Michigan Quality Improvement Consortium 2017 Annual Performance Measurement Report
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1 Michigan Quality Improvement Consortium Annual Performance Measurement Report
2 Table of Contents Executive Summary ADHD Asthma Bronchitis 9 Cardiovascular Chronic Kidney Disease 18 Depression Diabetes Low Back Pain. 30 Obesity/Overweight Adults.. 31 Children/Adolescents Osteoporosis Pharyngitis. 36 Prenatal and Postpartum Care Preventive Services Adults Adolescents Children Substance Use Tobacco Use
3 Executive Summary For over 18 years, the Michigan Quality Improvement Consortium has been developing and maintaining evidence-based clinical practice guidelines for primary care providers. MQIC was established to provide practitioners across the state with one set of clinical guidelines, in which all participating health plans endorse the final recommendations outlined. This ensures providers are not having to conform to multiple guidelines issued by multiple organizations. Six Michigan health plans and several professional organizations participated in MQIC at inception, and today the consortium includes 13 plans. MQIC s health plans offer insurance in all 83 counties, and approximately 7,000,000 Michigan residents are covered by these plans. Participating health plans and organizations: Aetna Better Health of Michigan Blue Care Network Blue Cross Blue Shield of Michigan Blue Cross Complete HAP Midwest Health Plan Harbor Health Plan Health Alliance Plan Meridian Health Plan Michigan Association of Health Plans Michigan Department of Health and Human Services Michigan Osteopathic Association Michigan State Medical Society Molina Health Care MPRO Physicians Health Plan Priority Health Total Health Care UnitedHealthcare Community University of Michigan Health System 3
4 Currently, MQIC supports 31 guidelines. Recommendations for preventive services are outlined for all age groups, and other guidelines issued are for disease conditions such as diabetes, hypertension, lipid management, and more. MQIC guidelines recommend evidence-based services found to increase healthy outcomes and behaviors, and assist providers in meeting targets for quality improvement measures and programs. MQIC provides a community result on a number of quality measures for commercial, and Medicare product lines, and only report on measures in which recommendations are aligned in the MQIC guidelines. In order to meet accreditation standards, MQIC plans provide data to the National Committee for Quality Assurance using the HEDIS measures set and specifications. Data includes members in the health plans HMO and PPO populations, and the eligible population is a combined total of members across all MQIC health plans for each specific product line/measure. MQIC does not report either Special Needs Population or Marketplace member data. HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). 4
5 % ADHD Medication Indicator Initiation Phase and Follow-up Visit HEDIS 43.24% 42.27% 42.95% Product National HEDIS Rate MQIC Best Practice 50.55% 44.50% 51.28% 5
6 ADHD Medication Indicator C ontinuation and Maintenance Phase HEDIS % 49.73% 53.78% 57.53% Product National HEDIS Rate MQIC Best Practice 46.50% 58.57% 54.50% 65.97% 6
7 Asthma Indicator Asthma member with one preventive exam in reporting year 93.60% 92.64% non-hedis 82.21% 69.89% 96.71% 98.62% Medicare Product MQIC Best Practice 96.50% 93.94% Medicare 100% 7
