Big anniversary, broader focus Medicare Star measures Statistically - - PowerPoint PPT Presentation

▶
big anniversary broader focus
SMART_READER_LITE
LIVE PREVIEW

Big anniversary, broader focus Medicare Star measures Statistically - - PowerPoint PPT Presentation

Aug 27, 2023 237 likes •613 views

Big anniversary, broader focus Medicare Star measures Statistically significant 3-5 year trends MACRA Future of performance measurement The State of Health Care Quality 2015 2 Medicare Star Measures Medicare Stars & HEDIS

slide-1
SLIDE 1
slide-2
SLIDE 2

The State of Health Care Quality 2015

Big anniversary, broader focus

  • Medicare Star measures
  • Statistically significant

3-5 year trends

  • MACRA
  • Future of performance

measurement

2

slide-3
SLIDE 3

Medicare Star Measures

slide-4
SLIDE 4

The State of Health Care Quality 2015

HEDIS Measures

Medicare Stars & HEDIS

4

Medicare Star Measures

11 overlapping measures (all improving)

slide-5
SLIDE 5

Medicare is Best

Colorectal Cancer Screening

slide-6
SLIDE 6

Medicare is Best

Colorectal Cancer Screening

10 20 30 40 50 60 70 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicare HMO Medicare PPO Rate

slide-7
SLIDE 7

Medicare is Best

Controlling Blood Pressure

slide-8
SLIDE 8

Medicare is Best

Controlling Blood Pressure

10 20 30 40 50 60 70 80 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicare HMO Medicare PPO

slide-9
SLIDE 9

Medicare is Best Diabetes Care- Blood Sugar Controlled (Lower is better)

slide-10
SLIDE 10

5 10 15 20 25 30 35 40 45 50 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Commercial HMO Medicare HMO

Medicare is Best Diabetes Care- Blood Sugar Controlled (Lower is better)

slide-11
SLIDE 11

Medicare is Best

Diabetes Care- Kidney Disease Monitoring

slide-12
SLIDE 12

Medicare is Best

Diabetes Care- Kidney Disease Monitoring

10 20 30 40 50 60 70 80 90 100 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicare HMO Medicare PPO

slide-13
SLIDE 13

Statistically significant trends

slide-14
SLIDE 14

Glass half empty or half full?

46 measures (34%) performance gains 15 measures (11%) performance declines 75 measures (55%) mixed results, no trend Statistically significant changes over 3-5 years:

slide-15
SLIDE 15

The State of Health Care Quality 2015

No Improvement But Strong Performance

Many stagnant measures are at high levels

15

High 62 %

Medium 30 %

Low 8 %

Low Rates 0-40 pct Medium Rates 41-65 pct High Rates 66+ pct

slide-16
SLIDE 16

Statistically significant improvement

slide-17
SLIDE 17

Adult BMI Assessment

slide-18
SLIDE 18

Adult BMI Assessment

Rate 10 20 30 40 50 60 70 80 90 100 2009 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicaid HMO Medicare HMO Medicare PPO

slide-19
SLIDE 19

Obesity-Related Measures

Measuring BMI (3-17 Years)

slide-20
SLIDE 20

Obesity-Related Measures

Measuring BMI (3-17 Years)

10 20 30 40 50 60 70 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicaid HMO Rate

slide-21
SLIDE 21

Obesity-Related Measures

Counseling for Physical Activity (3–17 Years)

slide-22
SLIDE 22

Obesity-Related Measures

Counseling for Physical Activity (3–17 Years)

10 20 30 40 50 60 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicaid HMO Rate

slide-23
SLIDE 23

Obesity-Related Measures

Counseling for Nutrition (3–17 Years)

slide-24
SLIDE 24

Obesity-Related Measures

Counseling for Nutrition (3–17 Years)

10 20 30 40 50 60 70 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicaid HMO Rate

slide-25
SLIDE 25

Mixed results for behavioral health

slide-26
SLIDE 26

Antidepressant Medication Management Effective Acute Phase Treatment

slide-27
SLIDE 27

Antidepressant Medication Management Effective Acute Phase Treatment

10 20 30 40 50 60 70 80 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicaid HMO Medicare HMO Medicare PPO

80 60 70

slide-28
SLIDE 28

Antidepressant Medication Management Effective Continuation Phase Treatment

10 20 30 40 50 60 70 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicaid HMO Medicare HMO Medicare PPO

60 70

slide-29
SLIDE 29

Follow-Up After Hospitalization for Mental Illness

slide-30
SLIDE 30

Follow-Up After Hospitalization for Mental Illness: Within 7 Days Post-Discharge

10 20 30 40 50 60 70 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicaid HMO Medicare HMO Medicare PPO

slide-31
SLIDE 31

Follow-Up After Hospitalization for Mental Illness: Within 30 Days Post-Discharge

10 20 30 40 50 60 70 80 90 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Commercial HMO Commercial PPO Medicaid HMO Medicare HMO Medicare PPO

slide-32
SLIDE 32

Other topics

slide-33
SLIDE 33

The State of Health Care Quality 2014

MACRA has two tracks. They must be easy to compare.

APM Alternative Payment Models MIPS Merit-Based Incentive Payment System

33

slide-34
SLIDE 34

The State of Health Care Quality 2014

5 MACRA principles

  • 1. Well-organized primary care

team for each patient

  • 2. Measurement for each unit
  • f accountability
  • 3. Core set of measures to

facilitate comparisons

  • 4. Measurement to aid fast

improvement, accountability

  • 5. Useful, accessible results

34

slide-35
SLIDE 35

The State of Health Care Quality 2014 1

Measurement’s Future

Now: Focus on structure & process. Needed: Focus on outcomes.

slide-36
SLIDE 36

The State of Health Care Quality 2015

Coming in December 2015

Analysis of Medicaid Quality in Expansion vs. Non-Expansion States

36

  • Any consistent effect?
  • If differences

predated expansion, what does that say about expansion?

slide-37
SLIDE 37