Provider Peer Grouping
Monthly Updates
September 9, 2013
Mat Spaan
Planning Director, Health Economics Program
This Morning’s Discussion
• PPG Advisory Committee Meeting Updates
• Upcoming Rapid Response Team Call
• Additional Updates
– Methodology Updates
• Report Timelines
Advisory Committee Updates
• Next meeting scheduled for October 9, 2013
from 3pm-5pm (location TBD)
• Discussion on
– The number and typography of peer groups for
the Clinic analysis
– Confidential report content and design for Clinic
reports
*Future meeting will address the public report
display for Hospital Round 2
Rapid Response Team
• Next call will be held in early October
• Discussion on
– Hospital Total Cost (Outliers, Case-mix
Adjustment, Risk Adjustment, Payment
Transformation)
– Hospital Quality Methods (Benchmarking and
Compositing)
Upcoming RRT Discussion Topics
Topic
Communication
Timing
Memos &
Conference Call
October, 2013
Memo only
November 2013
Memo & Conference
Call
November, 2013
Clinic Report: Total Cost (Part 2), including Cost Memo & Conference
measure calculation and Standardization
Call
December, 2013
Hospital Report: Total Cost, including Outliers,
Cost Transformation, Risk Adjustment, & Case
Mix Adjustment
Hospital Report: Quality Methods, including
Benchmarking and Compositing
Clinic Report: Attribution of patients to clinics
Clinic Report: Total Cost (Part 1) including
Outliers, Risk Adjustments and Exclusions
Clinic Report: (1) Categories of Service, (2)
Benchmarking
Clinic Report: Quality Methodology
Memo only
January, 2014
Memo & Conference
Call
February, 2014
Additional Updates
• Removal of Medical Education and
Disproportional Share Payments
– Identified/testing potential methods to remove
Medicare IME/DSH payments and Medicaid DPA
payments from hospital total cost of care
• Potentially Preventable Readmissions Measurement
– Completed testing of 3M’s PPR Grouping Software
– Presenting results to RARE Campaign workgroup
in mid-September
Report Timeline
Activity
Data Availability
Jan
Feb
Mar
Apr
May
Jun
2013
Jul
Aug
Sep
Oct
Nov
Dec
Jan
CY2008-11
Commercial &
Medicaid
CY2008-10 Medicare
Data
Feb
2014
Mar
Apr
May
Jun
CY2008-2012 All
Payers
Hospital Analysis
confidential release
Second round
(Fed FY2011
Commercial &
Medicaid cost
data; Fed FY 2010
Medicare cost
data)
assess method improvements, sensitivity tests comparing model options, create
data files, perform attribution, calculate costs, conduct benchmarking, etc.
hospital review & respond to inquiries
Clinic Analysis
confidential release
First round
(Fed FY2011
Commercial &
Medicaid cost
data; Fed FY 2010
Medicare cost
data)
Advisory
Committee
Meetings
(Anticipated)
Rapid Response
Team Meetings
(Anticipated)
public
report
sensitivity tests comparing model options, create data files, perform attribution, calculate
costs, conduct benchmarking, etc.
Pat. Exp.
Qual.
Measures;
Hospital
Peer Groups
Clinic Peer
Groups;
Conf.
Report
Design
Hospital Public Report
Design
Hospital
Clinic
Clinic Report:
Clinic
Report:
Report:
Report:
Attribution Clinic Report:
Cost and
Service Cats.
Quality
(Memo) & Total Cost II
Quality
&
Methods
Total Cost I (Meeting)
Method
Benchmarks
(Meeting)
(Meeting)
(Meeting)
(Memo)
clinic review & respond to
inquiries
Jul
Timing of Quality Data
Activity
Hospital Quality
Measures *
Clinic Quality Measures*
2013
Jan
Feb
Mar
Apr
May
Jun
Jul
2014
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
DOS
20112012
Claims-based:
DOS 20092011;
SQRMS:
2011-2012
DOS
20122013
Claims-based:
DOS 20102012;
SQRMS:
2012-2013
2014 SQRMS
Measure Set
Released
Hospital Analysis
confidential release
Second round
report development
hospital review & respond to
inquiries
pub.
report
Clinic Analysis
confidential release
First round
Jul
report development
*DOS vary by measure but generally include data from 2011-2012 for hospitals and 2009-2011 for clinics in 2013
clinic review & respond to
inquiries
Next call
October 14, 2013
7:30am
Resources
Additional information on PPG is available online:
www.health.state.mn.us/healthreform/peer/
Information on Minnesota’s health care market can also be found online:
www.health.state.mn.us/healtheconomics
Questions may be sent to:
Stefan Gildemeister at Stefan.Gildemeister@state.mn.us
Kevan Edwards at Kevan.Edwards@state.mn.us