Quality Corp reports ambulatory care measures for Oregon

In late February, the Oregon Health Care Quality Corporation (Quality Corp) began public reporting of ambulatory care measures for more than 2,200 adult primary care practitioners in about 300 doctors’ offices and 120 medical groups across Oregon. The measures, reported on Quality Corp’s Partner for Quality Care consumer website, provide a picture of care delivered to 2.5 million patients, primarily during 2008–2009.

The initial report covers nine standard measures for diabetes, heart disease, women’s health, and asthma care, based on administrative claims data from Oregon’s eight largest health plans.

“This is a great first step for Oregon,” said Nancy Clarke, executive director of Quality Corp. “For the first time, patients in Oregon can go online to see how their doctor’s office or medical group stacks up on nationally endorsed standards of care.”

Besides the statewide clinic comparisons, the website notes how Oregon compares to the national averages for the selected measures. For example, Oregon outperforms the national average on the four types of recommended care for people with diabetes, and on testing for breast cancer, but is below average on testing for chlamydia infection.

Quality Corp hopes to update the first reported measures by the end of 2010. Future steps may involve finding a cost-effective way to collect standardized data on patient experience with ambulatory care, and moving from claims-based reporting to electronic health record-based reporting.

Partner for Quality Care also reports Medicare Hospital Compare performance measures for Oregon hospitals. Acumentra Health assists by aggregating data from the Centers for Medicare & Medicaid Services into composite summary measures for uploading to the Partner for Quality Care website.

Funding for this initiative comes from foundations, purchasers, and health plans, including a grant from the Robert Wood Johnson Foundation.

Evaluating residential mental health care in Oregon

The principles of recovery-based care call for serving mental healthcare consumers in the least restrictive environment. State Medicaid programs—concerned about cost efficiency and about aligning services with the recovery model—seek to help consumers move from residential treatment to supported housing and other community-based services, where possible.

To gauge the efficiency and effectiveness of adult residential mental health services in Oregon, the Addictions and Mental Health Division (AMH) has contracted with Acumentra Health to perform an independent review of those services. The study will shed light on system capacity and utilization, consumer transition between levels of care, length-of-stay trends, treatment outcomes, and barriers to independence. Specific questions include:

1. Are individuals admitted at the correct level of care?
2. Are individuals ready to be at a lower level of care?
3. If other options were available, could the individual move to a lower level of care?
4. What treatment services are offered at each level of care to help individuals move to a lower level of care?
5. Does each individual receive individualized treatment services?
6. Are individuals more functional and more independent as a result of the treatment services?

To answer those questions, Acumentra Health will interview consumers and service providers and will review clinical records in 78 adult foster homes and residential treatment homes and facilities across Oregon.

The study results, to be delivered in September 2010, will help guide AMH’s efforts to ensure that adult residential mental health services are cost-effective and clinically appropriate.

New officers and trustees

Acumentra Health installed a new slate of officers at the February 8 meeting of its Board of Trustees. Shelley Barnes, MPHA, is the new board chair. Joy Conklin is vice chair (chair elect), and Andris Antoniskis, MD, is secretary/treasurer. In addition, Barbara Christensen has begun serving a full term on the board following an interim appointment. We are fortunate to be able to draw on the experience and insight of these knowledgeable professionals as we pursue our healthcare quality goals.

For more information about these and other trustees, please visit www.acumentra.org/corporate/board.php.

Acumentra Health in print

Acumentra Health staff authored an article for Medicine in Oregon, published by the Oregon Medical Association, on “Using EHRs for Data and Quality Improvement.” Ruth Medak, MD, associate medical director, described how the EHR Preventive Care Initiative has helped 41 small and medium-sized primary care practices in Oregon use EHRs to produce data reports for mammography, colorectal cancer screening, influenza vaccination, and pneumococcal vaccination. Clinics use the reports to identify opportunities to improve rates for these and other key clinical care measures, and determine whether practice changes improve their rates. Acumentra Health coordinates work on this CMS initiative with the EHR activities of independent practice associations across Oregon.

Jon K. Mitchell, president and CEO of Acumentra Health, contributed an opinion column to The Oregonian, stressing the importance of quality improvement work in “bending the cost curve” for health care. The column advocated a sharper focus on value—health outcomes achieved for money spent. Many experts say the best way to rein in spending is to improve the quality of care by offering more timely and appropriate treatments, eliminating unnecessary tests and drugs, preventing avoidable complications, and coordinating care between specialists and primary physicians and between settings of care.

Q-News, Issue 22
© 2010 Acumentra Health. All rights reserved.

This material was prepared by Acumentra Health, Oregon’s Medicare Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.

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3/16/10