Tablero de Control, Protección v Medición 1 Objeto

Michigan has invested in projects that will support a high quality information and improvement infrastructure. However, additional investments are required to enhance connectivity, usability, and efficiency of health information exchange for care coordination, as well as aggregation of claims and clinical data to support measurement of the value of care at the provider, practice, Accountable System of Care, and community levels.

Infrastructure that will be enhanced includes:

Health information exchange and the State of Michigan Data Hub – especially Michigan’s shared services infrastructure including a health provider directory to track provider affiliations to Patient Centered Medical Homes and Accountable Systems of Care

Collection and aggregation of cost and quality data from multiple payers and sources Mechanisms to prominently display progress towards overall Innovation Model goals Mechanisms to provide ratings and non-financial rewards to top-performing Accountable Systems of Care and Community Health Innovation Regions

The first two items are further described in chapter F. In regards to the third and fourth, it is believed that there are a number of non-financial rewards that will drive patients, providers, purchasers, and plans to choose value over volume in health care. Specifically, Michigan’s core data infrastructure will be leveraged in support of:

Public reporting of provider and delivery system performance

Public recognition programs that include profiling and performance rating of Patient Centered Medical Homes, Accountable Systems of Care, and Community Health Innovation Regions

Summary

This chapter has described Michigan’s proposed service delivery and payment models to achieve the aims of population health, better care, and lower cost.

Patient Centered Medical Homes address patient needs: clinicians are more accessible, care teams engage patients to work together on their health, and they monitor their patient population to assure that everyone is getting the care they need.

In Accountable Systems of Care, providers organize so that they can communicate effectively;

coordinate patient care across multiple settings, and make more efficient investments in the data analytics and technology to improve care. Through clinical integration – with formal governance and contractual relationships – providers co-create tools, workflows, protocols, and systematic processes, to provide care

that is accessible to patients and families, that supports self-management, is coordinated, and incorporates evidence-based guidelines. Managing the health of a population requires investments in health

information technology, data systems, and analytics. As these capacities are strengthened within an Accountable System of Care, the system can be held responsible for performance in terms of quality of care and the health outcomes of their assigned population.

In Community Health Innovation Regions, partners act cohesively for community-wide impact to make the environment healthier and to connect health services with related community services. The process begins with a collaborative community health needs assessment that identifies key health concerns, root causes of poor health outcomes, and sets strategic priorities. Action plans are developed that organize and align contributions from all partners in order for collective impact.

Payment models are designed to incentivize value over volume – aligning the interests of patients, communities, primary care providers, specialists, hospitals, payers, and policy makers towards universal aims of population health, high quality health care, at an affordable cost. To do this, a staged approach to payment reform is proposed in which Patient Centered Medical Homes and Accountable Systems of Care are encouraged to move away from fee-for-service and add capacity for coordinated care and

responsibility for outcomes.

Statewide infrastructure responds to patients, providers, communities and payers, and in turn, provides governance for the implementation of the model. State government must align policy, payment, and programming to reinforce the model elements and incentivize the desired outcomes. The state is a major purchaser of health care services for Medicaid beneficiaries, and for its own employees. The state has an important role in guiding investment in shared infrastructure and promoting practice transformation through statewide data monitoring, evaluation and dissemination. It establishes systems to monitor and reward performance, and disseminate information, including recognition of top performers.

The foundations are in place in Michigan to have a system of care that meets the vision and goals put forth by the State Innovation Model advisory committee. However, multi-payer payment models and other levers must be put in place to align behavior and organizational capacity to meet the goals of high quality, accessible, coordinated care that is integrated with community systems for population health. These will ensure that Michigan’s system simultaneously improves population health and experience of care while reducing waste, unnecessary administrative complexity, and cost.

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Chapter F: Health Information Technology and