2015 Health Care Quality Report

Transcription

1 2015 Health Care Quality Report Compare Clinic, Medical Group and Hospital Performance Measuring and Tracking Health Care Quality in MN To download the report and find more information visit: mncm.org Searchable results are available at our consumer-friendly website: MNHealthScores.org

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3 December 2015 MN Community Measurement (MNCM) is excited to release the 2015 Health Care Quality Report. A dozen years after the first edition, this annual report continues to expand and evolve each year. The first report featured results for just 61 medical groups on seven HEDIS quality measures. This year, we re highlighting data on 911 clinics, 263 medical groups and 132 hospitals on more than 75 measures of clinical quality, cost and patient experience. The growth in this report is a reflection of the increasing value that MNCM provides to all of the stakeholders in Minnesota s health care community: providers, patients, health plans, employers, policy leaders and the public at large. The Health Care Quality Report shines a light on our health care system; over the past year, we have added two companion reports that continue that illumination: the Health Equity of Care Report and the Total Cost of Care Report. Together, these provide a holistic view of health care in Minnesota, including the areas where we are excelling and the areas that we must push ourselves to provide better care. than ever. The demand for value accountability will continue to increase the need for meaningful measures that improve the lives of those served. We are focused on measures with the greatest potential for impact, thus enhancing the benefits and reducing the burdens of reporting for medical groups. We are also focused on maintaining the gains that our state has made in health care transparency and improvement, while continuing to identify areas of measurement and data collection that will push our community to achieve new milestones in health. MNCM is proud to be part of our thriving, innovative and collaborative health care community. And we re thankful to our community for continually coming together to work toward our shared goal of improving health and health care in Minnesota. We look forward to the continued partnership and the road ahead. MNCM strives to provide measures that truly improve the value of care in our community. We also seek to create new measures that address complex conditions and topics which are meaningful for both patients and providers. To that end, we publicly-reported new pediatric preventive care, patientreported outcome, and specialty care quality measures this year. We released the second cycle of statewide Patient Experience of Care Survey results, and the second year of Total Cost of Care results. Jim Chase President, MN Community Measurement After several years in of effort and community input, we applied actual-to-expected risk adjustment to quality measures for the first time. The goal of risk adjustment is to isolate the clinic or medical group s true impact on patients health, and allow them to be more easily compared. This report includes nine risk adjusted measures, and we are continuing to evaluate the expansion of risk adjustment to additional measures or using different factors. Penny Wheeler, MD Board Chair, MN Community Measurement As new reporting requirements and value-based payment mechanisms roll out, MNCM s trusted record of multistakeholder, consensus-based decision making to address complicated health care challenges in will be more important 3

4 2015 Health Care Quality Report Report Preparation Direction Anne M. Snowden, MPH, CPHQ Director of Performance Measurement, Validation & Reporting Key Contributor Ma iong, MPH Project Specialist/Data Analyst Other Contributors Erin Ghere, MPP Manager of Communications & Engagement Jaime Johnson, MBA Membership & Communications Project Manager Direct questions or comments to Anne M. Snowden (612)

5 Introduction 6 Executive Summary 7 Changes in the 2015 Report 10 Measure Overview 11 Contents QUALITY: CLINIC AND MEDICAL GROUP New Measures/Measures with Specification Changes for 2015 Reporting 15 Cervical Cancer Screening 16 Pediatric Preventive Care: Adolescent Mental Health and/or Depression Screening 19 Pediatric Preventive Care: Overweight Counseling 27 Spinal Surgery: Lumbar Discectomy/Laminotomy 36 Spinal Surgery: Lumbar Spinal Fusion 40 Total Knee Replacement 44 Optimal Diabetes Care 48 Optimal Vascular Care 56 Optimal Asthma Control Children and Adults 64 Controlling High Blood Pressure 77 Large Increase in Statewide Rate 80 Immunization for Adolescents 81 Avoidance of Antibiotics in the Treatment of Adult Bronchitis 85 Moderate Increase in Statewide Rate 89 Depression PHQ-9 Follow-Up at Six and 12 Months 90 Small Increase in Statewide Rate 111 Colorectal Cancer Screening 112 Chlamydia Screening in Women 126 Appropriate Testing for Children with Pharyngitis 130 Appropriate Treatment for Children with URI 134 Depression Remission and Response at Six Months 138 Depression Remission and Response at 12 Months 154 Small Decrease in Statewide Rate 170 Use of Spirometry Testing in the Assessment and Diagnosis of COPD 171 Maternity Care: Primary C-Section Rate 175 PHQ-9 Utilization 178 Breast Cancer Screening 190 Follow-up Care for Children Prescribed ADHD Medication 193 Childhood Immunization Status (Combo 3) 197 QUALITY: HOSPITAL 201 PATIENT EPERIENCE OF CARE: CLINIC 204 PATIENT EPERIENCE OF CARE: HOSPITAL 207 TOTAL COST OF CARE 209 HEALTH INFORMATION TECHNOLOGY: CLINIC Statewide and Medical Group Summary by Measure 216 Highest Performers in 2015 by Medical Group Type for Clinical Measures 218 Future Plans 222 Acknowledgements 224 List of Medical Groups and Hospitals Reported 225 Summary of Risk Adjustment and Non-Risk Adjustment Results by Measure 228 Appendix 1: Data Sources and Data Collection 408 Appendix 2: Methodology 410 Appendix 3: MNHealthScores.org 417

6 Introduction The MN Community Measurement 2015 Health Care Quality Report compares clinic, medical group and hospital performance on quality, patient experience, cost, and health information technology measures. Quality measures range from preventive to chronic care, along with hospital care for acute and surgical needs. This year marks MNCM s 12th annual report. The report provides valid, reliable and comparable information for clinics, medical groups and hospitals to use in their efforts to improve patient care and outcomes. MNCM began publicly reporting health care performance results in 2004 with a vision of improving health and health care in Minnesota and neighboring communities through public reporting. We believe that making this information transparent drives improvement in the cost, quality and patient experience of care. The information is most actionable at clinic and medical group levels since that s where accountability for care lies, so we strive to publicly report results at that level as often as possible. Our inaugural reporting effort in 2004 utilized Healthcare Effectiveness Data Information Set (HEDIS) measures, aggregating data from 10 health plans and reporting results at a medical group level. One year later, MNCM became an independent, collaborative, non-profit organization. Since inception, our Board of Directors has included physicians; health plans, hospital and state government representatives; employers; and consumers. We again reported HEDIS measures at a medical group level that year, and expanded our effort into reporting the results online for the first time. As we gained momentum and experience, medical group leaders encouraged us to obtain data from the most comprehensive source: their own electronic health record systems. In 2007, we piloted a process to collect data directly from clinics, which became known as Direct Data Submission (DDS). This process made reporting results for individual clinic sites possible. During the first year, 191 clinics were reported for the Optimal Diabetes Care measure; today, we report results for more than 590 clinics for that measure. The Health Care Quality Report has also expanded dramatically during this period. It now includes 32 clinical quality measures; 11 HEDIS measures; patient experience measures; cost measures; and hospital measures. This year, we added new patient-reported outcome measures for Total Knee Replacement, Lumbar Fusion and Lumbar Discectomy/ Laminotomy; as well as clinical quality measures for Adolescent Mental Health/Depression Screening and Pediatric Obesity Counseling. During 2015, we also released results of the second cycle of statewide Patient Experience of Care, which is reported every other year. Additionally, we made significant progress in the evaluation and implementation of risk adjustment in our measurement processes. Our Risk Adjustment Committee established a framework through which it will evaluate measures to determine if they re appropriate for risk adjustment, and the majority of MNCM s clinical quality measures have undergone that evaluation. The 2015 report includes the risk adjusted results of nine quality measures, all of which have been already or will be in the coming year posted on our consumer website, MNHealthScores.org. We appreciate the significant contributions of clinics, medical groups, health plans, hospitals and professional organizations that contribute data to this report, as well as the community stakeholders who share their expertise with us as Board, committee and workgroup members; pilot participants; members; and a variety of other ways. Achieving our mission to accelerate the improvement of health by publicly reporting health care information relies on this collaborative, multi-stakeholder effort. We strive to continue to be the trusted source for performance measurement, data sharing and public reporting locally and nationally. 6

7 Executive Summary This is MNCM s 12 th annual Health Care Quality Report. Included in this report are clinic performance results on 32 clinical quality measures, two Total Cost of Care measure, results on the Health Information Technology (HIT) Survey, Patient Experience of Care survey results for 2015, and hospital measures. Key Findings Clinical Measures Two clinical measures showed noteworthy improvement in their statewide rates: Immunization for Adolescents - The statewide rate increased from 62 percent in 2014 to 75 percent in 2015, translating into 570 more adolescents being immunized. Avoidance of Antibiotics in the Treatment of Adult Bronchitis - The statewide rate increased from 29 percent in 2014 to 34 percent in 2015, translating into 847 more adults receiving appropriate treatment (antibiotics were not prescribed) for their diagnosis of acute bronchitis. Two clinical measures showed noticeable improvement in their statewide rates: PHQ-9 Follow-Up at Six Months - The statewide rate increased from 31 percent in 2014 to 34 percent in 2015, translating into at least 3,200 more patients with a diagnosis of major depression or dysthymia and a PHQ-9 score greater than nine having a followup PHQ-9 test at six months from the index date. PHQ-9 Follow-Up at 12 Months - The statewide rate increased from 23 percent in 2014 to 26 percent in 2015, translating into at least 2,300 more patients with a diagnosis of major depression or dysthymia and a PHQ-9 score greater than nine having a followup PHQ-9 test at six months from the index date. Eight other clinical measures showed small improvements in their statewide rates: Colorectal Cancer Screening Chlamydia Screening in Women Appropriate Testing for Children with Pharyngitis Appropriate Treatment for Children with URI Depression Remission at Six Months Depression Response at Six Months Depression Remission at 12 Months Depression Response at 12 Months Two new clinical measures were collected and submitted using MNCM s Direct Data Submission (DDS) process. Pediatric Preventive Care: Adolescent Mental Health and/or Depression Screening had a statewide rate of 40 percent. Pediatric Preventive Care: Overweight Counseling had a statewide rate of 85 percent. Three orthopedic measure sets are new this year which includes Spinal Surgery: Lumbar Discectomy/ Laminotomy, Spinal Surgery: Lumbar Spinal Fusion, and Total Knee Replacement. One process measure and one functional status measure is reported for each measure this year. In 2014, three process measures were reported for the Total Knee Replacement measure. Six measures underwent a measure specification change in 2015 and therefore, do not have trending data: Cervical Cancer Screening Optimal Diabetes Care Optimal Vascular Care Optimal Asthma Control - Children Optimal Asthma Control - Adults Controlling High Blood Pressure 7

8 Executive Summary Patient Experience of Care - Clinic In 2015, there were 847 clinics in MN and neighboring states that had the surveys fielded on their behalf by a CAHPS-certified survey vendor. The response rate was 33 percent. An analysis of the data produced four composite scores called domains for each clinic. These clinic domain scores are reported as top box scores meaning the percent of responses that rated the clinic with the most positive response. Across all respondents, the overall top box domain averages for 2015 were: Access to Care: 60 percent Provider Communication: 83 percent Courteous & Helpful Office Staff: 81 percent Provider Rating: 79 percent Patient Experience of Care - Hospital The most current H-CAHPS data that is publicly reported was collected from admission dates January December 2013 and reports on 10 domains. Results for the H-CAHPS hospital measures can be found at MNHealthScores.org. Please also visit the Minnesota Hospital Association s Hospital Quality Report for an expanded list of H-CAHPS measures at mnhospitalquality.org. Cost measures A new report was published in December 2014 by MNCM that allows consumers for the first time to compare the total cost of care at medical groups across the state. Costs from more than 1.5 million patients were included in the report, which is the nation s most comprehensive look at the total cost of care. Information is available for 115 medical groups, representing 1,052 clinics across Minnesota and in neighboring communities on MNHealthScores.org. 8 Health Information Technology (HIT) measure 1,293 clinics in Minnesota and bordering states responded to the 2015 Health Information Technology (HIT) Ambulatory Clinic Survey. The 2015 response rate was 80 percent, compared to 86 percent in 2014 and 80 percent in We report milestones achieved under adoption, use, and exchange at MNHealthScores.org. Adopt: Information about a patient and the care the patient needs is recorded in an electronic health record (EHR) instead of a paper medical record. Utilization: A patient s doctor uses the EHR to order lab tests, track health problems and improve the patient s care. Exchange: A patient s information is sent and received in a secure manner between the doctors involved in the patient s care. Ninety-five percent of clinics have an EHR installed and have it in use in all areas of their clinics. This shows expanded use of EHRs across and within clinics; in 2014, 91 percent of clinics met this threshold, and in 2013 it was 83 percent. The advancements of EHR utilization continue to increase over time. The most advanced phase of utilization, which includes data benchmarking and creating patient preventive exam reminders, saw the greatest reported increase from 44 percent of clinics in 2013 to 60 percent of clinics reporting in 2014 and The ability of clinics to electronically send patient care information directly to other sites of care, both in and out-of-network, increased substantially: 78 percent of clinics exchanged patient information within their network as compared to 55 percent last year; and in 2015, two-thirds of clinics are able to exchange patient information with hospitals outside of their network. The HIT Survey will be fielded again in MNCM will continue to collaborate with HIT stakeholders statewide to implement a survey that provides a comprehensive assessment of HIT adoption, utilization, and exchange as well as continue to incorporate Meaningful Use Stage 2 guidelines.

