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Protecting, maintaining and improving the health of all Minnesotans
Peer Grouping Technical Panel
Meeting: August 25 Meeting Summary
Topic: Information Needs of Different Audiences
The technical panel reviewed the issue paper on the needs of different audiences for peer
grouping information. The following are key points and recommendations form that
discussion.
Data flow
The panel clarified the data flow and timeframes required for claims data run out
completion, processing by the data integrator, performance measurement and reporting
by the analysis and reporting vendor, and the time period for provider review before
public reporting. These timelines influence the degree to which these reports can be used
for some purposes. The use that was most compromised was the potential use by
providers for real time care management of specific patients. Information for other uses
for all audiences are most effective with the most recent data possible, but claims run out
and processing lags will not be a critical barrier to usefulness.
Audiences
Providers

Providers will use the information for quality improvement and possibly other
management uses such as internal incentive systems and marketing.

Physician practices would prefer the most granular provider information possible
for internal purposes even though the reporting may be at the clinic site level.

For data audit purposes, providers would like de-identified or summarized patient
level data, which is currently not in the plan.

For validation of attribution model and for other purposes, providers would like to
see the proportion of care provided by them versus other providers for attributed
patients. In addition, would like to know the type of service provided by them and
others.

It would be useful to have the other providers identified if HIPPA allows. Patient
self-selection of providers (e.g. health care home) improves the acceptability of
sharing data on care provided by other providers. The opinion was expressed that
HIPPA allows for providers to receive information on services provided by other
identified providers.

Providers would like to be able to decompose the measures by contributing payers
as a check on data reasonableness and drivers of performance
Payers and Purchasers

Reviewed payer and purchaser uses envisioned or required by the legislation

While community-wide quality measurement is being adopted, purchasers and
payers will continue to negotiate contracts to achieve their individual cost of care
objectives.

Further development of tiered network plans with the PG information and with
beneficiary benefits tied to choice among the tiers likely.

Payers and purchasers would find information on plan’s providers compared with
the aggregate for benchmarking their won plan or product performance useful.

Standardized resource use measures will be useful to plans.
Consumers

Uses to inform specific choices of providers and also education and awareness.

Web tool is useful, but may need to increase alternative tools/means for payers
and purchasers to report performance in the context of the actual choice facing
consumers (e.g. open enrollment)

Reports may need to be translated into Spanish. Beyond Spanish, the language
issue becomes less clear due to lower literacy in general offering no clear
substitute for English.

While payers and purchasers are informally adopting community-wide quality
measures, the cost of care to consumers is payer or purchaser specific.

Comparing current actual price to consumer with reported resource use
performance comparison may be confusing to consumers who will be facing
actual current prices through their respective payers with its benefit package.
(Clarified that the purpose of the resource use measure is to signal an overall cost
difference across providers as one piece of information that will provide context
for consumers even with different payers and benefits.)

With increased access to tiered network plans, consumers’ actual price in terms of
benefits (co-insurance, deductibles, or premium contribution) will likely be in line
with resource use PG performance measures.

Consumers with high deductable plans will use this information to compliment
service specific price information.

Consider the media as another consumer oriented audience.

Consider who consumers currently use as trusted sources of information on health
care choices as audiences.