Transcript No Slide Title

Michigan Quality
Improvement Consortium
Measurement Committee Year-End Report
December 14, 2006
Principal Accomplishments
• Information sharing among plans
– Health plan use of LOINC codes in lab data
– Administrative data
• Measures for new guidelines
– Adult preventive services (18-49 and 50 – 65+)
– Challenges
•
•
•
•
Vetted measure(s)
Eligible population
Prevalence
Examples
– Heart failure
– Deep Venous Thrombosis (DVT)
Principal Accomplishments
• Updated MQIC measurement specifications
– Remain current with
• HEDIS specifications
• MQIC guidelines
• Measurement practices of participating health plans
– MQIC Measures Summary document
– Measurement Specification document
• Reporting and Trending Policy
– Impact of rotated measures on trending
– MQIC “best practice”
Principal Accomplishments
• Aligned reporting with updated specifications
and limitations
– Data Submission Tool for HEDIS measures
– MQIC non-HEDIS data submission form
• Web-based measurement resources
(www.mqic.org/meas.htm)
–
–
–
–
MQIC Measures
MQIC Measurement Specifications
Measurement Committee Year-End Report
MQIC Lipid Lowering Agents
Principal Accomplishments
• Enhanced leadership links with Save
Lives Save Dollars initiative
– Collaborative opportunity on health plan
reporting
– Potential for further alignment on matters of
mutual interest, such as “implementation”
• Patient lists with “integrated” data
Analysis and Reporting
• Product-specific, community-level results based on
weighted data from reporting health plans
– Not simple average of plans as reported in Quality Compass
• Two or more health plans had to provide current year
data for an indicator to be included.
– Rotated measures: Included data as submitted in health plan
Data Submission Tool (DST)
– Impact on year to year trends
• Diabetes non-HEDIS measure “blood pressure control”
not required to report (rotation)
– Opportunity to collaborate with MDCH on voluntary diabetes
chart-based data collection
Analysis and Reporting
• Data not available
– Could not calculate “annual quit rate,” a “non-HEDIS” tobacco
control measure (eliminated: “recent quitters”)
– Newly Reported in Quality Compass: % current smokers by
health plan
• Need health plan data on # members 18+ for community rate
• Specification changes impacting trending and reporting
– Use of appropriate medications for people with asthma
• Redefined eligible population
• Significantly “improved” rate
– Breast cancer screening – admin only measure
– Cholesterol management for cardiovascular conditions
• Expanded to include ischemic vascular conditions
• Measure not reported publicly by NCQA due to data / specifications
Analysis and Reporting
• Product line reporting and trending
– Specifications differ by product line
• Continuous enrollment
– Data availability
• Administrative only vs. hybrid
– Benefit design
• Covered benefits
Michigan Quality Improvement Consortium
Chart Book - 2006
MQIC Measurement Committee
