Aligning Forces for Quality An Initiative of Quality Counts in Partnership with Maine Quality Forum and Maine Health Management Coalition Ted Rooney, RN, MPH AF4Q Project Leader PTE Project Leader

2 Aligning Forces for Quality Vision  By 2010, because of the efforts of QC in partnership with MQF & MHMC, and through activities funded by the AF4Q initiative, organizations and individuals in Maine (e.g. consumers, providers, employers, health plans, government, etc.) are aligned and working together to achieve best health outcomes for people in Maine. Mainers are healthier because we have changed the culture of healthcare in Maine and achieved the following:

3  All entities in Maine are working together collaboratively to improve health care  The Care Model is widely adopted and great care is delivered  People recognize and identify measurable differences in quality of health care, and understand what they can do to improve their care  People are responsible for self- management of their conditions

4 AF4Q Core Activities  Performance Measure & Public Report IOM: Safe, Timely, Effective, Efficient, Patient Centered and Equitable  Quality Improvement Capacity Ambulatory & Inpatient  Consumer Engagement Choosing high performing providers Partnering with providers to improve health  Analyze population & diversity data Plan interventions  Develop nurse led QI initiatives in hospitals E.g. RWJ Transforming Care at Bedside

6 Maine 2007 MaineCare All Members 2007 N%N% African American12, %9, % Asian11, %2, % Caucasian1,271, %288, % Hispanic15, % % Native American7, %4, % Pacific % % UnknownN/A 50, % Total1,317, , % Racial Distribution for Maine and MaineCare Members, 2007

7 Comparison of MaineCare Access and Prevention Composite Measures by Race, CY2007

8 Comparison of Mainecare Health and Chronic Condition Composite Measures by Race, CY2007

9 Overall Care Not Different  Overall, Non-Caucasian members do not appear to experience any lower rate of care and in fact have a higher rate of care on many measures.  However, 26,493 members had unknown background (vs. 14,691 non Caucasian)  These were only process measures.

11 What to Do Next?  Better documentation More accurate process measures Have to get to outcomes  Work with MHA and Hospitals Hospitals and others  EMR pilot Physician practices  Focus QI on MaineCare overall With a few exceptions, MaineCare members had lower use of required health screenings and chronic care than National commercial and Medicaid averages as well as Maine specific plan averages (where available).