BHCAG BHCAG Community Community

DialogueDialogue

Lawrence MassaPresident & CEOMinnesota Hospital Association

November 11, 2010

Health Care Quality & Public Reporting

CMS Quality Transparency: From Zero to 65 in 9 years

0

10

20

30

40

50

60

70

2005 2007 2008 2010 2011 2014

# o

f M

ea

sure

s

What have we learned in first 10 years of Leapfrog?

Collaboration is essentialMHA MN Dept. of Health MMA Stratis

BHCAG Health Plans MAPS

Growing interest in quality measurement and reporting

Need for balance of burdens and costs of collection/measurement with impact to care and results for patients

Minnesota continues its national leadership in …

Transparent Transparent communication communication

with patientswith patients

MN’s 2002 full disclosure model policy adopted by more than 90% of MN hospitals and sent to all 5,000 hospitals nationwide.

Patient safetyPatient safety Health Grades ranked MN 1st or 2nd over the past several years. MN had more “distinguished hospitals” than any other state.

Culture of safetyCulture of safety MN hospitals advocated for public reporting of adverse health events, including by facility.MN hospitals’ adoption of best practices improved dramatically since AHE law.

Decreased harm Decreased harm to patientsto patients

Overall trend of decreased harm over 8 years.Pressure ulcers continue to decline.Decrease number of falls.Retained objects trending downward.

Level of accountability is continually increasing Increased attention and resources

• 100+ hospitals addressing 4 most common AHEs through MHA’s calls to action

• Best practices up dramatically from 59% to 90%

Collaboration v. competition

• 87 hospitals (96% of discharges) voluntarily share patient safety information

Increased accountabilityIncreased Accountability

Transparency Pay for Reporting

Pay for Performance

Value Based Purchasing

2000 2003 2005 2012Leapfrog AHE

lawMHA/Stratis MHQP

Hospital Compare

MHA non-billing policy

CMS HAC, POA and nonpayment policy

VBP and Readmissions

Future of hospital quality & public reporting

Value of current reporting tools: Measuring what matters

Patient/ Consumer

Hospital Compare

Impact of 2008 legislation mandating hospital public reporting

Reliance exclusively on administrative data could be problematic• Admin data alone are insufficient for quality and

safety comparisons; potentially misleading

• MHA is leading research with the Agency for Healthcare Research and Quality (AHRQ) to improve admin data’s value by adding lab and pharmacy data

Provider peer grouping is ambitious, but unlikely to produce reliable results

Questions

&

Discussion