December, 2006
54.90%
50.86%
52.54%
60.00%
52.33%
Percent
70.00%
53.46%
80.00%
56.45%
88.76%
88.02%
84.45%
85.80%
84.12%
84.89%
90.00%
63.55%
100.00%
80.33%
HEDIS Diabetes Indicators
Commercial Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
50.00%
2003
40.00%
2004
30.00%
2005
20.00%
2006
10.00%
0.00%
Retinal Exams
Glyc Hb Testing
Measures
Measures
Retinal Exams
Glycosylated Hemoglobin Testing
HEDIS 2006 Results
54.80%
87.50%
MQIC Best Practice
67.88%
91.73%
93.73%
93.32%
89.27%
87.38%
2000
2001
27.65%
27.14%
29.97%
31.64%
2002
28.82%
40.00%
39.02%
60.00%
31.19%
Percent
80.00%
82.92%
65.82%
100.00%
76.78%
HEDIS Diabetes Indicators
Commercial Members
HEDIS 2001 - HEDIS 2006
2003
2004
2005
20.00%
2006
0.00%
Glyc Hb Poor Control
LDL-C Testing
Measures
Measures
Glycosylated Hemoglobin Poor Control
LDL-C Testing
HEDIS 2006 Results
29.70%
92.30%
MQIC Best Practice
19.95%
96.59%
43.08%
47.52%
73.04%
71.24%
65.41%
57.58%
37.85%
40.00%
48.24%
60.00%
39.25%
Percent
80.00%
56.94%
HEDIS Diabetes Indicators
Commercial Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
2003
20.00%
2004
0.00%
2005
LDL-C Control < 130
LDL-C Control < 100
2006
Measures
Measures
LDL-C Control < 130 mg/dL
LDL-C Control < 100 mg/dL
HEDIS 2006 Results
67.50%
43.80%
MQIC Best Practice
81.51%
54.26%
Percent
61.21%
54.62%
43.73%
50.00%
42.65%
60.00%
51.77%
57.99%
70.00%
62.37%
HEDIS Diabetes Indicators
Commercial Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
40.00%
2003
30.00%
2004
2005
20.00%
2006
10.00%
0.00%
Nephropathy Monitoring
Measures
Measures
Nephropathy Monitoring
HEDIS 2006 Results
55.10%
MQIC Best Practice
73.35%
80.05%
81.43%
73.48%
74.73%
75.56%
73.59%
69.33%
55.35%
49.90%
43.61%
41.31%
50.80%
53.51%
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
43.11%
Percent
HEDIS Diabetes Indicators
Medicaid Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
2003
2004
2005
2006
Retinal Exams
Glyc Hb Testing
Measures
Measures
Retinal Exams
Glycosylated Hemoglobin Testing
HEDIS 2006 Results MQIC Best Practice
48.60%
70.32%
76.20%
88.78%
83.54%
83.54%
72.99%
72.77%
68.49%
63.53%
54.60%
42.28%
42.70%
52.24%
57.47%
43.16%
46.48%
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
37.41%
Percent
HEDIS Diabetes Indicators
Medicaid Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
2003
2004
2005
2006
Glyc Hb Poor Control
LDL-C Testing
Measures
Measures
Glycosylated Hemoglobin Poor Control
LDL-C Testing
HEDIS 2006 Results MQIC Best Practice
49.10%
29.68%
80.50%
91.56%
46.07%
44.90%
34.11%
63.76%
61.88%
50.79%
41.18%
41.34%
35.79%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
27.07%
Percent
HEDIS Diabetes Indicators
Medicaid Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
2003
2004
2005
LDL-C Control < 130
LDL-C Control < 100
2006
Measures
Measures
LDL-C Control < 130 mg/dL
LDL-C Control < 100 mg/dL
HEDIS 2006 Results MQIC Best Practice
51.30%
72.26%
32.60%
62.04%
2000
2001
2002
2003
2004
Nephropathy Monitoring
Measures
Measures
