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Change Starts Here. The One with the Trend Graphs: Introduction to the IC-4 Measure ICPC National Coordinating Center.
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Change Starts Here. The One with the Trend Graphs: Introduction to the IC-4 Measure ICPC National Coordinating Center This material was prepared by CFMC (PM-4010-080 CO 2011), the Medicare Quality Improvement Organization for Colorado under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.
IC-4: measure definition (J-10) “Percentage of communities that can demonstrate four time series graphs showing positive trending data by intervention over four quarters.” • Numerator: Number of communities demonstrating improvement over a 4-quarter period • Denominator: Number of communities participating in the statewide Learning and Action Network • Polarity: Higher is better.
Evaluation and data source • Evaluation Targets • No baseline target • 18-month target: 25% of Track 2 communities • 27-month target: 75% of Track 2 communities Demonstrate 4-quarters of improvement on ≥4 outcomes across all Track 2 communities. • Data Source • Collected and reported by QIOs • Deliverable #51 (Community Intervention Plans) • Template to be provided by NCC
What to measure • Intervention implementation • Process • Reach/dosage of an intervention Counts; percentage of eligible population • Outcomes over time • Effect on root cause • Success of the intervention Rates; scores; rating scales Longitudinal data Best-fit line or other signal indicating improvement
Early considerations (10th SOW) • Root cause analysis • Map out the logic model • What is expected to change at the point of intervention? • Develop an operational definition of improvement and select the corresponding indicator. Existing outcomes already reported Expectations from root cause analysis How is the problem observed on site? • Develop a procedure for tracking implementation and outcome. • Logistics, standardization and enforcement • Plan to measure frequently to better demonstrate change. • Monthly interval yields 12 data points over given 4-quarter period (i.e., 1 year)
Selecting an outcome to measure Consider the following ideals: • Measureable – Can it be operationalized and clearly measured? • Plausible – Is it reasonably tied to the root cause? • Moveable – Is it likely to change in a clinically meaningful way? • Compelling – Will an observed change tell the story of improvement? • Practical – Are time series data readily collected or available?
Resources • Future presentations/discussion • Details and strategies for IC-4 • Toolkit • Outcome measurement (9th SOW Care Transitions) http://www.cfmc.org/caretransitions/toolkit_measure.htm • ICPC NCC contact: Tom Ventura tventura@coqio.sdps.org 303-784-5766
Questions? CO-ICPCTechnical@coqio.sdps.org The ICPC National Coordinating Center – www.cfmc.org/integratingcare Change Starts Here.