA, System Director of Pharmacy for Bronson Healthcare, presented Bronson’s efforts to improve health equity through pharmacy-supported discharge initiatives. One initiative focused on medication reconciliation at discharge, which leveraged unit-based pharmacists to complete medication reconciliation for patients hospitalized with chronic obstructive pulmonary disease, pneumonia, heart failure, and acute myocardial infarction. Additionally, Bronson’s “Meds to Beds” program engaged a multi-disciplinary team that included a retail pharmacist, pharmacy, technician, unit nurse, and care manager to hand-deliver patients’ medications at the bedside and provide medication counseling prior to discharge.

Next on the agenda was a presentation from Tiffany Jenkins, PharmD, BCACP, Director of Population Health Pharmacy at Trinity Health Alliance of Michigan, who shared insights about population health pharmacy initiatives within a physician organization, including a diabetes medication management initiative focused on evidence-based diabetes management to improve quality of care, reduce inappropriate use of pharmaceuticals, and lower cost of care; a pharmacy tech-led medication adherence monitoring strategy to engage patients, providers, and care teams in appropriate medication use; an obesity medication management initiative focused on evidence-based utilization of chronic weight management medications to lower cost of care; and a comprehensive medication management project that leverages pharmacist-care team collaboration to support medication management.

Closing out the morning session, Mark Bicket, MD, PhD, Co-Director of the Opioid Prescribing Engagement Network (OPEN) and Assistant Professor with the Division of Pain Research, Department of Anesthesiology at the University of Michigan, presented information on shifts to prescribing recommendations after surgery to decrease opioid use, techniques to promote the adherence of non-opioid medications and non-pharmacological approaches to pain management, and strategies to maximize safe storage and disposal of controlled substances.

In the afternoon following a networking lunch, the presenters participated in a panel discussion moderated by MVC Co-Director Michael Thompson, PhD, MPH. The group discussed strategies to change provider behavior and navigate the challenges of pharmacy-related improvement initiatives. The meeting concluded with a summary of the day and upcoming MVC activities, led by MVC Associate Program Manager Erin Conklin. The slides from Friday’s meeting have been posted to the MVC website. If you have questions about any of the topics discussed at the fall 2022 semi-annual meeting or are interested in finding out more, please reach out to the Coordinating Center at Michigan-Value-Collaborative@med.umich.edu. MVC’s next semi-annual meeting will be in person on Friday, May 19, 2023, at the Vistatech Center in Livonia.

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MVC Releases Its Fall Semi-Annual Agenda, Speaker Topics

MVC Releases Its Fall Semi-Annual Agenda, Speaker Topics

The MVC Coordinating Center recently released the full agenda for its forthcoming Fall 2022 Semi-Annual Meeting, which takes place in Lansing at the Radisson Hotel on Friday, October 28, 2022, from 9 a.m. to 2:30 p.m. MVC holds collaborative-wide meetings twice each year to bring together quality leaders and clinicians from across the state. This meeting’s theme of “Prescribing Health in Michigan” will support attendees in learning strategies to drive evidence-based medication utilization and support patient access to medications through the implementation and evaluation of quality improvement projects.

Speakers at semi-annual events are often members who share their successes, challenges, barriers, and solutions in pursuing a higher value and quality of care. The speakers this fall represent a variety of stakeholder groups, including member hospitals and physician organizations (POs), pharmacy experts, pain management experts, and of course MVC Coordinating Center leadership.

The keynote presentation will be given by Dr. Lindsey Kelley, Associate Chief of Pharmacy at Michigan Medicine. She also serves as Program Director for the PGY1 Community Pharmacy Residency and adjunct faculty at the University of Michigan College of Pharmacy. Dr. Kelley earned her Doctor of Pharmacy degree from the University of Arizona in Tucson. She completed a pharmacy practice residency at Abbott Northwestern Hospital in Minneapolis, MN, and received her MS from the University of Minnesota College of Pharmacy while completing a two-year Health-System Pharmacy Administration and Leadership residency at the University of Minnesota Health. Dr. Kelley has been an active member of national pharmacy associations, state affiliates, and advisory councils. She was also honored with the ASHP New Practitioners Forum Distinguished Service Award in 2010 and recognized as a fellow in 2019. Her presentation will focus on improving patient care through better access to high-cost and complex medications.

