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MN P4P Journey

MN P4P Journey. 1988 – Buyers Health Care Action Group (“BHCAG” pronounced bee-keg) large self-funded employer coalition drives reform 1993 – Institute for Clinical Systems Improvement (ICSI) develops care guidelines, measures, primary care transformation

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MN P4P Journey

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  1. MN P4P Journey • 1988 – Buyers Health Care Action Group (“BHCAG” pronounced bee-keg) large self-funded employer coalition drives reform • 1993 – Institute for Clinical Systems Improvement (ICSI) develops care guidelines, measures, primary care transformation • 1996 - HealthPartners (health plan) starts P4P • Early 2000s – Two other health plans begin P4P 3

  2. MN Background • 2004 MN Community Measurement (MNCM) produces first public report on diabetes using aggregated health plan data. • 2007 MNCM reports performance with clinical data submitted by providers for diabetes and CVD to meet MN Bridges to Excellence requirements • 2008 Legislature mandates common measures for public reporting, aligned P4P, data submission. BTE/MNCM adds depression as a P4P measure 7

  3. Optimal Diabetes Care Composite diabetes measure • Each patient must meet all five measures • Intermediate outcomes • Publicly reported since 2004 • Easier to compare physicians’ performance 4

  4. Optimal Diabetes Care • Five Measures • A1c < 7 • LDL < 100 • BP < 130/80 • Non-smoking status • Daily aspirin if > 40 y.o. • Credit for patients only passing all 5 measures 6

  5. Direct Data ResultsWide range of results by site

  6. Optimal Diabetes Care

  7. Rewards Threshold

  8. P4P

  9. 2007 Diabetes Performance (%) 8

  10. MNCM 2007 Report All Measures 53 49

  11. Future Plans in Lake Wobegon • Care model re-design • reimbursement re-design (medical home and Capitation 2.0) • Moving away from RVUs 42

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