Metrics & Scoring Committee Consent Agenda Review todays agenda - - PowerPoint PPT Presentation

Metrics & Scoring Committee

Consent Agenda

 Review today’s agenda  Approve February minutes

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Additional updates

 Metrics Coordinator  ED utilization among members with SPMI

– Reducing emergency department use with a focus on behavioral health (in preparation for the 2018 equity measure) will be a topic at next the Innovation Café hosted by the OHA Transformation Center (May 9) – More information: http://www.oregon.gov/oha/Transformation- Center/Pages/Innovation-Cafe.aspx – Registration: https://www.eventbrite.com/e/2017-innovation-cafe- improving-key-health-metrics-registration-32133641587

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Additional Discussion on Patient Experience Measures

Charles Gallia, OHA

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The Triple Aims

Each survey represents the voice of one important person with a valid perspective.

CAHPS Health Plan Survey

• Getting Needed care
• Getting Care Quickly
• How Well Doctors Communicate
• Customer Service
• Rating Questions
• Shared Decision Making
• Access to Specialized Services
• Access to Prescription Medicine
• Experience with Personal Doctor
• Coordination of Care (Child Only)
• Family Centered Care: Personal Doctor who Knows Child
• Children with Chronic Conditions’ experience
• Cultural Competency
• Health Literacy
• Flu shot, Assistance with Smoking Cessation (Adults Only)

Incentive Measure Access to Care Incentive Measure Called Satisfaction with Care

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Example of Important Finding: Access to Care

(Enter) DEPARTMENT (ALL CAPS) (Enter) Division or Office (Mixed Case)

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Child: Getting Emergency Care Adult: Getting Emergency Care Child: Getting Routine Care Adult: Getting Routine Care Adult: Getting Care Quickly Composite Child: Getting Care Quickly Composite Adult Getting Specialist Care Child Getting Specialist Care Child:Customer Service Adult: Customer Service Satatewide Average 88.6 81.5 85.6 78.6 80.1 87.1 77.6 75.5 84 82

65 70 75 80 85 90

Access to needed treatment or counseling Access to needed special equipment Access to needed therapy Getting care quickly Rating of health plan Children with Chronic Conditions 68% 73% 62% 85% 50% Children Without Chronic Conditions 68% 80% 80% 86% 63%

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Subgroup Analysis

CAHPS

Child's HP or doctor's office helped parent/guardian get needed treatment/counseling CCC (developmental or emotional

• r behavioral problem for which

treatment or counseling is needed) Yes No Total AHP 48.0% 52.0% 25 Cascade 60.0% 40.0% 35 CPCCO 65.2% 34.0% 23 EOCCO 38.0% 63.0% 24 FAMILYCARE 50.0% 50.0% 20 IHN 46.0% 54.0% 26 JCC 47.1% 52.9% 17 PSCS 68.0% 32.0% 25 PSG 86.4% 13.6% 22 PHJC 38.0% 63.0% 24 TRILLIUM 48.7% 51.3% 39 UMQUA 32.0% 68.0% 19 WOAH 50.0% 50.0% 22 WVCH 65.0% 35.0% 20 YCCO 51.6% 48.4% 31 HEALTHSHARE 64.0% 36.0% 25 OHP 53.3% 46.7% 435

A CCO level cross-tabulation of a subset of children with chronic conditions, those who have a persistent social/emotional concern, by whether assistance in getting treatment/counceling was provided by health plan or provider’s office

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Plan level interventions

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• Open Access Scheduling for

Routine and Urgent Appointments

• Streamlined Patient Flow
• Email for Administrative Help and

Clinical Advice

• Internet for Health Information and

Advice

• Rapid Referral Programs
• Policies and Processes and

Applications of Information Technology

• Training to Advance Physicians’

Communication Skills

• Tools to Help Patients

Communicate Their Needs

• Shared Decision-making
• Support Groups and Self-Care
• Delivery of Evidence-Based

Information

• Planned Visits
• Group Visits
• Listening Posts
• Patient and Family Advisory

Councils

• Service Recovery Programs
• Standards for Customer Service
• Reminder Systems for Preventive

Services and Immunizations

• Developing Shared Care Plans

State-level interventions

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• Encourage Trauma-Focused

Cognitive Behavioral Therapy (TF-CBT), through CME and MOC

• Disseminating Evidence-Based

Practice For Children & Adolescents

• Community Preparation
• OHA generated Community

Profiles, estimates, need and gap analyses

• Incredible years
• EQRO Clinical Focus Study
• CAHPS CCO –Sub analysis
• Best, and just good-

practices highlights

• Make it easy to select as a

performance improvement area for CCOs

• Healthy Communities

challenge, foundation supported

• Contract specs
• Policy and procedures

reviews

• Your thoughts?