8 Asthma Indicator ER visits/1000 Asthma Members non-hedis Medicare Product MQIC Best Practice Medicare
9 Acute Bronchitis Indicator Avoidance of Antibiotic Treatment in Adults 28.64% 29.72% 24.78% 26.77% HEDIS Product National HEDIS Rate MQIC Best Practice 29.90% 25.83% 30.40% 37.91% 9
10 C ardiovascular Indicator C ontrolling High Blood Pressure 59.49% 55.11% 55.42% HEDIS 56.22% 64.96% 78.73% Medicare Product National HEDIS Rate MQIC Best Practice 62.40% 74.70% 56.50% 67.15% Medicare 69.60% 80.78% 10
11 C ardiovascular Indicator Males age with Atherosclerotic Cardiovascular Disease Received Statin Therapy 81.53% HEDIS 76.33% 79.82% Medicare Product National HEDIS Rate MQIC Best Practice n/a 86.52% n/a 78.85% Medicare n/a 84.62% 11
12 C ardiovascular Indicator Males age with Atherosclerotic Cardiovascular Disease Statin Therapy Adherence 80% 68.60% HEDIS 71.62% 72.51% Medicare Product National HEDIS Rate MQIC Best Practice n/a 71.43% n/a 81.82% Medicare n/a 80.33% 12
13 C ardiovascular Indicator Females age with Atherosclerotic Cardiovascular Disease Received Statin Therapy HEDIS 70.67% 71.07% 73.55% Medicare Product National HEDIS Rate MQIC Best Practice n/a 73.99% n/a 72.98% Medicare n/a 76.95% 13
14 C ardiovascular Indicator Females age with Atherosclerotic Cardiovascular Disease Statin Therapy Adherence 80% 64.71% HEDIS 69.41% 68.95% Medicare Product National HEDIS Rate MQIC Best Practice n/a 66.20% n/a 83.81% Medicare n/a 76.52% 14
15 C ardiovascular Indicator Total Females and Males with Atherosclerotic Cardiovascular Disease Received Statin Therapy HEDIS % 77.77% 73.90% Medicare Product National HEDIS Rate MQIC Best Practice 79.20% 82.67% 74.70% 76.39% Medicare 77.30% 79.57% 15
16 C ardiovascular Indicator Total Females and Males with Atherosclerotic Cardiovascular Disease Statin Therapy Adherence 80% HEDIS % 70.69% 71.41% Medicare Product National HEDIS Rate MQIC Best Practice 69.80% 70.43% 60.90% 80.99% Medicare 75.50% 78.61% 16
17 C ardiovascular Indicator Percent Members Diagnosed with Hypertension non-hedis 11.46% 11.86% 11.27% 11.64% 42.37% 43.78% Medicare Product MQIC Best Practice 11.18% 8.75% Medicare 40.20% 17
18 C hronic Kidney Disease I ndicator % D iabetes or H ypertension members who had a Serum C reatinine T est (nec essary for GFR) M Q IC Community Rate non-h E DIS % 95.72% 97.94% 93.85% 87.40% 98.08% Medicare Product MQIC Best Practice 96.59% 95.65% Medicare 98.43% 18
19 % 71.14% Depression Indicator Effective Acute Phase Treatment HEDIS 60.84% 53.57% 79.33% 77.31% Medicare Product National HEDIS Rate MQIC Best Practice 67.20% 74.75% 53.10% 74.52% Medicare 69.40% 80.56% 19
20 % Depression Indicator Effective Continuation Phase Treatment 52.44% HEDIS 43.05% 36.78% 64.75% 61.27% Medicare Product National HEDIS Rate MQIC Best Practice 50.90% 54.30% 38.00% 60.78% Medicare 54.40% 64.97% 20
21 Diabetes Indicator HbA1c Testing HEDIS % 91.14% 91.36% 93.63% 86.44% 87.73% Medicare Product National HEDIS Rate MQIC Best Practice 90.60% 93.43% 86.70% 92.15% Medicare 93.50% 95.09% 21
22 % 24.61% Diabetes Indicator HbA1c Poor Control > 9% (lower rate is better control) HEDIS 39.96% 34.94% 15.94% 16.10% Medicare Product National HEDIS Rate MQIC Best Practice 33.00% 23.11% 43.30% 31.93% Medicare 26.30% 14.11% 22
23 % 61.95% Diabetes Indicator HbA1c Control < 8% HEDIS 50.68% 54.31% 75.53% 73.53% Medicare Product National HEDIS Rate MQIC Best Practice 56.00% 66.42% 47.10% 62.41% Medicare 62.90% 77.89% 23
