Lessons Learned EVENT NAHDO 30th Anniversary Conference October - - PowerPoint PPT Presentation

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Combining Clinical and Claims Data in a Multi-Payer Database: Lessons Learned EVENT NAHDO 30th Anniversary Conference October 28, 2015 BACKGROUND TIMELINE PRESENTER Myron Hepner Director, Michigan Data Collaborative, Information and

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EVENT NAHDO 30th Anniversary Conference October 28, 2015 PRESENTER Myron Hepner Director, Michigan Data Collaborative, Information and Data Management, Medical Center Information Technology (MCIT), University

f Michigan Health System

Combining Clinical and Claims Data in a Multi-Payer Database: Lessons Learned

TIMELINE BACKGROUND LESSONS LEARNED FINDINGS

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BACKGROUND

1. Medicaid
2. Medicare
3. BCBSM
4. BCN
5. Priority

Health

PHYSICIAN ORGANIZATIONS

= = Electr ctroni nic c Clini nica cal Qualit ity y Measur sures es (eCQ CQMs) )

PAYERS

EHR Data Claims Data

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Original Dashboard contained claims data for five Payers

BACKGROUND

Challenges

Combine clinical with claims data

Is a patient’s health getting better?

Obtained PO Support through MiPCT Incentive Program Leveraged existing processes and formats Flexibility and support Phased approach Dedicated staff

Success Factors

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TIMELINE

FALL

Investigate formats First communication with POs

SPRING

Developed data request

FUTURE

Incentives to improve patient health

2015 Proof of Concept files received (2012–2013) NOVEMBER

Final layout

ptions

implemented Data request spec completed

FEBRUARY

POs submit historic data production files for format confirmation

JUNE

POs began sending monthly production files

2012 2014 2013 JUNE

Measures Published Dashboard Release 9.0

SEPTEMBER

Incentive Calculations Dashboard Release 10.0

FEBRUARY

Incentive Calculations Dashboard Release 12.0 .0

2016 and beyond…

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LESSONS LEARNED

Incentives focused PO attention

n open issues

Demonstrating to POs how reporting is a better representation

f their patient population

Who owns the data? Help POs coordinate between IT, Quality Department, and Leadership Varied content for each PO Claims and Clinical data are both trusted sources of truth Needed explicit communication and in-person support POs didn’t update patient list when sending monthly data

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FINDINGS

Claims ms-based sed qu quality ty measures… …plus measures supplemented with th EHR-base ased d clini nical al data

80% 75%