WCHQ has built a reputation for using data to highlight opportunities for improvement and to facilitate transparent sharing to drive improvement. Today, we are bringing diverse partners into our work, creating new opportunities for member engagement and finding unique ways to use WCHQ’s data to create reports that will help our members define and measure the value of care.
The current pandemic has emphasized the criticality of actionable information while also revealing the need for analytic support from outside of health systems when analytic staff are repurposed. Data alone is not information. To better support our members, WCHQ is focused on providing enhanced analytics for our members via our new technology platform. We are committed to turning our robust data into actionable information.
Starting this month, we are launching a new feature in our newsletter. Each month we will highlight the statewide performance on one or two measures.
It is important to note that the featured results only describe where we would have been if it were not for a pandemic (just holding steady). We based our estimates on pre- pandemic rates but of course even then there were opportunities to improve. The challenge today is to not only make up for pandemic losses in preventative services but to continue to improve. To facilitate this improvement, WCHQ is committed to returning to its normal cadence of public reporting and planning the public release of more recent data soon. Our Measurement Advisory Committee voted to release calendar year 2021 data in the next few months (firm date coming soon). WCHQ members should be commended for their commitment to continue to always provide exceptional quality care.
We reviewed the most recently available data (June 2020) compared to pre-pandemic data (December 2019). While we saw a decline in performance on these measures (fewer colorectal cancer screenings and fewer HPV vaccinations) we also noted that some providers saw a dramatic drop in the number of patients that qualified for these measures. This means that because fewer patients were seen in the physician office, there were fewer patients that were given the opportunity to receive needed preventive services.
The number of people screened for colorectal cancer decreased by 2.2% across WCHQ’s total population, meaning more than 24,000 patients were not screened for colorectal cancer compared to pre-pandemic results.
We saw wide variation in the changes to patient population (that is adults seen by a provider who could order the colorectal cancer screening) with some organizations maintaining patient populations and others seeing a decline. Based on pre-pandemic screening rates, the organizations that saw a decrease in qualifying patient visits represent an additional 3,800 patients that went without a colorectal cancer screening.
The number of children vaccinated for HPV decreased by 2.0%, which in this smaller population means over 500 children were not vaccinated compared to pre-pandemic results.
This younger population was significantly impacted by a decrease in qualifying patient visits with nearly every reporting organization showing a decline in qualifying visits. This equates to 1,200 additional children who did not receive this life-saving vaccine based on pre-pandemic vaccination rates.
The results above are early indicators of the effect of avoided patient care. The wide variation in performance also provides an opportunity for learning and sharing of best practices, something WCHQ actively facilitates. WCHQ has an improvement team focused on adolescent health, contact Abbey Harburn to learn more.
Looking ahead, we will be providing more data snapshots to highlight opportunities for improvement. Ideas for additional analyses and questions are always welcome. Send your thoughts to email@example.com
Chronic kidney disease can be a devastating and costly illness. Early identification and treatment are critically important. WCHQ launched a new initiative February 16 aimed at reducing the disease burden of CKD through measurement and improvement. The project is supported by Bayer. A recording of the February 16 CKD Launch Event is here (passcode bb0+JQ#B). See the media announcement.
The initiative leverages WCHQ’s expertise in data collection, measurement and quality improvement with Bayer’s expertise in CKD. WCHQ’s member health systems will provide input into the selection and development of relevant clinical measures and actively test the usefulness of the metrics in the clinical setting. The resultant data will inform quality improvement efforts in health systems statewide.
WCHQ President and CEO Gabrielle Rude, PhD, said the project will have a far-reaching impact on the diagnosis of and treatment for CKD.
“WCHQ is unique in the health care environment because we collect data and then use it to monitor and drive quality improvement among our member health systems,” Dr. Rude said. “This project is focused on finding better ways to identify, prevent and treat chronic kidney disease and then share what we learn with practitioners across the country.”
WCHQ is now recruiting health care professionals from our member organizations who have a professional or personal interest in CKD to serve on a new WCHQ Statewide CKD Advisory Group. This group will be comprised of nephrologists, primary care physicians, advance practice professionals, nutritionists, quality improvement professionals, population health managers, epidemiologists, diabetes and hypertension educators, and representatives from provider-owned health plans who have an interest in improving the quality and affordability of care for those with CKD.
The Advisory Group will start meeting in late March. This group will determine the direction of this statewide initiative including the selection of measures. The Advisory Group will also foster opportunities for shared learning and identify topics to include in a statewide education summit on CKD for WCHQ members.
WCHQ is broadening its focus to develop tools that will help members assess and increase the value of care.
