Committee November 17, 2017 HEALTH POLICY & ANALYTICS Office - - PowerPoint PPT Presentation

HEALTH POLICY & ANALYTICS Office of Health Analytics

Metrics & Scoring Committee

November 17, 2017

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Consent agenda

 Review today’s agenda

– HPQMC debrief – Update on work related to development of health aspects of kindergarten readiness measure – Review 2018 work plan

 Approve October minutes  Written updates (HPQMC is separate agenda item)

Please note this meeting is being recorded. The recording will be made available on the Committee’s webpage:

http://www.oregon.gov/OHA/HPA/ANALYTICS/Pages/Metrics-Scoring-Committee.aspx

HEALTH POLICY & ANALYTICS Office of Health Analytics

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Public testimony

Health Plan Quality Metrics Committee (HPQMC) Debrief

HEALTH POLICY & ANALYTICS Office of Health Analytics

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Health Plan Quality Metrics Committee (1/5)

• Met November 9th to hear recommendations from the

Public Health Advisory Board and the Metrics and Scoring Committee.

– Outcome and measures reviewed to date on next slides

• Next meeting: December 14, 1.30-4.00
• Meeting information and materials are available online

at: http://www.oregon.gov/oha/hpa/analytics/Pages/Quality- Metrics-Committee.aspx

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Health Plan Quality Metrics Committee (2/5)

Measure Name HPQMC Tentative Decision (If Measure Has Been Reviewed) 2018 CCO Incentive Measures Access to Care (CAHPS) Not yet discussed Adolescent well-Care Visits Tentatively endorsed Ambulatory Care: Emergency Department Utilization Not yet discussed Assessments within 60 days for Children in DHS Custody Tentatively endorsed Follow-Up: potentially adopt for a Medicaid population only Childhood Immunization Status Tentatively endorsed Cigarette Smoking Prevalence Tentatively endorsed Colorectal Cancer Screening Tentatively endorsed Comprehensive Diabetes Care: HbA1c Poor Control Tentatively endorsed Controlling High Blood Pressure Tentatively endorsed Dental Sealants on Permanent Molars for Children Not yet discussed Developmental Screening in the First Three Years of Life Tentatively endorsed

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Health Plan Quality Metrics Committee (3/5)

Measure Name HPQMC Tentative Decision (If Measure Has Been Reviewed) 2018 CCO Incentive Measures (cont) *Disparity Measure: Emergency Department Utilization Among Members with Mental Illness Tentatively endorsed Effective Contraceptive Use Tentatively endorsed (adolescents WILL be included) Patient-Centered Primary Care Home Enrollment Not yet discussed Prenatal & Postpartum Care: Timeliness of Prenatal Care Not yet discussed Screening for Clinical Depression and Follow- up Plan Tentatively endorsed Follow-Up: replace with new HEDIS measure “Depression Screening and Follow-Up for Adolescents and Adults” when the measure has been validated *Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents Tentatively endorsed (glide path for development of evidence based measure tabled)

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Health Plan Quality Metrics Committee (4/5)

Measure Name HPQMC Tentative Decision (If Measure Has Been Reviewed) Additional Measures Requested by M&S for 2019 Menu EHR-based Alcohol or other substance misuse screening (SBIRT) Not yet discussed Dental care for adults with diabetes Not yet discussed Preventive dental services utilization for adults Not yet discussed Coordination of care (CAHPS) Not yet discussed Obesity: BMI screening and follow-up for adults Not yet discussed Food Insecurity Screening Not yet discussed Developmental Measures Proposed by M&S Kindergarten readiness Development supported Developmental screening in the first 36 months of life and follow-up Not yet discussed Evidence-based obesity measure Tabled

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Health Plan Quality Metrics Committee (5/5)

• Committee chose the MIPS 2017 50th percentile (30.4%) as

the 2018 benchmark for this measure

– Since this is a new measure, there is no improvement target (benchmark only) – OHA also learned that the MIPS benchmark is calculated as an average of the three rates: (1) recording BMI; (2) providing nutrition counseling; (3) providing physical activity counseling – There were considerations that the benchmark should be revisited given evidence that non-intensive nutritional and physical activity counseling are not effective in addressing obesity (specifically, discussion of only using BMI rate in benchmark)

• STAFF RECOMMENDATION: Keep benchmark at MIPS 50th percentile

– Rationale: As discussed, this measure has utility beyond its relationship with obesity (in terms of work PCPs do in relation to health promotion) – Data are not available to appropriately benchmark the BMI portion only (deciles published by CMS use average methodology, not by each component rate).

Update and input on health aspects of kindergarten readiness measure development

HEALTH POLICY & ANALYTICS Office of Health Analytics

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Health Aspects of Kindergarten Readiness: Stakeholder Input on CAHPS Survey Pilot

• Per M&S, the Children’s Institute is convening a technical

workgroup to create measure(s) of the health aspects of kindergarten readiness

• To inform this work, OHA is piloting the addition of questions

related to kindergarten readiness in the annual statewide CAHPS survey

• The pilot questions will be drawn from a national survey

called the National Survey of Children’s Health (NSCH)

• OHA worked with the Early Learning Division to survey

health and education professionals for input on which NSCH survey questions to include in the statewide CAHPS survey (full report in packets)

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Health Aspects of Kindergarten Readiness: Stakeholder Input on CAHPS Survey Pilot

• The 74 respondents were asked to rate each of the 22

NSCH questions on a ten point scale in terms of importance to 1) kindergarten readiness and 2) include in the CAHPS survey (1 being less important, 10 of greatest importance).

