OPQC OB Action Period Webinar

November 19, 201512:15 – 1:15 PM

Please put the call on mute not hold!

Welcome• AGMC's Women's Health Clinic• Aultman Physician Center-OB/GYN

Clinic• Brown County Women's Health• Center for Women’s Health,

University of Cincinnati Medical Center

• Doctors Hospital Women's Health Center

• Faculty Medical Center—OB Resident Clinic GSH (TriHealth)

• Fairview Perinatal Department (Cleveland Clinic)

• Five Rivers Health Centers, Center for Women's Health (Miami Valley Hospital)

• MacDonald Women's Hospital Clinic (Family Practice and OB Faculty Clinic)

• Maternal Fetal Medicine at Hillcrest Hospital Atrium (Cleveland Clinic)

• Mercy OB/GYN Associates Family Care Center/ MFM Clinic

• MetroHealth Women's Clinic• Mount Carmel St. Ann’s OB/GYN

Clinic• Mt. Carmel West Outpatient Clinic• OSU McCampbell Clinic• OSU Martha Morehouse MFM• OSU East• Outpatient Care Center at Grant

Medical Center• ProMedica Center for Health

Services – Women’s Services (ProMedica Toledo Hospital)

• Riverside OB Community Care Clinic/ MFM Consultative Practice

• St. Elizabeth Boardman’s Health Center

• Tri-State Maternal Fetal Medicine Associates, Inc.

• Women's Health Center at Summa Akron City Hospital

TodayTopic Objective Facilitator

Welcome Greetings Martha Rome

Improvement in Preterm Birth

Review ODH birth registry data(Do the happy dance!)

Dr. Jay Iams

Medicaid Partnership

• All teams, all Plans, all Medicaid patients

• Huddle with Plans• Skinny Forms /

Candidate Forms• Team Progress

Dr. Carole LannonMartha RomeTeams

Next Steps Complete work for November

Martha Rome

October Data Review inpatient data Dr. Jay Iams

Decreased Preterm Birth Rate for Women with a Prior Preterm Birth!

Something’s going right…

Great News !!!From January 2014 October 2015

Ohio Birth Registry Data • Recurrent preterm birth < 32 weeks decreased

by 20% at at OPQC hospitals• Recurrent preterm birth < 37 weeks decreased

by 11% at OPQC hospitals

• Recurrent preterm birth < 32 weeks decreased by 19% at all Ohio hospitals

• Recurrent preterm birth < 37 weeks decreased by 10% at all Ohio hospitals

MEDICAID PARTNERSHIPDr. Carole Lannon

OPQC and

The Medicaid Managed Care Plans

Goal: Identify pregnant women at risk of preterm birth and

adverse outcomes and quickly provide needed support and

intervention

OPQC + Medicaid MCP ProjectEnsure that women receive progesterone 17 weeks gestational age and other evidence-based interventions as soon as possible. MCPs working in partnership with providers should:

– Identify needed care, medical and social/emotional as well as practical supports

– Arrange for, or provide transportation to health appointments, assistance with continuation of insurance coverage, smoking cessation, home care, payment for progesterone in office, etc.

– Monitor and coordinate care to enhance the health and wellbeing of each mother and child

Need: Effective communication between

practice and MCPs to connect pregnant women at risk with

needed support

COMMUNICATION FORMMartha Rome

Communication (Skinny) Form

1. Brief risk assessment2. Communicate to Medicaid Managed Care Plan

for:– Expedited Progesterone– Decrease risk of loss of benefits (Plan contacts

County JFS)– Improves planning for care– Starts process for Care Management (if needed)

3. Collect data for improvement on some of our most vulnerable patients

More About the Communication Form

1. It’s really short2. It takes the place of the PRAF, a much

longer form3. It’s the same form for each Medicaid Plan4. You can customize it by adding to the back

or additional pages5. You get paid for completing it

Plan will partner to meet patient needs

How do you want return communication?

Plans will reimburse for first dose of Makenafree

OPQC +Medicaid MCP Project• All OPQC OB teams asked to begin to use new form

on November 2, 2015.• Use the Communication Form for ALL Medicaid OB

patients. • If you would like to collect additional information, you

may add that on the other side of the form or on additional pages.

• Complete an additional form when there is a demographic or risk change.

• All 5 managed care plans will be expecting to receive the communication form, rather than any other notification of pregnancy.

Communication Forms so far…

• 116 Forms• 12 Sites

We recognize ‘skinny’ communication form is new

work. And that it provides new +

useful data.