At a February 22 seminar for members, WCHQ previewed what will be the first of a series of reports for WCHQ provider members that include data related to quality, utilization and cost.
WCHQ President and CEO Gabrielle Rude, PhD noted that Wisconsin health care has consistently ranked among the best in the nation.
“Now, Wisconsin has an opportunity to leverage WCHQ’s improvement strategies into the world of value and focus on how to provide care that is more affordable for patients, payers and employers,” according to Dr. Rude.
The WCHQ Value Acceleration Initiative defined value as higher quality, more affordable care and limited its initial scope to the population of patients with diabetes. This group was selected because of its large size and large number of expensive complications and comorbidities. WCHQ developed value reports based on the Board-endorsed improvement strategies, which included:
Matt Gigot, WCHQ chief operating officer, shared specifics of the member reports that utilized data from multiple sources to establish a baseline for value measurement. These reports will contain information not previously available on several different indicators of value associated with delivering care to individuals with diabetes. This will include information on clinical quality, hospitalizations and resource utilization.
Gigot noted that the data in the report is blinded and not publicly available, but WCHQ members will be able to identify their own results. The value reports will be shared with provider members in early March.
“The goal of the value report is to introduce this data to WCHQ provider members, identify what current information is helpful to their work to increase value and to identify what additional decision-support information is needed from WCHQ to advance value improvement in their organization,” according to Gigot.
One WCHQ member is already tackling value improvement. Chris Elfner, vice president, clinically integrated networks, described how Bellin Health is using data to increase the value of care.
“We have claims, quality and community organizations that all have data. We need to bring that information together to get good knowledge of our populations across the state,” Elfner said. “This is challenging because we have piles of data, but it might not be the data we need. There are opportunities to mine the data to get to the information that is useful to us.”
Elfner explained that quality, experience and utilization data must be combined to manage a population health program, using internal and external information, with a measurement system that supports the entire process.
Parting thoughts on whether value is the right term from a patient’s perspective were shared by Dirk Steinert, MD, medical director of quality in specialty care at Ascension Wisconsin.
“Effective care is an outcome as understood by and planned for an individual,” according to Dr. Steinert. “Care must be affable, available (access), able to be delivered and affordable. If it is not, then we are not providing effective care. Effective care is a term that is understandable to and has meaning for patients.”
In mid-February, WCHQ began providing unblinded reports to members on their quality measures. The intent behind sharing these unblinded reports is to give WCHQ provider members the information they need to identify and address any measurement areas that may have been impacted as a result of COVID-19.
"We listened to our members and know how important access to timely information is to guiding clinical decision-making," explained WCHQ's Director of Performance Measurement Brian Slattery. "While WCHQ is working toward a return to regular, pre-pandemic reporting cadence, we thought we could extend some additional value to the members by sharing this unblinded information so that they can have the information they need to inform the important work of improving the quality of the care they provide to patients."
Overall, the unblinded reports have been well received by the members.
“At the end of the day, the WCHQ Board of Directors, Measurement Advisory Committee and WCHQ staff recognize that to continue to drive improvement, our members need more timely and actionable information,” according to Slattery. “We feel these reports, while still a work in progress, achieve those objectives.”
Questions about data submission and reports can be directed to Brian Slattery.
Since its inception, the WCHQ Oral Health Collaborative’s (OHC) mission to improve oral health care has aligned with the Wisconsin Dental Association’s (WDA) commitment to quality oral care.
On February 18, WCHQ CEO Gabrielle Rude, PhD, was invited to present to the WDA Board of Trustees at their meeting in Kohler, Wisconsin. Dr. Rude presented an overview of WCHQ as an organization that has facilitated improvement and public reporting of information submitted by medical providers for nearly 20 years. The Oral Health Collaborative, created in 2018, is following a similar path and that is to use data to inform improvement.
Dr. Rude described the progress that the OHC has made to date, which includes the development of several measures of quality, submitting data to WCHQ and using that information in their improvement work. The discussion with WDA centered on how the two organizations can work together to support future work at both WDA and in the WCHQ oral health collaborative.
Dr. Rude emphasized how WCHQ sees itself as operating in support of the WDA’s mission to promote professional excellence through education, encourage thought leadership, and advocate on behalf of the oral health community. Dr. Rude shared how members in the OHC have a focus on building integrative measures between oral and medical care and she emphasized that “the WDA is an important stakeholder in WCHQ’s work as we integrate medical and dental to provide holistic care.”
The two organizations will continue to collaborate and share information that support their mutual missions of service to oral health providers.
For more information about the Oral Health Collaborative contact Jen Koberstein.