9 Executive Summary Hospital measures For more information on hospital measures developed by the Agency for Healthcare Research and Quality (AHRQ) and Centers for Medicare and Medicaid Services (CMS), see page 201. Results for AHRQ, CMS, and H-CAHPS hospital measures can be found at MNHealthScores.org. 9

10 Changes to the Report This report features an indicator (*) for the Top 5 performers for medical groups and Top 15 performers for clinics. This is aligned with our consumer-focused website, MNHealthScores.org. In 2014 s report, Top 15 performers were identified at both the medical group and clinic level. Charts for clinic and medical group level results are no longer included in this report since the newly re-designed MNHealthScores.org provides this information in convenient, sortable tables for view and download. There were several new measures added to this year s report: Pediatric Preventive Care: Adolescent Mental Health and/or Depression Screening Pediatric Preventive Care: Overweight Counseling Spinal Surgery: Lumbar Discectomy/Laminotomy Spinal Surgery: Lumbar Spinal Fusion Total Knee Replacement (functional status) There were several measures that underwent a measure specification change: Optimal Diabetes Care Optimal Vascular Care Optimal Asthma Control - Children Optimal Asthma Control - Adults Controlling High Blood Pressure In 2014, the Cervical Cancer Screening measure underwent review by the MNCM Measurement and Review Committee (MARC) to compare the administrative method of data collection to the hybrid method. The measure was suppressed from public reporting in Results for this measure, using the hybrid data collection method, are included in the 2015 report. 10

11 Measure Overview The measures in this 2015 Health Care Quality Report were recommended by MNCM s Measurement and Reporting Committee (MARC) and approved by our Board of Directors. We have expanded, revised, and retired measures to stay aligned with evidence-based guidelines. Measurement changes across years are reflected in Table 1. Measures 11 Medical Group Results (Data Source: Health Plans & Medical Groups) Appropriate Testing for Children with Pharyngitis Appropriate Treatment for Children with Upper Respiratory Infection Avoidance of Antibiotics in the Treatment of Adult Bronchitis Childhood Immunization Status - Combo 3 Immunizations for Adolescents Well Child Visits (Retired due to measure inconsistencies with guidelines) Use of Appropriate Medications for People with Asthma (Ages 5-50) (Retired and replaced with measures that use data submitted by medical groups) Breast Cancer Screening (Ages 50-74) Cervical Cancer Screening (Ages 24-64) Colorectal Cancer Screening (Ages 51-75) (Retired and replaced with measure that uses data submitted by medical groups) Cancer Screening Combined (Breast, Cervical, Colorectal) (Ages 51-75) (Retired due to retirement of Colorectal Cancer Screening; used same denominator) Chlamydia Screening in Women (Ages 16-24) Controlling High Blood Pressure <140/90 mmhg Optimal Diabetes Care (Retired and replaced with measure that uses data submitted by medical groups) Optimal Vascular Care (Retired and replaced with measure that uses data submitted by medical groups) Depression Treatment - Acute Phase Medication Management (Retired and replaced with measure that uses data submitted by medical groups) Depression Treatment - Continuous Phase Medical Management (Retired and replaced with measure that uses data submitted by medical groups) Use of Spirometry Testing in the Assessment and Diagnosis COPD Follow-up Care for Children Prescribed ADHD Medication Maternity Care: Primary C-Section Rate Total Knee Replacement Spinal Surgery: Lumbar Discectomy/Laminotomy Spinal Surgery: Lumbar Spinal Fusion Total Clinics (# Medical Groups/# Clinics) Patient Experience of Care: Clinics (repeated every other year) Health Information Technology (HIT) Hospital Payment by Procedure Total Cost of Care TABLE 1: PERFORMANCE MEASURES OVER THE YEARS * Childhood Immunization Status - Combo 2 only ** Chlamydia Screening in Women - Ages *** Controlling High Blood Pressure - <=140/90 mmhg ^ Optimal Diabetes Care - Hem A1c <=8, Blood Pressure <130/85, LDL-C <130 mg/dl, Aspirin Use, Tobacco Free ^^ Optimal Diabetes Care - Hem A1c <=8, Blood Pressure <130/80, LDL-C <100 mg/dl, Aspirin Use, Tobacco Free # Optimal Diabetes Care - Hem A1c<7, Blood Pressure <130/80, LDL-C,100 mg/dl, Aspirin Use, Tobacco Free Optimal Vascular Care - Blood Pressure <130/80, LDL-C,100 mg/dl, Aspirin Use, Tobacco Free ` Optimal Vascular Care - Blood Pressure <140/90 if co-morbidity of diabetes, <130/80 if IVD only, LDL-C,100 mg/dl, Aspirin Use, Tobacco Free & Use of Appropriate Medications for People with Asthma (Ages 5-56) ~ Colorectal Cancer Screening (Ages 51-80) ~ Cancer Screening Combined (Breast, Cervical, Colorectal) (Ages 51-80) < In 2009 reported AHRQ measures only; in 2010 and 2011 reported AHRQ and CMS hospital measures + Breast Cancer Screening (Ages 50-69) ##Cervical Cancer Screening - administrative measure **^ Controlling High Blood Pressure <140/90mmHg ^^^ Optimal Diabetes Care - Hem A1c <8, Blood Pressure <140/90, LDL-C<100 mg/dl, Aspirin Use, Tobacco Free `` Optimal Vascular Care - Blood Pressure <140/90, LDL-C<100 mg/dl, Aspirin Use, Tobacco Free *# Optimal Asthma Care - Asthma well controlled, patient hospital and emergency room visits <2, written asthma management plan *& Total Knee Replacement - three process measures Total Medical Groups Clinic Results (Data Source: Medical Groups) Optimal Diabetes Care (ODC) Optimal Coronary Artery Diesase (CAD) Care (Retired and replaced with OVC) Optimal Vascular Care (OVC) Depression Remission at Six Months Depression Response at Six Months Depression Remission at 12 Months Depression Response at 12 Months Optimal Asthma Control- Ages 5-17 and Ages Colorectal Cancer Screening PHQ-9 Follow-Up at Six Months PHQ-9 Follow-Up at Twelve Months PHQ-9 Utilization Pediatric Preventive Care: Adolescent Mental Health Screening Pediatric Preventive Care: Overweight Counseling Other Results * * # Report Year & & & & & & ## ## ## ## ## ## ## ## ## ## ~ ~ ~ ~ ~ ~ ~ ~ ** ** ** ** ** *** *** *** **^ **^ **^ **^ **^ **^ ^# ^# ^# # # # # # < ^^ ^^^ ` `` 28/191 62/321 70/ / / / / / /911 *# ^^^ *# **^ ^^^ `` *# **^ *& ^^^ `` *#

12 Measure Overview The 2015 Health Care Quality Report is the second report to feature information on all three elements necessary to reach optimal health care performance: quality, patient experience and cost. The Quality section features information on 32 measures. There are seven new ambulatory care measures: Pediatric Prevent Care: Adolescent Mental Health and/or Depression Screening, Pediatric Preventive Care: Overweight Counseling, Spinal Surgery: Lumbar Discectomy/Laminotomy (two measures), Spinal Surgery: Lumbar Spinal Fusion (two measures) and Total Knee Replacement (functional status). There were six measures with measure specification changes in 2015: Optimal Diabetes Care, Optimal Vascular Care, Optimal Asthma Control - Adults Ages 18-50, Optimal Asthma Control - Children Ages 5-17 Cervical Cancer Screening and Controlling High Blood Pressure. The remaining ambulatory care quality measures are organized into the following categories based on the statewide average: Increases: Large, moderate, and small Decreases: Large, moderate, and small Please see page 408 for category definitions. Two measures had large increases in their statewide average: Immunizations for Adolescents and Avoidance of Antibiotics in the Treatment of Adult Bronchitis. Two measures had moderate increases in their statewide average: Depression PHQ-9 Follow-Up at Six Months and Depression PHQ-9 Follow-Up at 12 Months. Eight measures had small increases in their statewide average: Colorectal Cancer Screening, Chlamydia Screening in Women, Depression Response at Six Months, Appropriate Testing for Children with Pharyngitis, Depression Response at Twelve Months, Appropriate Treatment for Children with URI, Depression Remission at Six Months and Depression Remission at 12 Months. Six measures had small decreases in their statewide average: Use of Spirometry Testing in the Assessment and Diagnosis of COPD, Maternity Care: Primary C-Section Rate, PHQ-9 Utilization, Breast Cancer Screening, Follow-up Care for Children Prescribed ADHD Medication and Childhood Immunization Status (Combo 3). In 2015, no measures had moderate or large decreases in statewide rates between 2014 and 2015; therefore, those categories are not included in this report. Two types of measures are included in this section: Direct Data Submission (DDS) measures and HEDIS measures. DDS measures can be reportable on both the clinic and/or medical group levels. These measures relied on data specifications published in the 2015 Direct Data Submission Guides for each applicable measure. These measures are aligned with clinical guidelines established by the Institute for Clinical Systems Improvement (ICSI). This report includes 18 DDS measures: Pediatric Preventive Care: Adolescent Mental Health Screening, Pediatric Preventive Care: Overweight Counseling, Spinal Surgery: Lumbar Discectomy/Laminotomy, Spinal Surgery: Lumbar Spinal Fusion, Total Knee Replacement, Optimal Diabetes Care, Optimal Vascular Care, Optimal Asthma Control - Adults Ages 18-50, Optimal Asthma Control - Children Ages 5-17, Depression PHQ-9 Follow-up at Six Months, Depression PHQ-9 Follow-up at 12 Months, Colorectal Cancer Screening, Depression Response at Six Months, Depression Response at 12 Months, Depression Remission at Six Months, Depression Remission at 12 Months, Maternity Care: Primary C-Section Rate and PHQ-9 Utilization. HEDIS measures use data collected from health plan claims data. Health plan data collection uses either the administrative method (claims only) or hybrid method (claims plus chart review). Measures using health plan data relied on National Committee for Quality Assurance s (NCQA) HEDIS specifications, which are also aligned with ICSI s clinical guidelines. HEDIS is a national set of standardized performance measures originally designed for the managed care industry. 12

13 Measure Overview The measures have been adopted for use by MNCM to evaluate the performance of medical groups. MNCM reports on 11 HEDIS measures: Cervical Cancer Screening, Controlling High Blood Pressure, Immunizations for Adolescents, Avoidance of Antibiotics in the Treatment of Adult Bronchitis, Chlamydia Screening in Women, Appropriate Treatment for Children with URI, Use of Spirometry Testing in the Assessment and Diagnosis of COPD, Breast Cancer Screening, Follow-up Care for Children Prescribed ADHD Medication and Childhood Immunization Status (Combo 3). The Quality section also features information on hospital quality measures. These measures are developed by the Agency for Healthcare Research and Quality (ARHQ) and the Centers for Medicare and Medicaid Services (CMS). Results are provided to MNCM by the Minnesota Hospital Association (MHA) for public reporting. The Patient Experience section features information on both ambulatory care and hospital patient experience. The ambulatory care patient experience data utilizes the CG-CAHPS 12-month survey and is implemented throughout the state every-other-year. In 2013, MNCM published the first year of statewide patient experience survey results. This year s report includes 2015 Patient Experience of Care results. The hospital patient experience data utilizes the H-CAHPS survey designed for hospitals, and is reported annually. These results are also provided to MNCM by MHA for public reporting. The Cost section includes information on Total Cost of Care. There is Total Cost of Care Overall, which is also segmented by adults and pediatric patients. This measure uses data (commercial only) collected from four health plans in Minnesota: Blue Cross Blue Shield of Minnesota, HealthPartners, Medica and PreferredOne. It includes all costs associated with treating patients, including professional, facility inpatient and outpatient, pharmacy, lab, radiology, ancillary and behavioral health services. Finally, the Health Information Technology section includes information on how well ambulatory care clinics have integrated electronic medical records into their practices. This information is based on an annual survey conducted by MNCM on behalf of the Minnesota Department of Health. See the Methods appendix for more information on the methodology for each measure. In the Results by Measure section, results are listed with a description of the measure; charts, tables and figures describing the results; and a listing of performance highlights for that measure. 13

