Provider Peer Grouping
Monthly Updates
June 10, 2013
Stefan Gildemeister
Director, Health Economics Program
This morning’s discussion
• Advisory Committee Meeting
• Miscellaneous Updates
– Helpdesk
– CMS Qualified Entity Certification for Medicare Data Entry Program
• Ongoing Hospital Data Validation Efforts
• Progress Update: Summary Report
• Methodological Updates
– Attribution
– Quality Measure Set
– Patient Experience Compositing
• Updated Timeline
Advisory Committee Meeting
June 27, 2013
2:00 pm to 4:00 pm
Location:
Elmer L. Andersen Human Services Building, Room 2390
540 Cedar Street, St. Paul, MN, 55101
For more information:
http://www.health.state.mn.us/healthreform/peer/advisorycommittee.html
Advisory Committee meetings are open to the public
Advisory Committee Meeting
– Inclusion of patient experience in hospital
reports
– Discussion of trade-offs associated with
creating a 3rd Peer Group
• Teaching Status/Resident FTEs
• Trauma 1 Center designation
• Uncompensated care
General Updates
• Helpdesk closed on May 31, 2013
– Please direct all further questions, comments or concerns
directly to the state @ [email protected]
• CMS Qualified Entity Certification for Medicare Data
Entry Program (QECP)
– Simplified access to Medicare data for states that use data
for public reporting
– Will receive CMS data in a more timely manner
– Anticipate having QE CMS data by early 2014
Hospital Updates
• Ongoing discussion with hospitals
– Validation & appeals
• Development of summary report (July 2013)
– Analysis of practice patterns variation of cost and quality
– Highlighting of certain metrics, e.g., readmission/ patient
experience
• Analysis for round two & methodological revisions
– Quality compositing
– Risk adjustment (functional form)
– Outlier treatment (global truncation vs. at APR-DRG)
Clinic Updates
• Completing provider linkage
• Nearing finalization on attribution
– 50% threshold
– Tiebreaker methods
– Non-users
• Finalizing draft quality measure set for testing with
report template
– Inclusion of claims-based quality measures
– Patient experience measures: within composite or outside
of it
Updated Timeline
Anticipated Timeline, Provider Peer Grouping
Analysis
June, 2013
Activity
Data Availability
Mar
Apr
May
Jun
Jul
2013
Aug
Oct
Nov
Dec
Jan
Feb
CY2008-11
Commercial &
Medicaid
CY2008-10
Medicare Data
Hospital Analysis
Second round
(Fed FY2011 Commercial &
Medicaid cost data; Fed FY
2010 Medicare cost data)
Sep
Mar
Apr
May
2014
Jun
Jul
Aug
Sep
Oct
Nov
Dec
CY2008-2012
All Payers
confidential release
create data files, perform
attribution, calculate costs,
conduct benchmarking, etc.
hospital review & respond to public
inquiries
report
confidential release
create data files, perform
attribution, calculate costs,
conduct benchmarking, etc.
Third round*
(Fed FY2012 all payers)
Clinic Analysis
First round
(Fed FY2011 Commercial &
Medicaid cost data; Fed FY
2010 Medicare cost data)
hospital review & respond to public
inquiries
report
confidential release
create data files, perform attribution, calculate costs,
conduct benchmarking, perform quality compositing, etc.
clinic review & respond to
inquiries
confidential release
Second round*
(Fed FY2012 all cost data)
*Assumes CMS data available for inclusion in MN APCD by December 2013
create data files, perform
attribution, calculate costs,
conduct benchmarking, etc.
clinic review & respond to
inquiries
public
report
Next call
July 8, 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