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Regions

*Regional Notes

Rewards Paid to Date: 

  • $97,000 in 2006 (the 9 top scoring groups who achieved 10% Optimal Diabetes Care were rewarded)
  • $260,000 in 2007 for Optimal Diabetes Care (rewards were distributed to 39 clinic sites from 15 medical groups who achieved 20% Optimal Diabetes Care)
  • $88,000 in 2007 for Optimal Coronary Artery Disease Care (rewards were distributed to 42 clinic sites from 16 medical groups)

In 2007, Minnesota Bridges to Excellence has elected to recognize, report and reward individual clinic sites within medical groups.

To view a list of currently recognized clinic sites and their scores, as well as scores for all reporting clinic sites and medical groups, visit www.mnhealthcare.org.

Performance Assessment Organizations and Measures:

For diabetes, physician groups are rewarded based on their performance and adherence to ICSI's composite measure for "Optimal Diabetes Care" which requires each patient to meet 5 clinical indicators (HbgA1c<7; LDL<100; BP<130/80; non-smoking status; daily aspirin for patients over 40).

For CAD in 2007, physician groups will be rewarded based on their performance and adherence to ICSI's composite measure for CAD, "Optimal Cardiac Care," which requires each patient to meet 4 clinical indicators (LDL<100; BP<140/90; non-smoking status; daily aspirin).

MN Community Measurement performs the quality and review and public reporting functions of the program.  Historically, MNCM reviewed claims data and clinical data obtained through randomized chart abstraction.  For the first time, in 2007, medical groups and clinic performance was based on clinical data submitted by providers through a process called Direct Data Submission (DDS).  Through this process, more granular performance data on clinic sites became available.  Data submitted by 30 medical groups, including over 200 clinic sites, were thoroughly reviewed and validated, resulting in rewards for 39 clinic sites from 15 medical groups and public reporting of performance for 191 clinic sites from 27 medical groups.
   

 

Minneapolis, Minnesota

The Buyers Health Care Action Group (BHCAG) is a large employer business coalition committed to reforming the delivery of heatlh care in Minnesota.  Over the last 19 years, BHCAG has been a catalyst for many market reform initiatives.  Bridges to Excellence is one of BHCAG's initiatives aimed to create a tipping point for physicians to re-engineer care processes and to provide incentives to improve health care outcomes rather than simply delivering additional services.

The Minnesota market has several existing building blocks that have accelerated the implementation of Bridges to Excellence:

  • Pay-for-performance programs have been in place for several years in Minnesota through all major health plans.
  • The Institute for Clinical Systems Improvement (ICSI), a physician-based organization, has developed clinical guidelines, provided support for implementation of these guidelines, and developed measures for performance evaluation through a broad range of community physicians.
  • MN Community Measurement (MNCM) was formed in 2002 by several local health plans as a collaborative to collect performance data.  By aggregating health plan claims data and collecting clinical information from physician offices, MNCM publicly reports physicians' performance results.

As BHCAG began to implement Bridges to Excellence (BTE) in 2005, it formed a Guiding Coalition comprised of multiple community stakeholders including representatives from 4 of the market's largest health plans, Stratis, the Minnesota QIO, the Minnesota Medical Association (MMA), several large employers, providers, ICSI, and MN Community Measurement.  BHCAG and the Guiding Coalition continue to guide the design, development, implementation, and ongoing strategy for BTE in Minnesota.

An extremely valuable by-product of the Guiding Coalition's work was achieving consensus among the health plans to use the same composite measure for all Minnesota pay-for-performance programs for diabetes and coronary artery disease (CAD).  Going forward, the Guiding Coalition will strive to achieve greater alignment across payers in all Minnesota pay-for-performance programs to provide a clear and strong signal to physicians that quality outcomes will be rewarded.

QUICK MARKET FACTS


Number of Recognized Physicians:
9 groups in 2006 & 39 sites from 15 groups in 2007 for DCL; 42 sites from 16 groups for CCL

Rewards Paid to Date:
$445,000 since 2006*

BTE Programs Implemented:
Diabetes Care Link (2006 and 2007) and Cardiac Care Link (CAD) in 4th Quarter 2007

Geographic Scope of Market: 
State of Minnesota

Number of Covered Lives in Market:
773,000

Participating Employers: 3M , Carlson Companies , CCOGA , Minnesota Department of Human Services (Medicaid) , General Electric , Honeywell , Medtronic , Resource Training & Solutions , Minnesota Department of Employee Relations , Target , University of Minnesota , Wells Fargo

Licensed Health Plan Administrators:
None

Performance Assessment Organizations and Measures:
Minnesota Community Measurement (MNCM)*

Reward Amounts:

Recognition POL DCL CCL
Level I
N/A
$100
$150
Level II
N/A
N/A
N/A
Level III
N/A
N/A
N/A

Next Rewards Cycle:
July 2008

Regional Contacts:

Organization Contact Information Contact Type
LCD Solutions, Inc.
Linda Davis
[email protected]
952-484-7970
General BTE information and participation in MN
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© BTE 2007. All rights reserved.
Bridges to Excellence does not endorse any particular product or service or any physician or physician group. Bridges to Excellence relies on third-party performance assessment organizations such as the NCQA and Quality Improvement Organizations to measure a physician or physician's group performance and ability to demonstrate that they meet certain measures of quality care.