Nephropathy Monitoring
53.45%
49.88%
54.28%
53.35%
47.62%
45.26%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
41.02%
Percent
HEDIS Diabetes Indicators
Medicaid Members
HEDIS 2001 - HEDIS 2006
2005
2006
HEDIS 2006 Results MQIC Best Practice
48.80%
65.92%
76.19%
y
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LD
LC
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18.02%
54.37%
80.33%
93.04%
80.50%
100.00%
80.00%
60.00%
40.00%
20.00%
0.00%
R
Percent
HEDIS Diabetes Indicators
Medicare Members
HEDIS 2006
Measures
Measures
Retinal Exams
Glycosylated Hemoglobin Testing
Glycosylated Hemoglobin Poor Control
LDL-C Testing
LDL-C Control < 130 mg/dL
LDL-C Control < 100 mg/dL
Nephropathy Monitoring
HEDIS 2006 Results
66.50%
88.90%
23.60%
93.30%
71.60%
50.00%
60.20%
MQIC Best Practice
83.78%
95.09%
9.58%
97.81%
80.54%
54.74%
81.06%
40.00%
80.14%
78.30%
74.79%
2000
2001
2002
32.04%
39.98%
39.98%
50.00%
44.80%
60.00%
43.54%
Percent
70.00%
44.42%
80.00%
69.28%
68.29%
90.00%
68.28%
100.00%
77.83%
HEDIS Diabetes Indicators
BCBSM Members
HEDIS 2001 - HEDIS 2006
2003
2004
30.00%
2005
20.00%
2006
10.00%
0.00%
Retinal Exams
Glyc Hb Testing
Measures
38.73%
40.36%
30.04%
26.58%
40.00%
23.03%
60.00%
32.29%
85.11%
83.56%
82.56%
79.69%
87.11%
2000
22.30%
Percent
80.00%
75.54%
100.00%
71.70%
HEDIS Diabetes Indicators
BCBSM Members
HEDIS 2001 - HEDIS 2006
2001
2002
2003
20.00%
2004
0.00%
2005
LDL-C Testing
Nephropathy Monitoring
Measures
2006
Non-HEDIS Diabetes Indicators
Commercial M embers
Calendar Years 2004 - 2005
100.00%
90.00%
80.00%
Percent
70.00%
60.00%
63.53%
51.12%
2004
50.00%
2005
40.00%
30.00%
20.00%
10.00%
0.00%
Lipid Lowering Rx
Measures
Measures
Prescription Filled for Lipid Lowering Drugs
CY 2005 Results
63.53%
MQIC Best Practice
71.50%
Percent
Non-HEDIS Diabetes Indicators
Medicaid Members
Calendar Year 2005
100.00%
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
91.65%
2005
Lipid Lowering Rx
M easure
Measures
Prescription Filled for Lipid Lowering Drugs
CY2005 Results
91.65%
MQIC Best Practice
99.47%
Percent
Non-HEDIS Diabetes Indicators
BCBSM Members
Calendar Year 2005
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
63.87%
2005
Lipid Lowering Rx
Measures
91.49%
69.80%
66.80%
58.06%
64.44%
65.35%
64.53%
94.63%
78.28%
73.57%
63.45%
69.49%
64.49%
100.00%
80.00%
60.00%
40.00%
20.00%
0.00%
65.51%
Percent
HEDIS Asthma Indicators
Commercial Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
2003
2004
asthma med 5-9 yo
asthma med 10-17 yo
2005
*2006
Measures
*2005 - Specification Change
Measures
Appropriate Asthma Medications 5 - 9 Years Old
Appropriate Asthma Medications 10 - 17 Years Old
HEDIS 2006 Results MQIC Best Practice
95.70%
99.39%
91.70%
98.15%
91.13%
73.96%
71.31%
63.69%
68.75%
66.45%
67.60%
90.27%
74.29%
72.19%
69.84%
65.55%
Percent
80.00%
67.09%
100.00%
68.69%
HEDIS Asthma Indicators
Commercial Members
HEDIS 2001 - HEDIS 2006
2000
2001
60.00%
2002
40.00%
2003
20.00%
2004
0.00%
2005
asthma med 18-56 yo
