Welcome and Introductions

Transcription

1 Welcome and Introductions

2 Goals for 2015 TAG By September 1, 2015, evaluate the 2015 APCD data outputs using prior list of preferred clinical reporting measures* and choose two measures to develop into statutorily mandated public reports. Develop a provider-centric subcommittee to advise on attribution issues provider-clinic and patient-provider by March One community-based use case (1 actionable project) is fulfilled by APCD data for UPV, Choosing Wisely, or other community collaborative, by October 1, One data-show and tell event occurs to share uses of DIADS and APCD data to demonstrate community collaboration and drive use of data by December 31, Fulfill Cycle 3 grant obligations on display preferences and consumer feedback by December 31, 2015.

3 Diabetes Care Hemoglobin Testing Eligibility: Age at end of reporting period between 18 and 75 Continuous enrollment - Minimum of 11 months eligibility of primary medical coverage in current reporting period Denominator: Identification of Diabetes requires one of the following (Using 2 year look back): At least 2 visits in outpatient, Observation or Non-acute inpatient setting on separate dates, within the report period or the prior report period with a Diabetes diagnosis code. Note: Need 2 visits in any combination of settings over 2 year look back. One visit in an Acute Inpatient or Emergency Room setting, with in the report period or prior report period with a Diabetes diagnosis A Pharmacy claim for Insulin or Hypoglycemic/anti-hyperglycemic with in the report period or prior report period Exclusions No claim history with a diagnosis of Polycystic ovaries, period induced or gestational diabetes in the current report period or prior report period Numerator: Enrollee is included in denominator A visit for that enrollee is tagged with HbA1c Test and Visit Service Start date is in current period

4 American Fork/Alpine Ben Lomond Bountiful Box Elder County (Other) Brigham City Cache County (Other)/Rich County (All) Carbon/Emery Cedar City Clearfield/Hill Air Force Base Cottonwood Farmington/Centerville Grand/San Juan Juab/Millard/Sanpete Kearns Layton Lehi/Cedar Valley Logan Magna Midvale Millcreek Morgan County (All)/Weber County (East) Murray Ogden (Downtown) Orem (East) Orem (North) Orem (West) Pleasant Grove/Lindon Provo (North)/Brigham Young University Provo (South) Riverdale Riverton/Draper Roy/Hooper Salt Lake City (Avenues) Salt Lake City (Downtown) Salt Lake City (Foothill/University of Utah) Salt Lake City (Glendale) Salt Lake City (Rose Park) Sandy (Center) Sandy (Northeast) Sandy (Southeast) Sevier/Piute/Wayne South Jordan Holladay South Ogden South Salt Lake Southwest Local Health District (Other) Springville/Spanish Fork St George Summit County Syracuse/Kaysville Taylorsville (East)/Murray (West) Tooele County TriCounty Local Health District Unknown Utah County (South) Wasatch County Washington County (Other) West Jordan (North) West Jordan/Copperton West Valley (West) Woods Cross/North Salt Lake 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Diabetes Care: Hemoglobin A1c (HbA1c) Testing **DRAFT** High Similar Low Statewide NCQA 75%

5 Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis Eligibility: Age at end of report period between 20 and 64 Continuous enrollment for 12 months prior to index event and 7 days after (inclusive). No more than 1 month gap in coverage during this time Denominator: Must have one Outpatient, Observation or Emergency Dept visit Jan 1 thru Dec 24 of the current reporting year with a diagnosis of acute bronchitis AND NONE of the following: Any claim/encounter within 12 months prior to the index event with a comorbid condition: HIV, Malignant Neoplasms, Emphysema, COPD, Cystic fibrosis, Comorbid conditions Antibiotic Medication with filled-date within 30 days prior to the index event OR filleddate + days supply is equal to or greater than index event date Pharyngitis or Competing diagnosis within 30 days prior to index event or 7 days after. Numerator: Person has RX claim for Antibiotic Prescription with filled date between index event date and 3 days after the index event date. Index event is described as the first occurrence of the OP/ED/Observation visit. Measure uses a inverted rate: 1-(numerator/denominator). This calculation will need to be done in the reporting layer.