14 Please see next page. 14

15 RESULTS BY MEASURE New Measures/Measures with Specification Changes for 2015 Reporting Section Contents Cervical Cancer Screening Measures the percentage of women ages who were screened for cervical cancer during the measurement year. Pediatric Preventive Care: Adolescent Mental Health and/or Depression Screening Measures the percentage of pediatric patients ages who had a documented mental health and/or depression screening at a well-child visit. Pediatric Preventive Care, Overweight Counseling Measures the percentage of pediatric patients ages 3-17 who had an overweight or obesity assessment at a well-child visit and if the BMI percentile is greater than or equal to 85, had appropriate documentation of counseling for physical activity and nutrition. Spinal Surgery: Lumbar Discectomy/Laminotomy measures Percent of procedures with both pre-operative and three months post-operative Oswestry Disability Index (ODI) administered. Average change in ODI at three months post-operative (functional status). Spinal Surgery, Lumbar Spinal Fusion measures Percent of procedures with both pre-operative and one year post-operative Oswestry Disability Index (ODI) administered. Average change in ODI at one year post-operative (functional status). Total Knee Replacement measures Percent of procedures with both pre-operative and one year post-operative Oxford Knee Score (OKS) administered. Average OKS change at one year post-operative (functional status). Optimal Diabetes Care Measures the percentage of adult patients who have type 1 or type 2 diabetes with optimally managed modifiable risk factors. Optimal Vascular Care Measures the percentage of adult patients who have ischemic vascular disease (IVD) with optimally managed modifiable risk factors. Optimal Asthma Control Measures the percentage of children (ages 5-17) and adult (ages 18-50) patients who have asthma and meet specified targets to control their asthma. Controlling High Blood Pressure Measures the percentage of patients ages who had a diagnosis of hypertension (HTN) and whose blood pressure was adequately controlled during the measurement year. 15

16 NEW MEASURES/ MEASURES WITH SPECIFICATION CHANGES FOR 2015 REPORTING Cervical Cancer Screening This measures the percentage of women ages who were screened for cervical cancer during the measurement year using either of two criteria: women age who had a cervical cytology performed every three years or women age who had cervical cytology/human papillomavirus co-testing performed every five years. The data collection method changed from administrative to hybrid. Due to this change, no trend data is available for this measure at this time. The statewide rate for Breast Cancer Screening is 72 percent. Table 2 displays the details of this statewide rate. Data for this measure are collected from health plan claims. TABLE 2: STATEWIDE RATE FOR CERVICAL CANCER SCREENING Statewide Average (Weighted) 95% Cl Numerator Denominator (Patients who met treatment goals) (Patients Sampled) Total Eligible Cervical Cancer Screening 71.8% 70.9%-72.7% 6,231 9, ,247 *Statewide Average (above) includes those patients attibuted to a medical group AND those who could not be attributed to a medical group. THERE IS NO TREND CHART SINCE DATA COLLECTION METHODOLOGY CHANGED THIS YEAR. 16

17 PERFORMANCE HIGHLIGHTS FOR CERVICAL CANCER SCREENING Medical Group Results Highest performers in 2015 Medical group results showed that an average of 78 percent of women years of age received cervical cancer screening. Essentia Health Central Region set the benchmark of 90 percent. Six out of 24 medical groups had rates and confidence intervals fully above the medical group average. These groups are listed below from high to low performance. An asterisk (*) indicates a Top 5 performer for this measure. Essentia Health - Central Region* Unity Family Healthcare Avon* Fairview Medical Group* Mayo Clinic Health System-Owatonna* Park Nicollet Health Services* Allina Health Specialties Biggest improvement from Not applicable due to change in data collection methodology. Medical group performance over time ( ) Not applicable due to change in data collection methodology. 17

18 Please see next page. 18

19 NEW MEASURES/ MEASURES WITH SPECIFICATION CHANGES FOR 2015 REPORTING Pediatric Preventive Care: Adolescent Mental Health and/or Depression Screening This measure assesses the percentage of adolescent patients age who was administered a mental health and/or depression screening tool at a well-child visit. The following tools were acceptable for this measure: Patient Health Questionnaire - 9 item version (PHQ-9) PHQ-9M Modified for Teens/Adolescents Kutcher Depression Scale (KADS) Beck Depression Inventory II (BDI-II) Beck Depression Inventory Fast Screen (BDI-FS) Child Depression Inventory (CDI) Child Depression Inventory II (CDI-2) Patient Health Questionnaire - PHQ-2 Pediatric Symptom Checklist - 17 items (PSC-17) Pediatric Symptom Checklist - 35 items (PSC-35) or Youth Self Report (PCS Y-SR) Global Appraisal of Individual Needs (GAIN-SS) screens for mental health and substance abuse The statewide rate for this measure is 40 percent. Table 3 displays the details of this statewide rate. This is a first year measure so trending over time is not available. Data collected for this measure are submitted directly to MNCM by medical groups from electronic health records or paperbased medical charts. TABLE 3: STATEWIDE RATE FOR PEDIATRIC PREVENTIVE CARE: ADOLESCENT MENTAL HEALTH SCREENING Statewide Average (Weighted) 95% Cl Numerator Denominator (Patients who were screened) (Patients Sampled) Total Eligible Pediatric Preventive Care: Adolescent Mental Health and/or Depression Screening 39.9% 39.6%-40.2% 37, , ,399 THERE IS NO TREND CHART BECAUSE THIS IS THE FIRST YEAR OF PUBLIC REPORTING FOR THIS MEASURE. 19

20 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: ADOLESCENT MENTAL HEALTH AND/OR DEPRESSION SCREENING Clinic Results Highest performers in 2015 Clinic results showed an average of 40 percent of pediatric patients ages who had a documented mental health and/or depression screening at a well-child visit. South Lake Pediatrics Eden Prairie set the benchmark of 100 percent. There were 143 of 512 clinics with rates and confidence interval fully above the statewide average. The high performing clinics are listed below in alphabetical order under their medical group name. An asterisk (*) indicates Top 15 performers for this measure. AALFA Family Clinic Affiliated Community Medical Centers Affiliated Community Medical Centers - Benson Clinic Affiliated Community Medical Centers - New London Clinic All About Children Pediatrics - Children s Health Network Allina Health - Annandale Allina Health - Bandana Square (Aspen) Allina Health - Blaine Allina Health - Bloomington (Aspen) Allina Health - Brooklyn Park Allina Health - Buffalo Allina Health - Burnsville (Quello) Allina Health - Cambridge Allina Health - Centennial Lakes (Quello) Allina Health - Champlin Allina Health - Coon Rapids Allina Health - Cottage Grove Allina Health - Eagan Allina Health - East Lake Street (Aspen) Allina Health - Elk River Allina Health - Faribault Allina Health - Farmington Allina Health - Forest Lake Allina Health - Highland Park (Aspen) Allina Health - Maplewood (Aspen) Allina Health - Nininger Road Allina Health - Ramsey Allina Health - Savage (Quello) Allina Health - Shoreview Allina Health - St. Francis Health Services - Jordan Allina Health - West St. Paul Allina Health Specialties Allina Health Specialties - New Ulm Medical Center Cedar Riverside People s Center Cedar Riverside People s Center - People s Center Medical Clinic CentraCare Health CentraCare Health- Melrose CentraCare Health Plaza- Pediatrics CentraCare Health Plaza-Family Medicine Central Pediatrics Central Pedatrics St. Paul Central Pediatrics Woodbury Children s Hospitals and Clinics of Minnesota Children s General Pediatric Clinic - Minneapolis Children s General Pediatric Clinic - St. Paul Metropolitan Pediatric Specialists - Burnsville Metropolitan Pediatric Specialists - Edina Metropolitan Pediatric Specialists - Shakopee Northeast Pediatric Clinic Partners in Pediatrics Brooklyn Park* Partners in Pediatrics Calhoun* Partners in Pediatrics Maple Grove* Partners in Pediatrics Plymouth* Partners in Pediatrics Rogers* Dakota Pediatrics, P.A. Eagan Valley Pediatrics Entira Family Clinics Entira Family Clinics - Highland Entira Family Clinics - Shoreview Entira Family Clinics - West St. Paul Entira Family Clinics - White Bear Lake/Banning Ave Fairview Health Services Fairview Bloomington Lake Minneapolis Fairview Bloomington Lake erxes Fairview EdenCenter Clinic Fairview Rogers Clinic Fairview Mesaba Clinics Range Regional Health Services dba Fairview Mesaba Clinic - Hibbing Range Regional Health Services dba Fairview Mesaba Clinic - Mountain Iron Range Regional Health Services dba Fairview Mesaba Clinic - Nashwauk Fridley Children s & Teenagers Medical Center - Children s Physician Network* Glencoe Regional Health Services Glencoe Regional Health Services - Lester Prairie Gundersen Health System Gundersen Health System - La Crescent Clinic Gundersen Health System - Spring Grove Clinic HealthPartners Central Minnesota Clinics HealthPartners Clinics HealthPartners - Andover HealthPartners - Anoka HealthPartners - Apple Valley HealthPartners - Arden Hills HealthPartners - Bloomington HealthPartners - Brooklyn Center HealthPartners - Como HealthPartners - Coon Rapids HealthPartners - Cottage Grove HealthPartners - Eagan HealthPartners - Elk River HealthPartners - Highland Park HealthPartners - Inver Grove Heights HealthPartners - Lino Lakes HealthPartners - Maplewood HealthPartners - Midway HealthPartners - Nokomis HealthPartners - Riverside HealthPartners - Roseville HealthPartners - St Paul HealthPartners - West HealthPartners - White Bear Lake HealthPartners - Woodbury Hennepin County Medical Center (HCMC) Clinics Hennepin County Medical Center (HCMC) Clinics - Brooklyn Park Clinic Hennepin County Medical Center (HCMC) Clinics - Downtown Pediatric Clinic Hennepin County Medical Center (HCMC) Clinics - Richfield Clinic Integrity Health Network St. Cloud Medical Group - Clearwater IHN* St. Cloud Medical Group - Cold Spring -IHN St. Cloud Medical Group - NW- IHN St. Cloud Medical Group - South -IHN Lac Qui Parle Clinic Mankato Clinic, Ltd. Mankato Clinic - Children s Health Center Mankato Clinic - Daniel s Health Center Mankato Clinic - Main Street Mankato Clinic - North Mankato Mankato Clinic - Wickersham Campus Mayo Clinic Mayo Clinic - Baldwin Building, Pediatrics Mayo Clinic - Kasson Mayo Clinic - Northeast Mayo Clinic - Northwest Mayo Clinic Health System Mayo Clinic Health System Albert Lea 20

21 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: ADOLESCENT MENTAL HEALTH AND/OR DEPRESSION SCREENING Clinic Results Mayo Clinic Health System Austin Mayo Clinic Health System Faribault Hwy 60 Mayo Clinic Health System Mankato Specialty Clinic Mayo Clinic Health System Red Wing Mendakota Pediatrics Ltd Multicare Associates Multicare Associates - Fridley Medical Center Native American Community Clinic North Metro Pediatrics* Northwest Family Physicians Northwest Family Physicians - Plymouth Northwest Family Physicians - Rogers Olmsted Medical Center Olmsted Medical Center - Byron Clinic Olmsted Medical Center - Plainview Clinic Olmsted Medical Center - Rochester Southeast Open Door Health Center Pediatric Services - Children s Physician Network South Lake Pediatrics South Lake Pediatrics Chaska* South Lake Pediatrics - Childrens West* South Lake Pediatrics - Eden Prairie* South Lake Pediatrics - Maple Grove* South Lake Pediatrics - Minnetonka South Lake Pediatrics Plymouth* Southdale Pediatric Associates, Ltd Southdale Pediatric Associates, Ltd - Eden Prairie Southdale Pediatric Associates, Ltd - Edina St. Luke s Clinics St Luke s Clinics-Lester River St Luke s Clinics-Mount Royal St Luke s Clinics-P.S. Rudie Medical Clinic St Luke s Clinics-Pediatrics Stillwater Medical Group Stillwater Medical Group - Curve Crest Clinic Stillwater Medical Group - Mahtomedi Clinic University of Minnesota Physicians University of Minnesota Physicians - Bethesda Family Medicine Clinic Wayzata Children s Clinic Wayzata Children s Clinic - Chaska Wayzata Children s Clinic Delano* Wayzata Children s Clinic - Minnetonka Wayzata Children s Clinic - Spring Park West Side Community Health Services West Side Community Health Services - La Clinica Winona Health Services Winona Health - Rushford Clinic Winona Health - Winona Clinic Biggest improvement from Not applicable because this is a first year measure. Clinic performance over time ( ) Not applicable because this is a first year measure. 21