MVC members will also hear presentations from their peer hospitals and POs about pharmacy initiatives implemented at other sites. Dr. Troy Shirley, System Director of Pharmacy at Bronson Healthcare, will present on improving health equity through pharmacy-based initiatives. Dr. Tiffany Jenkins, Director of Population Health Pharmacy at Trinity Health Alliance of Michigan, will present on population health pharmacy initiatives within a PO.

The Opioid Prescribing Engagement Network (OPEN) will touch on pain management best practices and resources. They are represented by Dr. Mark Bicket, Co-Director of OPEN and Assistant Professor in the Division of Pain Research in the Department of Anesthesiology at the University of Michigan. His presentation will focus on improving medication adherence for surgical pain management.

Attendees can also expect to hear from MVC Coordinating Center leadership and staff about the MVC Component of the BCBSM Pay-for-Performance (P4P) Program, unblinded data on prescribing practices across the collaborative, new conditions and data sources that are available to members on the registry and in push reports, MVC’s new Qualified Entity status and resulting patient-level Medicare data, and updates about other upcoming MVC events. The guest presentations will be followed by a panel discussion about medication adherence facilitated by MVC leadership.

At the conclusion of the meeting, attendees will have learned approaches to improving medication access and utilization, patient experience, treatment adherence, care transitions, post-discharge support, patient education, reduced readmissions, and health equity. The full agenda can be accessed online here.

These presentations would be informative and applicable for any of the following stakeholders who are invited to attend:

  • MVC hospital site coordinators
  • MVC PO site coordinators
  • Quality leadership
  • Physicians
  • Nurse practitioners
  • Pharmacists
  • Community-based organizations or social workers
  • CQI staff

CME CREDITS AVAILABLE

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The University of Michigan Medical School designates this live activity for a maximum of 4.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Those interested in attending this informative and collaborative meeting should register here. The MVC Coordinating Center looks forward to a fantastic meeting. See you there!

Activity Planners

Hari Nathan, MD, PhD; Deborah Evans, RN; Erin Conklin, MPA; Chelsea Pizzo, MPH; Chelsea Andrews, MPH

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Semi-Annual Summary: Turning Data & Collaboration into Action

Semi-Annual Summary: Turning Data & Collaboration into Action

The Michigan Value Collaborative (MVC) held its first semi-annual meeting of 2022 last Friday. A total of 158 leaders joined the MVC Coordinating Center’s virtual meeting, representing 68 different hospitals and 15 physician organizations (POs) from across the state of Michigan. “Turning Data and Collaboration into Action” was the theme of this year’s first semi-annual, putting the spotlight on quality initiatives that successfully leveraged data or collaboration to bring about improvements in healthcare.

MVC’s Director, Dr. Hari Nathan, kicked off Friday’s meeting with an update from the MVC Coordinating Center. He welcomed two new collaborative members, McLaren Caro Region and UP Health System - Bell, as well as MVC’s newest team member, Engagement Associate Chelsea Andrews. Dr. Nathan also highlighted the successes delivered by the Coordinating Center during the first six months of 2022. This included the incorporation of Medicaid data into MVC’s suite of push reports to provide a more complete view of the collaborative’s patient population, the launch of three new push reports (colectomy, pneumonia, and P4P), and the incorporation of additional demographic data into MVC's reporting.

MVC’s recent Qualified Entity accreditation was also highlighted, representing a breakthrough for the collaborative that will allow the relaxation of certain data use agreement regulations and improve the granularity of data available to members. As part of extending this improved access, the Coordinating Center will reach out to site coordinators to have authorized representatives at each institution complete a new data use form. To align with the security requirements of the Qualified Entity program, the MVC registry will also begin requiring multi-factor authentication for users upon login. More information on each of these elements will be shared with the collaborative in the coming weeks. Chelsea Abshire Pizzo, MVC’s Manager of Analytics, rounded off the meeting welcome by sharing some highlights from Program Year 2021 of the MVC Component of the Blue Cross Blue Shield of Michigan Pay-for-Performance (P4P) Program.

Showcasing opportunities where MVC data can drive change was a focal point for the meeting. Utilizing unblinded data from the collaborative, MVC Analyst Jessica Yaser led attendees through a data session focused on MVC’s two Value Coalition Campaigns (VCCs): Preoperative Testing and Cardiac Rehab. This allowed attendees to see their preoperative testing and cardiac rehab utilization rates compared to their peers. Hospitals performing well were invited to offer insights as to how this was achieved and what mechanisms other hospitals could adopt to improve performance levels. Jessica also announced new collaborative-wide goals around cardiac rehab utilization rates (see Figure 1), which will continue to be promoted and highlighted in the months ahead.

