June 22, 2022

9 AM – 3:30 PM

Monona Terrace Convention Center, Madison, WI

In person and virtual option

‍REGISTER

AGENDA

Registration is open for the annual 2022 WCHQ Quality and Value Improvement Event June 22 at Monona Terrace. This education session is open only to WCHQ provider members, corporate sponsors and annual partners. The registration fee of $100 includes all conference sessions and lunch.

Highlights during the day include:

• Angela Fitch, MD, the associate director of Massachusetts General Hospital Weight Center and on faculty at Harvard Medical School, will keynote the event with a presentation on “Combination Therapy for Optimal Obesity Care.” Dr. Fitch has been a guest on numerous national podcasts sharing her expertise in evidence-based management of obesity and weight gain.
• WCHQ will present its 2022 Quality Leadership, recognizing Fort HealthCare. Michael Wallace, Fort Healthcare CEO will describe their approach to quality and community health improvement.
• WCHQ released its first Health Care Value Report earlier this year. WCHQ President and CEO Gabrielle Rude, PhD, will describe the evolution of this work, how members are shaping the work and incorporating value into their organizations, and what to expect in the future.
• Mbonu Ikezuagu, MD, vice president and chief quality officer at ThedaCare, will explain how they are using WCHQ data to improve health care value in their organization.

The WCHQ Diabetes Summit, sponsored in partnership with Novo Nordisk will start in the afternoon and feature three outstanding presentations:

• Caroline Richardson, MD, program director of the Michigan Collaborative for Type 2 Diabetes, will explain how their collaborative is shifting the paradigm for treating and managing type 2 diabetes by engaging and empowering clinicians.
• Novo Nordisk Patient Ambassador Len Elmore is a former NBA player, sportscaster and lecturer at Columbia University. After being diagnosed with type 2 diabetes, Len tried to stick to his medication plan and healthy lifestyle but found that to be a difficult journey. He has partnered with Novo Nordisk to raise awareness and teach others to recognize the signs of type 2 diabetes. Melanie Smith, DO, Advocate Aurora Health Care, is a family medicine physician with expertise in obesity medicine. Dr. Smith will facilitate a dialogue between the audience and Len Elmore following Len’s presentation.  
• Eric Johnson, PharmD, BCPS, Gundersen Health, is working with a team that is focused on delivering better care to patients. Pharmacists play an essential role in a diabetes care team, one that will be explored in this presentation.

Registration is open. The agenda is here. The registration fee is $100. This event is open to WCHQ member providers, corporate sponsors and annual partners. For more information contact Mary Kay Fahey.
‍

Upcoming Events

‍WCHQ Adolescent and Child Health Assembly

September 20, 2022
9 AM – Noon
Virtual

‍

‍WCHQ Obesity Summit

October 13, 2022
9 AM – 4 PM
(hybrid)
The Hotel Retlaw, Fond du Lac

‍

WCHQ Disparities Assembly

November 10, 2022
(Format: TBD)

WCHQ is in the process of adding a position to the Measurement Team. The Data Analyst will support organization-wide projects and initiatives related to performance measurement and analytics, quality improvement, research and other shared initiatives that support improved health, better care and value initiatives.  

“WCHQ members trust us to collect data and run performance reports that informs their internal improvement activities. We’ve been able to use this information to help drive evidence-based improvements in quality on a statewide level, too” said Brian Slattery, Director of Performance Measurement and Analytics. “That said, I think we’ve only scratched the surface in terms of the value that we can provide to the membership. By investing in this additional data analyst position, we will have additional capacity that will allow us to more quickly deliver data that will help us be better informed and able to resolve some of the issues that are most pressing to our members and funders.”

Click here for information or to apply for the job.

WCHQ was pleased to welcome Katharine A. R. Price, MD, to present at a webinar May 5 on strategies to increase HPV vaccination rates in Wisconsin. Dr. Price reviewed the indications, benefits, and safety of the vaccine. She summarized the vaccination rates and discussed health disparities related to HPV vaccination rates. Dr. Price went into detail about how to increase HPV vaccination rates while discussing barriers and how to overcome them.  

As an oncology surgeon, Dr. Price noted that 70 percent of the cancers she treats are preventable. The treatment of HPV head and neck cancer includes surgery, radiation therapy and chemotherapy. The short- and long-term toxicity from head and neck cancer treatment is substantial. These cancers cause unnecessary suffering and loss of life for men and women, young and old.  

Dr. Price discussed the ability of the HPV vaccination to prevent cervical, vulvar, anal and vaginal cancers.

“The most critical disparity to address in HPV vaccination is the rural-urban divide,” according to Dr. Price. The WCHQ 2020 Health Disparities Report supported this, finding substantial disparities in HPS vaccination rates in rural advantaged areas of the state.

Dr. Price reviewed the CDC recommendations for HPV vaccinations, which included:

• Recommended age for HPV vaccination is 11-26 years old;
• HPV vaccination is recommended for all preteens (including girls and boys) at age 11–12 years;
• Can start series at age 9;
• Ideal timing is before initiation of sexual activity;
• FDA approval is through age 45; and,
• Individuals ages 27-45 may benefit from HPV vaccination based on risk.

