Kentucky Core Healthcare Measures Set Driving health improvements through measurement alignment KY Performance Measures Alignment Committee Meeting #1 July 23, 2019
Welcome and Meeting Goals • Subcommittee Recommendation Review • KCHMS Adoption Discussion Kentucky Core Healthcare Measures Set 2 Kentucky Core Healthcare Measures Set 2
Welcome and Introductions • Aetna Better Health of Kentucky • Kentucky Equal Justice Center • Norton Healthcare • Anthem BCBS • Kentucky Health Information • Papa John's International Exchange • Ashland Children's Clinic • Passport Health Plan • Kentucky Hospital Association • Baptist Health • QSource • Kentucky Medical Association • CareSource • St. Elizabeth Physicians • Kentucky Nurses Association • Estill Medical Clinic • UAW/Ford Community Health • Kentucky Rural Health Information Initiative • Family Health Centers Organization • UK College of Medicine • Foundation for a Healthy Kentucky • Kentucky Voices for Health • UK Healthcare • Friedell Committee • KentuckyOne Health Partners • WellCare of KY • GE Appliances, a Haier company • Ky Primary Care Association • White House Clinics • Humana • KY Regional Extension Center (REC) • Kentucky Department for Medicaid Services • Louisville Metro Department of Public Health and Wellness • Kentucky Employees' Health Plan Kentucky Core Healthcare Measures Set 3 Kentucky Core Healthcare Measures Set 3
Kentucky Core Healthcare Measures Set Driving health improvements through measurement alignment • The FIRST STEP towards incentivizing the things that matter • Created to find areas where we can all FOCUS EFFORTS to improve health in our community • Designed specifically with the NEEDS OF THE COMMONWEALTH of Kentucky in mind Kentucky Core Healthcare Measures Set 4
PMAC Goals The goals of the Kentucky Core Healthcare Measures Set are to establish broadly agreed upon core quality measures that: • Improve the quality and value of care • Reduce provider reporting complexity • Align Kentucky’s healthcare organizations Kentucky Core Healthcare Measures Set 5
Subcommittee Measure Selection • Each subcommittee consists of experts from a variety of stakeholder types • Focus to include practicing clinicians • Members looked at commonly used measures, had opportunities to add their own priorities/measures • Meeting/discussion summaries can be found on PMAC portal • www.KHCollaborative.org/pmacportal Kentucky Core Healthcare Measures Set
PMAC Crosswalk • Includes core measures sets, national and local priorities: • 2018 KCHMS • KY Payer Alignment • HEDIS • MIPS • National Medicaid Adult and Children Core Sets • CMS/AHIP Core Set (PCP and Peds) • CMS Stars Kentucky Core Healthcare Measures Set
PMAC Crosswalk Priority Measurement Sets CMS/AHIP Core Set CMS KY Payer Measure Primary Care Pediatrics Medicaid 2018 2018 CMS NQF# Quality Alignment MIPS (Adult or KCHMS HEDIS Stars ACO ACO ID (Of 5 plans) Ped) (Measures in italics are in multiple categories) Preventive Care X PCMH Body Mass Index (BMI) Screening and Follow-Up 421 128 HIGH 0 X X PCMH Breast Cancer Screening 2372 112 HIGH 5 X X X X PCMH Cervical Cancer Screening (CCS) 32 309 HIGH 4 X X X X PCMH Colorectal Cancer Screening (COL) 34 113 HIGH 2 X X X Chlamydia Screening in Women (CHL) 33 310 STANDARD 3 X X X X Influenza Immunization 41 STANDARD 0 X Adult BMI Assessment X X X Care for Older Adults (COA) – Medication Review 553 X X Care for Older Adults Functional Status Assessment X X
Selection Process Members submitted rubric scoring for potential measures Committee went through each measure Committee selected measures together
Rubric
2018 Kentucky Core Healthcare Measures Set 89 Measures Incented in KY 34 Primary Care Measures Spanning Five Domains of Care • Preventive Care: 6 measures • Behavioral Health: 5 measures • Chronic Care and Acute Care: 12 measures • Pediatric Care: 9 measures • Cost and Utilization: 2 measures Each measure classified as “high” or “standard” priority Kentucky Core Healthcare Measures Set 11