asthma med all
*2006
Measures
*2005 - Specification Change
Measures
Appropriate Asthma Medications 18 - 56 Years Old
Appropriate Asthma Medications Combined Ages
HEDIS 2006 Results MQIC Best Practice
88.50%
94.59%
89.90%
95.91%
63.59%
63.82%
58.98%
64.42%
63.61%
56.04%
65.44%
64.39%
61.48%
51.11%
60.00%
60.76%
Percent
80.00%
65.22%
100.00%
86.47%
87.56%
HEDIS Asthma Indicators
Medicaid Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
2003
40.00%
2004
2005
20.00%
*2006
0.00%
asthma med 5-9 yo
asthma med 10-17 yo
Measures
*2005 - Specification Change
Measures
Appropriate Asthma Medications 5 - 9 Years Old
Appropriate Asthma Medications 10 - 17 Years Old
HEDIS 2006 Results MQIC Best Practice
88.00%
94.59%
85.60%
92.26%
Percent
86.21%
68.22%
67.07%
62.09%
66.90%
62.90%
61.97%
85.58%
72.29%
70.03%
68.23%
70.39%
63.43%
100.00%
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
62.89%
HEDIS Asthma Indicators
Medicaid Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
2003
2004
2005
*2006
asthma med 18-56 yo
asthma med all
Measures
*2005 - Specification Change
Measures
Appropriate Asthma Medications 18 - 56 Years Old
Appropriate Asthma Medications Combined Ages
HEDIS 2006 Results MQIC Best Practice
83.40%
91.18%
85.70%
92.18%
Percent
93.74%
72.55%
70.26%
69 .50 %
66.40%
64.51%
79.62%
76.29%
62.36%
70.00%
67.94%
80.00%
69.63%
90.00%
72.16%
100.00%
75 .07 %
96.89%
HEDIS Asthma Indicators
BCBSM Members
HEDIS 2001 - HEDIS 2006
2000
2001
60.00%
2002
50.00%
2003
40.00%
2004
30.00%
2005
20.00%
*2006
10.00%
0.00%
asthma med 5-9 yo
asthma med 10-17 yo
Measures
*Specification Change
Percent
91.72%
75.31%
72.77%
72.81%
71.42%
67.74%
66.62%
90.44%
75.36%
72.91%
73.30%
72.50%
68.37%
100.00%
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
67.55%
HEDIS Asthma Indicators
BCBSM Members
HEDIS 2001 - HEDIS 2006
2000
2001
2002
2003
2004
2005
*2006
asthma med 18-56 yo
Measures
*Specification Change
asthma med all
131.78
2001
90.66
88.10
81.86
85.99
2002
73.61
62.60
97.33
115.02
200
180
160
140
120
100
80
60
40
20
0
76.09
Rate
Non-HEDIS Asthma Indicators
Commercial Members
Calendar Years 2001 - 2005
2003
2004
2005
Asthma ER Rate/1000
Asthma Px Exams (%)
Measures
Measures
Emergency Room Visits for Asthma/1000
Members with Asthma
Periodic Assessment for Asthma
CY 2005 Results
MQIC Best Practice
97.33
46.76
90.66%
93.69%
Non-HEDIS Asthma Indicators
Medicaid Members
Calendar Year 2005
200.00
160.31
Rate
150.00
100.00
2005
71.35
50.00
0.00
Asthma ER Rate/1000
Asthma Px Exams (%)
Measures
Measures
Emergency Room Visits for Asthma/1000
Periodic Assessment for Asthma
CY 2005 Results
160.31
71.35%
MQIC Best Practice
96.88
96.55%
Non-HEDIS Asthma Indicators
BCBSM Members
Calendar Years 2001-2005
200
180
44.19
76.09
49.78
60
52.57
80
57.54
100
76.30
2002
75.94
120
75.88
2001
73.20
140
52.19
Rate
160
2003
2004
2005
40
20
0
Asthma ER Rate/1000
Asthma Px Exams (%)
Measures
Percent
71.70%
59.23%
75.23%
56.60%
60.00%
57.87%
70.00%
70.41%
80.00%
65.86%
