Tracking Reform
MMA Holds Physician Feedback Forum
Approximately 40 physicians and clinic administrators met last month to provide the Minnesota Department of Health with feedback about its draft proposal for a statewide system for measuring and publicly reporting on the quality of health care, which is required by the 2008 Health Care Reform Act. The MMA hosted the feedback forum on behalf of the health department. The goal of the new system is to have a common set of measures that physicians, clinics, hospitals, insurers, and other third-party payers can all use for quality reporting and incentive programs. The draft proposal outlines the common set, a means for adding measures, and the timeline and process for public reporting.
As of January 1, 2010, all providers must be registered with the Department of Health and some providers must start reporting data relating to the care of patients with diabetes and cardiovascular disease, as well as information about the clinic’s use of health information technology. The state will begin publicly reporting clinics’ performance on various measures July 1, 2010. The initial diabetes and cardiovascular care measures the state will implement are the same as the ones currently being used by MN Community Measurement. The diabetes measure focuses on smoking cessation, blood sugar levels, blood pressure, cholesterol levels, and aspirin use. The cardiovascular disease measure is similar but does not include the blood sugar component.
The following are some of the comments and recommendations the MMA submitted to the Department of Health:
- Change the definition of a “physician clinic.” The proposal requires data reporting at the clinic site level. The MMA noted that reporting at that level will be difficult for many clinics, particularly if they use a common Tax Identification Number across clinic sites for claims submission. The MMA urged the Department of Health to change the rules to require data submission at the site level only if such data is currently available and to further evaluate the timeline and processes for statewide site-level reporting;
- Clarify what is required regarding risk adjustment. The definition of risk adjustment includes factors such as severity of illness and patient demographics, but the rule only requires data submission about payer mix;
- Include the entire MN Community Measurement set in the standardized measure set;
- Clarify the data submission requirements such as whether clinics are required to submit data for their entire patient population or whether and what type of sampling methodologies may be used;
- Expedite the completion of the data transmission and submission requirements. The MMA noted that the current language, terms, and processes are confusing, undefined, and incomplete;
- Change the timeline for the process of adding new measures to the standardized list and to the list of measures required for public reporting so the measures would be finalized by October 1 rather than January 1, allowing providers more time to collect, compile, and submit data; and
- Reduce the number of measures for which health plans can require providers to submit data. The proposed rule allows health plans to ask for data on measures included in the Healthcare Effectiveness Data and Information Set (HEDIS), endorsed by the National Quality Forum (NQF), required by federal or state law or regulation, required by the Minnesota Department of Human Services, and “structural” quality measures that are not specific to the patients served by a health care provider (for example, a measure related to clinic capacity, scope of services offered, or physical features of the clinic). The NQF alone currently endorses more than 500 measures.
To view and comment on the draft proposal, go to www.health.state.mn.us/health reform/measurement/draftrule.html.
To read a copy of the letter submitted to the Department of Health by the MMA, go to www.mmaonline.net.
Register Your Clinic
As part of the new statewide quality reporting and measurement system, all Minnesota medical clinics must register with the Commissioner of Health or a designee on an annual basis. MN Community Measurement will serve as the commissioner’s designee for 2010 and will begin accepting registrations in early September. Register your clinic at https://data.mncm.org/login. If you have questions about registration or using the MN Community Measurement portal, please contact MN Community Measurement at support@mncm.org.
Help with Direct Data Submission
If your clinic is new to direct data submission (DDS), MN Community Measurement has resources that can help. The 2010 DDS Guide, which addresses steps in the reporting process, will be available in early September. You can access the guide at https://data.mncm.org/login, download a copy at www.mncm.org/site/?p=resources, or request a copy by email by writing support@mncm.org.
Informational webinars that address measurement reporting steps are also available at www.mncm.org (click on the “Resources” tab). If you have questions about reporting, contact MN Community Measurement at support@mncm.org.