2018 KY Core Healthcare Measures Set Preventive Care Priority Chronic and Acute Care Priority Cervical Cancer Screening High Colorectal Cancer Screening High Comprehensive Diabetes Care: Hemoglobin (HbA1c) Poor Control High Breast Cancer Screening High Medication Adherence for Diabetes Medications High Body Mass Index (BMI) Screening and Follow-Up High Statin Therapy for Patients with Diabetes High Influenza Immunization Standard Statin Therapy for Patients with Cardiovascular Disease High Chlamydia Screening in Women Standard Controlling High Blood Pressure (Hypertension) High Medication Adherence for Hypertension (RAS antagonists) High Pediatric Care Medication Management for People with Asthma High Childhood Immunization Status (Combination 10) High Medication Reconciliation Post-Discharge High Immunizations for Adolescents (Combination 2) High Comprehensive Diabetes Care: Medical Attention for Nephropathy Standard Tobacco Use and Help with Quitting Among Adolescents High Comprehensive Diabetes Care: Foot Exam Standard Well-Child visits in the 3-6 Years of Life High Comprehensive Diabetes Care: Eye Exam (Retinal) Performed Standard Well-Child Visits in the First 15 Months of Life High Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis Standard Follow-Up Care for Children Prescribed Attention- Deficit/Hyperactivity Disorder (ADHD) Medication Standard Appropriate Testing for Children with Pharyngitis Standard Behavioral Health Appropriate Treatment for Children with Upper Respiratory Infection Standard Screening for Clinical Depression and Follow Up Plan High Contraceptive Care – Most and Moderately Effective Methods: Ages Tobacco Use: Screening and Cessation Intervention High 15–20 Standard Antidepressant Medication Management High Use of Opioids at High Dosage Standard Cost and Utilization Use of Opioids from Multiple Providers Standard Plan All-Cause Readmissions High Use of Imaging Studies for Low Back Pain Standard
Proposed KCHMS Preventive Care Priority Changes Cervical Cancer Screening High Colorectal Cancer Screening High Breast Cancer Screening High Body Mass Index (BMI) Screening and Follow-Up High Influenza Immunization Standard Chlamydia Screening in Women Standard Chronic and Acute Care Priority Documentation of Signed Opioid Treatment Agreement Comprehensive Diabetes Care: Hemoglobin (HbA1c) Poor Control High Medication Adherence for Diabetes Medications High Pediatric Care Statin Therapy for Patients with Diabetes High Childhood Immunization Status (Combination 7) High Statin Therapy for Patients with Cardiovascular Disease High Childhood Immunization Status: Influenza Controlling High Blood Pressure (Hypertension) High Immunizations for Adolescents (Combination 1) High Medication Adherence for Hypertension (RAS antagonists) High Immunizations for Adolescents: HPV Medication Management for People with Asthma High Tobacco Use and Help with Quitting Among Adolescents High Medication Reconciliation Post-Discharge High Well-Child visits in the 3-6 Years of Life High Comprehensive Diabetes Care: Medical Attention for Nephropathy Standard Well-Child Visits in the First 15 Months of Life High Comprehensive Diabetes Care: Foot Exam High Follow-Up Care for Children Prescribed Attention- Deficit/Hyperactivity Disorder (ADHD) Medication Standard Comprehensive Diabetes Care: Eye Exam (Retinal) Performed High Appropriate Testing for Children with Pharyngitis Standard Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis Standard Appropriate Treatment for Children with Upper Respiratory Infection Standard Comprehensive Diabetes Care: Blood Pressure Control Contraceptive Care – Most and Moderately Effective Methods: Ages 15–20 Standard Behavioral Health Adolescent Well-Care Visits Weight Assessment and Counseling Screening for Clinical Depression and Follow Up Plan High Tobacco Use: Screening and Cessation Intervention High Antidepressant Medication Management Cost and Utilization High Use of Opioids at High Dosage Standard Plan All-Cause Readmissions High Use of Opioids from Multiple Providers Standard Use of Imaging Studies for Low Back Pain Standard Depression Response at 12 Months – Progress Towards Remission CG-CAHPS
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