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CONFIDENTIAL

CONFIDENTIAL WSHA CQIP Peer Review and Quality Improvement Information. Protected from disclosure or discovery under RCW 43.70.510. What’s the Goal!. Department of Social and Health Services Health & Recovery Services Administration Jeff Thompson, M.D.

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CONFIDENTIAL

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  1. CONFIDENTIAL WSHA CQIP Peer Review and Quality Improvement Information. Protected from disclosure or discovery under RCW 43.70.510

  2. What’s the Goal! Department of Social and Health Services Health & Recovery Services Administration Jeff Thompson, M.D. Chief Medical Officer, Washington State Medicaid April , 2010 Washington State Department of Social & Health Services

  3. How good is your Statistical Gene? • How many of you can remember what you had for lunch two weeks ago for lunch? • How many know there generic fill rates for the last quarter? • How many of you know your NTSV c-section rates? • How many of you are in the top quartile?

  4. Pharmacy initiatives via HB5892 • The community has agreed to increase generic fill rate by additional 20 points (63 to 83%) using data and working together: • Transparency in generic and “Dispense As Written” (DAW) use through feedback reports • Use Generics First for new starts when appropriate • Maximize less costly OTC and generics on the Preferred Drug List when appropriate • Control “off label” use when appropriate Washington State Department of Social & Health Services

  5. New edition of Generic News is out with the second round of feedback reports

  6. After providing 824 prescribers with their baseline feedback measures in six therapeutic classes 112 prescribers are now above 80% generic prescribing and below 25% Dispense-As-Written (DAW) in ALL six therapeutic classes. 160 providers have moved up to best practice group!  Of the other 712 prescribers, for at least one therapeutic class:* 29% improved both generic and DAW * 54% improved generic only * 45% improved DAW * 18% had no change In the best practice group (top quartile) *47% improved both generic and DAW *85% improved generic only *49% improved DAW *13% had no change. Feedback Report go to prescribers if they were below 80% in generic prescribing or above 25% in DAW, or one or more standard deviations from the mean on each measure

  7. Generic News and feedback reports note changes in all prescribing and prescribers!

  8. What do the Numbers Say? Absolute numbers, all ages, all group and all gestational ages note increase in rates!

  9. What Do the Numbers Say? Cesarean rates rose significantly in each state from 1996 to 2007 (see table). The magnitude of the increases varied. Six states (Colorado, Connecticut, Florida, Nevada, Rhode Island, and Washington) had increases of over 70%. In 34 states, cesarean delivery rates increased by 50% or more Cesarean rates vary greatly by hospital and region using 2008 data and 2006 NTSV look the same in variation. Level 3 Hospitals: Mean 34% (range 18 – 39%) Level 2 Hospitals: Mean 28% (range 23 – 36%) Level 1 Hospitals: Mean 27% (range 10 – 39%)

  10. Question: What’s the Goal? Washington State Department of Social & Health Services

  11. Jeff Thompson, M.D. Chief Medical Officer, Washington Medicaid Health and Recovery Services Administration, DSHS 360-725-1630 THOMPJ@dshs.wa.gov

  12. CONFIDENTIAL WSHA CQIP Peer Review and Quality Improvement Information. Protected from disclosure or discovery under RCW 43.70.510

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