Provider Peer Grouping
Monthly Updates
August 13, 2012
Stefan Gildemeister
Director, Health Economics Program
Outline
• Background of Provider Peer Grouping
• Progress Update: Advisory committee update
– Announcement of committee members
– First Advisory committee meeting
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What is Provider Peer Grouping?
• A system for publicly comparing provider
performance on cost and quality
– …a uniform method of calculating providers' relative cost of
care, defined as a measure of health care spending
including resource use and unit prices, and relative quality
of care… (M.S.§62U.04, Subd. 2)
– a combined measure that incorporates both provider riskadjusted cost of care and quality of care… (M.S.§62U.04,
Subd. 3)
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What types of Provider Peer Grouping
need to be developed?
1. Total care
2. Care for specific conditions
The commissioner shall develop a peer grouping system for
providers based on a combined measure that incorporates
both provider risk-adjusted cost of care and quality of care,
and for specific conditions… (M.S.§62U.04, Subd. 3)
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Stakeholder involvement
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Provider Peer Grouping Advisory Group
Rapid Response Team
Reliability Workgroup
Feedback during review period & at public meetings
Monthly conference calls
• Advisory Committee
• Data validation Work Group
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Progress Update:
Advisory Committee
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PPG Advisory Committee
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As required by MN Laws, 2012, Regular Session, Chapter 164—SF1809,
sec. 4, Commissioner of Health will convene an Advisory Committee
Membership will include representatives of:
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Health care providers
Health plan companies
Consumers
State agencies
Employers
Academic researchers
Organizations that work to improve health care quality in Minnesota
Call for nominations w/due date of July 11, 2012:
www.health.state.mn.us/healthreform/peer/advisorycommittee.html
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Advisory Committee, contd.
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Committee will meet no fewer than 3 times per year
Committee will provide advice on developing and administering the
Provider Peer Grouping System:
Establishing peer groups
Selecting quality measures
Recommending thresholds for completeness of data and statistical significance
Considering methods for risk adjustment, including whether certain provider
characteristics should be included
– Including or excluding certain cost information in the analysis
– Adopting patient attribution
– Performing scoring on quality and costs
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Advisory Committee Appointments
Health Commissioner Dr. Ed Ehlinger last week appointed members to an advisory
committee to provide recommendations as the Minnesota Department of Health
(MDH) implements the Provider Peer Grouping system – an initiative to provide
consumers, payers and providers with greater transparency about value in health care.
The Commissioner appointed a group of 24 representatives from health
systems/hospitals, physician clinics, health plan companies, consumers, state agencies,
employers, academic researchers, and organizations that work to improve health care
quality in Minnesota.
Commissioner Ehlinger stated, “We're fortunate to have a group of people willing to
step forward with this level of experience and expertise advising the Health
Department as we make the decisions necessary to implement the Provider Peer
Grouping system. I value their contribution to the community and look forward to
their help in holding us to our goals of scientific rigor, actionable results and
transparency of approach.”
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Representing health systems and hospitals:
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Allie Coronis, Allina Hospitals & Clinics
Andy McCoy, Fairview Health System
Bob Stevens, Ridgeview Medical Center
Jim Naessens, Mayo Clinic System
Sam Van Norman, Park Nicollet
Todd Sandberg, Sibley Medical Center
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Representing physician clinics:
Daniel Trajano, Park Nicollet
David Luehr, Integrity Health Network
Julie Anderson, St. Cloud Medical Group
Katie Lust, Boynton Health Center, University of
Minnesota
• Linda Ridlehuber, MN Association of Community
Health Centers
• William Davis, Winona Health
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Representing health plan companies:
• Kristie Ruma, Medica
• Larry Lee, Blue Cross Blue Shield of Minnesota
• Sue Knudson, HealthPartners
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Representing consumers and employers:
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Akhtar Chaudri, Vertelligence
Patrick Irvine, consultant
Peter Benner, retired, AFSCME
Shawn Leavitt, Carlson Companies
Stacie Weeks, Legal Services Advocacy Services
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Representing academic researchers and organizations
that work to improve health care quality:
• Bryan Dowd, University of Minnesota
• Tina Frontera, MN Community Measurement
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Representing state agencies:
• Mark Hudson, MN Department of Human Services
• Nathan Moracco, State Employees Group Insurance
Program (SEGIP)
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Advisory Committee Meeting
The first meeting of the Advisory Committee will be held Sept. 7,
2012, 1-4 p.m. at the Eagan Community Center.
All meetings of the Advisory Committee will be open to the
public.
Facilitating the Advisory Committee’s work will be Carrie
Coleman, recently selected after MDH’s informal solicitation for
professional services related to project planning, meeting
facilitation and communication planning work.
Resources
For more information about the Advisory Committee and the Provider Peer
Grouping system, see:
http://www.health.state.mn.us/healthreform/peer/index.html.
Or contact:
Stefan Gildemeister
Director, Health Economics Program
651-201-3554
Carrie Coleman
Consultant, MDH Health Economics
651-675-7457