Figure 1.

With the scene set, MVC welcomed guest speakers Mary Pool and Holly Gould from McLaren Port Huron hospital. Mary and Holly provided attendees with an overview of how they have used MVC data to help tackle high readmission rates for the congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) patient populations at McLaren Port Huron. Specifically, data provided by the Coordinating Center helped confirm the suspicion that although follow-up rates were high across the institution, this wasn’t being translated into a reduction in readmissions. Stratifying these data further helped McLaren Port Huron introduce tailored initiatives in the form of their COPD and Heart Failure Navigator Programs, aimed at driving the effectiveness of follow-up visits (see Figure 2).

Figure 2.

After hearing from McLaren Port Huron, Michelle Marchese from BCBSM provided an overview of how their Physician Group Incentive Program (PGIP) platform supports value-based care. As part of this, Michelle provided a walk-through of the current state of BCBSM data and report sharing, outlining how these all fit together to provide valuable healthcare insights for physician organizations (POs) (see Figure 3). MVC’s ongoing partnership with BCBSM to identify PO-level opportunities for improvement was also highlighted – a collaboration that will continue moving forward to enhance the level of support available to POs across the state. Michelle then passed the baton to Dr. Shannon Martin from MyMichigan Health who shared how MyMichigan has used its internal data to develop, implement, and assess its “Health Aging Program.” This initiative is aimed at decreasing the use of high-risk medications in the elderly population, saving many seniors from the harm of adverse drug effects.

Figure 3.

The meeting concluded with a summary of the day and key upcoming activities, led by MVC Engagement Associate Chelsea Andrews. The recording from Friday’s meeting is available here. If you have questions about any of the topics discussed at the semi-annual or are interested in finding out more about MVC, please reach out to the Coordinating Center. MVC’s next semi-annual meeting will be in person on Friday, October 28 at the Radisson in Lansing – we look forward to seeing you all then!

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MVC Releases Agenda, Speakers for May Semi-Annual Meeting

MVC Releases Agenda, Speakers for May Semi-Annual Meeting

The MVC Coordinating Center recently released the full agenda for its forthcoming spring Semi-Annual Meeting on Friday, May 13, 2022, from 10-11:30 a.m. The MVC Coordinating Center holds collaborative-wide meetings twice each year to bring together quality leaders and clinicians from across the state. This meeting’s theme of “turning data and collaboration into action” reflects how members often balance multiple internal and external data sets in addition to a broad portfolio of resources from MVC and other CQIs.

Speakers at semi-annual events are often members who share their successes, challenges, barriers, and solutions in pursuing a higher value and quality of care. The speakers outlined on May’s meeting agenda will share examples of quality initiatives that successfully leveraged data or collaboration to bring about improvements in healthcare. The speakers also represent a variety of stakeholder groups, including hospitals, physician organizations (POs), payers, and of course MVC Coordinating Center leadership.

The first guest presentation will be from hospital leaders at McLaren Port Huron’s Quality Improvement and Organizational Excellence team. Regional Director Mary Pool and Manager Holly Gould will discuss partnering for clinical efficiency and effectiveness. This presentation will be followed by Michelle Marchese, Director of Care Delivery Analytics at Blue Cross Blue Shield of Michigan (BCBSM), who will present about how BCBSM’s Physician Group Incentive Program (PGIP) supports value-based care. The final guest presentation of the day will feature PO members and comes from leaders at the MyMichigan Collaborative Care Organization. Dr. Shannon Martin, Primary Care Council of MyMichigan Medical Group, will present on affecting medication overload in seniors.

Attendees can also expect to hear from MVC Coordinating Center leadership and staff about the MVC Component of the BCBSM Pay-for-Performance (P4P) Program, as well as insights on how performance in the areas of preoperative testing and cardiac rehabilitation utilization compares across the collaborative.

At the conclusion of the meeting, attendees will be able to identify the value of a variety of data sources and collaboration opportunities to assist with implementing and evaluating quality improvement projects. The full agenda can be accessed online here.

These presentations would be informative and applicable for any of the following stakeholders who are welcome to attend:

  • MVC Hospital Site Coordinators
  • MVC Physician Organization Site Coordinators
  • Quality Leadership
  • Clinicians
  • Healthcare abstractors, analysts, and statisticians
  • CQI staff

Those interested in attending this informative and collaborative meeting should register here. The MVC Coordinating Center looks forward to a fantastic meeting. See you there!