So, we can stop collecting ‘old’ data.

Candidate Forms

Candidate vs. SkinnyCandidate Form• All progesterone

candidates• Clinic name• Patient ID (from log)• Progesterone reason• Progesterone

accepted/declined• Type of progesterone• GA @ Rx• GA at birth• Enter into OPQC website

Skinny Form• All Medicaid patients• Clinic Demographics• Patient Demographics• Progesterone reason• Date given/to be given

progesterone• Type of progesterone• Medicaid assistance• Fax to Plan• Reimbursement for

each form by Plans

Progesterone Log

Keep the Log Log Elements

• Gestational age at Rx• History of preterm birth

or short cervix• Declined progesterone• 17P or vag P• Continued after 4

weeks

Need: Effective communication between

practice and MCPs to connect pregnant women at risk with

needed support: huddles

“Huddle” with Medicaid Plans• Invite them to your meetings to partner on

patients• Get creative – think of new (better) ways to

do things• Talk about your whole population of patients

and individual needs, both met and unmet• Use Huddles for the “Study” part of PDSAs• Rotate weeks with different Plans• Have a “go to” person from each Plan• Keep it brief!

Communication with Medicaid and Plans – what barriers are you having and how would you like return

info from the Skinny Form? (1 minute briefs)

• Center for Women’s Health, University of Cincinnati Medical Center

• Doctors Hospital Women's Health Center • Faculty Medical Center—OB Resident Clinic GSH (TriHealth)• Aultman Physician Center-OB/GYN Clinic• Five Rivers Health Centers, Center for Women's Health (Miami

Valley Hospital)• Mercy OB/GYN Associates Family Care Center/ MFM Clinic• MetroHealth Women's Clinic• Mount Carmel St. Ann’s OB/GYN Clinic• AGMC's Women's Health Clinic

Communication with Medicaid and Plans – what barriers are you having and how would you like return

info from the Skinny Form? (1 minute briefs)

• Mt. Carmel West Outpatient Clinic• OSU McCampbell Clinic• OSU Martha Morehouse MFM• OSU East• Outpatient Care Center at Grant Medical Center• ProMedica Center for Health Services – Women’s Services

(ProMedica Toledo Hospital)• Riverside OB Community Care Clinic/ MFM Consultative Practice• St. Elizabeth Boardman’s Health Center• Tri-State Maternal Fetal Medicine Associates, Inc.• Women's Health Center at Summa Akron City Hospital

What’s Next? Identify Primary and Secondary Contacts:

email names and contact info to: Stephanie.Buckler@cchmc.org• Let us know how you prefer to get

communication from the Plans: email, spreadsheet, fax, phone

Complete Monthly Progress Report by Nov. 5– The link will be sent to the OPQC OB

Progesterone Project Key Contact Be sure to open your Monthly Newsletters for

FAQ, success stories, upcoming calls and meetings!

INPATIENT DATADr. Jay Iams

Inpatient Data Collection

• Why Do We Want Inpatient Data?– Isn’t it too late? No, and It’s Important!

• We Need to Know: – The Fraction of ALL PTB’s that Our

OPQC Progesterone Project Can Affect.– Where Do Progesterone-Eligible Women

Come From? Hosps? Clinics? Zip Codes?

– How Can We Find More of Them?

We Are Doing Well On ANCS Administration

And Documentation

HOSPITAL DATA COLLECTED BY INPATIENT TEAMSNUMBER OF PRETERM BIRTHS / MONTH

PARTICIPATION INCREASED JANUARY AUGUSTBUT HAS DROPPED OFF SINCE THEN – WHY?

THIS DATA CREATES THEDENOMINATOR FOR THENEXT GRAPH

HOSPITAL COLLECTED DATA % OF WOMEN WHO DELIVER PRETERM

WHO ARE ELIGIBLE FOR PROGESTERONEWHO ARE or ARE NOT RX’D

August Ratio of ALL PTBsTo ELIGIBLE PTBs:72 / 493 = 15%31 / 72 = 43%31 / 493 = 6% Really?

Percent of FIRST SPONTANEOUS PTBs at OPQC Charter Sites

January October 2015Do We Need This Data?

YES WE DO !

AUGUST = 366 1ST TIME sPTB493 minus 366 = 97 2nd + PTBs72 / 97 = ~ 75% = ~ Right %31 / 72 = 43 % = About Right

Distribution of GA for Inpatient Data

75% of Neonatal Mortality