A WCHQ member comment after the webinar sums up the effectiveness of Dr. Price’s presentation: “No question, I would love to take you on tour to promote this message!”

A recording of the presentation is HERE. Use Passcode: w?jr8ND2 (meeting starts at 08:00)

Precision medicine is rapidly evolving the treatment landscape creating opportunities to improve care and mortality rates for patients diagnosed with cancer. On May 19, WCHQ presented an online seminar, “Revolutionizing Health Improvement and Disease Treatment,” that explained how biomarkers are used in the field of oncology to ensure a proper diagnosis and to guide treatment.

Dorothy 'Dot' Guccione, RN, senior biomarker testing executive with Genentech, identified some of the gaps in cancer diagnosis as:

• Lack of clarity around test selection and results interpretation;
• Lack of clear processes for collecting sufficient amounts of tissue and ordering tests;
• Lack of clear processes for choosing labs and ordering tests;
• Uncertainty around diagnosis access, reimbursement and inefficient prior authorization process.

Better diagnostics play a role in delivering better outcomes and a better patient experience. This point was illustrated by Alecia Mandal, a colon cancer patient who found she qualified for immunotherapy after biomarker testing.

“When your patients come into the primary care clinic, please hook them up with biomarker testing,” said Ms. Mandel. “I am here, I am alive because of immunotherapy and biomarker testing.”

“As her GI medical oncologist, before we knew about biomarker testing, I will say it would not have been possible for Alecia to be in the health state where she currently is,” according to Sheetal Kircher, MD Associate professor at Robert H. Lurie Comprehensive Cancer Center, Northwestern University.

Dr. Kircher said first line cancer therapy can be time sensitive and it depends on knowing the results of the biomarker testing. She said some health systems are starting initiatives to order biomarker testing in the primary care office so the results are available at the first visit the patient has with the oncology specialist.

Clinical trials have evolved as well, according to Dr. Kircher, no longer being the “last resort” but rather the first line of therapy using biomarkers to guide treatment.

“It takes a village to put this together. There are so many people the cancer patient depends on that they may not meet, but it comes down to working together and not having unnecessary delays in accessing treatment,” Guccione concluded.

Listen to the webinar HERE using this access code: 6+UjC*C0

Obesity

WCHQ Unveils Results of Obesity Prevalence Measure  

WCHQ Obesity Advisory Group members agreed to begin measuring the prevalence of obesity in health systems. The measure specification includes patients who have either:

• a BMI < 30 or
• a BMI < 27 for patients of Asian descent or those with certain co-morbidities.

The obesity prevalence rate across the WCHQ health systems reporting this measure through December of 2020 is 58 percent. This rate is higher than what is typically reported from other sources, such as the Wisconsin Department of Health, because it requires two primary care visits to qualify. Our assumption is that the two-visit requirement coupled with the impact of Covid on our measurement period drove up the reported obesity prevalence rate as patients who qualified for the denominator were likely those who had co-morbidities that required a visit. The high percentage of those with the disease of obesity reinforces the work WCHQ is doing on obesity to drive improvement. WCHQ members requested additional data including how many of these patients are on medications that increase weight, the number of patients on anti-obesity medications, and geography, payer, race, and ethnicity. The Advisory Group will meet in July to begin to develop quality improvement activities.

The Obesity Advisory Group is participating in an upcoming training on obesity for employers. The Alliance, along with WCHQ, M3 and Health Payment Systems, are sponsoring an educational event that includes obesity providers, psychologists and employers. This learning event is focused on the impact that obesity has on people in their work environment. Register for this free event here.

To learn more about the Obesity Advisory Group, contact Jen Koberstein.

Disparities

Health Systems Share Goals for Reducing Disparities

Health systems shared their individual goals for improving disparities at the May Improvement Team meeting. Each health system participating in the Disparities Improvement Team will select a measure, priority population and goal to improve health equity. These goals vary based on the populations served, location, resources and systems. One health system has identified data collection as a goal, citing the need to ensure that data on race, ethnicity, and social determinants of health are consistently and accurately captured. Another health system has set a goal to close the disparities gap in colorectal cancer and breast cancer screenings between people of color and white populations. See recent article on this topic HERE.

In addition to discussing improvement goals, the team also reviewed updated disparities data from 2019 and 2020. The team reviewed statewide, stratified data on diabetes testing and control, hypertension control, and colorectal cancer screening by geography and race/ethnicity. These data, which describe the impact of the first year of the COVID-19 pandemic on health disparities, will be published in a series of brief reports at the end of June.

To participate in the Disparities Improvement Team, contact Abbey Harburn.

Chronic Disease

Chronic Kidney Disease Advisory Group Continues to Define Scope, Recruit Health Systems

A subcommittee of the Chronic Kidney Disease (CKD) Advisory Group met in May to further discuss the opportunity to look beyond patients with diabetes and to consider including additional populations at risk of developing chronic kidney disease. There was robust discussion and by the end of the meeting, the group was confident with their recommendations and next steps. Their recommendations encouraged an evidence-based approach that could be supported through measure development and educational opportunities.