6 American Fork/Alpine Ben Lomond Bountiful Box Elder County (Other) Brigham City Cache County (Other)/Rich County (All) Carbon/Emery Cedar City Clearfield/Hill Air Force Base Cottonwood Farmington/Centerville Grand/San Juan Holladay Juab/Millard/Sanpete Kearns Layton Lehi/Cedar Valley Logan Magna Midvale Millcreek Morgan County (All)/Weber County (East) Murray Ogden (Downtown) Orem (East) Orem (North) Orem (West) Pleasant Grove/Lindon Provo (North)/Brigham Young University Provo (South) Riverdale Riverton/Draper Roy/Hooper Salt Lake City (Avenues) Salt Lake City (Downtown) Salt Lake City (Foothill/University of Utah) Salt Lake City (Glendale) Salt Lake City (Rose Park) Sandy (Center) Sandy (Northeast) Sandy (Southeast) Sevier/Piute/Wayne South Jordan South Ogden South Salt Lake Southwest Local Health District (Other) Springville/Spanish Fork St George Summit County Syracuse/Kaysville Taylorsville (East)/Murray (West) Tooele County TriCounty Local Health District Unknown Utah County (South) Wasatch County Washington County (Other) West Jordan (North) West Jordan/Copperton West Valley (West) Woods Cross/North Salt Lake 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Avoidance of Antibiotics in Adults with Bronchitis **DRAFT** (Higher is better) High Similar Low Statewide NCQA 75%

7 Chlamydia Screening in Women (16-24 y) Eligibility: Person Age in years between 16 and 24 at end of reporting period Gender = F Continuous enrollment for 1 year: no more than 1 month gap during the report period Denominator: Person is in eligible population and has either of the following during the report period: Medical Visit with Pregnancy or Sexual activity indication Pharmacy Claim for contraceptive Numerator: Person is in denominator and has at least one visit with a chlamydia test during the report period

8 American Fork/Alpine Ben Lomond Bountiful Box Elder County (Other) Brigham City Cache County (Other)/Rich County (All) Carbon/Emery Cedar City Clearfield/Hill Air Force Base Cottonwood Farmington/Centerville Grand/San Juan Holladay Juab/Millard/Sanpete Kearns Layton Lehi/Cedar Valley Logan Magna Midvale Millcreek Murray Ogden (Downtown) Orem (East) Orem (North) Orem (West) Pleasant Grove/Lindon Provo (North)/Brigham Young University Provo (South) Riverdale Riverton/Draper Roy/Hooper Salt Lake City (Avenues) Salt Lake City (Downtown) Salt Lake City (Foothill/University of Utah) Salt Lake City (Glendale) Salt Lake City (Rose Park) Sandy (Center) Morgan County (All)/Weber County (East) Sandy (Northeast) Sandy (Southeast) Sevier/Piute/Wayne South Jordan South Ogden South Salt Lake Southwest Local Health District (Other) Springville/Spanish Fork St George Summit County Syracuse/Kaysville Taylorsville (East)/Murray (West) Tooele County TriCounty Local Health District Unknown Utah County (South) Wasatch County Washington County (Other) West Jordan (North) West Jordan/Copperton West Valley (West) Woods Cross/North Salt Lake 60% 50% 40% 30% 20% 10% 0% Chlamydia Screening **DRAFT** High Similar Low Statewide NCQA 75%

9 Breast Cancer Screening (52-74y) Eligibility: Gender = F Age at end of report period between Continuous Enrollment: Eligibility look back 27 months At least 11 months eligibility of primary medical coverage in current reporting period At least 11 months eligibility of same LOB primary medical coverage in prior reporting period Must have additional prior reporting period with last 3 months (Oct Dec) eligibility Exclusions any enrollee with claim history indicating: Bilateral mastectomy, unilateral mastectomy with all dates of service Denominator: Eligible population Numerator: One or more visits with Mammogram codes and Visit Service start date is in the 27-month lookback period Count of each unique service date of tagged visits during the 27-month lookback period.

10

11 Deeper Dive for Use of Data for 2015 What part of the data? Current measures Pharmacy data Other Potential use cases Provider initiatives Payer initiatives State Innovation Model Report to Legislature Compelling interpretation from TAG

12 State Innovation Model Planning Metrics NQF 0418-screenign for depression and follow up plan NQF 0105 Antidepressant management NQF 0004 initiation of alcohol, drug dependence treatment NQF 0421 Adult Weight screening and f/u NQF 0024 Wt Assessm t, Nutrition and Phys Activity Counseling for Children NQF 0575 A1c control NQF 0059 A1c poor control NQF 0064 LDL Mgmt and control NQF 0061 DM BP control

13 Next Steps What will we accomplish from now to end of 2015?