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 8th, 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:

• McLaren Thumb
• Genesys PHO
• Henry Ford Medical Group
• Medical Network One
• Michigan State University Health
• Physician Healthcare Network
• New addition to the MVC Coordinating

Center

87

Hospitals

40

Physician Organizations 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 Medicare Advantage) 1/1/2014 – 12/31/2019 3/31/2020 BCN HMO (Commercial and Medicare Advantage) 1/1/2014 – 12/31/2019 3/31/2020 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
• f Collaborative performance in PY18 and PY19
• Distributed to Site Coordinators in March and available in the

resource section of the registry

2018 2017 2016 2015

Baseline Baseline Performance Performance PY 2019 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?

• $1,200
• $1,000
• $800
• $600
• $400
• $200

$0 $200 $400 $600 $800 AMI Pneumonia CHF AMI Pneumonia CHF PY 2018 PY 2019 Change in Payment Index Post-Acute Care Readmissions Professional

Where Did Payments Change in Surgical Conditions?

• $5,000
• $4,000
• $3,000
• $2,000
• $1,000

$0 $1,000 $2,000 $3,000 $4,000 Colectomy CABG Joint Spine Colectomy CABG Joint Spine PY 2018 PY 2019 Change in Payment Index Post-Acute Care Readmissions Professional

Total Points

2 4 6 8 10 12 14 16 18 1 2 3 4 5 6 7 8 9 10

Number of Hospitals

Points Earned

Program Year: 2018

2 4 6 8 10 12 14 16 18 1 2 3 4 5 6 7 8 9 10

Number of Hospitals

Points Earned

Program Year: 2019

Mean: 4.6 Median: 5 Mean: 6.2 Median: 7

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

2020 2019 2018 2017

Baseline Baseline Performance Performance PY 2021 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
• Colorectal Cancer
• Disc Herniation Surgery
• Endarterectomy
• Esophagectomy
• Gastrectomy
• Gastric Bypass
• Heart Valve Repair
• Hernia Repair - Abdominal
• Hernia Repair – Groin
• Hysterectomy
• Joint Replacement
• Kidney Stone Surgery
• Lung Cancer Resection
• Pancreatectomy
• Prostatectomy
• Sleeve

Resource Utilization Metrics

Index Admission 30 Days After Discharge

• Percent inpatient
• Inpatient length of stay
• ICU utilization
• Blood product utilization
• Ventilator utilization
• Discharge disposition

(Home, Home Health, SNF, IPR, LTC)

• Readmission rates
• Emergency Department

rates

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

Inpatient Length of Stay

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

Rate of ICU Utilization

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

Rate of Blood Product Utilization

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