March 23, 2022
Noon – 1:30 PM
April 21, 2022
9 AM - Noon
May 5, 2022
Noon – 1 PM
Dr. Katherine Price, Mayo Clinic
June 22, 2022
9 AM – 4 PM
Monona Terrace, Madison
October 13, 2022
9 AM – 4 PM
The Retlaw, Fond du Lac
November 10, 2022
Upcoming Behavioral Health Education Event
Speakers and topics include:
Education Series on Obesity Targets Employers
The WCHQ Obesity Advisory Group met in February with the sub-group working on payer and provider issues to begin designing an education series for employers in Wisconsin. The series will focus on providing medical information about obesity as a disease, treatment options and how employers can support employees who are seeking support for their condition. The series will feature presentations from payers that offer comprehensive obesity coverage. The group expects to launch this series in June.
On March 23, the Obesity Advisory Group will present a virtual education event from 12:00-1:30 PM, “Obesity Treatment: A Pathway to a Healthier Wisconsin.” Dr. Samantha Pabich, assistant professor, Division of Endocrinology, Diabetes and Metabolism, University of Wisconsin. She will discuss “The State of the State’s Body Composition: Obesity and Diabetes in Wisconsin in 2022.” Dr. Melanie Smith, Board-Certified Family Medicine; Diplomate, Obesity Medicine, Advocate Aurora, will present “Treating Obesity to Reduce Cardiovascular Risk in Type 2 Diabetes.”
Following Dr. Smith’s presentation, WCHQ staff will describe measurement and other related activities that are supporting obesity improvement. Find more information and register here.
Advancing Health Equity and Reducing Disparities
The Disparities Improvement Team met in February to finalize their charter and identify the roles, responsibilities and activities needed to advance health equity and reduce disparities in Wisconsin. Of particular focus was the need to involve stakeholders and communities that are experiencing disparities in this work. The Disparities Improvement Team will be reaching out to community groups and organizations to identify appropriate participants. In future meetings, the Improvement Team will participate in focus groups facilitated by the Health Innovation Program and WCHQ to learn more about the process for selecting interventions for addressing health disparities. The Team also plans to share current priorities and strategies implemented at member health systems as a starting point for identifying best practices in reducing health disparities.
For more information, contact Abbey Harburn.
The Current State of Blood Lead Poisoning Testing in Wisconsin
The Childhood Lead Poisoning Prevention Program presented at the February meeting of the Adolescent and Child Health Improvement Team on the status of blood lead testing in Wisconsin. Routine blood lead testing is recommended between the ages of one and five depending on several risk factors, including city of residence, age of housing and Medicaid status. Prior to the pandemic, Wisconsin struggled to test every recommended child. In 2019, only 67.2 percent of one-year-old children enrolled in Medicaid were tested for blood lead levels, even though 100 percent of those children are required to be tested by Medicaid. As a result of the pandemic and a recall of point-of-care blood lead tests, Wisconsin has seen a drastic decrease in blood lead testing. To increase the rate of testing, the Wisconsin Childhood Lead Poisoning Prevention Program sent Medicaid provider reports to every primary care provider in the state who saw at least five Medicaid patients in calendar year 2020. This data allows providers to compare themselves to the best performer in the state and provides a list of specific patients who were not tested.
To increase the rate of blood lead testing, the Lead Poisoning Prevention Program recommends that clinics take the following steps: audit office performance, reduce dependence on WIC clinics for lead testing, collect blood samples in-office and utilize electronic medical record prompts. The Adolescent and Child Health Improvement Team spent the February meeting reviewing strategies that members have implemented in their electronic medical records and within their clinics to increase the rates of lead testing. Strategies employed by members include electronic alerts based on risk factor and standing orders for blood lead testing. For more information or to participate in the Adolescent and Child Health Improvement Team, please contact Abbey Harburn.
Chronic Disease Learning Collaborative, Team-Based Care Workgroup
With nearly 1 in 2 US adults (47.3 percent) diagnosed with high blood pressure, the Centers for Disease Control and Prevention recognizes team-based care (TBC), medication therapy management (MTM), and self-measured blood pressure monitoring (SMBP) as effective ways to manage high blood pressure.
WCHQ member health systems have expressed interest in implementing or enhancing team-based care efforts as well as initiatives that support SMBP programs within their health systems. Several health systems are preparing SMART goals for an upcoming workgroup meeting March 28, 2022. WCHQ is facilitating this work and continues to support members as they collaborate to improve care for patients with high blood pressure.
To join the WCHQ Team-Based Care workgroup series, contact Sheryl Pierce.