Metrics & Scoring Committee November 17, 2017 HEALTH POLICY & ANALYTICS Office of Health Analytics
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 2
Public testimony HEALTH POLICY & ANALYTICS Office of Health Analytics 3
Health Plan Quality Metrics Committee (HPQMC) Debrief HEALTH POLICY & ANALYTICS Office of Health Analytics 4
Health Plan Quality Metrics Committee (1/5) • Met November 9 th 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 5
Health Plan Quality Metrics Committee (2/5) HPQMC Tentative Decision (If Measure Name Measure Has Been Reviewed) 2018 CCO Incentive Measures Access to Care (CAHPS) Not yet discussed Adolescent well-Care Visits Tentatively endorsed Ambulatory Care: Emergency Not yet discussed Department Utilization Tentatively endorsed Assessments within 60 days for Children Follow-Up: potentially adopt for a Medicaid in DHS Custody population only Childhood Immunization Status Tentatively endorsed Cigarette Smoking Prevalence Tentatively endorsed Colorectal Cancer Screening Tentatively endorsed Comprehensive Diabetes Care: HbA1c Tentatively endorsed Poor Control Controlling High Blood Pressure Tentatively endorsed Dental Sealants on Permanent Molars for Not yet discussed Children Developmental Screening in the First Tentatively endorsed Three Years of Life 6
Health Plan Quality Metrics Committee (3/5) HPQMC Tentative Decision (If Measure Measure Name Has Been Reviewed) 2018 CCO Incentive Measures (cont) *Disparity Measure: Emergency Department Utilization Among Members with Mental Tentatively endorsed Illness Tentatively endorsed (adolescents WILL be Effective Contraceptive Use included) Patient-Centered Primary Care Home Not yet discussed Enrollment Prenatal & Postpartum Care: Timeliness of Not yet discussed Prenatal Care Tentatively endorsed Follow-Up: replace with new HEDIS measure Screening for Clinical Depression and Follow- “Depression Screening and Follow -Up for up Plan Adolescents and Adults” when the measure has been validated *Weight Assessment and Counseling for Tentatively endorsed (glide path for Nutrition and Physical Activity for Children development of evidence based measure and Adolescents tabled) 7
Health Plan Quality Metrics Committee (4/5) HPQMC Tentative Decision (If Measure Measure Name Has Been Reviewed) Additional Measures Requested by M&S for 2019 Menu EHR-based Alcohol or other substance Not yet discussed misuse screening (SBIRT) Dental care for adults with diabetes Not yet discussed Preventive dental services utilization for Not yet discussed adults Coordination of care (CAHPS) Not yet discussed Obesity: BMI screening and follow-up for Not yet discussed adults Food Insecurity Screening Not yet discussed Developmental Measures Proposed by M&S Kindergarten readiness Development supported Developmental screening in the first 36 Not yet discussed months of life and follow-up Evidence-based obesity measure Tabled 8
Health Plan Quality Metrics Committee (5/5) • Committee chose the MIPS 2017 50 th 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 50 th 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). 9
Update and input on health aspects of kindergarten readiness measure development HEALTH POLICY & ANALYTICS Office of Health Analytics 10
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) 11
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. 12
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? 13
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. 14
Oregon Metrics & Scoring Committee November 17, 2017 Elena Rivera Dr. Dana Hargunani
Update: Kindergarten Readiness Metric Technical Workgroup
Vision 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 ond - collectively support children, parents, caregivers, and communities to achieve kindergarten readiness.
Kindergarten Readiness Kindergarten readiness is shaped Early by a myriad of Childhood experiences, Prenatal environments and supports beginning Preconception before birth through school entry.
Opportunity • 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
KR Technical Workgroup • 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
Work Plan Planning Workgroup Deliv Deliver erables bles Recruitment Phase Convening
Planning Phase Planning Workgroup Deliv Deliver erables bles Recruitment Phase Convening
Planning Phase (underway) 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
Recruitment Planning Workgroup Deliv Deliver erable ble Recruitment Phase Convening
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