24 % Diabetes Indicator HbA1c C ontrol < 7% (select population) HEDIS 42.84% 43.18% 38.82% Product National HEDIS Rate MQIC Best Practice 37.70% 45.07% 34.60% 46.90% 24
25 % 59.53% Diabetes Indicator Eye Exam (Retinal) Performed HEDIS 59.87% 63.27% 76.32% 77.40% Medicare Product National HEDIS Rate MQIC Best Practice 53.60% 69.95% 54.90% 71.72% Medicare 70.40% 82.73% 25
26 Diabetes Indicator Medical Attention for Nephropathy HEDIS 89.48% 89.82% 91.15% 91.37% 95.63% 95.83% Medicare Product National HEDIS Rate MQIC Best Practice 90.20% 94.40% 89.90% 94.89% Medicare 95.60% 97.08% 26
27 Diabetes Indicator BP Control <140/90 mm Hg 67.21% 60.64% 58.66% HEDIS 60.86% 64.14% 72.97% Medicare Product National HEDIS Rate MQIC Best Practice 61.60% 79.78% 59.70% 75.91% Medicare 63.90% 80.59% 27
28 Diabetes Indicator Statin Therapy Received - Patient with Diabetes 59.55% HEDIS 63.15% 70.41% Medicare Product National HEDIS Rate MQIC Best Practice 60.20% 63.15% 60.20% 68.18% Medicare 70.70% 71.53% 28
29 Diabetes Indicator Statin Therapy Adherence 80% - Patient with Diabetes HEDIS 67.87% 68.16% 71.23% Medicare Product National HEDIS Rate MQIC Best Practice 66.50% 70.03% 59.30% 78.93% Medicare 75.30% 78.30% 29
30 Low Back Pain Indicator Proportion for whom Imaging Studies did not occur (within 28 days of diagnosis) 73.02% HEDIS 75.45% 71.80% 72.84% Product National HEDIS Rate MQIC Best Practice 73.80% 79.95% 70.50% 78.39% 30
31 % 89.67% Overweight/Obesity Indicator Adult BMI Assessment HEDIS 89.99% 92.95% 92.88% 97.46% Medicare Product National HEDIS Rate MQIC Best Practice 76.60% 96.67% 80.70% 97.14% Medicare 94.20% 99.09% 31
32 Overweight/Obesity Indicator BMI Assessment Ages 3-17 Years 82.40% 81.74% 76.61% 75.31% HEDIS Product National HEDIS Rate MQIC Best Practice 65.20% 90.75% 69.10% 88.08% 32
33 Overweight/Obesity Indicator C ounseling for Nutrition Ages 3-17 Years 73.78% 73.67% 67.74% 67.48% HEDIS Product National HEDIS Rate MQIC Best Practice 60.80% 79.65% 65.30% 79.81% 33
34 Overweight/Obesity Indicator C ounseling for Physical Activity Ages 3-17 Years HEDIS % 67.20% 59.20% 62.27% Product National HEDIS Rate MQIC Best Practice 55.50% 77.13% 57.60% 73.72% 34
35 Osteoporosis Indicator Osteoporosis Management in Women Who Had a Fracture HEDIS 47.08% 48.84% Medicare Product National HEDIS Rate MQIC Best Practice Medicare 41.90% 72.67% 35
36 Pharyngitis Indicator Appropriate Testing for Children with Pharyngitis HEDIS % 82.29% 68.16% 71.13% Product National HEDIS Rate MQIC Best Practice 80.70% 87.70% 66.50% 78.49% 36
37 Prenatal and Postpartum Care Indicator Timeliness of Prenatal Care 83.14% 76.96% 78.67% HEDIS 80.76% Product National HEDIS Rate MQIC Best Practice 85.10% 98.33% 81.70% 83.33% 37
38 Prenatal and Postpartum Care Indicator Postpartum Care Visit HEDIS % 83.78% 61.13% 69.38% Product National HEDIS Rate MQIC Best Practice 74.10% 97.50% 63.70% 75.80% 38
39 % 74.70% Adult Preventive Services Indicator Breast C ancer Screening HEDIS 59.67% 62.41% 81.26% 80.89% Medicare Product National HEDIS Rate MQIC Best Practice 72.67% 79.70% 58.90% 7 Medicare 72.10% 84.75% 39
40 Adult Preventive Services Indicator C ervical C ancer Screening HEDIS % 73.73% 63.95% 65.69% Product National HEDIS Rate MQIC Best Practice 74.30% 79.34% 58.00% 69.10% 40
41 Adult Preventive Services Indicator C hlamydia Screening in Women ages HEDIS % 56.66% 69.29% 70.26% Product National HEDIS Rate MQIC Best Practice 53.50% 60.70% 62.20% 76.35% 41