HEDIS Hypertension Indicators - CBP
HEDIS 2004 - HEDIS 2006
50.00%
2004
40.00%
2005
30.00%
2006
20.00%
10.00%
0.00%
Comm
Medicaid
Medicare
Product
Product
Commercial
Medicaid
Medicare
HEDIS 2006 Results
68.80%
61.40%
66.40%
MQIC Best Practice
76.86%
75.96%
72.26%
Non-HEDIS Hypertension Indicator
Percent Members with any Diagnosis of Hypertension
Calendar Year 2005 - Baseline
71.70%
Percent
80.00%
60.00%
40.00%
20.00%
2005
18.81%
11.78%
0.00%
Commercial
Medicaid
Medicare
Product
Product
Commercial
Medicaid
Medicare
CY 2005 Results
18.81%
11.78%
71.70%
MQIC Best Practice
12.03%
19.43%
69.44%
HEDIS Tobacco Control Indicators
Medicaid Members
HEDIS 2005 - HEDIS 2006
38.35%
42.02%
32.70%
40.00%
37.75%
50.00%
38.15%
60.00%
38.20%
Percent
70.00%
69.71%
80.00%
71.58%
90.00%
67.64%
100.00%
30.00%
20.00%
10.00%
0.00%
Adv Smokers to Quit
Disc Smok Cess Meds
Disc Smok Cess Strat
Measures
Measures
Advising Smokers to Quit
Discussion of Smoking Cessation Medications
Discussion of Smoking Cessation Strategies
HEDIS 2006 Results
65.60%
31.90%
34.10%
MQIC Best Practice
75.85%
44.68%
50.16%
2004
2005
2006
42.46%
41.24%
40.57%
41.96%
44.95%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
42.84%
70.00%
60.00%
46.33%
76.56%
74.52%
47.86%
Percent
90.00%
80.00%
74.73%
100.00%
74.90%
HEDIS Tobacco Control Indicators
Commercial Members
HEDIS 2004 - HEDIS 2006
2003
2004
2005
2006
Adv Smokers to Quit
Disc Smok Cess Meds
Disc Smok Cess Strat
Measures
Measures
Advising Smokers to Quit
Discussion of Smoking Cessation Medications
Discussion of Smoking Cessation Strategies
HEDIS 2006 Results
71.20%
39.40%
39.00%
MQIC Best Practice
83.33%
48.82%
50.16%
43.41%
38.94%
44.02%
72.51%
68.99%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
43.12%
Percent
HEDIS Tobacco Control Indicators
BCBSM Members
HEDIS 2006
2005
2006
Adv Smokers to Disc Smok Cess Disc Smok Cess
Quit
Meds
Strat
Measures
20.00%
40.48%
38.01%
25.14%
25.76%
30.00%
25.00%
40.00%
18.91%
Percent
50.00%
38.43%
56.94%
41.58%
59.08%
60.00%
56.10%
54.92%
70.00%
60.67%
HEDIS Depression Indicators
Commercial M embers
HEDIS 2003 - HEDIS 2006
40.07%
2002
2003
2004
2005
25.72%
2006
10.00%
0.00%
Anti-Dep Med Opt Contact
Anti-Dep Med Acute Tx
Anti-Dep Med Cont Tx
M easures
Measure
Antidepressant Medications, Optimal Contacts
Antidepressant Medications, Effective Acute
Treatment Phase
Antidepressant Medication, Effective Continuation Treatment Phase
HEDIS 2006 Results
20.60%
61.40%
MQIC Best Practice
28.91%
63.55%
45.00%
48.19%
HEDIS Depression Indicators
Medicare Members
HEDIS 2006
60.00%
47.62%
Percentage
50.00%
40.00%
31.97%
30.00%
20.00%
2006
13.61%
10.00%
0.00%
Anti-Dep Med Opt
Contact
Anti-Dep Med Acute
Tx
Anti-Dep Med Cont Tx
Measures
Measure
Antidepressant Medications, Optimal Contacts
Antidepressant Medications, Effective Acute
Treatment Phase
Antidepressant Medication, Effective Continuation Treatment Phase
HEDIS 2006 Results
11.80%
54.90%
MQIC Best Practice
13.71%
47.83%
41.00%
39.13%
