OUR ACO QUALITY RESULTS 2012 AND 2013

Transcription

1 OUR ACO QUALITY RESULTS 2012 AND 2013

2 Patient and Caregiver Experience Source ACO - 1 CAHPS: Getting Timely Care, Appointments and Information Survey ACO - 2 CAHPS: How Well your Doctors Communicate Survey ACO - 3 CAHPS: Patients Rating of Doctor Survey ACO - 4 CAHPS: Access to Specialists Survey ACO - 5 CAHPS: Health Promotion and Education Survey ACO - 6 CAHPS: Shared Decision Making Survey ACO - 7 CAHPS: Health Status / Functional Status Survey Care Coordination and Patient Safety ACO - 8 Risk-Standardized All Cause Readmission Claims ACO - 9 Ambulatory Sensitive Condition Admissions: COPD Claims ACO - 10 Ambulatory Sensitive Condition Admissions: CHF Claims ACO - 11 Percent of PCPs who Qualify for Meaningful Use CMS data 84.09% 84.66% ACO - 12 Medication Reconciliation after Discharge GPRO 92.9% 80.36% ACO - 13 Falls: Screening for Fall Risk GPRO 77.4% 86.81% 2

3 Preventive Health Source ACO - 14 Influenza Immunization GPRO 64.8% 81.52% ACO - 15 Pneumococcal Vaccination GPRO 65.7% 82.18% ACO - 16 Adult Weight and Follow up GPRO 60.9% 83.53% ACO - 17 Tobacco use and Cessation Intervention GPRO 87.6% 92.32% ACO - 18 Depression Screening and Follow up GPRO 44.6% 81.89% ACO - 19 Colon Cancer Screening GPRO 47.3% 69.96% ACO - 20 Mammography Screening GPRO 64.5% 71.53% ACO - 21 BP Screening GPRO 40.4% 38.58% At Risk Populations ACO Diabetes - Composite GPRO 36.5% 39.78% ACO - 27 Diabetes - A1c poor Control GPRO 19.2% 16.54% ACO - 28 HTN BP Control GPRO 63.7% 74.74% ACO - 29 IVD Lipid panel + LDL < 100 GPRO 63.4% 74.42% ACO - 30 IVD Aspirin/antithrombotic GPRO 92.0% 91.54% ACO - 31 CHF B blocker for LVSD GPRO 97.7% 92.34% ACO - 32 CAD Composite Lipid control and ACE/ARB for CAD+ DM or CAD+CHF GPRO 75.4% 76.76% 3

4 Quality Scoring Methodology ACO performance level Table 1 Sliding Scale Measure Scoring Approach Quality points 90+ percentile FFS/MA Rate or 90+ percent 2.00 points 80+ percentile FFS/MA Rate or 80+ percent 1.85 points 70+ percentile FFS/MA Rate or 70+ percent 1.70 points 60+ percentile FFS/MA Rate or 60+ percent 1.55 points 50+ percentile FFS/MA Rate or 50+ percent 1.40 points 40+ percentile FFS/MA Rate or 40+ percent 1.25 points 30+ percentile FFS/MA Rate or 30+ percent 1.10 point <30 percentile FFS/MA Rate or <30+ percent No points NOTE: FFS = Fee-for-Service; MA = Medicare Advantage. Quality points are doubled for the EHR measure. SOURCE: Table 3 from, Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations; Final Rule. 76 Fed. Reg. at 67,899. Domain Table 2 Total Points for Each Domain within the Quality Performance Standard Domain Patient/Caregiver Experience Care Coordination/ Patient Safety Number of Individual Measures Total Measures for Scoring Purposes 7 1 measure with 6 survey module measures combined, plus 1 individual measure 6 6 measures, plus the electronic health records measure double-weighted (4 points) Total Possible Per Domain Domain Weight 4 25% 14 25% Preventive Health 8 8 measures 16 25% At-Risk Population 12 7 measures, including 5-component diabetes composite measure and 2- component coronary artery disease composite measure 14 25% Total % SOURCE: Table 4 from, Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations; Final Rule. 76 Fed. Reg. at 67,899 4

5 Percentile The value in the boxes are the threshold performance defined for each percentile by CMS Blue is 2012 Blue 2012 Yellow 2013 Green 2012 = 2013 Patient and Caregiver Experience 30th 40th 50th 60th 70th 80th 90th ACO 1 CAHPS: Timely Care, Appointments / Information ACO 2 CAHPS: How Well your Doctors Communicate ACO 3 CAHPS: Patients Rating of Doctor ACO 4 CAHPS: Access to Specialists ACO 5 CAHPS: Health Promotion and Education ACO 6 CAHPS: Shared Decision Making ACO 7 CAHPS: Health Status / Functional Status n/a n/a n/a n/a n/a n/a n/a Care Coordination and Patient Safety ACO 8 Risk-Standardized All Cause Readmission Number at the right of the slide is the points that we earned ACO 9 Ambulatory Sensitive Condition Admissions: COPD ACO 10 Ambulatory Sensitive Condition Admissions: CHF Final quality score for 2013 is waiting for results on the CMS derived measures ACO 11 Percent of PCP s who Qualify for Meaningful Use 84.1% ACO 12 Medication Reconciliation after Discharge 92.9% 79.9% ACO 13 Falls: Screening for Fall Risk 77.4% 86.9%

6 2012 and 2013 The value in the boxes are the threshold performance defined for each percentile by CMS Blue is 2012 Blue 2012 Yellow 2013 Green 2012 = 2013 Preventive Health th 40th 50th 60th 70th 80th 90th ACO 14 Influenza Immunization 64.8% 81.5% ACO 15 Pneumococcal Vaccination 65.7% 82.2% ACO 16 Adult Weight and Follow up 60.9% 83.3% ACO 17 Tobacco use and Cessation Intervention 87.6% 92.3% ACO 18 Depression Screening and Follow up 44.6% 81.9% ACO 19 Colon Cancer Screening 47.3% 70.0% ACO 20 Mammography Screening 64.5% 71.5% ACO 21 BP Screening 40.4% 38.6% At-Risk Populations ACO 22 Diabetes - Composite 36.5% 39.8% Number at the right of the slide is the points that we earned ACO 27 Diabetes - A1c poor Control 19.2% 16.6% ACO 28 HTN BP Control 63.7% 74.7% Final quality score for 2013 is waiting for results on the CMS derived measures ACO 29 IVD Lipid panel + LDL < % 74.4% ACO 30 IVD Aspirin/antithrombotic 92.0% 91.5% ACO 31 CHF B blocker for LVSD 97.7% 92.3% ACO 32 CAD Composite Lipid control and ACE/ARB for CAD+ DM or CAD+CHF 75.4% 76.6%

7 ACO Quality Score Number of Measures 2012 ACO Quality Score 2013 ACO Quality Score Patient And Care Giver Experience Safety and Care Coordination Preventive Health At Risk Populations TOTAL