Transparency John Yindra, MD Associate Medical Director October, 2012

Transparency John Yindra, MD Associate Medical Director October, 2012

MMC PHO Overview • Joint venture: MMC and Community Physicians of Maine • Board of Directors 50/50 • Formed in 1994; not-for-profit, taxable organization __________________________________________ P = Community Physicians of Maine (CPM) • 1080 members • 57% employed • Greater Portland, Norway, Boothbay Harbor, Damariscotta, MidCoast, Belfast, Rockland, Biddeford H = Maine Medical Center (Soon to be all MH Hospitals)

MMC PHOEvolution 250 docs 1100 docs One community Eight communities

What is Transparency? • The process by which data regarding quality and cost/utilization of healthcare services is made available for review and reflection in order to effect positive change • Internal transparency occurs when data is shared by the health care providers in an integrated health care delivery system • External transparency refers to the sharing of quality and cost data with the consumers of health care.

Driving Change • Encourage quality improvement, innovation • Understand variation • Appeal to professionalism • Spur competition to attain the goals of the organization • Share best practices • Achieve trust in accuracy of data • Create a sense of team/allegiance/responsibility • Strengthen the PHO by increasing accountability • Support Accountable Care • Cost and Quality = Value Source: May 2012. The Commonwealth Fund. Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices and Quality

Guiding Principles We will: • Protect patient privacy in all transparency efforts • Display measures electronically for physicians (password protected) • Engage all PHO members with quality and cost/utilization data - physicians now, hospitals in the future • Align measures with PHO organizational objectives • Risk adjust data when possible • Review of data by the appropriate PHO committee • Share data with appropriate members of the PHO

Existing & New Efforts • Public Reporting (Pathways to Excellence) • Internal transparency among Primary Care Providers through monthly Clinical Improvement Registry (CIR)practice level reports • Creation of an Accountable Care Organization • Participation in the Medicare Shared Savings Program • ACO Quality Metrics • Committees to review and respond to data • Central & Regional • Northern New England Accountable Care Collaborative (NNEACC) - a data trust

Maine Health Management Coalition Pathways to Excellence Program http://getbettermaine.org/

NCQA Websitehttp://ncqa.org/

MMC PHO Internal Transparency Reporting

What is an ACO? • A group of healthcare providers who agree to work together and assume responsibility for improving the quality and reducing the cost of care for their patients

Accountable Care • The MaineHealth Accountable Care Organization (MHACO) requires a transparent approach to engaging Participants in discussions regarding performance and healthcare value • These “discussions” must serve at least two purposes: • Pro-active identification of opportunities and setting of goals for improvement on specific efficiency and quality measures • Predictable and transparent way to respond to / correct challenges relating to unwarranted variance • Measures: • Quality • Cost/Utilization

Northern New England Accountable Care Collaborative (NNEACC)

What does it mean for you? Beginning now…. • Engage in data collection & quality reporting • Participate in active review of your data • Assess your data for accuracy • Review benchmarks and your data for performance comparison • Develop plans within your practice to improve where needed, and if accuracy is a problem work to understand and fix any issues

What does it mean for your patients? Over time….. Public reporting will expand • External reporting is already a reality • Many primary care members of CPM and many hospitals already report quality measures on the Get Better Maine public website Data reporting expectations will increase • The number of quality measures will increase • Cost will need to be addressed

Questions?

Transparency John Yindra, MD Associate Medical Director October, 2012

Transparency John Yindra, MD Associate Medical Director October, 2012

Presentation Transcript

Physician Leadership and Incentives to Sustain Change Michael Gilbert, MD Associate Medical Director

Neal Shonnard, MD Spine SCOAP Medical Director Bree Collaborative Meeting October 1, 2012

Family Orientation Student Health Services John G. Inman MD Medical Director

John Meurer, MD, MBA, Professor and Director

John N. Lavis, MD, PhD Associate Professor and

Brittany Jones Associate Director Fall 2012

Jenny Atas MD Associate Professor Wayne State University Medical Director Region 2 South Medical

StrataRx John Freedman MD MBA October 16, 2012

April 25, 2014 T. Hanh Trinh, MD Associate Medical Director

Leslie Raffel, MD Associate Director and Cedars-Sinai Site Director,

Weijing Sun, MD Associate Professor of Medicine Director of GI Medical Oncology

Alireza Atri, MD, PhD Associate Director, Clinical Programs,

John N. Lavis, MD, PhD Associate Professor and

Ida Sim, MD, PhD Associate Professor of Medicine Associate Director for Medical Informatics

Adult Safeguarding Andrew Coombe Associate Director, Safeguarding LMC 24 October 2012

David Soria MD - Medical Director

John Kanellopoulos, MD Clinical Associate Professor NYU Medical School, NY

Michael B. Streiff, MD Associate Professor of Medicine Division of Hematology Medical Director,

John Caron Unidata October 2012

Michael Toubbeh, MD - Senior Medical Director

Elisabeth Dykens, PhD — Director Louis Muglia, MD — Associate Director

Ida Sim, MD, PhD Associate Professor of Medicine Associate Director for Medical Informatics