Opportunities and Challenges in Identifying Nationally Consistent, Locally Adaptable Approaches to Make Performance Results Available (Text Version)

On September 28, 2010, Karen Jones made this presentation at the 2010 Annual Conference. Select to access the PowerPoint® presentation (370 KB). 

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Slide 1

A1c Current (Past Year)

Image: A line graph compares the percentage of diabetes patients with A1c tested from August 31, 2009, to June 29, 2010, in a number of medical facilities. The Target line is at 93%. Ratios for the medical facilities over the charted period are as follows:

Medical Facility	8/31/09	9/8/09	10/6/09	10/20/09	11/3/09	11/16/09	11/30/09	12/14/09	12/31/09	1/15/10	2/1/10	2/26/10	4/30/10	6/29/10
Wellspan Medical Group	82%	82%	82.5%	82.5%	83%	83%	83%	83%	83.5%	83.5%	84%	84.5%	85%	86%
Apple Hill Internal Medicine	85%	85.5%	85.9%	85.8%	86%	86%	86.1%	86.3%	86.5%	86.7%	86.9%	86.7%	86.8%	86.5%
Pine Grove Adult Medicine	87%	86.5%	87%	87.5%	89%	90%	89%	87.5%	90%	89%	89%	88%	94%	95%
York Hospital Community Health Center	89%	90%	93%	92.5%	92.8%	93%	93%	92.9%	92.8%	92.9%	93%	93%	91%	92%
Stony Brook	83%	83%	82.75%	83%	83.5%	83.25%	83.5%	83.5%	84%	84%	83.9%	84%	84.5%	85%
Dallastown	89%	89.5%	89%	88%	87.5%	87%	87%	86.8%	86.5%	86.5%	87%	87.3%	87.3%	87%
Gettysburg Adult Medicine	97%	96.8%	97%	96.8%	96.8%	96.8%	96.5%	96.3%	96%	96.3%	97%	96.3%	96.4%	96.6%
Biglerville Family Medicine	81%	79%	82%	82%	82%	82.5%	83%	82.75%	82.5%	82%	83.5%	83.5%	83.6%	83.5%
East Berlin	90.5%	90%	90.5%	92%	93.1%	93%	92.9%	93%	93.2%	93%	93%	92.9%	92.9%	93%
Wheatlyn	84%	83.5%	93.5%	84.5%	84.8%	84.8%	84.9%	85%	85%	84.5%	85%	85%	85.1%	85%
Yorktowne	77%	77%	77%	77%	77%	76.5%	76%	76.5%	77%	76.8%	76.9%	77.5%	82%	81%
Brockie International Med Consultants	97%	97%	97.5%	98%	98%	98%	97.8%	97.6%	97.8%	96%	96.7%	96%	96%	94.9%
PRO Combined (AHIM/DFM/SBFM)	86%	86%	85.9%	86%	86.2%	86%	86.2%	86.3%	86.3%	86.4%	86.5%	86.6%	86.6%	86.75%
Thomas Hart Family Practice Center	76%	76.5%	81%	80%	80.5%	79%	78%	77.8%	77.6%	77.4%	77.2%	77%	76.7%	82%
Adams-Cumberland FM	75.5%	76%	76.5%	76.8%	77%	77.3%	78%	81%	81.5%	81.5%	82%	82%	82.5%	82.4%
Gotham	88%	88%	87.9%	87.9%	87.7%	87.9%	88%	87.7%	87.7%	87.5%	87.4%	87%	86.8%	91.5%

Notes: For diabetes patients % with A1c tested within measurement year, age 18-75.
Target NCQA top 10 percentile.

Slide 2

MicroAlbumin Current

Image: A line graph compares the MicroAlbumin/Creatinine Ratio for diabetes patients in a number of medical facilities from August 31, 2009, to June 29, 2010. The Target line is just below 70%. Ratios for the medical facilities over the charted period are as follows:

Medical Facility	8/31/09	9/8/09	10/6/09	10/20/09	11/3/09	11/16/09	11/30/09	12/14/09	12/31/09	1/15/10	2/1/10	2/26/10	4/30/10	6/29/10
Wellspan Medical Group	49%	48%	49.5%	49.5%	49.5%	49.5%	49.5%	49.5%	50%	50%	50%	50.5%	54%	59%
Apple Hill Internal Medicine	51%	51.5%	52%	52%	54%	54%	55%	56%	57%	57%	60.5%	60.5%	64%	67%
Pine Grove Adult Medicine	74%	72%	73%	74%	75%	74.5%	73%	77%	76.5%	79%	79%	84%	89%	88%
York Hospital Community Health Center	75%	74.5%	67%	66%	67%	65%	65%	66%	67%	67%	65%	63%	60%	63%
Stony Brook	54%	53%	54%	54.5%	55%	55%	55.5%	55.5%	55%	55%	53%	56%	60%	62%
Dallastown	39%	38%	38%	38%	38.5%	39%	39%	39%	39.5%	39.5%	40%	42%	45%	49.5%
Gettysburg Adult Medicine	80%	79%	80.5%	81%	82%	82.5%	83%	84%	82%	85%	87%	90%	89%	92%
Biglerville Family Medicine	55%	54%	61%	62%	61%	64%	63.5%	62%	61%	62%	63%	64%	61%	60%
East Berlin	65%	64%	68%	70%	70.5%	70%	70%	72%	73%	73%	72%	71.5%	71%	70%
Wheatlyn	54%	53%	53%	54%	54%	54%	54%	55.5%	53%	51%	52%	54%	55.5%	55%
Yorktowne	42%	42%	42%	42%	42%	40.5%	40.5%	40.5%	40.5%	40%	42%	46%	56%	68%
Brockie International Med Consultants	74%	72%	71%	69%	69%	68.5%	66%	67%	67%	67%	67%	66.5%	70%	80%
PRO Combined (AHIM/DFM/SBFM)	48%	47%	48%	48%	48%	49%	49.5%	49.5%	50%	50%	50%	51%	55%	59%
Thomas Hart Family Practice Center	42%	41%	45%	46%	45%	44%	44%	43%	43.5%	43.5%	42%	42%	45%	60%
Adams-Cumberland FM	48%	47%	48%	49%	50%	51%	52%	53%	54%	54%	55%	56%	62%	62%
Gotham	54%	53%	55%	55%	55.5%	56%	57%	58%	59.5%	59.5%	58%	58%	60%	65%

Notes: For diabetes patients, % with MicroAlbumin/Creatinine Ratio tested within measurement year. 
Target WMG top 10 percentile.

Slide 3

• Data for internal feedback and QI can be imperfect ("directional & good enough").
• Public data for comparison has a financial impact & must be impeccable:
  • Measures broadly accepted
  • From a trusted source and methodology
  • Consistent across payers
  • Meaningful
  • Timely
  • Actionable
  • Tied to QI initiatives/tools
  • Payment reform to support QI work and *financially reward reporting of practice level data
• Critical—to improve/coordinate care using data that is collected during the course of routine care.
• Cost of care—need more focus on specialty care/procedures.