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Fall Semi-Annual Meeting Agenda Highlights Health Equity Topics

Fall Semi-Annual Meeting Agenda Highlights Health Equity Topics

The MVC Coordinating Center recently released the full agenda for its forthcoming fall Semi-Annual Meeting on Friday, October 22, 2021, from 10:00-11:30 am. The MVC Coordinating Center holds collaborative-wide meetings twice each year to bring together quality leaders and clinicians from across the state. This year’s theme of “the social risk and health equity dilemma” is reflective of a growing priority within the healthcare system generally, as well as newer activities within the MVC Coordinating Center.

Speakers at semi-annual events are often members who share their stories of success, challenges, barriers, and solutions in pursuing a higher value and quality of care. The speakers outlined on October’s agenda showcase the breadth and depth of knowledge that exists within the collaborative in the health equity space. They also represent a variety of stakeholder groups, including hospitals, physician organizations (POs), Collaborative Quality Improvement (CQIs) programs, and of course MVC Coordinating Center leadership.

The first guest speaker will be Carol Gray, Program Manager of the new Michigan Social Health Interventions to Eliminate Disparities (MSHIELD) CQI. She leads the overall management, performance, and coordination of the MSHIELD program and Coordinating Center team. She has extensive experience managing public health research teams, communicating across and coordinating with multiple partnerships, and linking and engaging with community-based organizations in Detroit and academic faculty at the University of Michigan. Her presentation on, “Aligning Partnerships to Achieve Health Equity,” will speak to that expertise.

The meeting also features the expertise of Dr. Nicole J. Franklin, Assistant Medical Director at the McLaren Bariatric and Metabolic Institute. She provides psychological support to bariatric patients before and after weight loss surgery. In addition, Dr. Franklin is the chair of the Diversity and Inclusion Committee at McLaren Flint and has co-facilitated the Diversity Committee within all three local hospitals’ psychology training programs for the last 10 years. She is an Air Force veteran and a graduate of Wright State University’s School of Professional Psychology. Referencing her work within the greater Flint community, her session will address, “The Health Gap: An Exploration of how one hospital is working to bridge the gaps between health care and social care.”

Another perspective will be brought by Leah Corneail, Director of Utilization and Population Health at the Integrated Healthcare Association (IHA). In this role, she is responsible for leading utilization and cost improvement efforts, ensuring success in risk-based contracts and CMS demonstration programs, and collaborating with community partners to improve population health. Corneail has several years of experience in population health and health policy. Prior to joining IHA, she served as a Senior Project Manager in the Michigan Medicine Population Health Office, where she managed Michigan Medicine’s portfolio of value-based payment models and partnered with operations to implement care transformation initiatives. Leah received her Master of Public Health degree from The George Washington University’s Milken Institute School of Public Health. She will speak to, “IHA Efforts to Screen and Address Patient Social Influencers of Health (SIOH).”

Also representing the approach of a PO will be Melissa Gary, Community Liaison with the Great Lakes Physician Organization (GLPO). In this role, Melissa is responsible for bridging the gap between healthcare providers of GLPO and the local community agencies to better align the mission of GLPO. Utilizing her several years of experience in healthcare and nonprofit organizations, she has built the GLPO social determinants of health process. She is a passionate community servant with the ability to motivate and inspire individuals to identify their own potential and shares in the passion to serve others. Melissa is a graduate from Ferris State University where she studied nuclear medicine and healthcare administration. She has minors in science, biology, pre-pharmacy and paralegal.

Attendees can also expect to hear from MVC Coordinating Center leadership and staff about MVC’s Medicaid data, the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program, and general program updates.

These presentations could be informative and useful for any of the following stakeholders who are welcome to attend:

  • MVC Hospital Site Coordinators and Champions
  • MVC Physician Organization Site Coordinators
  • Quality Leadership
  • Clinicians
  • Managers and front-line staff in the following clinical areas:
    • Population health
    • Chronic disease management
    • Post-acute care
    • Value-based care
    • Care coordination
    • Discharge planning
    • Social work
    • Others whose work addresses health equity or social risk factors

In addition, hospitals that have attended both of MVC's 2021 Semi-Annual Events (May 2021 and October 2021) will be eligible for one additional bonus point toward Program Year 2021 of the MVC Component of the BCBSM P4P Program.

Those interested in attending this informative and collaborative meeting should register here. The MVC Coordinating Center looks forward to a fantastic meeting. See you there!