• OHA then evaluated the average ranking of each question

in each of these domains.

• OHA also stratified the responses to see if there was a

difference in responses from those in the health versus education sectors.

• There was a distinct break in the data in that five questions

were consistently ranked highly across both domains, as well as across respondents from both the health and education sectors.

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Health Aspects of Kindergarten Readiness: Stakeholder Input on CAHPS Survey Pilot

• 1. How often does this child play well with others?
• 2. When he or she is paying attention, how often can this child

follow instructions to complete a simple task?

• 3. How often does this child lose control of his or her temper

when things do not go his or her way?

• 4. In the past 12 months, were you ever asked to keep your

child home from any child care or preschool because of behavior?

• 5. How often can this child calm down when excited or all

wound up?

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Health Aspects of Kindergarten Readiness: Stakeholder Input on CAHPS Survey Pilot

• These questions will be included in the CAHPS survey

being fielded in early 2018.

• Results of the pilot will be available in summer 2018, and

shared with the Metrics and Scoring Committee, Measuring Success Committee, and the workgroup being established to by the Children’s Institute.

Oregon Metrics & Scoring Committee

November 17, 2017 Elena Rivera

• Dr. Dana Hargunani

Update: Kindergarten Readiness Metric Technical Workgroup

Every child in Oregon arrives at school ready to learn. All sectors - hea health, e lth, educ ducation, tion, huma human n ser services, and bey vices, and beyond

• nd - collectively

support children, parents, caregivers, and communities to achieve kindergarten readiness.

Vision

Kindergarten readiness is shaped by a myriad of experiences, environments and supports beginning before birth through school entry.

Kindergarten Readiness

Preconception Prenatal Early Childhood

• What is the health system’s role and responsibility for

achieving kindergarten readiness for Oregon’s children?

• Adopt a health system accountability measure that:

– Drives health system behavior change, quality improvement, and investments that meaningfully contribute to improved kindergarten readiness – Catalyzes cross-sector collective action necessary for achieving kindergarten readiness

Opportunity

• Children’s Institute will convene the workgroup

– Support provided by OHA’s Health Analytics Team

• Sponsored by the Metrics & Scoring Committee
• Approved by the Health Plan Quality Metrics

Committee

– Update regarding scope, work plan, roster and deliverables will be presented to HPQMC on January 11, 2018

KR Technical Workgroup

Work Plan

Planning Phase Recruitment Workgroup Convening

Deliv Deliver erables bles

Planning Phase

Planning Phase Recruitment Workgroup Convening

Deliv Deliver erables bles

 Stakeholder interviews  National and Oregon scan of KR definition and domains  Focus groups with parents, caregivers  Preparation by CI staff and consultant

• Foundational Elements

KR definition and domains, community/consumer perspective, clear scope and work plan

Planning Phase (underway)

Recruitment

Planning Phase

Recruitment

Workgroup Convening

Deliv Deliver erable ble

 Based on applications & brief phone interviews

• Fulfill desired expertise and representation
• Motivated to participate in an innovative and transformative
• pportunity

 Proposed roster to be developed by CI in coordination with Oregon Health Authority and Early Learning Division  Review by committee chairpersons (M&S, HPQMC)  Roster finalized by January 2018

Recruitment (late November)

 Expected workgroup roster (approximate):

• Expertise in health care quality measurement (5)
• Health care providers (2)
• Coordinated Care Organization (CCO) representatives (2)
• Individuals representing insurers or large employers (2)
• Hospital representatives (1)
• Health care consumer representatives (2)
• Individuals with expertise in early learning and school readiness (1)
• Individuals representing the K-12 education sector (1)

Recruitment (late November)

Convening

Planning Phase

Recruitment

Workgroup Convening

Deliv Deliver erable ble

 Monthly meetings  Support team:

• Expert consultants (policy, quality measurement, facilitation)
• CI staff support
• OHA Health Analytics team support
• Advisory roles

 Interim updates as desired  Report to M&S Committee by September 2018

Convening (February 2018)

 Health system accountability measure that:

• Drives health system behavior change, quality improvement and

investments that meaningfully contribute to improved kindergarten readiness

• Catalyzes cross-sector collective action necessary for achieving

kindergarten readiness  Spectrum of potential recommendations may include: add validated, endorsed measure; add modified measure; modify P4P approach  Other potential recommendations to drive cross-sector collective action that achieves KR

• E.g., further measure development, data sharing, dashboard

Deliverables

Input and Questions Welcome

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Time for a break.

2018 Work Plan (see draft

in meeting materials)

HEALTH POLICY & ANALYTICS Office of Health Analytics

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Next Meeting: Happy New Year! January 19, 2018

• Program structure and support – level set

– Overview of CCO accountability measures (incentive, state performance, PIP, others) – OHA structure and metrics support 101 (Office of Health Analytics, Transformation Center TA, TAG, QHOC) – Role of Committee (re: above and HPQMC)