Massachusetts Health Care Quality and Cost Council 1

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Health Care Quality and Cost CouncilPerformance
Measurement Expert Panel

• November 17, 2009

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Quality Related Healthcare Initiatives in the
Commonwealth

• Public
• HIT Council
• Disparities Council
• MassHealth P4P Program
• MassHealth Medical Homes Project
• Statewide Multipayer Medical Homes Project
• MassHealth Dual Eligibles Program
• GIC
• Healthy Massachusetts Initiative
• HITEP input on definition of meaningful use
  measures for HIT
• State Quality Improvement Institute
• Private
• MAHP
• Aligning Forces for Quality
• MHQP
• Eastern Massachusetts Healthcare Initiative
• And many more.

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Agenda

• Welcome, vision, goals and introductions
  (Secretary Bigby)
• Purpose and products of Expert Panel (Dwight
  McNeill)
• Quality measurement in the Commonwealth
• State of the art and challenges (Barbra Rabson)
• Quality measurement at MassHealth (David
  Polakoff)
• Background on three deliverables
• Performance measurement alignment (Larry
  Gottlieb)
• Statewide dashboard (Dwight McNeill)
• System transformation (Tom Lee)
• Next Steps (Katie Barrett)

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Purposes of performance measurement

• Inform providers about opportunities for
  improvement to achieve better outcomes.
• Inform policy makers to help them set goals and
  targets and to monitor and fine-tune
  interventions to improve statewide health and
  health care.
• Inform consumers to help them make the best
  decisions possible about their health care
  choices.
• Provide the foundation for incentive systems to
  reward the delivery of high quality and efficient
  health care.
• Influence delivery systems to become more
  integrated, coordinated, and person centered.
• Hold all stakeholders accountable for their
  performance in improving the health status of
  Massachusetts residents.

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Products of Expert Panel

• Make recommendations on a statewide dashboard of
  measures to monitor state goals including
  benchmark targets.
• Make recommendations on uniform measures of
  provider performance that may be used for
  incentives, tracking health improvements, and
  tracking quality of care.
• Develop a strategic framework for systems
  measures that promote more care coordination,
  integration, patient centered care, alignment
  with new payment models, and reductions in
  disparities by race and ethnicity.

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HCQCC Information for Consumers
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And for Providers
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And for policy makers Stroke Risk-Adjusted
Mortality Rate per 100 Hospital Discharges
Source Division of Health Care Finance Policy,
Measuring Quality and Cost, October 2009
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HCQCCMeasurement and Reporting Evolution

• Near-term (CY2010)
• Website updates twice a year
• Measures reporting for readmissions and mortality
• State dashboard on HCQCC goals and measures
• Reports on quality and efficiency
• Communication and coordination of performance
  measures for key statewide initiatives, e.g. HIT,
  disparities, PCMH
• Fill in measurement gaps in key
  condition/population areas
• Substance abuse, mental health, and childrens
  health

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HCQCC Measurement and Reporting Evolution

• Mid-term (CY2011)
• Develop and implement new measures
• Bundled payments and refined cost data
• Ambulatory care measures and medical group
  reporting
• Systems measures of coordination and integration
• Integrate measures with quality improvement
  initiatives and payment
• Care coordination
• Patient centered medical home

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HCQCC Measurement Reporting Evolution

• Long-term (CY2012)
• Utilize all-payer claims data for important
  public purposes, e.g. comparative effectiveness,
  monitoring state demonstration programs,
  population health
• Report on disparities in hospital quality of care
• Collaborate with other state entities on
  community measures of health

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Commonwealth of MAHealth Care Quality and Cost
Goals

• I. Reduce the annual rise in health care costs
  to no more than the unadjusted growth in gross
  domestic product.
• Promote cost-efficiency through development of a
  website providing comparative cost information
• Reduce health care spending by preventing the
  need for avoidable hospital stays
• II. Ensure patient safety and effectiveness of
  care
• Eliminate Hospital Associated Infections by 2012
• Eliminate serious reportable events and never
  events
• Improve overall patient safety and effectiveness
  of care
• III. Improve screening for and management of
  chronic illnesses in the community
• Improve care of congestive heart failure,
  diabetes, and asthma (and associated depression)
• Reduce disease complications, preventable
  readmissions, and avoidable hospitalizations

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Commonwealth of MAHealth Care Quality and Cost
Goals

• IV. Develop measures of health care for which
  current data are inadequate
• Develop processes and measures to improve
  adherence to patients wishes in providing care
  at the end of life.
• V. Eliminate racial and ethnic disparities in
  health and in access to and utilization of health
  care.
• HAIs, SREs, disease complication rates,
  readmission rates, and avoidable hospitalizations
• VI. Promote transparency through development of
  a website and other materials providing
  comparative quality information.

As determined by the Health Care Quality and
Cost Council
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Brief overview of state of the artand background
on three proposed products

• Performance measurement alignment (Larry
  Gottlieb)
• Statewide dashboard (Dwight McNeill)
• System transformation (Tom Lee)

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Next Steps

• Feedback on meeting from expert panel members
• Meeting frequency and dates
• Team leads
• Website for communications
• Ongoing agenda development
• Feedback on meeting from expert panel members
• Closing remarks