22 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: ADOLESCENT MENTAL HEALTH AND/OR DEPRESSION SCREENING Regional Clinic Results Highest performers in 2015 by region Clinic results showed differences in performance among the different geographic regions in Minnesota. Boundaries of the nine regions were determined by synthesizing health care and geopolitical data, including from the Metropolitan Council and State of Minnesota. The results have been organized to identify areas of the state with the highest proportion of high-performing clinics. The nine regions are listed below based on their proportion of high-performing clinics from high to low. The number of high-performing clinics is shown along with the total number of clinic sites that submitted data for this measure. The high-performing clinics are listed in under their medical group name alphabetical order by region. West Metro - 34 out of 85 (40 percent) All About Children Pediatrics - Children s Health Network All About Children Pediatrics, P.A. Allina Health - Bloomington (Aspen) Allina Health - Brooklyn Park Allina Health - Centennial Lakes (Quello) Allina Health - Champlin Allina Health - Savage (Quello) Allina Health - St. Francis Health Services - Jordan Children s Hospitals and Clinics of Minnesota Metropolitan Pediatric Specialists - Edina Metropolitan Pediatric Specialists - Shakopee Partners in Pediatrics Brooklyn Park Partners in Pediatrics Calhoun Partners in Pediatrics Maple Grove Partners in Pediatrics Plymouth Partners in Pediatrics Rogers Fairview Health Services Fairview Bloomington Lake erxes Fairview EdenCenter Clinic Fairview Rogers Clinic HealthPartners Clinics HealthPartners - Bloomington HealthPartners - Brooklyn Center HealthPartners - West Hennepin County Medical Center (HCMC) Clinics Hennepin County Medical Center (HCMC) Clinics - Brooklyn Park Clinic Northwest Family Physicians Northwest Family Physicians - Plymouth Northwest Family Physicians - Rogers Pediatric Services - Children s Physician Network Pediatric Services South Lake Pediatrics South Lake Pediatrics - Childrens West South Lake Pediatrics - Eden Prairie South Lake Pediatrics - Maple Grove South Lake Pediatrics - Minnetonka South Lake Pediatrics - Plymouth Southdale Pediatric Associates, Ltd Southdale Pediatric Associates, Ltd - Eden Prairie Southdale Pediatric Associates, Ltd - Edina Wayzata Children s Clinic Wayzata Children s Clinic - Chaska Wayzata Children s Clinic - Minnetonka Wayzata Children s Clinic - Spring Park East Metro - 39 out of 88 (44 percent) AALFA Family Clinic Allina Health - Blaine Allina Health - Burnsville (Quello) Allina Health - Coon Rapids Allina Health - Cottage Grove Allina Health - Eagan Allina Health - Farmington Allina Health - Forest Lake Allina Health - Maplewood (Aspen) Allina Health - Nininger Road Allina Health - Ramsey Allina Health - Shoreview Allina Health - West St. Paul Central Pediatrics Central Pediatrics Woodbury Children s Hospitals and Clinics of Minnesota Metropolitan Pediatric Specialists - Burnsville Northeast Pediatric Clinic Dakota Pediatrics, P.A. Eagan Valley Pediatrics Entira Family Clinics Entira Family Clinics - Shoreview Entira Family Clinics - West St. Paul Entira Family Clinics - White Bear Lake/ Banning Ave Fridley Children s & Teenagers Medical Center HealthPartners Clinics HealthPartners - Andover HealthPartners - Anoka HealthPartners - Apple Valley HealthPartners - Arden Hills HealthPartners - Coon Rapids HealthPartners - Cottage Grove HealthPartners - Eagan HealthPartners - Inver Grove Heights HealthPartners - Lino Lakes HealthPartners - Maplewood HealthPartners - Roseville HealthPartners - White Bear Lake HealthPartners - Woodbury Mendakota Pediatrics Ltd Multicare Associates Multicare Associates - Fridley Medical Center North Metro Pediatrics Stillwater Medical Group Stillwater Medical Group - Curve Crest Clinic 22

23 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: ADOLESCENT MENTAL HEALTH AND/OR DEPRESSION SCREENING Regional Clinic Results Central - 14 out of 64 (22 percent) Allina Health - Annandale Allina Health - Buffalo Allina Health - Cambridge Allina Health - Elk River CentraCare Health CentraCare Health- Melrose CentraCare Health Plaza- Pediatrics CentraCare Health Plaza-Family Medicine HealthPartners Central Minnesota Clinics HealthPartners Clinics HealthPartners - Elk River Integrity Health Network St. Cloud Medical Group - Clearwater - IHN St. Cloud Medical Group - Cold Spring -IHN St. Cloud Medical Group - NW- IHN St. Cloud Medical Group - South -IHN Wayzata Children s Clinic Wayzata Children s Clinic - Delano Minneapolis - Nine out of 29 (31 percent) Allina Health - East Lake Street (Aspen) Cedar Riverside People s Center Cedar Riverside People s Center - People s Center Medical Clinic Children s Hospitals and Clinics of Minnesota Children s General Pediatric Clinic - Minneapolis Fairview Health Services Fairview Bloomington Lake Minneapolis HealthPartners Clinics Saint Paul - 11 out of 24 (46 percent) Allina Health - Bandana Square (Aspen) Allina Health - Highland Park (Aspen) Central Pediatrics Central Pedatrics St. Paul Children s Hospitals and Clinics of Minnesota Children s General Pediatric Clinic - St. Paul Entira Family Clinics Entira Family Clinics - Highland HealthPartners Clinics HealthPartners - Nokomis HealthPartners - Riverside Hennepin County Medical Center (HCMC) Clinics Hennepin County Medical Center (HCMC) Clinics - Downtown Pediatric Clinic Hennepin County Medical Center (HCMC) Clinics - Richfield Clinic Native American Community Clinic HealthPartners - Como HealthPartners - Highland Park HealthPartners - Midway HealthPartners - St Paul University of Minnesota Physicians University of Minnesota Physicians - Bethesda Family Medicine Clinic West Side Community Health Services West Side Community Health Services - La Clinica Southeast - 25 out of 59 (42 percent) Allina Health - Faribault Allina Health Specialties Allina Health Specialties - New Ulm Medical Center Gundersen Health System Gundersen Health System - La Crescent Clinic Gundersen Health System - Spring Grove Clinic Mankato Clinic, Ltd. Mankato Clinic - Children s Health Center Mankato Clinic - Daniel s Health Center Mankato Clinic - Main Street Mankato Clinic - North Mankato Mankato Clinic - Wickersham Campus Mayo Clinic Mayo Clinic - Baldwin Building, Pediatrics Mayo Clinic - Kasson Mayo Clinic - Northeast Mayo Clinic - Northwest Mayo Clinic Health System Mayo Clinic Health System Albert Lea Mayo Clinic Health System Austin Mayo Clinic Health System Faribault Hwy 60 Mayo Clinic Health System Mankato Specialty Clinic Mayo Clinic Health System Red Wing Olmsted Medical Center Olmsted Medical Center - Byron Clinic Olmsted Medical Center - Plainview Clinic Olmsted Medical Center - Rochester Southeast Open Door Health Center South Lake Pediatrics South Lake Pediatrics - Chaska Winona Health Services Winona Health - Rushford Clinic Winona Health - Winona Clinic 23

24 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: ADOLESCENT MENTAL HEALTH AND/OR DEPRESSION SCREENING Regional Clinic Results Northeast - Seven out of 31 (23 percent) Fairview Mesaba Clinics Range Regional Health Services dba Fairview Mesaba Clinic - Hibbing Range Regional Health Services dba Fairview Mesaba Clinic - Mountain Iron Range Regional Health Services dba Fairview Mesaba Clinic - Nashwauk St. Luke s Clinics St Luke s Clinics-Lester River St Luke s Clinics-Mount Royal St Luke s Clinics-P.S. Rudie Medical Clinic St Luke s Clinics-Pediatrics Southwest - Four out of 39 (10 percent) Affiliated Community Medical Centers Affiliated Community Medical Centers - Benson Clinic Affiliated Community Medical Centers - New London Clinic Glencoe Regional Health Services Glencoe Regional Health Services - Lester Prairie Lac Qui Parle Clinic 24

25 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: ADOLESCENT MENTAL HEALTH AND/OR DEPRESSION SCREENING Medical Group Results Highest performers in 2015 Results by medical group showed an average of 40 percent of pediatric patients ages who had a documented mental health and/or depression screening at a well-child visit. South Lake Pediatrics set the benchmark of 99 percent. There were 34 of 105 medical groups with rates and confidence interval fully above the statewide average. The high-performing medical groups are listed below from high to low performance. An asterisk (*) indicates a Top 5 performer for this measure. South Lake Pediatrics* Fridley Children s & Teenagers Medical Center - Children s Physician Network* North Metro Pediatrics* Central Pediatrics* Wayzata Children s Clinic* Mendakota Pediatrics Ltd Pediatric Services - Children s Physician Network All About Children Pediatrics - Children s Health Network Eagan Valley Pediatrics Children s Hospitals and Clinics of Minnesota Winona Health Services AALFA Family Clinic Dakota Pediatrics, P.A. Mankato Clinic, Ltd. Gundersen Health System Lac Qui Parle Clinic HealthPartners Clinics Open Door Health Center Stillwater Medical Group Fairview Mesaba Clinics Cedar Riverside People s Center Southdale Pediatric Associates, Ltd HealthPartners Central Minnesota Clinics CentraCare Health Northwest Family Physicians Mayo Clinic Native American Community Clinic Allina Health Specialties St. Luke s Clinics Olmsted Medical Center Entira Family Clinics Hennepin County Medical Center (HCMC) Clinics Integrity Health Network Biggest improvement from Not applicable because this is a first year measure. Medical group performance over time ( ) Not applicable because this is a first year measure. 25

26 Please see next page. 26

27 NEW MEASURES/ MEASURES WITH SPECIFICATION CHANGES FOR 2015 REPORTING Pediatric Preventive Care: Overweight Counseling This measure assesses the percentage of pediatric patients ages 3-17 who had an overweight or obesity assessment at a well-child visit. If the BMI percentile was greater than or equal to 85, the patient had appropriate documentation of counseling for physical activity and nutrition. The statewide rate for this measure is 85 percent. Table 4 displays the details of this statewide rate. This is a first year measure so trending over time is not available. Data collected for this measure are submitted directly to MNCM by medical groups from electronic health records or paperbased medical charts. TABLE 4: STATEWIDE RATE FOR PEDIATRIC PREVENTIVE CARE: OVERWEIGHT COUNSELING Statewide Average 95% Cl Numerator Denominator (Patients who received counseling) (Patients Sampled) Total Eligible Pediatric Preventive Care: Overweight Counseling 85.3% 80,536 97, ,627 THERE IS NO TREND CHART BECAUSE THIS IS THE FIRST YEAR OF PUBLIC REPORTING FOR THIS MEASURE. 27

28 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: OVERWEIGHT COUNSELING Clinic Results Highest performers in 2015 Clinic results showed an average of 85 percent of pediatric patients ages 3-17 had appropriate documentation of counseling for physical activity and nutrition if their BMI percentile from an overweight or obesity assessment was greater than or equal to 85. There were 71 clinics that set the benchmark of 100 percent. There were 229 of 458 clinics with rates and confidence interval fully above the statewide average. The high performing clinics are listed below in alphabetical order under their medical group name. Due to the high number of clinics that achieved a rate of 100%, there is no Top 15 performer indication. Affiliated Community Medical Centers Affiliated Community Medical Centers - Benson Clinic Affiliated Community Medical Centers - Granite Falls Clinic Affiliated Community Medical Centers - Litchfield Clinic (East) Affiliated Community Medical Centers - Litchfield Clinic (West) Affiliated Community Medical Centers - New London Clinic Affiliated Community Medical Centers - Redwood Falls Clinic Affiliated Community Medical Centers - Willmar Clinic Affiliated Community Medical Centers- Marshall Clinic Alexandria Clinic Alexandria Clinic, A Service of Douglas County Hospital All About Children Pediatrics - Children s Health Network Allina Health - Annandale Allina Health - Bandana Square (Aspen) Allina Health - Blaine Allina Health - Bloomington (Aspen) Allina Health - Brooklyn Park Allina Health - Cambridge Allina Health - Centennial Lakes (Quello) Allina Health - Champlin Allina Health - Cokato Allina Health - Coon Rapids Allina Health - Cottage Grove Allina Health - Eagan Allina Health - East Lake Street (Aspen) Allina Health - Elk River Allina Health - Faribault Allina Health - Farmington Allina Health - First Street Allina Health - Forest Lake Allina Health - Inver Grove Heights (Aspen) Allina Health - Lakeville (Quello) Allina Health - Maple Grove Allina Health - Maplewood (Aspen) Allina Health - Nininger Road Allina Health - North Branch Allina Health - Northfield Allina Health - Ramsey Allina Health - Richfield Allina Health - Shakopee Allina Health - Shoreview Allina Health - St. Michael Allina Health - West St. Paul Allina Health - Woodbury Altru Health System Altru Health System - Main Catalyst Medical Clinic Cedar Riverside People s Center Cedar Riverside People s Center - People s Center Medical Clinic CentraCare Family Health Center CentraCare Health CentraCare Clinic - Becker CentraCare Health Plaza- Pediatrics Central Pediatrics Central Pedatrics St. Paul Central Pediatrics Woodbury Children s Hospitals and Clinics of Minnesota Children s General Pediatric Clinic - Minneapolis Children s General Pediatric Clinic - St. Paul Children s Pediatric & Adolescent Care of Minnesota (PACE) - West St. Paul Metropolitan Pediatric Specialists - Burnsville Metropolitan Pediatric Specialists - Edina Metropolitan Pediatric Specialists - Shakopee Northeast Pediatric Clinic Partners in Pediatrics Brooklyn Park Partners in Pediatrics Calhoun Partners in Pediatrics Maple Grove Partners in Pediatrics Plymouth Partners in Pediatrics Rogers Community University Health Care Center Dakota Pediatrics, P.A. Duluth Family Medicine Clinic Eagan Valley Pediatrics Essentia Health Ada Essentia Health - Central Region Essentia Health St. Joseph s - Brainerd Clinic Essentia Health St. Joseph s - Pillager Essentia Health St. Joseph s - Pine River Clinic Essentia Health St. Joseph s Baxter Clinic Essentia Health - East Region Essentia Health - Ashland Clinic Essentia Health - Aurora Clinic Essentia Health - Deer River Clinic Essentia Health - Duluth Clinic 1st St Essentia Health - Ely Clinic Essentia Health - Hayward Clinic Essentia Health - Hermantown Clinic Essentia Health - Hibbing Clinic Essentia Health - International Falls Clinic Essentia Health - Lakeside Clinic Essentia Health - Lakewalk Clinic Essentia Health - Proctor Clinic Essentia Health - Spooner Clinic Essentia Health - St. Mary s-superior Clinic Essentia Health - Virginia Clinic Essentia Health - Fosston Essentia Health - St. Mary s EH- Menahga EH-Park Rapids Essentia Health - Detroit Lakes Essentia Health - West Essentia Health - Moorhead Essentia Health - South University Essentia Health - Wahpeton Essentia Health - West Acres Essentia Health - West Fargo Essentia Health Casselton Fairview Mesaba Clinics Range Regional Health Services dba Fairview Mesaba Clinic - Hibbing Range Regional Health Services dba Fairview Mesaba Clinic - Mountain Iron Range Regional Health Services dba Fairview Mesaba Clinic - Nashwauk FirstLight Health System FirstLight Health System - Mora Fridley Children s & Teenagers Medical Center - Children s Physician Network 28

