Michigan Data Collaborative Overview Last Updated: March 26, 2012

MDC – the Michigan Data Collaborative Data collection, enrichment, and provisioning group at the University of Michigan. Collect claims and eligibility data from Medicare, Medicaid, BCBSM, and BCN Collect other data such as registry, immunization, self-reported data Build “multi-payer claims database” Enrich data by defining and calculating meaningful metrics Create and distribute reports that: Helps to identify high risk and at-risk patients Establishes baseline performance Identifies opportunities for improvement Support report interpretation and practice use

Multi-Payer Claims Database Collect, standardize and aggregate data from multiple payers (insurance carriers) Creates a more complete picture of a patient’s information when they: Receive benefits from multiple insurance carriers over time Visit physicians from different practices or Physician Organizations Collects more complete information on a patient’s: Procedures Diagnoses Visits Tests Test Results (if results are collected) Prescriptions (if Rx data are collected) Multi-Payer Claims Database Medicare Medicaid BCN BCBSM MiPCT

Multi-Payer Claims Database Reporting PO Multi-Payer Claims Database datasets reports Practice Summary level and PO-specific Available to POs via secure web portal POs will distribute to practices Retrospective Reports Quality and Utilization performance metrics chosen for the project Only claims-based metrics for Year 1 Requires 2-3 month run-out to ensure availability of complete data Prospective Reports Timely feedback about attributed population for use in care management Providers are not being measured/scored Incentive Payments Reports Incentive scores and payments

Goals of Reporting Provide timely, actionable information Provide reports to POs that can be easily distributed further to practices Promote improvements in efficiency and cost savings (to ensure budget neutrality is achieved in the near term) and also improve/maintain quality of care Easily understood and used by providers Allow providers to identify high risk patients and access important information about utilization on those patients Provide information on a provider’s patients across multiple payers (Medicare, BCBSM, Medicaid Managed Care, BCN) Allow stakeholders to track progress toward MiPCT goals

Dashboards Membership/Population Quality & Efficiency Measures Membership Information Attributed members by Payer Risk Information # of members by Risk Level (H/M/L) Population Information # patients by Chronic Condition (Asthma, COPD, CHF, etc) Quality & Efficiency Measures Quality Measures Diabetes Test Rates, Cancer Screenings, etc ED & Inpatient Measures Visit Rates, Admit Rates, Re-admit Rates, etc Comparison to Benchmarks Trend Charts Risk Scores Costs Quality Metrics

Attributed/High Risk Patient List Physician Level attribution list, by Practice Includes information on Risk Scores, Visits, and Conditions Member Information Name DOB Age Age Group Gender Payer Attribution Information Physician Practice PO Risk Score Risk Group Visit Counts # Inp. Visits # Readmits # PC visits # Care Coord. Encounters # Maint. Rx Scripts Risk Conditions Asthma COPD CHF CAD Diabetes HTN ADHD CKD Obesity

Attribution Information Most Recent ED Visit Date ED Summary Report Patient-level report showing number of ED visits Includes patient attribution information Member Information Name DOB Age Gender Payer Attribution Information Physician Practice PO ED Summary Total ED Visits Most Recent ED Visit Date

Attribution Information Discharge Disposition Diagnosis 2 Description ED Detail Report Patient-level report showing ED visit information Includes patient attribution information Member Information Name DOB Age Gender Payer Attribution Information Physician Practice PO ED Detail Facility Name Date of Visit Discharge Disposition Discharge Diagnosis Diagnosis 2 Description

Contact Information MDC Email: MichiganDataCollaborative@umich.edu Myron Hepner mhepner@med.umich.edu 734-232-1698