Semi-Annual Virtual Collaborative Meeting May 8 th , 2020 Welcome - PowerPoint PPT Presentation

Helping improve the health of Michigan through sustainable, high-value healthcare Semi-Annual Virtual Collaborative Meeting May 8 th , 2020

Welcome • Thanks from the MVC Coordinating Center • Please ask any questions through the Zoom Q&A function  In doing so, please provide your name and hospital/PO affiliation.  We will do our best to answer some of these questions in the Q&A function, and at the end of each section  If your questions are not covered, rest assured we will follow-up separately with answers after the meeting’s conclusion .

Agenda Welcome and MVC Updates 11:00am – 11:05am MVC Component of the BCBSM P4P Program 11:05am – 11:15am COVID-19: Coordinating Center Activity 11:15am – 11:25am Questions and Next Steps 11:25am – 11:30pm

New Members • Welcome to our new members since the last collaborative-wide meeting: 87  McLaren Thumb Hospitals  Genesys PHO 40  Henry Ford Medical Group  Medical Network One Physician Organizations  Michigan State University Health  Physician Healthcare Network • New addition to the MVC Coordinating Center Clarissa Brezzell, Administrative Assistant

MVC Updates More frequent data updates Increased frequency of push reporting MVC Component of BCBSM P4P Program Member Evaluation COVID-19 Resource Utilization Report MI-COVID19 Project Add Medicaid data

MVC Registry • The MVC registry continues to be updated on a monthly basis, with the latest data available as follows: Data feed Index admissions Follow-up data through BCBSM PPO (Commercial and 1/1/2014 – 12/31/2019 3/31/2020 Medicare Advantage) BCN HMO (Commercial and 1/1/2014 – 12/31/2019 3/31/2020 Medicare Advantage) Medicare FFS 1/1/2012 – 6/30/2019 9/30/2019

MVC Component of the BCBSM P4P Program

MVC Component of BCBSM P4P Program • First two year cycle of the MVC component of the BCBSM P4P program complete • To mark this, the Coordinating Center undertook an evaluation of Collaborative performance in PY18 and PY19 • Distributed to Site Coordinators in March and available in the resource section of the registry PY 2019 Performance Baseline 2015 2016 2017 2018 Baseline Performance PY 2018

Payment Changes • Program Year 2018: total payment change: -$14,664,347 • Conditions with overall reductions • Joint Replacement • AMI • Colectomy • CABG • Program Year 2019: total payment change: $5,180,837 • Conditions with overall reductions • Joint Replacement • CABG • Pneumonia

Where Did Payments Change in Medical Conditions? $800 $600 $400 $200 Change in Payment $0 -$200 -$400 -$600 -$800 -$1,000 -$1,200 AMI Pneumonia CHF AMI Pneumonia CHF PY 2018 PY 2019 Index Post-Acute Care Readmissions Professional

Where Did Payments Change in Surgical Conditions? $4,000 $3,000 $2,000 Change in Payment $1,000 $0 -$1,000 -$2,000 -$3,000 -$4,000 -$5,000 Colectomy CABG Joint Spine Colectomy CABG Joint Spine PY 2018 PY 2019 Index Post-Acute Care Readmissions Professional

Total Points Program Year: 2018 Program Year: 2019 18 18 Mean: 6.2 Mean: 4.6 16 16 Median: 7 Median: 5 Number of Hospitals Number of Hospitals 14 14 12 12 10 10 8 8 6 6 4 4 2 2 0 0 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Points Earned Points Earned

Current Cycle • The next two-year cycle includes Program Years 2020 and 2021 • Changes from previous cycle – New service lines selected – Excludes transfer cases – Includes BCN and Medicare Advantage plans – CABG condition includes emergent cases PY 2021 Performance Baseline 2017 2018 2019 2020 Baseline Performance PY 2020

COVID-19 Implications • The COVID-19 pandemic will affect the performance year for Program Year 2021 • The Coordinating Center is evaluating how to adjust the program to maintain a fair and transparent program

Questions?

MVC Resource Utilization Report

MVC Resource Utilization Report • Hospitals now need to prioritize which surgical services can begin again • New report developed with MSQC to help guide hospital decision making during surgical ramp-up • Historical look at their resource utilization for 17 elective procedures • Should be considered in conjunction with: – Aggressiveness of the disease/condition – Risk of delay – Alternative treatments — either temporary or permanent – Symptoms

17 Elective Procedures ● CABG ● Hernia Repair – Groin ● Colorectal Cancer ● Hysterectomy ● Disc Herniation Surgery ● Joint Replacement ● Endarterectomy ● Kidney Stone Surgery ● Esophagectomy ● Lung Cancer Resection ● Gastrectomy ● Pancreatectomy ● Gastric Bypass ● Prostatectomy ● Heart Valve Repair ● Sleeve ● Hernia Repair - Abdominal

Resource Utilization Metrics Index Admission 30 Days After Discharge • Percent inpatient • Readmission rates • Inpatient length of stay • Emergency Department • ICU utilization rates • Blood product utilization • Ventilator utilization • Discharge disposition (Home, Home Health, SNF, IPR, LTC)

https://mvc.arbormetrix.com/Registry/login

Inpatient Length of Stay Prostatectomy 2 Endarterectomy 2 Sleeve 3 Kidney Stone Surgery 3 Joint Replacement 3 Hysterectomy 3 Gastric Bypass 3 Disc Herniation Surgery 3 Hernia Repair – Groin 4 Hernia Repair – Abdominal 5 Lung Cancer Resection 6 Colorectal Cancer 6 Heart Valve Repair 7 Pancreatectomy 9 CABG 9 Gastrectomy 10 Esophagectomy 10 0 1 2 3 4 5 6 7 8 9 10 Median Inpatient LOS (Days)

Rate of ICU Utilization Hernia Repair – Groin 1% Kidney Stone Surgery 2% Joint Replacement 2% Hysterectomy 2% Prostatectomy 2% Disc Herniation Surgery 4% Sleeve 4% Hernia Repair – Abdominal 5% Gastric Bypass 9% Colorectal Cancer 20% Gastrectomy 52% Pancreatectomy 62% Esophagectomy 63% Endarterectomy 68% Lung Cancer Resection 75% Heart Valve Repair 87% CABG 91% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% ICU Utilization Rate

Rate of Blood Product Utilization Kidney Stone Surgery 1% Hernia Repair – Groin 1% Sleeve 1% Hernia Repair – Abdominal 2% Hysterectomy 3% Endarterectomy 3% Disc Herniation Surgery 3% Gastric Bypass 4% Prostatectomy 5% Joint Replacement 7% Lung Cancer Resection 9% Colorectal Cancer 23% Esophagectomy 25% Pancreatectomy 36% Gastrectomy 36% Heart Valve Repair 44% CABG 46% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Rate of Blood Product Utilization

MVC Registry • These metrics may be very different at your hospital • To gain access to your hospital’s data, you can request access to the MVC Registry: https://mvc.arbormetrix.com/Registry/requestAccess • Access your hospitals combined payer view on the registry, under new Resource Utilization tab

Questions?

Upcoming Events • CDM Workgroup: May 19 • Advanced Webinar: May 21 • Joint Workgroup: May 21 • Sepsis Workgroup: June 2 • Introductory Webinar: June 9 • CHF Workgroup: June 11 • Advanced Webinar: June 18 Next Semi-annual meeting: Kensington Hotel, Ann Arbor, MI 48108 Friday, October 30, 2020

Thank you If you have any questions or wish to get in touch with the MVC Coordinating Center, please email: michiganvaluecollaborative@gmail.com