Provider Peer Grouping
Monthly Updates
February 11, 2013
Stefan Gildemeister
Director, Health Economics Program
This morning’s discussion
• Hospital report update
– Revised version 1 hospitals reports (confidential release)
– Distribution plan
– Summary brief
• Clinic report update
– Quality compositing
– HEDIS measures
– Risk adjustment
– Attribution
• Hospital data validation efforts
• Advisory group work
• Updated timeline
Hospital report update
Release and distribution plan
Hospital Reports
Report release update
• Release dates
– Mid-to end March
– Nearing completion of revised confidential hospital report
– Developing additional value added products
– Final refinement
• MDC grouper
• Updated data for analysis, but still using 2008 (Medicare) and 2009
(commercial + Medicaid)
• This is a confidential release – Further methodology
refinement based on stakeholder and community feedback
will take place for future iterations.
Hospital reports
Distribution Plan and Summary Brief
• Distribution plan
– Identify hospital contacts for report receipt
– Public webinar & one public meeting
– Post-release validation
• Additional cost and discharge data
• Offer one-to-one meetings
• Summary brief
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Summary-level data aggregated
Overall cost and quality trends/ metrics
Regional variation
Publicly distributed
Clinic report update
Methodology
Clinic report update
Clinic report methodology
• Quality compositing
– Number of domains
– How to weight each domain, i.e.,
absolute, relative or a
combination
• HEDIS measures
– Available at medical group level
– Convert to clinic-based
discussion using administrative
data
• Which measures can be
converted
• Attribution decisions
– Multiple proportionate
attribution vs. single clinic
attribution
– Assessing use of 30/40/50
percent attribution model
• Risk adjustment
– What risk adjusters
– How much historical data
– How to handle continuity of
eligibility
Clinic report update
Clinic data validation
• Clinic validation
– Number of visits/encounters
– Distribution by
• payer,
• product type,
• demographics and cost
• Challenges
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Attribution methodology
Lack of benchmarking data set
Volume of data
Confidentiality protections of data
• Partnership with clinics and health systems one-on-one and in
technical workgroup(s)
Ongoing hospital report data validation efforts
Advisory Committee(s)/Group(s)
• Various advisory bodies to PPG
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Advisory Committee
RRT
Reliability workgroup
Validation workgroup
• How to best leverage stakeholder input w/o overburdening
our colleagues
– Technical issues
– Higher-level policy issues
– Making adequate progress
• Advisory Committee: finalizing meeting date in March
Updated Timeline
• Hospital PPG:
– revised v.1, confidential release: mid-to end of March,
2013
– summary report: May 2013
– v.2, public release: Oct/Nov 2013
• Clinic:
– v.1, confidential release: Sept/Oct 2013
– summary report: December 2013
– v.2, public release: Spring 2014
Next call
March 11, 2013
7:30am
Resources
Additional information on PPG is available online:
www.health.state.mn.us/healthreform/peer/
Information on Minnesota’s health care market can also be found online:
www.health.state.mn.us/healtheconomics
Questions may be sent to:
Stefan Gildemeister at [email protected] or 651-201-3554