Substance Use Disorders HEDIS Indicators
Commercial Members
HEDIS 2004 - HEDIS 2006
100.00%
90.00%
80.00%
Percent
70.00%
60.00%
55.07%
2004
52.24% 49.52%
50.00%
2005
40.00%
2006
25.10% 25.50%
30.00%
21.31%
20.00%
10.00%
0.00%
Initiation of AAOD Tx
Engagement of AAOD Tx
Measures
Measures
Initiation of Alcohol & Other Drug Dependence
Treatment
Engagement of Alcohol & Other Drug Dependence
Treatment
HEDIS 2006 Results
44.50%
MQIC Best Practice
55.65%
14.10%
25.00%
Percentage
Substance Use Disorders HEDIS Indicators
Medicare Members
HEDIS 2006
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
68.39%
2006
5.81%
Initiation of AAOD Tx
Engagement of AAOD Tx
Measures
Measures
Initiation of Alcohol & Other Drug Dependence
Engagement of Alcohol & Other Drug Dependence
Treatment
HEDIS 2006 Results
50.90%
MQIC Best Practice
83.33%
4.70%
8.33%
Percent
HEDIS AC Pharyngitis Indicators
HEDIS 2004 - HEDIS 2006
100.00%
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
69.81% 67.19%
63.32%
2004
35.60% 34.82%
26.60%
Commercial
2005
2006
Medicaid
Product
Percent 2 - 18 Years Old Tested for Strept and Were Prescribed an Antibiotic
Product
HEDIS 2006 Results MQIC Best Practice
Commercial
69.70%
74.00%
Medicaid
52.00%
58.78%
HEDIS AC Pharyngitis Indicators
BCBSM Members
HEDIS 2004 - HEDIS 2006
100.00%
90.00%
80.00%
70.00%
60.00%
54.58%
54.99%
54.17%
2004
50.00%
2005
40.00%
2006
30.00%
20.00%
10.00%
0.00%
2-18 Years Old Tested
Percent
Adult Preventive Services Indicators
Commerical Members
HEDIS 2006 - Baseline
100.00%
90.00%
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
86.59%
77.82%
58.68%
2006
39.20%
chlamscrg 1625 yrs
colcascrg 5180 yrs
cxcascrg 21-64 brcascrg 52-69
yrs
yrs
Measures
Me a sure s
Chlamydia Screening Combined
16-25 yrs
HEDIS 2006 Re sults
34.90%
MQIC Be st Pra ctice
48.30%
Colorectal Cancer Screening
52.30%
69.34%
Cervical Cancer Screening
81.80%
88.60%
Breast Cancer Screening
72.00%
82.22%
Adult Preventive Services Indicators
M edicaid M embers
HEDIS 2006 - Baseline
66.00%
64.21%
64.00%
62.00%
Percent
60.00%
57.11%
58.00%
56.00%
2006
54.67%
54.00%
52.00%
50.00%
48.00%
chlamscrg 16-25 yrs
cxcascrg 21-64 yrs
brcascrg 52-69 yrs
M easures
Measures
Chlamydia Screening Combined
16-25 yrs
HEDIS 2006 Results
50.60%
MQIC Best Practice
64.30%
Cervical Cancer Screening
65.00%
74.45%
Breast Cancer Screening
53.90%
61.77%
Adult Preventive Services Indicators
Medicare Members
HEDIS 2006 - Baseline
90.00%
80.09%
80.00%
70.00%
64.33%
Percent
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
colcascrg 51-80 yrs
2006
brcascrg 52-69 yrs
Measures
Measures
Colorectal Cancer Screening
Breast Cancer Screening
HEDIS 2006 Results
MQIC Best Practice
53.90%
69.81%
71.60%
85.97%
Adult Preventive Services Indicators
BCBSM Members
HEDIS 2006 - Baseline
75.00%
74.71%
Percent
74.00%
73.00%
72.00%
71.32%
71.00%
70.00%
69.00%
cxcascrg 21-64 yrs
brcascrg 52-69 yrs
Measures
2006
THANK YOU ALL
FOR YOUR CONTRIBUTIONS
Measuring
Reporting
Improving
Collaborating