Provider Peer Grouping
Monthly Updates
November 12, 2013
Stefan Gildemeister
Director, Health Economics Program
This Morning’s Discussion
• PPG Advisory Committee Meeting Updates
• Rapid Response Team call and Upcoming
Meetings
• Additional Updates
• Report Timelines
Advisory Committee Updates
• Meeting held Oct. 9
– Follow-up discussion on
• patient experience in hospital quality composite score
• Removal of add-on payment and
• testing of risk adjustment through further case mix
adjustment
– Discussion on template for confidential clinic reports
and Round 1 Clinic methodology
• Next meeting will take place in December (TBD)
Rapid Response Team
• RRT convened Oct. 25 and Nov. 1
– Proposed changes to quality measure scoring/
compositing,
– Indirect standardization for case-mix adjustment,
– price standardization and
– methodology to remove add-on payments
• Next conference call will be held in December
– Will cover clinic total cost of care (outliers, risk
adjustments and exclusions)
Upcoming RRT Discussions
Topic
Communication
Timing
Memos &
Conference Call
October, 2013
Memo only
November 2013
Memo & Conference
Call
December, 2013
Clinic Report: Total Cost (Part 2), including Cost Memo & Conference
measure calculation and Standardization
Call
December, 2013
Hospital Report: Total Cost, including Outliers,
Cost Transformation, Risk Adjustment, & Case
Mix Adjustment
Hospital Report: Quality Methods, including
Benchmarking and Compositing
Clinic Report: Attribution of patients to clinics
Clinic Report: Total Cost (Part 1) including
Outliers, Risk Adjustments and Exclusions
Clinic Report: (1) Categories of Service, (2)
Benchmarking
Clinic Report: Quality Methodology
Memo only
January, 2014
Memo & Conference
Call
February, 2014
Additional Updates
• Confidential clinic report template will undergo
physician testing
• MDH and Mathematica continuing to refine method
for removing Medicaid DPA payments from hospital
total costs
– Medicare DSH/IME will also be removed
• MDH released an RFP for a data aggregation vendor
with the contract starting at the end of 2013
– Please contact Sue Manning ([email protected]
for a copy)
PPG Timeline
Dec 2013,
RRT meeting
October, 2013
Jan 2014, RRTmeeting
Oct 2013,
AC meeting
Dec 2013,
AC meeting
2013
Oct
Nov
Jul 2014, End of
review (no public
report)
Mar 2014, Clinic
Report, v.1
Oct 2013,
RRT meeting
Dec
Jan
2014
Feb
Mar
Apr
May
Today
Dec 2013, Hospital
Report v.2
conduct cost & quality
analysis
confidential review by hospitals of HR.2
implement clinic/medical
group attribution
calculate clinic-based
quality measures
perform cost analysis
confidential review by clinics of CR.1
Apr 2014, HR v.2
public reporting
Jun
Jul
2014
Next call
December 9, 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]
Kevan Edwards at [email protected]
Ellen Wolter at [email protected]