Mipct evaluation overview update
This presentation is the property of its rightful owner.
Sponsored Links
1 / 16

MiPCT Evaluation Overview & Update PowerPoint PPT Presentation


  • 90 Views
  • Uploaded on
  • Presentation posted in: General

MiPCT Evaluation Overview & Update. MiPCT Retreat February 27 th , 2014. Objectives. How is MiPCT being evaluated? Metrics: cost, utilization, and quality MiPCT patients compared to other patients Snapshot of Results to Date Care Manager Activity Trends (from PO quarterly report)

Download Presentation

MiPCT Evaluation Overview & Update

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Mipct evaluation overview update

MiPCTEvaluation Overview & Update

MiPCT Retreat

February 27th, 2014


Objectives

Objectives

  • How is MiPCT being evaluated?

    • Metrics: cost, utilization, and quality

    • MiPCT patients compared to other patients

  • Snapshot of Results to Date

    • Care Manager Activity Trends

      (from PO quarterly report)

    • 2013 Care Manager Surveys

  • Future Surveys and Timeline


Two evaluations

Two evaluations

  • Research Triangle Institute (RTI) = National evaluator

  • Michigan Public Health Institute (MPHI)=Michigan evaluator


How will rti and cms determine success

How will RTI (and CMS) determine success?

What would have happened in Michigan without the MAPCP demonstration?


Rti measures

RTI Measures

Cost

Utilization

All-cause hospitalizations

ACSC hospitalizations (PQI)

All-cause ED visits

% ED visits that do not lead to hospitalization

Discharges from short-term general, rehabilitation, and SNF with (billed) clinical follow-up within 14 days

Rate of 30-day unplanned readmissions (CMS definition developed by the Yale New Haven Health Services Corporation)

  • Average PMPM

  • Measured as Medicare payments

    • By risk group

    • By dual eligible status

  • Cost buckets

    • Other inpatient

    • Emergency room

    • Hospital outpatient

    • Primary care services

    • Specialist services

    • Laboratory

    • Imaging

    • Home health

    • Other


Rti measures quality metrics

RTI Measures: Quality Metrics

Diabetes care:

  • LDL-C screening

  • HbA1c testing

  • Retinal eye examination

  • Medical attention for nephropathy

  • All 4 diabetes tests

  • None of the 4 diabetes tests

    Ischemic Vascular Disease:

  • Total lipid panel test

    Patient experience survey


To be considered a success

To be considered a success:

Outcomes of MiPCT beneficiaries must improve at a greater rate than comparison beneficiaries


Total average pmpm payments

Total Average PMPM Payments

Demo start


Total average pmpm payments1

Total Average PMPM Payments

Demo start


How is mipct being evaluated in michigan

How is MiPCT being evaluated in Michigan?

Multi-payer evaluation conducted by MPHI

Each payer might do additional evaluation


Cost measures

Cost Measures

National Evaluation

MiPCT Evaluation

Average PMPM

Standardized costs estimated based on service use

All payers

Dashboards

By risk group

By chronic conditions

By payer

Cost buckets (in development)

ED: total and ACSC

Hospitalization: Total and ACSC

Other

  • Average PMPM

  • Medicare Payments

  • Total

    • Demo payments excluded

    • By risk group

    • By dual eligible status

  • Cost buckets

    • Other inpatient

    • Emergency room

    • Hospital outpatient

    • Primary care services

    • Specialist services

    • Laboratory

    • Imaging

    • Home health

    • Other


Utilization measures

Utilization measures

National Evaluation

MiPCT Evaluation

All-cause hospitalizations

ACSC hospitalizations (PQI)

All-cause ED visits

‘Potentially preventable’ ED according NY algorithm

Non-emergent

Primary care treatable

Preventable/avoidable

All cause readmissions (HEDIS)

  • All-cause hospitalizations

  • ACSC hospitalizations (PQI)

  • All-cause ED visits

  • % ED visits that do not lead to hospitalization

  • Discharges from short-term general, rehabilitation, and SNF with (billed) clinical follow-up within 14 days

  • Rate of 30-day unplanned readmissions (CMS definition developed by the Yale New Haven Health Services Corporation)


Quality metrics

Quality Metrics

National Evaluation

MiPCT Evaluation

Diabetes

Asthma

Hypertension

Cardiovascular

Obesity

Adult preventive care

Child preventive care

Childhood lead screening (Medicaid)

(available: www.mipctdemo.org)

Patient experience survey

Diabetes care:

  • LDL-C screening

  • HbA1c testing

  • Retinal eye examination

  • Medical attention for nephropathy

  • All 4 diabetes tests

  • None of the 4 diabetes tests

    Ischemic Vascular Disease:

  • Total lipid panel test

    Patient experience survey


Core michigan evaluation questions

Core Michigan Evaluation Questions

  • What are the quantifiable improvements to practice infrastructure, processes, and capacity made by practices as a result of the MiPCT program?

  • To what extent is practice transformation in these areas (as measured within the MiPCT infrastructure requirements and the 4 functional tiers) associated with benefits for cost, utilization, quality, and patient experience?

  • How do MiPCT patient outcomes compare to patients in non-MiPCT PCMH and non-PCMH settings?


Both evaluations utilize comparison g roups

Both evaluations utilize comparison groups

1) Patients of other PCMH practices

2) Patients of other practices that are not PCMH


How can we know if we are having an impact now

How can we know if we are having an impact now?

  • Payers are pulling comparison data right now

  • Final results ~ 2015

  • In the meantime:

    • Monitor trends – use the MDC dashboard

    • Compare to benchmarks

  • Look at progress on ‘near term’ outcomes

    • Practice change

    • Care management implementation


  • Login