Context

1. Michigan Center for Clinical Systems Improvement(Mi-CCSI)_________________Collaborating for Quality and Sustainability Spring 2011

2. Context • 50 million nonelderly people in the U.S.—19% of those under age 65—don’t have health insurance (as of 2009, the latest date for which figures are available) • The Kaiser Commission on Medicaid and the Uninsured (Dec 2010) • Health reform will increase the number of insured Americans but this prospect threatens to overwhelm primary care • Payment reform continues to be elusive and complex • Payers and providers have significant barriers to overcome to cooperate on common approaches to system transformation and payment redesign • Employers and consumers have difficulty engaging in reform initiatives Mi-CCSI Overview

3. Purpose of Mi-CCSI • Create and maintain an environment for collaboration among health care stakeholders to reduce variation in clinical care and administrative practices • Promote systems and practices that improve patient experience and population health while lowering per capita cost • Focus on problems that no one party can solve on its own • Reduce health care disparities among minority populations • Ensure that regional communities lead the effort toward health system reform and stability Mi-CCSI Overview

4. History • West Michigan Physicians for Transformation created the foundation for the organization • Key physicians from all of the area’s health systems participated in early meetings and helped create the mission and guiding principles • The Development Steering Committee continues to be made up of a subset of founding physicians • ICSI in Minnesota provided a ready organizational model and the two organizations are collaborating through a consulting agreement (see slide for a brief overview of ICSI) • Blue Cross Blue Shield of Michigan provided initial funding and Mi-CCSI was awarded the RWJ AF4Q grant for QI work in 2011-21 • Five west and southwest Michigan delivery systems have provided additional funding Mi-CCSI Overview

5. Development Steering Committee • MaryEllen Benzik, MD—Integrated Health Partners, Battle Creek • Frank Belsito, DO—Metro Health, Grand Rapids • David Blair, MD—Advantage Health, Grand Rapids • John MacKeigan, MD—Spectrum Health, Grand Rapids • Phil Henderson, MD—Spectrum Medical Group, Grand Rapids • Paul Ponstein, DO—Lakeshore Health Network, Muskegon • Rem Sprague, MD—Mercy Health Partners, Muskegon • Tom Ruane, MD—BCBSM • Mike VanPutten—BCN • Hugh Hufnagel—Independent Consultant • Steve Williams—Independent Consultant Mi-CCSI Overview

6. Mission and Vision • Mission • Create a permanent multi-stakeholder collaborative to promote health care value and patient-centered care and optimize the health of communities. Work to sustain an effective and efficient system of care consistent with the needs of people, employers, providers and payers. • Vision • West Michigan will be a region with exceptional healthcare experiences, optimal population health and financial sustainability. Mi-CCSI Overview

7. Overview of ICSI-Minnesota • ICSI brings together diverse groups to transform the health care system so that it delivers patient-centered and value-driven care. It is comprised of 62 medical groups and sponsored by five Minnesota and Wisconsin health plans. • Programs • Common clinical guidelines • Statewide solution to high tech radiology authorizations • Depression management program—DIAMOND • Health care homes • www.icsi.org Mi-CCSI Overview

8. Initial Program Agenda • Depression • Adapt DIAMOND/Impact model implemented by ICSI in Minnesota • Build and expand elements of PCMH • Focus on Triple Aim goals • CHF • Develop common reporting of metrics for providers participating in west Michigan demonstration project sponsored by BCBSM and BCN • Diabetes • Focus is on ambulatory care for patients with uncontrolled diabetes (hypothesis; still in development) Mi-CCSI Overview

9. Future Program Possibilities • Advanced care planning • Palliative care • High tech diagnostic imaging guidelines • Public reporting (in collaboration with employer alliances) • Other chronic conditions Mi-CCSI Overview

10. Collaboration Opportunities • First, do no harm • Second, do not duplicate effort • Third, collaborate, cooperate, support (AFH, MPCC, ICSI) • Focus on reducing variation and common approaches • Advance concepts like medical home and the chronic care model (depression, diabetes) • Share infrastructure wherever possible, but hold parties accountable for achieving goals • Create an environment where collaboration is the norm Mi-CCSI Overview