Data, Data and More Data; Findings from the Practice Assessment Tool Prepared for HCDI SAN This webinar is provided free-of-charge and is supported by Grant Number 1L1CMS-331480-01-00 from the U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services. The contents provided in this webinar are solely the responsibility of the presenters and do not necessarily represent the official views of HHS or any of its agencies.

Objectives/Topics Review the TCPI Aims Understand purpose and use of the TCPI Practice Assessment Tool (PAT) Review Great Lakes PTN PAT results Identify opportunities to optimize data using the PAT tool

Transforming Clinical Practice Goals

Practice Assessment Tool The Practice Assessment Tool (PAT) is used by PTNs to capture data and information about their practices. This tool assesses the stages of transformation and measures the opportunities for improvement.

Great Lakes Practice Transformation Network Tierra Pinkins, MPH, CHES – Senior Network Coordinator

Agenda Introduction to Great Lakes Practice Transformation Network Data Lessons Learned

GLPTN: Who We Are GLPTN formed as part of the Transforming Clinical Practices Initiative (TCPI) to help clinicians achieve large-scale health transformations through collaborative and peer-based learning networks One of 29 practice transformation networks (PTNs) awarded 10 support and alignment networks (SANs) awarded to support PTNs Awarded $46.4 million of $685 million total Lead organizations: Indiana University (primary grant recipient) Purdue Healthcare Advisors (Indiana) Northwestern University (Illinois) Altarum Institute (Michigan and Ohio) University of Kentucky (Kentucky) ** For GLPTN network only

GLPTN Key Facts $46.4M received $1B in cost savings Over 33 healthcare partners 8 universities Indiana, Michigan, Illinois, Ohio, Kentucky, West Virginia 15,500+ clinicians (35% over goal!) 10 million+ lives impacted More than 52 on-site, on-demand Quality Improvement Advisors

Clinical Quality Measures Medication Management Controlling high blood pressure Anticoagulation therapy in patients with atrial fibrillation Unnecessary Testing Advanced diagnostic imaging Esophageal-gastric-duodenoscopy (EGD) Colonoscopy Prevention Influenza vaccination rates Behavioral Health Depression screening and follow-up Chronic Disease Management Diabetes Chronic Obstructive Pulmonary Disorder (COPD) Congestive Heart Failure (CHF) Reducing Preventable Hospitalizations

TCPI Key Indicators of Success Partner with 11,500 clinicians to transform to value-based care Improve health outcomes for 10 million patients Reduce unnecessary hospitalizations Generate at least $1B in cost savings to payers Reduce unnecessary testing and procedures to improve efficiency Build evidence base to scale effective solutions ** For GLPTN network only

Our Transformation Toolkit We offer a four-part change package to help you shape your practice for the future of healthcare delivery and compensation. Implementation Science: Learn how to identify practice areas that could benefit most from improvement, and those that should get immediate attention Lean and Six Sigma: Improve the flow of your workplace, so you can make changes to your processes as soon as you see the need for them Personalized Population Health: Help with reporting data for patient groups with certain core conditions so treatments that benefit them become clear CMS Compliance: Prepare you to get ready for new performance-based compliance standards, and qualify for incentives under MIPS.

Agenda Introduction to Great Lakes Practice Transformation Network Data Lessons Learned

Demographics 37.7% Medically Underserved 11% FQHCs

TCPI Five Phases of Practice Transformation Set aims Use data to drive care Achieve progress on aims Achieve benchmark status Thrive as a business via pay-for-value approaches ** For GLPTN network only

Practice Assessments

Practice Assessments

Practice Assessments 0.0% 0.3% 9.4% 6.4% 32.0% 3.9% 16.6% 3.1% 20.3% DRIVER Driver % Completion   Specialist Primary Care 0.0% 0.3% 0. Aims 1.1 Patient Family Engagement 9.4% 6.4% 1.2 Team Based Relationship 32.0% 3.9% 1.3 Population Management 16.6% 3.1% 1.4 Community Partner 20.3% 11.2% 1.5 Coordinated Care 13.1% 1.7% 1.6 Organized Evidenced-Based Care 28.0% 1.7 Enhanced Access 51.4% 80.2% 2.1 Engaged and Committed Leadership 1.4% 2.2 QI Strategy Supporting Culture of Qualit 12.9% 5.3% 2.3 Transparent Measurement and Monitoring 21.7% 15.9% 2.4 Optimized Health Information Technology 5.4% 17.0% 3.1 Strategic Use of Revenue 58.6% 38.5% 3.2 Workforce Vitality and Joy in Work 19.4% 23.5% 3.3 Capability to Analyze and Document Value 3.4 Operational Efficiency 5.1% 2.8%

Practice Assessments Driver % Completion Urban Suburban Rural Mix   Driver % Completion Urban Suburban Rural Mix Driver 0.0% 0.8% 0. Aims 1.1 Patient Family Engagement 9.1% 2.9% 9.3% 16.7% 1.2 Team Based Relationship 16.8% 5.0% 33.9% 50.0% 1.3 Population Management 8.6% 21.2% 33.3% 1.4 Community Partner 15.0% 10.8% 23.7% 1.5 Coordinated Care 5.5% 0.7% 20.3% 1.6 Organized Evidenced-Based Care 14.5% 30.5% 1.7 Enhanced Access 66.1% 87.8% 41.5% 2.1 Engaged and Committed Leadership 1.4% 4.2% 2.2 QI Strategy Supporting Culture of Qualit 5.9% 29.7% 2.3 Transparent Measurement and Monitoring 17.3% 3.6% 40.7% 2.4 Optimized Health Information Technology 13.9% 5.8% 3.1 Strategic Use of Revenue 59.3% 53.4% 3.2 Workforce Vitality and Joy in Work 23.4% 13.7% 24.6% 3.3 Capability to Analyze and Document Value 3.4 Operational Efficiency 3.0%

Agenda Introduction to Great Lakes Practice Transformation Network Data Lessons Learned

1. Identifying Bright Spots States identify exceptional performance Confirm the positive deviance Share throughout the network using Healthcare Communities platform

2. Developing Action Plans Identify goals TCPi Utilization Aims Clinical Outcomes Business Operations Implementation Plan Quality Measures

3. Developing Affinity Groups Strategize how clinician affinity groups within GLPTN will be created Specialty Clinical Quality Measures Practice Type Pediatrics Affinity Group first to be formed out of Illinois

4. MACRA/MIPS Readiness Preparing practices for Merit-Based Incentive Payment System or an Alternative Payment model Combining PAT, quality measure data and other sources of information to provide a diagnostic assessment

Thank you! Questions? Email: info@glptn.org Website: glptn.org

Knitasha V. Washington, DHA, FACHE kwashington@patientsafety.org Consumers Advancing Patient Safety 405 N. Wabash Ave., Ste. P2W Chicago, IL, 60611 Telephone: 312-464-0602 www.patientsafety.org facebook/drknitashawashington @drknitasha or @CAPS_SafetyORG – Twitter