29 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: OVERWEIGHT COUNSELING Clinic Results Gateway Family Health Clinic Gateway Family Health Clinic - Hinckley Gateway Family Health Clinic - Moose Lake Gateway Family Health Clinic - Sandstone Glencoe Regional Health Services Glencoe Regional Health Services - Glencoe HealthPartners Clinics HealthPartners - Andover HealthPartners - Apple Valley HealthPartners - Arden Hills HealthPartners - Bloomington HealthPartners - Brooklyn Center HealthPartners - Como HealthPartners - Cottage Grove HealthPartners - Eagan HealthPartners - Elk River HealthPartners - Inver Grove Heights HealthPartners - Lino Lakes HealthPartners - Maplewood HealthPartners - Midway HealthPartners - Riverside HealthPartners - Roseville HealthPartners - St Paul HealthPartners - West HealthPartners - White Bear Lake HealthPartners - Woodbury Hennepin County Medical Center (HCMC) Clinics Hennepin County Medical Center (HCMC) Clinics - Brooklyn Park Clinic Hennepin County Medical Center (HCMC) Clinics - Downtown Pediatric Clinic Hennepin County Medical Center (HCMC) Clinics - East Lake Clinic Hennepin County Medical Center (HCMC) Clinics - Golden Valley Clinic Hennepin County Medical Center (HCMC) Clinics - Richfield Clinic Hennepin County Medical Center (HCMC) Clinics - St. Anthony Village Clinic Hennepin County Medical Center (HCMC) Clinics - Whittier Clinic Hutchinson Health Hutchinson Health - Dassel Clinic Indian Health Board of Minneapolis Indian Health Board of Minneapolis Integrity Health Network Buffalo Clinic-Albertville-St. Michael Clinic: IHN Buffalo Clinic-IHN Buffalo Clinic-Monticello: IHN St. Cloud Medical Group - Clearwater - IHN St. Cloud Medical Group - Cold Spring -IHN St. Cloud Medical Group - NW- IHN St. Cloud Medical Group - South -IHN Lac Qui Parle Clinic Lake View Clinic - Two Harbors Mankato Clinic, Ltd. Mankato Clinic - Children s Health Center Mankato Clinic - Daniel s Health Center Mankato Clinic - Main Street Mankato Clinic - Wickersham Campus Mayo Clinic Mayo Clinic - Baldwin Building, Family Medicine Mayo Clinic - Baldwin Building, Pediatrics Mayo Clinic - Kasson Mayo Clinic - Northeast Mayo Clinic - Northwest Mendakota Pediatrics Ltd Native American Community Clinic North Clinic North Clinic - Oakdale Office in Robbinsdale North Clinic - Osseo Office North Clinic - WestHealth Office in Plymouth North Memorial North Memorial Clinic - Arbor Lakes North Memorial Clinic - Brooklyn Park Physicians North Memorial Clinic - Elk River Physicians North Memorial Clinic - Rockford Road North Memorial Clinic, Silver Lake - Blaine North Metro Pediatrics NorthPoint Health & Wellness Center Park Nicollet Health Services Park Nicollet Clinic - Bloomington Park Nicollet Clinic - Brookdale Park Nicollet Clinic - Burnsville Park Nicollet Clinic - Carlson Park Nicollet Clinic - Champlin Park Nicollet Clinic - Eagan Park Nicollet Clinic - Lakeville Park Nicollet Clinic - Maple Grove Park Nicollet Clinic - Minneapolis Park Nicollet Clinic - Plymouth Park Nicollet Clinic - Prairie Center Park Nicollet Clinic - Prior Lake Park Nicollet Clinic - Rogers Park Nicollet Clinic - Shakopee Park Nicollet Clinic - St. Louis Park 3850 Bldg. Park Nicollet Clinic - St. Louis Park Family Medicine Park Nicollet Clinic - Wayzata Pediatric Services - Children s Physician Network Ridgeview Clinics Ridgeview Winsted Clinic Riverwood Healthcare Center Riverwood Aitkin Clinic Sanford Health - Fargo Region Sanford Bemidji 1611 Anne St Clinic Sanford Bemidji Black Duck Clinic Sanford Broadway Clinic Sanford Children s Southwest Clinic Sanford Health Detroit Lakes Clinic Sanford Health Walker Clinic Sanford Moorhead Clinic Sanford Moorhead Family Medicine Sanford Health - Sioux Falls Region Sanford 26th and Sycamore Family Medicine Sanford 41st and Sertoma Family Medicine Sanford Brandon Family Medicine Sanford Canton-Inwood Clinic Sanford Children s Clinic 26th & Sycamore Sanford Children s Clinic 69th & Louise Sanford Children s Clinic Aberdeen Sanford Children s Clinic MB2 Sanford Health Beresford Clinic Sanford Health Ipswich Clinic Sanford Health Mitchell Clinic Sanford Health Watertown Clinic Sanford Luverne Clinic Sanford Tracy Clinic Sanford Westbrook Clinic Scenic Rivers Health Services Scenic Rivers Health Services - Bigfork/Big Falls South Lake Pediatrics South Lake Pediatrics - Eden Prairie South Lake Pediatrics - Maple Grove South Lake Pediatrics - Minnetonka South Lake Pediatrics - Plymouth St. Luke s Clinics St Luke s Clinics-Denfeld St Luke s Clinics-Lester River St Luke s Clinics-Mount Royal St Luke s Clinics-P.S. Rudie Medical Clinic St Luke s Clinics-Pediatrics Stillwater Medical Group Stillwater Medical Group - Curve Crest Clinic Synergy Family Physicians, P.A Tri-County Health Care Tri-County Health Care - Wadena Clinic United Family Medicine Unity Family Healthcare, Family Medical Center Family Medical Center Wayzata Children s Clinic Wayzata Children s Clinic - Chaska 29

30 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: OVERWEIGHT COUNSELING Clinic Results Wayzata Children s Clinic - Delano Wayzata Children s Clinic - Minnetonka Wayzata Children s Clinic - Spring Park West Side Community Health Services West Side Community Health Services - La Clinica West Side Community Health Services - McDonough Homes Clinic Williams Integracare Clinic Integracare Ltd dba Williams Clinic Winona Health Services Winona Health - Winona Clinic Biggest improvement from Not applicable because this is a first year measure. Clinic performance over time ( ) Not applicable because this is a first year measure. 30

31 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: OVERWEIGHT COUNSELING Regional Clinic Results Highest performers in 2015 by region Clinic results showed differences in performance among the different geographic regions in Minnesota. Boundaries of the nine regions were determined by synthesizing health care and geopolitical data, including from the Metropolitan Council and State of Minnesota. The results have been organized to identify areas of the state with the highest proportion of high-performing clinics. The nine regions are listed below based on their proportion of high-performing clinics from high to low. The number of high-performing clinics is shown along with the total number of clinic sites that submitted data for this measure. The high-performing clinics are listed in under their medical group name alphabetical order by region. West Metro - 49 out of 76 (64 percent) All About Children Pediatrics - Children s Health Network Allina Health - Bloomington (Aspen) Allina Health - Brooklyn Park Allina Health - Centennial Lakes (Quello) Allina Health - Champlin Allina Health - Maple Grove Allina Health - Richfield Allina Health - Shakopee Catalyst Medical Clinic Children s Hospitals and Clinics of Minnesota Metropolitan Pediatric Specialists - Edina Metropolitan Pediatric Specialists - Shakopee Partners in Pediatrics Brooklyn Park Partners in Pediatrics Calhoun Partners in Pediatrics Maple Grove Partners in Pediatrics Plymouth Partners in Pediatrics Rogers HealthPartners Clinics HealthPartners - Bloomington HealthPartners - Brooklyn Center HealthPartners - West Hennepin County Medical Center (HCMC) Clinics Hennepin County Medical Center (HCMC) Clinics - Brooklyn Park Clinic Hennepin County Medical Center (HCMC) Clinics - Golden Valley Clinic Hennepin County Medical Center (HCMC) Clinics - St. Anthony Village Clinic North Clinic North Clinic - Oakdale Office in Robbinsdale North Clinic - Osseo Office North Clinic - WestHealth Office in Plymouth North Memorial North Memorial Clinic - Arbor Lakes North Memorial Clinic - Brooklyn Park Physicians North Memorial Clinic - Rockford Road Park Nicollet Health Services Park Nicollet Clinic - Bloomington Park Nicollet Clinic - Brookdale Park Nicollet Clinic - Carlson Park Nicollet Clinic - Champlin Park Nicollet Clinic - Maple Grove Park Nicollet Clinic - Plymouth Park Nicollet Clinic - Prairie Center Park Nicollet Clinic - Prior Lake Park Nicollet Clinic - Rogers Park Nicollet Clinic - Shakopee Park Nicollet Clinic - St. Louis Park 3850 Bldg. Park Nicollet Clinic - St. Louis Park Family Medicine Park Nicollet Clinic - Wayzata Pediatric Services - Children s Physician Network South Lake Pediatrics South Lake Pediatrics - Eden Prairie South Lake Pediatrics - Maple Grove South Lake Pediatrics - Minnetonka South Lake Pediatrics - Plymouth Wayzata Children s Clinic Wayzata Children s Clinic - Chaska Wayzata Children s Clinic - Minnetonka Wayzata Children s Clinic - Spring Park East Metro - 41 out of 69 (59 percent) Allina Health - Blaine Allina Health - Coon Rapids Allina Health - Cottage Grove Allina Health - Eagan Allina Health - Farmington Allina Health - First Street Allina Health - Forest Lake Allina Health - Inver Grove Heights (Aspen) Allina Health - Lakeville (Quello) Allina Health - Maplewood (Aspen) Allina Health - Nininger Road Allina Health - Ramsey Allina Health - Shoreview Allina Health - West St. Paul Allina Health - Woodbury Central Pediatrics 31 Central Pediatrics Woodbury Children s Hospitals and Clinics of Minnesota Children s Pediatric & Adolescent Care of Minnesota (PACE) - West St. Paul Metropolitan Pediatric Specialists - Burnsville Northeast Pediatric Clinic Dakota Pediatrics, P.A. Eagan Valley Pediatrics Fridley Children s & Teenagers Medical Center - Children s Physician Network HealthPartners Clinics HealthPartners - Andover HealthPartners - Apple Valley HealthPartners - Arden Hills HealthPartners - Cottage Grove HealthPartners - Eagan HealthPartners - Inver Grove Heights HealthPartners - Lino Lakes HealthPartners - Maplewood HealthPartners - Roseville HealthPartners - White Bear Lake HealthPartners - Woodbury Mendakota Pediatrics Ltd North Memorial North Memorial Clinic, Silver Lake - Blaine North Metro Pediatrics Park Nicollet Health Services Park Nicollet Clinic - Burnsville Park Nicollet Clinic - Eagan Park Nicollet Clinic - Lakeville Stillwater Medical Group Stillwater Medical Group - Curve Crest Clinic Synergy Family Physicians, P.A