42 Adult Preventive Services Indicator C olorectal C ancer Screening HEDIS % 69.31% 79.41% Medicare 79.66% Product National HEDIS Rate MQIC Best Practice 62.00% 75.29% Medicare 67.10% 81.75% 42
43 Adult Preventive Services Indicator Non-recommended PSA-based Screening in Older Men HEDIS % Medicare 32.79% Product National HEDIS Rate MQIC Best Practice Medicare 31.30% 18.05% 43
44 Adult Preventive Services Indicator Flu Vaccinations for Adults Ages HEDIS % 47.21% 37.81% 36.47% Product National HEDIS Rate MQIC Best Practice 48.10% 54.10% 38.60% 44.90% 44
45 Adult Preventive Services Indicator Flu Vaccinations for Adults Ages 65 and Older HEDIS % Medicare 69.35% Product National HEDIS Rate MQIC Best Practice Medicare 71.10% 75.33% 45
46 Adult Preventive Services Indicator Pneumococcal Vaccination Status for Older Adults HEDIS 65.18% Medicare Product National HEDIS Rate MQIC Best Practice Medicare 74.00% 79.16% 46
47 Adolescent Preventive Services Indicator Adolescent Well-Care Visits HEDIS % 47.22% 56.15% 56.97% Product National HEDIS Rate MQIC Best Practice 47.70% 50.64% 50.60% 64.42% 47
48 Adolescent Preventive Services Indicator C hlamydia Screening in Women ages HEDIS % 52.29% 62.49% 63.87% Product National HEDIS Rate MQIC Best Practice 42.50% 55.85% 53.90% 71.37% 48
49 % 35.00% % 15.00% 5.00% Adolescent Preventive Services Indicator Non-recommended C ervical Cancer Screening in Adolescent Females 3.10% 4.16% 1.97% 2.70% HEDIS Product National HEDIS Rate MQIC Best Practice 1.80% 0.32% 2.00% 0.97% 49
50 Adolescent Preventive Services Indicator Immunizations for Adolescents - Meningococcal 91.17% 91.54% 89.41% 89.71% HEDIS Product National HEDIS Rate MQIC Best Practice 78.60% 93.67% 77.40% 92.94% 50
51 Adolescent Preventive Services Indicator Immunizations for Adolescents - Tdap 91.52% 91.60% 89.81% HEDIS 88.66% Product National HEDIS Rate MQIC Best Practice 87.00% 92.94% 84.90% 92.21% 51
52 Adolescent Preventive Services Indicator Immunizations for Adolescents - Combination % 90.47% 87.64% HEDIS 87.22% Product National HEDIS Rate MQIC Best Practice 77.00% 92.46% 75.10% 91.24% 52
53 Pediatric Preventive Services Indicator Well C hild Visits First 15 months (6+ visits) HEDIS % 84.30% 65.84% 70.20% Product National HEDIS Rate MQIC Best Practice 79.20% 88.20% 61.70% 74.88% 53
54 Pediatric Preventive Services Indicator Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life 77.65% 79.11% 75.74% HEDIS 76.85% Product National HEDIS Rate MQIC Best Practice 76.80% 85.67% 72.20% 79.08% 54
55 Pediatric Preventive Services Indicator C hildhood Immunization Status - DTaP HEDIS % 88.70% 78.32% 78.51% Product National HEDIS Rate MQIC Best Practice 85.30% 91.84% 76.80% 81.94% 55
56 Pediatric Preventive Services Indicator C hildhood Immunization Status - IPV HEDIS % 93.72% 91.37% 91.31% Product National HEDIS Rate MQIC Best Practice 90.40% 96.44% 88.70% 93.92% 56
57 Pediatric Preventive Services Indicator C hildhood Immunization Status - MMR 91.47% 92.24% 91.25% 91.01% HEDIS Product National HEDIS Rate MQIC Best Practice 92.80% 95.37% 89.50% 93.19% 57
58 Pediatric Preventive Services Indicator C hildhood Immunization Status - HiB HEDIS % 94.12% 88.58% 88.70% Product National HEDIS Rate MQIC Best Practice 91.30% 95.37% 88.10% 92.70% 58
