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MiPCT Evaluation Update

MiPCT Evaluation Update

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MiPCT Evaluation Update

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  1. MiPCTEvaluation Update Clare Tanner March 14, 2014

  2. CMS Evaluation Question: What would have happened in Michigan without the MiPCT demonstration? Conducted by: Research Triangle Institute (RTI)

  3. 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 Quality Diabetes care: • LDL-C screening • HbA1c testing • Retinal eye examination • Medical attention for nephropathy • All 4 diabetes tests Ischemic Vascular Disease: • Total lipid panel test Patient experience survey

  4. To be considered a success: Outcomes of MiPCT beneficiaries must improve at a greater rate than comparison beneficiaries

  5. MiPCT Medicare Beneficiaries

  6. MiPCT Medicare Beneficiaries

  7. MiPCT Medicare Beneficiaries

  8. HbA1c Testing Rate

  9. Retinal Eye Examination Rate National benchmark: 82%

  10. Nephropathy Rate National benchmark: 94%

  11. LDL-C Screening Rate National benchmark: 94%

  12. Cost Savings? Demonstration effect: The change in outcomes during the demonstration period among beneficiaries assigned to MAPCP Demonstration practices compared to the change in outcomes for beneficiaries assigned to comparison PCMH practices.

  13. MiPCT in Comparison (Medicare)

  14. Quarterly Trend Comparison: Medicare PMPM Payments

  15. Quarterly Trend Comparison: Payments to PC and Specialty Physicians

  16. Quarterly Trend Comparison: Hospital Admissions

  17. Michigan Data A Multi-payer Perspective

  18. Inpatient Admissions per 1000 Attributed Patients

  19. 30-Day All-Cause Readmission Rate

  20. Diabetes HbA1c Testing Rate

  21. Diabetes % with A1C: Change 2012-2013

  22. Care Management Activity Source: PO quarterly reporting, 2013

  23. * Data missing from one PO

  24. Typical Daily Care Manager Activity Quarter 4

  25. Care Manager Activity Benchmark Performance Quarter 4

  26. Care Manager Survey Source: Surveys conducted May 2013 and Dec 2013/January 2014 50% response rate

  27. Average Self-reported Patient Caseload

  28. Care Manager Survey Results

  29. Care Manager Survey Results 22% of all respondents specifically noted that no other staff member is designated to assist with any of the tasks

  30. Care Manager Survey Results

  31. Care Manager Survey Results

  32. Care Manager Survey Results

  33. May-June 2014 April - May 2014 March - April 2014 October 2014 Next Steps Ongoing Claims Analyses Contact: ctanner@mphi.org