32 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: ADOLESCENT MENTAL HEALTH AND/OR DEPRESSION SCREENING Regional Clinic Results Central - 31 out of 60 (52 percent) Allina Health - Annandale Allina Health - Cambridge Allina Health - Cokato Allina Health - Elk River Allina Health - North Branch Allina Health - St. Michael CentraCare Family Health Center CentraCare Health CentraCare Clinic - Becker CentraCare Health Plaza- Pediatrics Essentia Health - Central Region Essentia Health St. Joseph s - Brainerd Clinic Essentia Health St. Joseph s - Pillager Essentia Health St. Joseph s - Pine River Clinic Essentia Health St. Joseph s Baxter Clinic Essentia Health - St. Mary s EH- Menahga FirstLight Health System FirstLight Health System - Mora Gateway Family Health Clinic Gateway Family Health Clinic - Hinckley Gateway Family Health Clinic - Sandstone HealthPartners Clinics HealthPartners - Elk River Integrity Health Network Buffalo Clinic-Albertville-St. Michael Clinic: IHN Buffalo Clinic-IHN Buffalo Clinic-Monticello: IHN St. Cloud Medical Group - Clearwater - IHN St. Cloud Medical Group - Cold Spring -IHN St. Cloud Medical Group - NW- IHN St. Cloud Medical Group - South -IHN North Memorial North Memorial Clinic - Elk River Physicians Sanford Health - Fargo Region Sanford Health Walker Clinic Tri-County Health Care Tri-County Health Care - Wadena Clinic Unity Family Healthcare, Family Medical Center Family Medical Center Wayzata Children s Clinic Wayzata Children s Clinic - Delano Williams Integracare Clinic Minneapolis - 13 out of 25 (52 percent) Allina Health - East Lake Street (Aspen) Cedar Riverside People s Center Cedar Riverside People s Center - People s Center Medical Clinic Children s Hospitals and Clinics of Minnesota Children s General Pediatric Clinic - Minneapolis Community University Health Care Center HealthPartners Clinics HealthPartners - Riverside Hennepin County Medical Center (HCMC) Clinics Hennepin County Medical Center (HCMC) Clinics - Downtown Pediatric Clinic Hennepin County Medical Center (HCMC) Clinics - East Lake Clinic Hennepin County Medical Center (HCMC) Clinics - Richfield Clinic Hennepin County Medical Center (HCMC) Clinics - Whittier Clinic Indian Health Board of Minneapolis Native American Community Clinic NorthPoint Health & Wellness Center Park Nicollet Health Services Park Nicollet Clinic - Minneapolis Southeast - 12 out of 57 (21 percent) Allina Health - Faribault Allina Health - Northfield Mankato Clinic, Ltd. Mankato Clinic - Children s Health Center Mankato Clinic - Daniel s Health Center Mankato Clinic - Main Street Mankato Clinic - Wickersham Campus Mayo Clinic Mayo Clinic - Baldwin Building, Family Medicine Mayo Clinic - Baldwin Building, Pediatrics Mayo Clinic - Kasson Mayo Clinic - Northeast Mayo Clinic - Northwest Winona Health Services Winona Health - Winona Clinic Saint Paul - Nine out of 15 (60 percent) Allina Health - Bandana Square (Aspen) Central Pediatrics Central Pedatrics St. Paul Children s Hospitals and Clinics of Minnesota Children s General Pediatric Clinic - St. Paul HealthPartners Clinics HealthPartners - Como HealthPartners - Midway HealthPartners - St Paul United Family Medicine West Side Community Health Services West Side Community Health Services - La Clinica West Side Community Health Services - McDonough Homes Clinic 32

33 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: OVERWEIGHT COUNSELING Regional Clinic Results Southwest - 16 out of 38 (Ten percent) Affiliated Community Medical Centers Affiliated Community Medical Centers - Benson Clinic Affiliated Community Medical Centers - Granite Falls Clinic Affiliated Community Medical Centers - Litchfield Clinic (East) Affiliated Community Medical Centers - Litchfield Clinic (West) Affiliated Community Medical Centers - New London Clinic Affiliated Community Medical Centers - Redwood Falls Clinic Affiliated Community Medical Centers - Willmar Clinic Affiliated Community Medical South Dakota - 12 out of 25 (48 percent) Sanford Health - Sioux Falls Region Sanford 26th and Sycamore Family Medicine Sanford 41st and Sertoma Family Medicine Sanford Brandon Family Medicine Sanford Canton-Inwood Clinic Sanford Children s Clinic 26th & Sycamore 33 Centers- Marshall Clinic Alexandria Clinic Alexandria Clinic, A Service of Douglas County Hospital Glencoe Regional Health Services Glencoe Regional Health Services - Glencoe Hutchinson Health Hutchinson Health - Dassel Clinic Lac Qui Parle Clinic Ridgeview Clinics Ridgeview Winsted Clinic Sanford Health - Sioux Falls Region Sanford Luverne Clinic Sanford Tracy Clinic Sanford Westbrook Clinic Sanford Children s Clinic 69th & Louise Sanford Children s Clinic Aberdeen Sanford Children s Clinic MB2 Sanford Health Beresford Clinic Sanford Health Ipswich Clinic Sanford Health Mitchell Clinic Sanford Health Watertown Clinic Northeast - 24 out of 32 (75 percent) Duluth Family Medicine Clinic Essentia Health - East Region Essentia Health - Aurora Clinic Essentia Health - Deer River Clinic Essentia Health - Duluth Clinic 1st St Essentia Health - Ely Clinic Essentia Health - Hermantown Clinic Essentia Health - Hibbing Clinic Essentia Health - International Falls Clinic Essentia Health - Lakeside Clinic Essentia Health - Lakewalk Clinic Essentia Health - Proctor Clinic Essentia Health - Virginia Clinic Fairview Mesaba Clinics Range Regional Health Services dba Fairview Mesaba Clinic - Hibbing Range Regional Health Services Northwest - 10 out of 27 (37 percent) Essentia Health - Ada Essentia Health - Fosston Essentia Health - St. Mary s EH-Park Rapids Essentia Health - Detroit Lakes Essentia Health - West Essentia Health - Moorhead Sanford Health - Fargo Region Sanford Bemidji 1611 Anne St North Dakota - Eight out of 25 (32 percent) Altru Health System Altru Health System - Main Essentia Health - West Essentia Health - South University Essentia Health - Wahpeton Essentia Health - West Acres Wisconsin - Four out of Seven (57 percent) Essentia Health - East Region Essentia Health - Ashland Clinic Essentia Health - Hayward Clinic Essentia Health - Spooner Clinic Essentia Health - St. Mary s-superior Clinic Medicine dba Fairview Mesaba Clinic - Mountain Iron Range Regional Health Services dba Fairview Mesaba Clinic - Nashwauk Gateway Family Health Clinic Gateway Family Health Clinic - Moose Lake Lake View Clinic - Two Harbors Riverwood Healthcare Center Riverwood Aitkin Clinic Scenic Rivers Health Services Scenic Rivers Health Services - Bigfork/Big Falls St. Luke s Clinics St Luke s Clinics-Denfeld St Luke s Clinics-Lester River St Luke s Clinics-Mount Royal St Luke s Clinics-P.S. Rudie Medical Clinic St Luke s Clinics-Pediatrics Clinic Sanford Bemidji Black Duck Clinic Sanford Health Detroit Lakes Clinic Sanford Moorhead Clinic Sanford Moorhead Family Medicine Essentia Health - West Fargo Essentia Health Casselton Sanford Health - Fargo Region Sanford Broadway Clinic Sanford Children s Southwest Clinic

34 PERFORMANCE HIGHLIGHTS FOR PEDIATRIC PREVENTIVE CARE: OVERWEIGHT COUNSELING Medical Group Results Highest performers in 2015 Results by medical group showed an average of 85 percent of pediatric patients ages 3-17 had appropriate documentation of counseling for physical activity and nutrition if their BMI percentile from an overweight/ obesity assessment was greater than or equal to 85. Eight medical groups set the benchmark of 100 percent. There were 56 of 100 medical groups with rates and confidence interval fully above the statewide average. The high-performing medical groups are listed below from high to low performance. An asterisk (*) indicates a Top 5 performer for this measure. Dakota Pediatrics, P.A.* Essentia Health Ada* Synergy Family Physicians, P.A* Wayzata Children s Clinic* Mayo Clinic* NorthPoint Health & Wellness Center* Hennepin County Medical Center (HCMC) Clinics* Children s Hospitals and Clinics of Minnesota* Central Pediatrics Fairview Mesaba Clinics Alexandria Clinic Catalyst Medical Clinic All About Children Pediatrics - Children s Health Network Cedar Riverside People s Center Mendakota Pediatrics Ltd Integrity Health Network Williams Integracare Clinic Essentia Health - Central Region Stillwater Medical Group Park Nicollet Health Services North Metro Pediatrics Lac Qui Parle Clinic Gateway Family Health Clinic Affiliated Community Medical Centers Essentia Health - East Region Essentia Health - St. Mary s Essentia Health - Fosston Essentia Health - West HealthPartners Clinics United Family Medicine Mankato Clinic, Ltd. Unity Family Healthcare, Family Medical Center Lake View Clinic - Two Harbors Fridley Children s & Teenagers Medical Center - Children s Physician Network Sibley Medical Center DBA Ridgeview Sibley Medical Center Native American Community Clinic Duluth Family Medicine Clinic North Clinic Riverwood Healthcare Center North Memorial Eagan Valley Pediatrics Indian Health Board of Minneapolis Winona Health Services CentraCare Health St. Luke s Clinics Pediatric Services - Children s Physician Network Scenic Rivers Health Services West Side Community Health Services CentraCare Family Health Center South Lake Pediatrics Glencoe Regional Health Services Community University Health Care Center Tri-County Health Care Sanford Health - Sioux Falls Region Sanford Health - Fargo Region Biggest improvement from Not applicable because this is a first year measure. Medical group performance over time ( ) Not applicable because this is a first year measure. 34

35 Please see next page. 35

36 NEW MEASURES/ MEASURES WITH SPECIFICATION CHANGES FOR 2015 REPORTING Spinal Surgery: Lumbar Discectomy/Laminotomy This is the first year of public reporting for the Spinal Surgery: Lumbar Discectomy/Laminotomy measure set. The eligible population for this measure are patients age 18 and older who underwent a lumbar discectomy/laminotomy procedure for a diagnosis of disc herniation with the date of procedure between 1/1/2013 and 12/31/2013. The following measures are reported in 2015: The percentage of patients with a lumbar discectomy/laminotomy procedure who had an ODI assessment tool administered both pre-operatively (within three months prior to the procedure) and three months postoperatively (six to 20 weeks after the procedure). Average post-operative functional status at three months who underwent a lumbar discectomy/laminotomy procedure as measured by the ODI assessment tool. The statewide rate for administration of the ODI tool pre-operatively and post-operatively was 37 percent. Table 5 displays the details of the statewide rate for the process measure. The ODI assessment tool calculates a score based on the patient s answers to questions about their low back pain and function. The score can be between 0 and 100, where a higher score reflects a higher degree of disability. The statewide average change in score after a Lumbar Discectomy/Laminotomy procedure was 22.0 points, with medical groups ranging between 10.9 and 32.9 points. See Table 6 for the details of the functional status measure. These are first year measures so trending over time is not available. Data collected for this measure are submitted directly to MNCM by medical groups from electronic health records or paperbased medical charts. TABLE 5: STATEWIDE RATE FOR LUMBAR DISCECTOMY/LAMINOTOMY PRE-OP AND POST-OP ODI AT THREE MONTHS Statewide Average 95% Cl Numerator Denominator (Patients who met treatment goals) Number of Lumbar D/L Procedures with Pre-Op & Post-Op ODI at Three Months 36.9% 34.8%-39.0% 725 1,966 THERE IS NO TREND CHART BECAUSE THIS IS THE FIRST YEAR OF PUBLIC REPORTING FOR THIS MEASURE. 36

37 PERFORMANCE HIGHLIGHTS FOR LUMBAR DISCECTOMY/LAMINOTOMY WITH PRE-OP & POST-OP ODI AT THREE MONTHS Medical Group Results Highest performers in 2015 Medical group results showed an average of 37 percent of patients with a Lumbar Discectomy/Laminotomy procedure had an ODI assessment tool administered both pre-operatively (within three months prior to the procedure) and post-operatively (within six to 20 weeks after the procedure). Institute for Low Back and Neck Care set the benchmark of 72 percent. There were six of 16 medical groups with rates and confidence intervals fully above the statewide average. The high-performing medical groups are listed below in order starting with the best performance. An asterisk (*) indicates a Top 5 performer for this measure. Institute for Low Back and Neck Care* University of Minnesota Physicians* Twin Cities Spine Center* Sanford Health - Fargo Region* Midwest Spine & Brain Institute* HealthPartners Clinics Biggest improvement from Not applicable since this is a first year measure. Medical group performance over time ( ) Not applicable since this is a first year measure. 37

