The Minnesota Community Measurement

Minneapolis—A community healthcare initiative in Minnesota aimed at improving the quality of healthcare is showing that strong collaboration and sharing of information among all key stakeholders in healthcare delivery can improve outcomes.

Called the Minnesota (MN) Community Measurement, the focus of the initiative is to accelerate the improvement of healthcare through public reporting of needed information that providers and patients can use to make informed decisions on care and improve outcomes. “Transparency does matter to help determine what to do differently to get better outcomes,” said Jim Chase, president, MN Community Measurement, during a contemporary issues session at the AMCP meeting titled The Minnesota Community Measurement—Accelerating the Improvement of Healthcare.

To make data transparent, the initiative offers a number of resources on a Web site (www.mncm.org/site/?page=index) comprised of data submitted directly from providers and health plans. Mr. Chase said the Web site makes it easy for both patients and providers to compare measures of quality of care that determine outcomes. According to Mr. Chase, the initiative focuses on developing measures with the “triple aim” of including the patient experience of care, clinical quality of care (including measures on patient functional status, specialty and procedural care, and population health), and the cost of care.

Using depression as an example, Mr. Chase emphasized the importance of including the patient experience of care as one of the aims of measuring quality. To that end, the Depression Care Measure developed includes the Patient Health Questionnaire-9 assessment tool, a patient self-reporting tool, along with 6-and 12-month remission and response rates. Mr. Chase emphasized that he believes health plans will be willing to pay for treatment that incorporates these new measures based on their willingness to pay for a program called DIAMOND (Depression Improvement Across Minnesota, Offering a New Direction) in Minnesota that redesigned care of depression with improved results.

In 2011, the initiative developed its first measurement on a procedure for colonoscopy quality and surveillance. The measurement permits a comparison among providers on volume of procedures performed, completion rates, and adenoma detection rate. It also includes a surveillance measure that shows if a patient waited an appropriate interval for repeat colonoscopy. According to Mr. Chase, the differences seen among providers in these areas are motivating providers to do more to get better results for their patients. Among the new measures under development are the use of high-tech diagnostic imaging, shared decision making, healthcare homes, and hospital readmissions. The last measure is being developed due to changes in Medicare that no longer permit payment for readmission. Mr. Chase said the number of providers sharing data has grown from an initial 65 provider groups to a current 315 medical groups and 550 clinics statewide.

Currently, the Web site is used more by providers than consumers, Mr. Chase said, although he said that the Web site gets a lot of traffic from consumers interested in cost data. According to Mr. Chase, the initiative is working well in Minnesota and making a difference. “Hopefully, lessons learned here will help others in their communities to get better outcomes,” he said. Among the lessons learned, he said, is that public reporting does have an impact, one of which is that providers pay more attention to quality of care. Also key is the importance of engaging local communities to gather data and create measures that can be used across payers. Still needed, Mr. Chase said, is a focus on best measures and a way to standardize measures without mandates.