Considerations/ suggestions

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• Align with PRQRS
• Focus on low performing areas or ones with variation between Plans
• Is there an action pathway?
• Align with other metrics, complementary
• Drivers of ratings

– Emphasis on prevention – Shared decision-making – Being ‘up to date’ about care from other providers – Developing trust

• Separate Child and Adult Access

Oral Health in Oregon CCOs: A Metrics Report

March 17, 2017

Metrics & Scoring Committee Meeting

Presentation overview

• Background and context for oral health metrics

reporting on CCOs

• Measures of oral health in Oregon CCOs –

preliminary data

• Q&A and discussion

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Background and context: Oral health in Oregon CCOs

Oral health is fundamental to coordinated care model

• A growing body of evidence shows oral health is linked to overall

health:

Heart disease Diabetes Low birth weight Certain cancers Well-being Missed school/work days

• Integration of physical, oral and behavioral health care is a key goal
• f health system transformation and Oregon CCOs

– Oral health in CCO global budget: Jul 2014 – ½ of CCOs included oral health in Transformation Plans – CCO incentive metrics: dental sealants, foster care

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Oral health in Oregon CCOs…where are we now?

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Stakeholders identified key oral health metrics

Dental Quality Metrics WG CCO Oregon Dental WG MAC Oral Health WG Purpose Dental quality metrics for CCO incentives to Metrics & Scoring Committee Quality metrics core and a la carte set for use in CCO contracts Oral health monitoring measures for understanding access in OHP Key measures

• Current measures

selected by Metrics & Scoring Committee: dental sealants and foster care

• Addtl measures for

monitoring/incentives recommended CCO-DCO Quality Measure Sets Utilization, patient experience, care coordination (ED use), measures focused on specific populations (e.g. pregnant women, people with diabetes) 15 total measures under 6 priorities of access: provider distribution, utilization (quality of services), patient experience, care coordination, integration, patient- centered care

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Measure Endorsed by

Utilization (Quality of Services) Any preventive service (adults & children) MAC, CCO OR Any dental services– adults & children MAC, Dental Quality Topical fluoride varnish Dental Quality Patient Experience Regular dentist Dental Quality Access to emergency care MAC, Dental Quality Care Coordination Follow-up after ED visit for dental reasons MAC, CCO OR Oral health evaluation for patients with periodontitis MAC, CCO OR Integration Dental care for adults with diabetes MAC, CCO OR

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Measures overview

Some caveats

• Much of the data in this report are being produced for the first time
• Some data used preliminary specifications, courtesy of the national

Dental Quality Alliance (DQA)

• Some measures recommended by the Medicaid Advisory

Committee’s Oral Health Workgroup not yet available:

– New CAHPS questions: dental provider explanations to patient; customer service experience

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Utilization (quality of services)

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Statewide: 2015—33.0% Mid-2016—33.7%

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Statewide: 2015—53.1% Mid-2016—54.8%

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Statewide: 2015--18.1% Mid-2016--19.4%

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Statewide: 2015—48.3% Mid-2016—50.1%

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Statewide: 2015—14.5% Mid-2016—16.3%

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Patient Experience

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Statewide: child—79% adult—57%

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Statewide: child—52% adult—44%

Care Coordination

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Statewide: 2015—36.6% Mid-2016—37.1%

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Statewide: 2015—13.7% Mid-2016—14.7%

Integration

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Statewide: 2015—24.2% Mid-2016—24.1%

Questions?

Amanda Peden, Policy Analyst, Office of Health Policy Health Policy & Analytics Division amanda.m.peden@state.or.us

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Discussion

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• Each Committee member to create their own “short list” of

measures for 2018.

• This includes any of the current measures that should be

included / dropped moving forward, plus any new measures from the topics that have been explored to date.

• Please email your shortlist to milena.malone@state.or.us by

Friday, April 7th

• Staff will compile and bring back for discussion at our April

meeting.

Next Meeting: April 21, 2017