38 PERFORMANCE HIGHLIGHTS FOR LUMBAR DISCECTOMY/LAMINOTOMY FUNCTIONAL STATUS AT THREE MONTHS Medical Group Results The following table displays medical group results for functional status at three months as measured by the ODI assessment tool. The medical groups are listed in order by rating. The statewide average change in score after Lumbar Discectomy/Laminotomy Surgery was 22.0 points. Mayo Clinic had the greatest improvement with an average score change of 32.9 points. There is no indication of Top performers due to there being less than 10 reportable medical groups for this measure. TABLE 6: MEDICAL GROUP RESULTS FOR LUMBAR DISCECTOMY/LAMINOTOMY FUNCTIONAL STATUS AT THREE MONTHS Medical Group Name STATEWIDE AVERAGE Twin Cities Spine Center Institute for Low Back and Neck Care University of Minnesota Physicians HealthPartners Clinics Park Nicollet Health Services Mayo Clinic Sanford Health - Fargo Region Midwest Spine and Brain Institute Result (Actual) N (# used to calculate score) Lower Bound of 95% CI Upper Bound of 95% CI Result (Expected) Actual to Expected Ratio Rating Above Average Expected Expected Expected Expected Expected Expected Below Average Biggest improvement from Not applicable since this is a first year measure. Medical group performance over time ( ) Not applicable since this is a first year measure. 38

39 Please see next page. 39

40 NEW MEASURES/ MEASURES WITH SPECIFICATION CHANGES FOR 2015 REPORTING Spinal Surgery: Lumbar Spinal Fusion This is the first year of public reporting for the Spinal Surgery: Lumbar Spinal Fusion measure set. The eligible population for this measure are patients age 18 and older who underwent a lumbar spinal fusion procedure between 1/1/2013 and 12/31/2013. The following measures are reported in 2015: The percentage of patients with a lumbar spinal fusion procedure who had an ODI assessment tool administered both pre-operatively (within three months prior to the procedure) and one year post-operatively (nine to 15 months after the procedure). Average post-operative functional status at one year who underwent a lumbar spinal fusion procedure as measured by the ODI assessment tool. The statewide rate for administration of the ODI tool pre-operatively and post-operatively was 43 percent. Table 7 displays the details of the statewide rate for the process measure. The ODI assessment tool calculates a score based on the patient s answers to questions about their low back pain and function. The score can be between 0 and 100, where a higher score reflects a higher degree of disability. The statewide average change in score after Lumbar Fusion Surgery is 16.7 points, with medical groups ranging between 11.2 and 19.5 points. See Table 8 for the details of the functional status measure. These are first year measures so trending over time is not available. Data collected for this measure are submitted directly to MNCM by medical groups from electronic health records or paperbased medical charts. TABLE 7: STATEWIDE RATE FOR LUMBAR SPINAL FUSION PRE-OP & POST-OP ODI AT ONE YEAR Statewide Average 95% Cl Numerator Denominator (Patients who met treatment goals) Number of Lumbar Fusion Procedures With Pre-Op & Post-Op ODI at One Year 42.6% 40.4%-44.7% 874 2,054 THERE IS NO TREND CHART BECAUSE THIS IS THE FIRST YEAR OF PUBLIC REPORTING FOR THIS MEASURE. 40

41 PERFORMANCE HIGHLIGHTS FOR LUMBAR SPINAL FUSION WITH PRE-OP & POST-OP ODI AT ONE YEAR Medical Group Results Highest performers in 2015 Medical group results showed an average of 43 percent of patients with a Lumbar Spinal Fusion procedure had an ODI assessment tool administered both pre-operatively (within three months prior to the procedure) and post-operatively (within nine to 15 months after the procedure). Institute for Low Back and Neck Care set the benchmark of 69 percent. There were two of 13 medical groups with rates and confidence intervals fully above the statewide average. The high-performing medical groups are listed below in order starting with the best performance. An asterisk (*) indicates a Top 5 performer for this measure. Institute for Low Back and Neck Care* Twin Cities Spine Center* Biggest improvement from Not applicable since this is a first year measure. Medical group performance over time ( ) Not applicable since this is a first year measure. 41

42 PERFORMANCE HIGHLIGHTS FOR LUMBAR SPINAL FUSION FUNCTIONAL STATUS AT ONE YEAR Medical Group Results The following table display medical group results for functional status at one year as measured by the ODI assessment tool. The medical groups are listed in order by rating. The statewide average change in score after Lumbar Spinal Fusion Surgery was 16.7 points. Twin Cities Spine Center had the greatest improvement with an average score change of 19.5 points. There is no indication of Top performers due to there being less than 10 reportable medical groups for this measure. TABLE 8: MEDICAL GROUP RESULTS FOR LUMBAR SPINAL FUSION FUNCTIONAL STATUS AT ONE YEAR Medical Group Name STATEWIDE AVERAGE Twin Cities Spine Center University of Minnesota Physicians Mayo Clinic HealthPartners Clinics Sanford Health - Fargo Region Midwest Spine and Brain Institute Institute for Low Back and Neck Care Result (Actual) N (# used to calculate score) Lower Bound of 95% CI Upper Bound of 95% CI Result (Expected) Actual to Expected Ratio Rating Above Average Expected Expected Expected Expected Below Average Below Average Biggest improvement from Not applicable since this is a first year measure. Medical group performance over time ( ) Not applicable since this is a first year measure. 42

43 Please see next page. 43

44 NEW MEASURES/ MEASURES WITH SPECIFICATION CHANGES FOR 2015 REPORTING Total Knee Replacement (TKR) This is the first year of public reporting for the Total Knee Replacement functional status measure. The eligible population for this measure were patients age 18 and older who underwent a primary or revision total knee replacement procedure during the measurement period (January 1, 2013 to December 31, 2013). The following measures are reported in 2015: The percentage of patients with a total knee replacement procedure who have an OKS assessment tool administered both pre-operatively (within three months prior to the procedure) and one year postoperatively (nine to 15 months after the procedure). Average post-operative functional status at one year for patients who underwent a primary total knee replacement as measured by the OKS tool. Three process measures were publicly reported in In 2015, MNCM will publicly report data on two measures: pre-operative and post-operative OKS tool administration and functional status as measured by the OKS tool. Only primary TKR procedures are reported for the functional status measure. The statewide rate for administration of the OKS tool pre-operatively and post-operatively was 24 percent. Table 9 displays the details of the statewide rate for the process measure. The OKS assessment tool calculates a score based on the patient s answers to questions about their knee pain and mobility. The score can be between 0 and 48, where a higher score reflects better knee function. The statewide average change in score after surgery for patients in Minnesota was 17.1 points, with medical groups ranging between 12.5 and 18.5 points. A higher number of points indicate greater improvement in a patient s pain, function and mobility after surgery. See Table 10 for the details of the functional status measure. This is the first year of reporting the functional status measure and so trending is not available. TABLE 9: STATEWIDE RATE FOR NUMBER OF TKR WITH PRE-OP AND POST-OP OKS ADMINISTERED Statewide Average 95% Cl Numerator Denominator (Patients who met treatment goals) Number of TKR Procedures w/pre-op & Post-Op OKS 24.0% 23.1% % 2,426 10,123 44

45 PERFORMANCE HIGHLIGHTS FOR TKR - NUMBER OF TKR PROCEDURES WITH PRE-OP AND POST-OP OKS Medical Group Results Highest performers in 2015 Medical group results showed an average of 24 percent of patients with a TKR procedure had an OKS assessment tool administered both pre-operatively (within three months prior to the procedure) and one year postoperatively (nine to 15 months after the procedure). Affiliated Community Medical Centers set the benchmark of 66 percent. There were ten of 31 medical groups with rates and confidence intervals fully above the statewide average. The high-performing medical groups are listed below in order starting with the best performance. An asterisk (*) indicates a Top 5 performer for this measure. Affiliated Community Medical Centers* Little Falls Orthopedics* Northern Orthopedics, Ltd.* Southwest Minnesota Orthopedics and Sports Medicine* The Orthopaedic & Fracture Clinic* Lake Region Healthcare Mayo Clinic Health System Mayo Clinic Essentia Health - St. Mary s Biggest improvement from The greatest improvement since report year 2014 in administration of the ODI assessment tool pre-operatively and post-operatively at one year to patients who underwent a TKR procedure was made by Southwest Minnesota Orthopedics and Sports Medicine. Their score increased by more than 60 percentage points. Medical group performance over time ( ) Not applicable because this is the second year of reporting this measure. 45

46 PERFORMANCE HIGHLIGHTS FOR PRIMARY TKR FUNCTIONAL STATUS AT ONE YEAR Medical Group Results The following table display medical group results for functional status for primary total knee replacement procedures at one year as measured by the OKS assessment tool. The medical groups are listed in order by rating. The statewide average change in score was 17.1 points. Northern Orthopedics, Ltd. had the greatest improvement with an average score change of 18.5 points. There is no indication of Top performers for this measure. TABLE 10: MEDICAL GROUP RESULTS FOR PRIMARY TOTAL KNEE REPLACEMENT FUNCTIONAL STATUS AT ONE YEAR Medical Group Name STATEWIDE AVERAGE Mayo Clinic Mayo Clinic Health System Sanford Health - Fargo Region HealthPartners Clinics The Orthopaedic & Fracture Clinic Little Falls Orthopedics Essentia Health - St. Mary's Essentia Health - East Region Northern Orthopedics, Ltd. Lake Region Healthcare Heartland Orthopedic Specialists Park Nicollet Health Services Allina Health Specialties Fairview Health Services Result (Actual) N (# used to calculate score) 2, Lower Bound of 95% CI Upper Bound of 95% CI Result (Expected) Actual to Expected Ratio Rating Above Average Expected Expected Expected Expected Expected Expected Expected Expected Expected Expected Expected Below Average Below Average Below Average Biggest improvement from Not applicable since this is a first year measure. Medical group performance over time ( ) Not applicable since this is a first year measure. 46

47 Please see next page. 47

48 NEW MEASURES/ MEASURES WITH SPECIFICATION CHANGES FOR 2015 REPORTING Optimal Diabetes Care* This measures the percentage of patients with diabetes (Type 1 and Type 2) ages who reached all four of the following treatment goals to reduce cardiovascular risk: Blood pressure less than 140/90 mmhg Hemoglobin A1c (HbA1c) less than 8 Daily aspirin use for diabetes patients with a co-morbidity of ischemic vascular disease unless contraindicated Documented tobacco-free status The statewide rate for Optimal Diabetes Care is 53 percent. Table 11 displays the details of this statewide rate. *For the 2015 report year, this composite measure included four components. In 2016, it will return to a five component composite. Credit is given for achieving this composite rate when all four measure components are met. Data collected for this measure are submitted directly to MNCM by medical groups/clinics from electronic health records or paper-based medical charts. TABLE 11: STATEWIDE RATE FOR OPTIMAL DIABETES CARE Statewide Average (Weighted) 95% Cl Numerator (Patients who met treatment goals) Denominator (Patients sampled) Total Eligible Optimal Diabetes Care 53.5% 53.3%-53.7% 131, , ,878 THERE IS NO TREND CHART BECAUSE THE MEASURE SPECIFICATION CHANGED FOR THIS MEASURE. 48

