Collaborative Learnings from the School of Hard Knocks Melinda Karp Director of Strategic Planning...
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Collaborative Learnings from the School of Hard Knocks Melinda Karp Director of Strategic Planning and Development, MHQP AHRQ Annual Meeting September 10, 2012
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Transcript of Collaborative Learnings from the School of Hard Knocks Melinda Karp Director of Strategic Planning...
Collaborative Learnings from the School of Hard Knocks
Melinda Karp
Director of Strategic Planning and Development, MHQP
AHRQ Annual Meeting
September 10, 2012
© MHQP 2012
About MHQP
MHQP’s mission is to drive measureable improvements in health care quality, patients’ experiences of care, and use of resources in Massachusetts through patient and public engagement and broad-based collaboration among health care stakeholders.
MHQP was first established in 1995 by a group of Massachusetts health care leaders who identified the importance of valid, comparable measures to drive improvement.
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© MHQP 2012
MHQP Background
MHQP has been in operation as a collaborative for over fifteen years, demonstrating success at bringing diverse stakeholders together for meaningful dialogue and results.
MHQP has a long track record working with health plans to develop common priorities and address issues that are best addressed across plans.
MHQP has earned the trust of the physician community and is well positioned to communicate with physicians about their performance.
MHQP established a Patient and Public Engagement Council to leverage the important role patients, families, and the public have in developing a high quality affordable healthcare system in Massachusetts.
© MHQP 2012
MHQP’s Measurement and Public Reporting Foundation
Clinical Quality Annual report on primary care
performance in Commercial plans for over 150 medical groups in Massachusetts Publicly reported since 2005 on over 30
measures of preventative and chronic health care
Clinical reporting for Mass Health in 2011
Patient Experience Biennial report on over 500 practice
sites in Commercial plans Publicly reported since 2006 on 10
aspects of the doctor – patient relationship
Over 80,000 Massachusetts patients respond to survey about their primary care experience
Fielding Massachusetts aligned Patient Experience Survey on behalf of the Executive Office of Health and Human Services in 2011
© MHQP 2012
Impact of MHQP’s Clinical Performance Reporting
Impact of seven years of public release of physician performance of 150 MA medical groups using clinical HEDIS measures Statewide improvement on all 8 measures that can be trended
over last seven years Public release has influenced physician organization investments
in information systems to support quality Physician organizations use MHQP’s internal performance reports
to reward individual physicians within the group
MHQP is the independent, trusted source for tracking the performance of MA physicians statewide
© MHQP 2012
Impact of MHQP’s Patient Experience Performance Reporting
Impact of public release of physician performance on patient experience surveys with over 400 MA practice sites Public release has motivated physician organizations to
focus on improvements in patient experience Physician organizations use MHQP’s internal performance
reports to reward individual physicians within the group Health plan adoption of patient experience in physician
incentive programs Most recent release with Consumer Reports reached
hundreds of thousands of consumers
MHQP is the only entity that broadly tracks the experience of patients in MA through delivery and payment system changes
© MHQP 2012
The Long and Winding Road Toward Financial Sustainability…Where We Find Ourselves Now
Despite relevance and demonstrated impact…financial sustainability remains elusive
MHQP funding model hasn’t kept pace with current strategic directions/objectives
Perceived inequities in current funding model have created strain among collaborative members
Changing financing and delivery models in the health care system, including new performance based incentives and organizational structures (i.e. ACOs, PCMHs), create new opportunities to leverage MHQP value
Widespread health care system cost pressures
CONFIDENTIAL - NOT FOR DISTRIBUTION 8
© MHQP 2012
The Long and Winding Road Toward Financial Sustainability…
“The Collaborative by its very nature is fragile…in the best of times”
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© MHQP 2012
The Long and Winding Road Toward Financial Sustainability…The Vision
A sustainable financing model that: Brings in ongoing revenues from diverse sources
and results in outputs of great interest/relevance to individual, diverse collaborative members
Maintains a structure for Collaborative member contributions that feels equitable to all members—direct value for the $$
Supports the public good mission of the collaborative
Aligns effectively with the Collaborative’s Governance model
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© MHQP 2012
Breakdown of MHQP 2011 Revenues
Confidential -- MedPharma Partners LLC
© MHQP 2012
Lessons Learned: the Beauty of the Vision versus the Challenges of the Reality
The Reality (for MHQP): Creating value for one member stakeholder can
lead to divisive challenges with others around “high stakes” use of the data
Strategic direction and funding model must be aligned with local market trends, needs
Ongoing, effective communication is critical and sometimes difficult to achieve
It can be hard to disentangle governance from financing
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© MHQP 2012
For more information about MHQP…
Melinda Karp
Director of Strategic Planning and Development
[email protected] 600-4875
www.mhqp.org
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