Transcript Slide 1

AIM
For Excellence
Delivering Quality Outpatient Care
AIM for Excellence –
A collaborative initiative to promote
health care quality in the
outpatient setting
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
AIM Project Collaborators
• Dallas-Fort Worth Business Group
on Health
• American Airlines
• UnitedHealthcare
• Primary Care Physicians in N. TX
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
What “AIM” Stands For:
A - Awareness
I - Improvement
M - Measurement
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
DFW Business Group on Health
•
Coalition of 120 employers (55 Corporate & 65 Allied)
•
Represents over 800,000 DFW-based employees and their
dependents
•
Members spend >$2.1 billion on employee health care in DFW
•
Member of Texas Business Group on Health and National Business
Coalition on Health
•
Mission:
 Promote health care quality, accountability and cost effectiveness
 Empower employers and their employees to make informed health
care purchase decisions
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
American Airlines
•
Employs approximately 22,000 workers in DFW area
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Purchases health care services for over 55,000 DFW-based
employees and their dependents
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Spends over $15 million/year on health care in DFW
•
Offers worksite wellness, health promotion and disease
management programs to employees
•
Uses UnitedHealthcare as its third party administrator for selfinsured claims
•
Board Member of Dallas-Fort Worth Business Group on Health
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
United HealthCare
•
Second largest health insurer in Texas
•
Claims administrator for American Airlines’ self-insured plans
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Evaluates physicians against evidence-based medical quality
standards
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Provides performance report cards to individual physicians
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Recently rolled out UnitedHealth Premium Program in 20
markets (including Austin, Dallas, Houston, San Antonio)
•
Premium designation based on quality and efficiency
standards
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
Project Goals
• Ensure quality care for AA employees
with heart disease, stroke and diabetes
• Evaluate purchaser influence on clinical
practices
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
Physician Participants
• Test Group:
PCPs in UHC’s N.TX network who treated
>100 DFW-based AA employees and/or
dependents in 2004
• Control Group:
All PCPs in UHC’s N.TX network
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
Performance Measures*
• Heart Disease & Stroke:
– LDL Cholesterol
– Beta Blockers
– ACE Inhibitors
• Diabetes:
– HgA1c
– LDL Cholesterol
* Evidence-based Medical standards
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
Physician Task Force
• Ad hoc committee of 5 Aim physicians
• Provide feedback to project leaders regarding
physician communications
• Provide physician to physician advocacy for proactive
participation in project
• Review aggregate performance data and help identify
opportunities for improvement
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
AIM Interventions
• Clinical Practice Toolkit:
Diabetes & CAD educational materials; EBM checklist; Chart
flow-sheet; Resources list
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•
•
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CME Workshops
Quarterly Teleconferences
Performance Feedback
Personal Visits by UHC Medical Director
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
AIM Baseline Measures
(July 2004 – June 2005)
AIM FP
AIM IM
LDL-CAD
96%
91%
91%
93%
82%
HgA1C
94%
94%
92%
92%
87%
LDL-Diabetes
91%
85%
87%
87%
91%
© 2005 Dallas-Fort Worth Business Group on Health
Control FP Control IM
HEDIS
2004
AIM
For Excellence
Delivering Quality Outpatient Care
AIM Baseline Measures
Performance Rate
AIM Baseline Performance Measures Jul 2004 - Jun
2005
100%
95%
90%
85%
80%
75%
70%
LDL-CAD
HgA1C
LDL-Diabetes
AIM FP AIM IM Control Control
FP
IM
AIM Measures
© 2005 Dallas-Fort Worth Business Group on Health
HEDIS
04
AIM
For Excellence
Delivering Quality Outpatient Care
Opportunities For Improvement
Number of Aim FP
< 85% Implementation
Number of Aim IM
< 85% Implementation
LDL-CAD
5 of 63 (8%)
4 of 21 (20%)
HgA1C
9 of 77 (12%)
2 of 21 (10%)
LDL-Diabetes*
16 of 77 (21%)
9 of 21 (43%)
* Biggest opportunity for improvement
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
Physician Recognition
• Framed plaque recognizing physician as AIM
participant
• AIM participants recognized on DFWBGH and AA
websites*
• “Star” next to physician names in UHC Directory
• AIM participants names included in Project Report*
* With AIM participant’s permission
© 2005 Dallas-Fort Worth Business Group on Health
AIM
For Excellence
Delivering Quality Outpatient Care
Expected Outcomes
• Better quality care for AA employees with diabetes
and heart disease
• Stronger relationship between DFW employers and
physicians
• Recognition and promotion of AIM physicians
• An effective model for similar employer-led QI
initiatives in other communities
© 2005 Dallas-Fort Worth Business Group on Health