49 PERFORMANCE HIGHLIGHTS FOR OPTIMAL DIABETES CARE Clinic Results Highest performers in 2015 Clinic results showed an average of 53 percent of patients with diabetes met all four required components in this measure. Cromwell Medical Clinic - IHN set the benchmark of 74 percent. There were 154 of 594 clinics with rates and confidence intervals fully above the statewide average. The high-performing clinics are listed below in alphabetical order under their medical group name. An asterisk (*) indicates a Top 15 performer for this measure. Affiliated Community Medical Centers Allina Health - Uptown* HealthEast Clinics Affiliated Community Medical Centers - Allina Health - Vadnais Heights HealthEast Cottage Grove Clinic Litchfield Clinic (East) Allina Health - West St. Paul HealthPartners Clinics Affiliated Community Medical Centers - Allina Health - Woodbury HealthPartners - Arden Hills New London Clinic Allina Health Specialties HealthPartners - Bloomington Affiliated Community Medical Centers- Allina Health Specialties - Abbott Northwestern HealthPartners - Brooklyn Center Marshall Clinic General Medicine Associates - Edina HealthPartners - Coon Rapids Apple Valley Medical Clinic HealthPartners - Elk River Allina Health - Bandana Square (Aspen) Catalyst Medical Clinic* HealthPartners - Hlth Ctr for Women Allina Health Blaine* CentraCare Health HealthPartners - Lino Lakes Allina Health - Bloomington (Aspen) CentraCare Clinic - Northway HealthPartners - Roseville Allina Health - Brooklyn Park CentraCare Clinic - St. Joseph* HealthPartners - West Allina Health - Buffalo CentraCare Health Plaza-Family Medicine HealthPartners - White Bear Lake Allina Health - Burnsville (Quello) CentraCare Health Plaza-Internal Medicine HealthPartners - Woodbury Allina Health - Centennial Lakes (Quello)* CentraCare River Campus-Internal Integrity Health Network Allina Health - Champlin Medicine Cromwell Medical Clinic-IHN* Allina Health - Chanhassen (Quello) Edina Sports Health & Wellness St. Cloud Medical Group - Clearwater - IHN Allina Health Chaska Entira Family Clinics St. Cloud Medical Group - Cold Spring -IHN Allina Health - Cokato Entira Family Clinics - Highland Mankato Clinic, Ltd. Allina Health - Coon Rapids Entira Family Clinics - Inver Grove Heights Mankato Clinic - North Mankato Allina Health - Cottage Grove Entira Family Clinics - North St. Paul Mankato Clinic - Wickersham Campus Allina Health - Dean Lakes Entira Family Clinics Shoreview* Mayo Clinic Allina Health Eagan* Entira Family Clinics - Vadnais Heights Mayo Clinic - Northeast Allina Health - Edina Entira Family Clinics - West St. Paul Mayo Clinic Health System Allina Health - Elk River Entira Family Clinics - White Bear Lake- Mayo Clinic Health System Faribault Hwy Allina Health - Faribault Bellaire Avenue* 60 Allina Health - Farmington Entira Family Clinics - White Bear Lake/ Mayo Clinic Health System Lake City Allina Health - First Street Banning Ave Mayo Clinic Health System Le Sueur Allina Health - Forest Lake Entira Family Clinics - Woodbury Mayo Clinic Health System Mankato Allina Health - Highland Park (Aspen) Essentia Health - Central Region Eastridge Allina Health - Inver Grove Heights (Aspen) Essentia Health St. Joseph s - Brainerd Clinic Mayo Clinic Health System Mankato Allina Health - Isles Essentia Health - East Region Northridge Allina Health - Lakeville (Quello) Essentia Health - Aurora Clinic Mayo Clinic Health System Owatonna Allina Health - Maple Grove Essentia Health - Ely Clinic Mayo Clinic Health System Plainview Allina Health - Maplewood (Aspen) Essentia Health - Hermantown Clinic Mayo Clinic Health System St. Peter Allina Health - Nicollet Mall Essentia Health - St. Mary s Mayo Clinic Health System Wabasha Allina Health - Nininger Road EH-Park Rapids Mayo Clinic Health System Waseca Allina Health - Northfield Fairview Health Services Mayo Clinic Health System- Franciscan Allina Health - Plymouth Fairview Bloomington Lake erxes Healthcare in LaCrescent Allina Health Ramsey* Fairview Burnsville Clinic North Memorial Allina Health - Richfield Fairview Crosstown Clinic North Memorial Clinic - Maple Grove Allina Health - Savage (Quello) Fairview Eagan Clinic North Memorial Clinic - Rockford Road Allina Health - Shakopee Fairview Maple Grove Medical Center North Memorial Clinic, Silver Lake - St. Allina Health - Sharpe Dillon Cockson & Fairview Oxboro Clinic Anthony Associates PA Fairview Prior Lake Clinic Olmsted Medical Center Allina Health - Shoreview Fairview Rogers Clinic Olmsted Medical Center - Preston Clinic Allina Health - St. Francis Health Services Fairview Rosemount Clinic Park Nicollet Health Services - Jordan Family Practice Medical Center of Willmar Park Nicollet Clinic - Bloomington Allina Health - St. Michael France Avenue Family Physicians - Minnesota Park Nicollet Clinic - Brookdale Allina Health - United Medical Specialties* Healthcare Network Park Nicollet Clinic - Burnsville 49

50 PERFORMANCE HIGHLIGHTS FOR OPTIMAL DIABETES CARE Clinic Results Park Nicollet Clinic - Carlson* Park Nicollet Clinic - Chanhassen Park Nicollet Clinic - Eagan Park Nicollet Clinic - Golden Valley Park Nicollet Clinic - Maple Grove Park Nicollet Clinic - Plymouth Park Nicollet Clinic - Prairie Center* Park Nicollet Clinic - Prior Lake Park Nicollet Clinic Rogers* Park Nicollet Clinic - Shakopee Park Nicollet Clinic - Shorewood Park Nicollet Clinic - St. Louis Park Family Medicine Park Nicollet Clinic - St. Louis Park Internal Medicine Park Nicollet Clinic - Wayzata Richard Schoewe MD Sanford Health - Fargo Region Sanford Bemidji Main Clinic Internal Medicine Sanford Broadway Internal Medicine Clinic Sanford Mahnomen Clinic Sanford Moorhead Internal Medicine Sanford North Fargo Clinic Sanford Southpointe Family Medicine Sanford Southpointe Internal Medicine Sanford Thief River Falls Clinic Sanford Valley City Clinic Sanford West Fargo Clinic Sanford Health - Sioux Falls Region Sanford 41st and Sertoma Family Medicine Sanford Canton-Inwood Clinic Sanford Health Mountain Lake Clinic Sanford Health Vermillion Clinic* Sanford Internal Medicine Clinic Sanford Jackson Clinic Sanford Westbrook Clinic Sanford Women s Internal Medicine St. Luke s Clinics St Luke s Clinics-P.S. Rudie Medical Clinic Stillwater Medical Group Stillwater Medical Group - Curve Crest Clinic Vibrant Health Family Clinics and Minnesota Health Network Vibrant Health Family Clinics-Ellsworth Vibrant Health Family Clinics-Spring Valley* Biggest improvement from Not applicable due to measure specification changes. Clinic performance over time ( ) Not applicable due to measure specification changes. 50

51 PERFORMANCE HIGHLIGHTS FOR OPTIMAL DIABETES CARE Clinic Regional Results Highest performers in 2015 by region Clinic results showed differences in performance among the different geographic regions in Minnesota. Boundaries of the nine regions were determined by synthesizing health care and geopolitical data, including from the Metropolitan Council and State of Minnesota. The results have been organized to identify areas of the state with the highest proportion of high-performing clinics. The nine regions are listed below based on their proportion of high-performing clinics from high to low. The number of high-performing clinics is shown along with the total number of clinic sites that submitted data for this measure. The high-performing clinics are listed under their medical group name in alphabetical order by region. East Metro - 45 out of 85 (53 percent) Allina Health - Bloomington (Aspen) Allina Health - Brooklyn Park Allina Health - Centennial Lakes (Quello) Allina Health - Champlin Allina Health - Chanhassen (Quello) Allina Health - Chaska Allina Health - Dean Lakes Allina Health - Edina Allina Health - Maple Grove Allina Health - Plymouth Allina Health - Richfield Allina Health - Savage (Quello) Allina Health - Shakopee Allina Health - Sharpe Dillon Cockson & Associates PA Allina Health - St. Francis Health Services - Jordan Allina Health Specialties Allina Health Specialties - Abbott Northwestern General Medicine Associates - Edina Catalyst Medical Clinic Edina Sports Health & Wellness Fairview Health Services Fairview Bloomington Lake erxes Fairview Crosstown Clinic Fairview Maple Grove Medical Center Fairview Oxboro Clinic Fairview Prior Lake Clinic Fairview Rogers Clinic France Avenue Family Physicians - Minnesota Healthcare Network HealthPartners Clinics HealthPartners - Bloomington HealthPartners - Brooklyn Center HealthPartners - West North Memorial North Memorial Clinic - Maple Grove North Memorial Clinic - Rockford Road Park Nicollet Health Services Park Nicollet Clinic - Bloomington Park Nicollet Clinic - Brookdale Park Nicollet Clinic - Carlson Park Nicollet Clinic - Chanhassen Park Nicollet Clinic - Golden Valley Park Nicollet Clinic - Maple Grove Park Nicollet Clinic - Plymouth Park Nicollet Clinic - Prairie Center Park Nicollet Clinic - Prior Lake Park Nicollet Clinic - Rogers Park Nicollet Clinic - Shakopee Park Nicollet Clinic - Shorewood Park Nicollet Clinic - St. Louis Park Family Medicine Park Nicollet Clinic - St. Louis Park Internal Medicine Park Nicollet Clinic - Wayzata East Metro - 41 out of 80 (51 percent) Allina Health - Blaine Allina Health - Burnsville (Quello) Allina Health - Coon Rapids Allina Health - Cottage Grove Allina Health - Eagan Allina Health - Farmington Allina Health - First Street Allina Health - Forest Lake Allina Health - Inver Grove Heights (Aspen) Allina Health - Lakeville (Quello) Allina Health - Maplewood (Aspen) Allina Health - Nininger Road Allina Health - Ramsey Allina Health - Shoreview Allina Health - Vadnais Heights Allina Health - West St. Paul Allina Health - Woodbury Apply Valley Medical Clinic Apple Valley Medical Clinic - Family Practice Entira Family Clinics Entira Family Clinics - Inver Grove Heights Entira Family Clinics - North St. Paul Entira Family Clinics - Shoreview Entira Family Clinics - Vadnais Heights Entira Family Clinics - West St. Paul Entira Family Clinics - White Bear Lake/ Banning Ave Entira Family Clinics - White Bear Lake- Bellaire Avenue Entira Family Clinics - Woodbury Fairview Health Services Fairview Burnsville Clinic Fairview Eagan Clinic Fairview Rosemount Clinic HealthPartners Clinics HealthEast Cottage Grove Clinic HealthPartners - Arden Hills HealthPartners - Coon Rapids HealthPartners - Lino Lakes HealthPartners - Roseville HealthPartners - White Bear Lake HealthPartners - Woodbury North Memorial North Memorial Clinic, Silver Lake - St. Anthony Park Nicollet Health Services Park Nicollet Clinic - Burnsville Park Nicollet Clinic - Eagan Richard Schoewe MD Stillwater Medical Group Stillwater Medical Group - Curve Crest Clinic 51

52 PERFORMANCE HIGHLIGHTS FOR OPTIMAL DIABETES CARE Clinic Regional Results Central - 13 out of 75 (17 percent) Allina Health - Buffalo Allina Health - Cokato Allina Health - Elk River Allina Health - St. Michael CentraCare Health CentraCare Clinic - Northway CentraCare Clinic - St. Joseph CentraCare Health Plaza- Family Medicine CentraCare Health Plaza- Internal Medicine CentraCare River Campus- Internal Medicine Essentia Health - Central Region Essentia Health St. Joseph s - Brainerd Clinic HealthPartners Clinics HealthPartners - Elk River Integrity Health Network St. Cloud Medical Group - Clearwater - IHN St. Cloud Medical Group - Cold Spring -IHN Minneapolis - Three out of 42 ( Seven percent) Allina Health - Uptown Allina Health - Isles Allina Health - Nicollet Mall Saint Paul - Five out of 31 (16 percent) Allina Health - Bandana Square (Aspen) Allina Health - Highland Park (Aspen) Allina Health - United Medical Specialties Southeast - 17 out of 75 (23 percent) Allina Health - Faribault Allina Health - Northfield Mankato Clinic, Ltd. Mankato Clinic - North Mankato Mankato Clinic - Wickersham Campus Mayo Clinic Mayo Clinic - Northeast Mayo Clinic Health System Mayo Clinic Health System Faribault Hwy 60 Mayo Clinic Health System- Franciscan Healthcare in LaCrescent Mayo Clinic Health System Lake City Mayo Clinic Health System Le Entira Family Clinics Entira Family Clinics - Highland HealthPartners Clinics HealthPartners - Hlth Ctr for Women Sueur Mayo Clinic Health System Mankato Eastridge Mayo Clinic Health System Mankato Northridge Mayo Clinic Health System Owatonna Mayo Clinic Health System Plainview Mayo Clinic Health System St. Peter Mayo Clinic Health System Wabasha Mayo Clinic Health System Waseca Olmsted Medical Center Olmsted Medical Center - Preston Clinic Southwest - Seven out of 50 (14 percent) Affiliated Community Medical Centers Affiliated Community Medical Centers - Litchfield Clinic (East) Affiliated Community Medical Centers - New London Clinic Affiliated Community Medical Centers- Marshall Clinic Family Practice Medical Center of Willmar Family Practice Medical Center of Willmar Sanford Health - Sioux Falls Region Sanford Health Mountain Lake Clinic Sanford Jackson Clinic Sanford Westbrook Clinic Northeast - Five out of 44 (11 percent) Integrity Health Network Cromwell Medical Clinic-IHN Essentia Health - East Region Essentia Health - Aurora Clinic Essentia Health - Ely Clinic Essentia Health - Hermantown Clinic St. Luke s Clinics St Luke s Clinics-P.S. Rudie Medical Clinic 52