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Western New York Quality Measurement Collaborative 1 WNYQMC Grant Funding • Supports a two-year project focused on improving care for patients enrolled in health plans. • P2 Collaborative serves as grant administrator. • Clinical Support Services, Inc. serves as PMO. • The area’s three health plans -- Independent Health, HealthNow and Univera -- partnered together to obtain the WNYQMC funding. • Program designed to make available to each primary care physician in the region’s eight counties his or her own aggregated quality measures report. – Internists – Family Practitioners – Pediatricians 2 Quality Measures Report • The data will be comprised of pharmacy and medical claims data provided by the area’s three health plans and aggregated by a third-party technology vendor who will prepare the quality metric results. • Physicians will be able to review their aggregated quality metric results via password-protected web portal. 3 Quality Measures Report • Supporting patient-level data will be made available on the portal to individual physicians who sign and fax a Business Associate Agreement to CSS. • For the first time, primary care physicians will be receiving one quality report detailing the results of 19 quality metrics, rather than three different statistical reports from each of the plans. • Honorarium available for physician participation. 4 Report Distribution 5 WNYQMC Report Portal Phase 1 Phase 2 (Optional) Phase 1 Report Ready Notify Physician (Physician Packet) Physician Registration (Aggregate Report) Complete BAA Patient Level Data Review Results Complete Survey Honorarium 6 NYSDOH Grant Nineteen health quality measures will be reported in the document: - - Breast cancer screening Colorectal cancer screening Childhood immunization status Cholesterol management for patients with cardiovascular conditions ACE/ARB treatment (post-heart failure) Comprehensive diabetes care (hemoglobin A1C testing, retinal exam, nephropathy screening, LDL testing) Use of appropriate medications for people with asthma Appropriate testing for children with pharyngitis - Cervical cancer screening Chlamydia screening Lead screening in children Persistence of beta-block treatment after a heart attack - Prenatal/postpartum care - Antidepressant medication management – acute phase treatment & continuation phase - Appropriate treatment for children with upper respiratory infection 7 NYSDOH Grant • Grant also calls for distribution of Inpatient Hospital Quality Rates as reported on www.hospitalcompare.com. 8 Timeline • 2005-2007 Data – Evaluated by WNYQMC Clinical Advisory Committee – June 2009 • 2008 Data – Available to PCPs throughout eight WNY counties in November 2009. • 1Q 2009 Data – Available via to physicians in December 2009. • 2Q 2009 Data – Available via to physicians in February 2010. • March 2010 - Public reporting first two quarters 2010. A requirement of the RWJF grant. 9 www.p2wny.org www.p2quality.com 10