59 Pediatric Preventive Services Indicator C hildhood Immunization Status - Hepatitis B 91.72% 92.34% 92.67% 92.58% HEDIS Product National HEDIS Rate MQIC Best Practice 85.40% 95.02% 88.00% 94.65% 59
60 Pediatric Preventive Services Indicator C hildhood Immunization Status - VZV 91.52% 91.87% 90.95% 91.00% HEDIS Product National HEDIS Rate MQIC Best Practice 92.00% 95.02% 89.00% 93.43% 60
61 Pediatric Preventive Services Indicator C hildhood Immunization Status - Pneumococcal conjugate HEDIS % 88.10% 77.41% 78.68% Product National HEDIS Rate MQIC Best Practice 85.40% 90.39% 77.20% 82.97% 61
62 Pediatric Preventive Services Indicator C hildhood Immunization Status - Hepatitis A 83.51% 84.71% 84.23% 85.50% HEDIS Product National HEDIS Rate MQIC Best Practice 86.80% 89.05% 84.20% 91.67% 62
63 Pediatric Preventive Services Indicator C hildhood Immunization Status - Rotavirus HEDIS % 81.53% 67.74% 69.10% Product National HEDIS Rate MQIC Best Practice 80.50% 86.73% 69.00% 76.16% 63
64 Pediatric Preventive Services Indicator C hildhood Immunization Status - Influenza HEDIS % 61.96% 45.96% 45.91% Product National HEDIS Rate MQIC Best Practice 64.50% 68.37% 45.30% 62.04% 64
65 Pediatric Preventive Services Indicator C hildhood Immunization Status - C ombination 2 HEDIS % 83.68% 76.28% 76.70% Product National HEDIS Rate MQIC Best Practice 78.50% 87.90% 73.00% 80.29% 65
66 Pediatric Preventive Services Indicator C hildhood Immunization Status - C ombination 3 HEDIS % 81.39% 71.31% 72.50% Product National HEDIS Rate MQIC Best Practice 76.50% 85.46% 69.70% 77.13% 66
67 Pediatric Preventive Services Indicator C hildhood Immunization Status - C ombination 10 HEDIS % 54.38% 33.99% 33.52% Product National HEDIS Rate MQIC Best Practice 51.00% 62.24% 33.30% 49.88% 67
68 Pediatric Preventive Services Indicator Lead Screening in C hildren HEDIS 77.58% 79.11% Product National HEDIS Rate MQIC Best Practice 67.60% 85.83% 68
69 Substance Use Disorders Indicator Initiation of Alcohol and Other Drug Dependence Treatment HEDIS % 32.73% 43.59% Medicare 45.43% Product National HEDIS Rate MQIC Best Practice 33.50% 43.77% Medicare 32.70% 62.60% 69
70 Substance Use Disorders Indicator Engagement of Alcohol and Other Drug Dependence Treatment HEDIS % 35.00% % 15.00% 5.00% 8.87% 9.40% 4.09% Medicare 5.18% Product National HEDIS Rate MQIC Best Practice 11.30% 12.36% Medicare 3.60% 8.73% 70
71 Tobacco Control Indicator Advising Smokers and Tobacco Users to Quit HEDIS 80.20% 78.81% 80.06% 80.45% 79.05% 86.84% Medicare Product National HEDIS Rate MQIC Best Practice 75.10% 81.82% 76.20% 82.17% Medicare 85.60% 91.89% 71
72 % Tobacco Control Indicator Discussing C essation Medications HEDIS 54.29% 56.09% 53.29% Product National HEDIS Rate MQIC Best Practice 42.90% 58.33% 44.10% 60.80% 72
73 % Tobacco Control Indicator Discussing C essation Strategies HEDIS 44.94% 44.78% 45.78% Product National HEDIS Rate MQIC Best Practice 48.10% 50.65% 49.50% 51.63% 73
74 % 13.28% Tobacco Control Indicator Percent Current Smokers non-hedis 42.52% 39.46% 12.74% Medicare Product MQIC Best Practice 7.17% 30.82% Medicare n/a 74
75 Please visit mqic.org to access the current Michigan Quality Improvement Consortium: Clinical Practice Guidelines Measurement Specifications and Reports Physician Practice Tools Sign up here to receive notice when guidelines have been updated. An MQIC mobile app for ios and Android devices is available in the Apple Store and Google Play. Search MQIC. 75
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