QBPC PI CME Performance Dashboards Reference Guide

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1 QBPC PI CME Performance Dashboards Reference Guide QBPC PI-CME has been designed to enhance knowledge, competency and performance in the management of patients with cardiovascular (CV) metabolic risk factors. The QBPC PI-CME program provides ongoing attributed patient data analysis and tailored CME opportunities to participating physicians to address gaps in care and ensure patients are treated according to national guidelines. Practices are benchmarked against QBPC clinical measure target goals, QBPC peer practices, Southeastern regional practices and nationally with other Symphony Performance Health, Inc. (formerly MDdatacor) enrolled practices. The QBPC PI-CME Performance Dashboards are generated by The Consortium for Southeastern Hypertension Control (COSEHC). Please refer to the sample report found on pages 6 and 7 of this guide. 1. When viewing your report, you will note the Quality Blue Primary Care (QBPC) logo and the Integrated Medical Processes, LLC (IMP) logo in the upper top corners. IMP is a physicianled, clinical integration consultancy focused on population management and value-based care models and IMP s IMPACT program serves as the foundation for QBPC, providing the framework and implementation strategy to enable care transformation. 2. Looking at the middle top heading, you will find the title of the report: QBPC PI-CME Performance. 3. The second line in the middle heading denotes that this is a Baseline Report. Once you have received your baseline report, additional reports will be denoted here as Follow-up Reports. 4. The third line in the middle heading gives the Practice site location. The rationale for using the practice site location is because from a performance improvement viewpoint, different sites may operate differently in terms of the staff and their processes. Please note that within MDinsight you can drill down to each individual physician, but from the performance improvement perspective, process changes happen at the location level. 5. The Report Period is noted just below the IMP logo. This is the date range which the data was retrieved for the reporting period, meaning relevant biometric measures are analyzed for eligible patients only if they occurred within the prior 12 months of the reporting period listed on the report. Before dissecting the sections of the performance dashboards, please note that only eligible patients are counted in the report. An eligible patient is defined as a BCBSLA member patient who has had a clinic visit within the 24 months prior to the end of the reporting period. Again, relevant biometric measures are analyzed for eligible patients only if they occurred within the 12 months of the reporting period listed on your report. Eligible patients without a relevant biometric measure within the 12 months prior to the end of the reporting period are considered out of control and are recorded as zero in calculating the percent of a measure s attainment. Page 1

2 The performance dashboard reports are formatted into sections according to the clinical suites assigned by MDinsight: 6. The top section reflects the percent of eligible patients in a practice attaining the defined biometric measures. NOTE: The emphasis of this section is that this is all BCBSLA patients including patients that do not have a chronic disease diagnosis. This gives a higher level population view for all BCBSLA patients. The first column, Metric, lists three measures, Blood Pressure, LDL Cholesterol and Non-HDL Cholesterol. The second column, ALL BCBSLA PATIENTS, is divided into two sections. The section titled Your Practice refers to your practice site location and includes data for all physicians at that specific site. This is their performance level. The section titled All of QBPC refers to all BCBSLA patients. When looking at the Blood Pressure measure in the example above, the percentage of eligible patients in your practice that attained a blood pressure reading <140/90 is 71% compared to 57% for all of QBPC. The third column, BENCHMARKS, is divided into two sections, Southeastern and National. The Southeastern benchmark is provided by COSEHC and will benchmark QBPC against COSEHC locations from the southeast region. The National benchmark, which is highlighted in gray, will be provided by Symphony Performance Health, Inc. (formerly MDdatacor) and will benchmark QBPC practices against other Symphony Performance Health, Inc. enrolled practices across the nation. When looking at the Blood Pressure measure in the example above, your practice had 71% and all of QBPC had 57%. Your practice at 71% compared to the benchmark for all of QBPC is more than 5 percentage points above all of QBPC at 57%. Since it is greater than 5 percentage points in absolute terms, then you receive a GREEN dot in the comparison column vs. ALL OF QBPC which denotes that your practice is Above Average by greater than 5%. When compared to the Southeastern Benchmark, your practice at 71% is > 5 percentage points below the Southeastern benchmark at 80%. Since your practice is below by greater than 5 percentage points of the benchmark (Average), you will receive a RED dot in the comparison Page 2

3 column vs. SOUTHEAST. If your practice is within + or - 5 percentage points of the benchmark you will receive a YELLOW dot in the comparison column. 7. The bottom sections under QBPC Clinical Quality Measures, contains the six suites that are in MDinsight: Optimal Diabetes Care, Optimal Vascular Care, Optimal CKD Care, Hypertension Control, Vascular Pharmacy Measure and CKD Pharmacy Measure. These suites are not inclusive of all BCBSLA patients and only include the members in the reporting time period with the specific disease diagnosis. Each measure in the respective suite reflects the percentage of eligible patients attaining the target goal. Page 3

4 The Optimal Composite reflects the percentage of patients that have met all listed measures in the suite. You will note that the Optimal Diabetes Care suite has four target measures: HbA1c (<8.0%), Blood Pressure (<140/90mm Hg), LDL Cholesterol (<100mg/dl) and Non-smoker. When looking at the Optimal Composite for Diabetes Care above, your practice is at 25% and all of QBPC is at 13%. Compared to the ALL OF QBPC benchmark, your practice is greater than 5 percentage points above and you receive a GREEN dot in the comparison column vs. ALL OF QBPC. NOTE: The Optimal Composite is only compared to ALL of QBPC because we have no great benchmarks to compare this against. In the Optimal CKD Care suite, the Optimal Composite reflects the percent attainment* of measures in the suite of eligible patients (patients with diagnosis of Chronic Kidney Disease, a Diagnosis code for proteinuria or readings of lab/other test values outlined in the Policy and Procedure Manual for this measure). *Only attainment of the blood pressure measure is required if the patient is without proteinuria; if proteinuria is present, both the blood pressure measure and the ACE/ARB Rx measure must be met. When looking at the Optimal CKD Care suite example above, your practice has 90% of patients with proteinuria on ACE/ARB Rx compared to the benchmark for all of QBPC of 18%. Compared to the ALL OF QBPC benchmark, your practice is greater than 5 percentage points above and you receive a GREEN dot in the comparison column vs. ALL OF QBPC. Page 4

5 The Vascular Pharmacy Measure is designed to reflect compliance to statin class of medications used to treat hyperlipidemia. The On Statin measure reflects the percentage of patients with vascular disease on a statin medication. The Proportion of Days Covered measure estimates the percentage of patients that have medications available to consume for 80% of the days remaining in the year from the first dispensed date through the end of the year. The CKD Pharmacy Measure is similar to the Vascular Pharmacy Measure and is designed to reflect compliance with and essential medication for the medical condition; which in this case is Chronic Kidney Disease WITH Proteinuria. The ACE/ARB Rx reflects only those with significant proteinuria (i.e. 300mg/g using a spot Cr/Albumin test) who are on an ACE/ARB. The Proportion of Days Covered measure also estimates the patients who fill their medication so that they have medications available to consume 80% or more days of the year. Page 5

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