MN P4P Journey 1988 – Buyers Health Care Action Group (“BHCAG” pronounced bee-keg) large self-funded employer coalition drives reform 1993 – Institute.

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Presentation transcript:

MN P4P Journey 1988 – Buyers Health Care Action Group (“BHCAG” pronounced bee-keg) large self-funded employer coalition drives reform 1993 – Institute for Clinical Systems Improvement (ICSI) develops care guidelines, measures, primary care transformation 1996 - HealthPartners (health plan) starts P4P Early 2000s – Two other health plans begin P4P 3

MN Background 2004 MN Community Measurement (MNCM) produces first public report on diabetes using aggregated health plan data. 2007 MNCM reports performance with clinical data submitted by providers for diabetes and CVD to meet MN Bridges to Excellence requirements 2008 Legislature mandates common measures for public reporting, aligned P4P, data submission. BTE/MNCM adds depression as a P4P measure 7

Optimal Diabetes Care Composite diabetes measure Each patient must meet all five measures Intermediate outcomes Publicly reported since 2004 Easier to compare physicians’ performance 4

Optimal Diabetes Care Five Measures A1c < 7 LDL < 100 BP < 130/80 Non-smoking status Daily aspirin if > 40 y.o. Credit for patients only passing all 5 measures 6

Direct Data Results Wide range of results by site

Optimal Diabetes Care

Rewards Threshold

P4P

2007 Diabetes Performance (%) 8

MNCM 2007 Report All Measures 53 49

Future Plans in Lake Wobegon Care model re-design reimbursement re-design (medical home and Capitation 2.0) Moving away from RVUs 42