Sarang Baman, MD, Advocate Aurora, will bring the subcommittee’s recommendations to the Advisory group at the June 2, 2022, CKD Advisory Group meeting. This information will segue into finalizing the CKD Advisory Group Charter.

WCHQ is actively recruiting members to create a diverse level of expertise to support this work. To learn more about this work or to join the CKD Advisory Group, contact Sheryl Pierce.

Chronic Disease Learning Collaborative (CDLC) Hypertension Workgroup

Korina Hendricks, MPH from University Wisconsin Madison Health Innovation Program, Neighborhood Health Partnership (NHP) Program, presented at the May meeting of the Chronic Disease Learning Collaborative. In addition to the measurement data reporting tools that utilize WCHQ measures, the NHP recently added sociodemographic profile reporting capabilities that utilize US Census Bureau data. Both tools provide powerful data that can be turned into actionable improvement efforts. For additional information, visit the Neighborhood Health Partnership Program.

The group discussed current hypertension initiatives and a number of members reported progress related to their hypertension SMART goals. Overall, the group seemed optimistic about current progress while noting a few new obstacles along the way as sometimes resources needed to be reallocated. Whether seeking new resources or retaining current resources, demonstrating a return on investment appears to be an important part of the equation to support improvement efforts worked on by care management staff. This topic will be explored further at upcoming meetings.

The CDLC Hypertension workgroup will continue to meet this year to share best practices and work toward goals with a final presentation in January 2023. The final presentations will summarize SMART goal accomplishments and lessons learned from the members of the CDLC Hypertension, Diabetes, and Team-Based Care workgroups.  

To join or to learn more about the CDLC Hypertension workgroup, contact Sheryl Pierce.

Behavioral Health

Emphasis on Behavioral Health Continues

The pandemic has significantly increased the demand for behavioral health services. WCHQ members continue to review data from the depression screening, PHQ-9, and depression remission and response measures. While health systems have dramatically improved their rates for depression screening, more progress could be made. At the next few improvement team meetings, the group will hear from high performers on each measure in the coming months to hear what they have implemented to increase their scores.  

In May, the behavioral health team met with WCHQ staff to learn more about the disparities work being led by WCHQ. Members want to more thoroughly understand where disparities are occurring related to depression screening, remission and response.  WCHQ will provide members disparities-related data on over the next several months. The group discussed the need to ensure that patients have access to services and are not encountering barriers, such as long wait times for an appointment. The group members will work with WCHQ to determine what metrics could be useful in assessing progress on that issue.  

To join this improvement team or learn more about behavioral health initiatives at WCHQ, contact Jen Koberstein.

Adolescent and Child Health

Depression in Adolescents: A Growing Concern

Adolescents face incredible pressures during normal times and the addition of the pandemic added to the burden teens were already facing at home and in school. In 2021, the US Attorney General issued an advisory calling on the American people to pay attention to the urgent public health issue related to children’s mental health and released recommendations. The recommendations include health systems surrounding young people with resources to address mental health issues. It also suggests the need to focus on underserved populations.  

WCHQ members continue to monitor the rates of depression screening within the health systems and learn from those who are screening high numbers of adolescents.  Additionally, those diagnosed with dysthymia or depression received PHQ-9 screening and these rates are monitored and action is taken to improve follow-up. WCHQ members were pleased to see that PHQ-9 screening rates for adolescents went up during the pandemic from forty-eight to forty-nine percent. This was largely due to the systems’ ability to pivot to virtual services when the pandemic hit.  

The Adolescent and Child Health and Behavioral Health Improvement Teams will continue to spotlight the importance of adolescent and child behavioral health screening, services, and access. For more information, contact Abbey Harburn.

Oral Health

June is National Oral Health Month        

Many of the WCHQ oral health providers recite the phrase, “the mouth is part of the body.” The WCHQ Oral Health Collaborative and its partners are committed to ensuring the integration of medical and oral health. Oral health is often not part of the initial discussion about health, which causes issues downstream for the patient and their providers.

June is National Oral Health Month and here are a few reminders of the importance that oral health has on overall health:  

Diabetes significantly raises the risk of developing gum disease and regular appointments with the dentist can help address this issue quickly. Patients with diabetes are three times as likely to develop periodontitis which negatively impacts HbA1c control.

Periodontal disease among pregnant women is known to contribute to adverse birth outcomes, including low birthweight and preterm birth. WCHQ oral health members contributed earlier this year to a perinatal resource tool to ensure that oral health is included in considerations.

Most recently, the Journal of Clinical Periodontology published an article drawing conclusions about the connection between COVID-19 and gum disease. This is emerging work that the oral health members will continue to monitor.

The WCHQ Oral Health Collaborative members understand the importance of medical and dental integration and have aligned the oral health work with the WCHQ medical side to prioritize patients who have diabetes. A cross-cutting dental-medical diabetes measure will be publicly reported in the fall of 2022.

For information about the WCHQ Oral Health Collaborative, contact Jen Koberstein.‍