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Western New YorkQuality Measurement

Collaborative

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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

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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.

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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.

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INDEPENDENTHEALTH

Prescription &Medical Claims

DataHEALTHNOW

Prescription &Medical Claims

Data UNIVERA

Prescription &Medical Claims

Data

PHYSICIANREPORT

PHYSICIAN One aggregated report for each physician. More robust (larger denominators)

Provider Linking

Patient Attribution

MeasureProduction

Report Distribution

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WNYQMCReport Portal

Report Ready

Patient Level Data

Notify Physician(Physician Packet)

Review Results

Complete Survey

Honorarium

Complete BAA

Physician Registration(Aggregate Report)

Phase 1 Phase 1Phase 2(Optional)

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NYSDOH GrantNineteen health quality measures will bereported in the document:- Breast cancer screening - Cervical cancer screening- Colorectal cancer screening - Chlamydia screening- Childhood immunization status - Lead screening in children- Cholesterol management for patients - Persistence of beta-block with cardiovascular conditions treatment after a heart attack- ACE/ARB treatment (post-heart failure) - Prenatal/postpartum care- Comprehensive diabetes care - Antidepressant medication (hemoglobin A1C testing, retinal exam, management – acute phase nephropathy screening, LDL testing) treatment & continuation phase- Use of appropriate medications for - Appropriate treatment for people with asthma children with upper respiratory- Appropriate testing for children with infection pharyngitis

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NYSDOH Grant

• Grant also calls for distribution of Inpatient Hospital Quality Rates as reported on www.hospitalcompare.com.

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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.

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www.p2wny.org

www.p2quality.com