Michigan Center for Clinical Systems Improvement

(Mi-CCSI)_________________

Collaborating for Quality and Sustainability

Spring 2011

Context 50 million nonelderly people in the U.S.—19% of those

under age 65—don’t have health insurance (as of 2009, the latest date for which figures are available) The Kaiser Commission on Medicaid and the Uninsured

(Dec 2010) Health reform will increase the number of insured Americans

but this prospect threatens to overwhelm primary care Payment reform continues to be elusive and complex Payers and providers have significant barriers to overcome

to cooperate on common approaches to system transformation and payment redesign

Employers and consumers have difficulty engaging in reform initiatives

Mi-CCSI Overview2

Purpose of Mi-CCSI

Create and maintain an environment for collaboration among health care stakeholders to reduce variation in clinical care and administrative practices

Promote systems and practices that improve patient experience and population health while lowering per capita cost

Focus on problems that no one party can solve on its own

Reduce health care disparities among minority populations

Ensure that regional communities lead the effort toward health system reform and stability

3 Mi-CCSI Overview

History

Mi-CCSI Overview4

West Michigan Physicians for Transformation created the foundation for the organization

Key physicians from all of the area’s health systems participated in early meetings and helped create the mission and guiding principles The Development Steering Committee continues to be made up of

a subset of founding physicians ICSI in Minnesota provided a ready organizational model

and the two organizations are collaborating through a consulting agreement (see slide for a brief overview of ICSI)

Blue Cross Blue Shield of Michigan provided initial funding and Mi-CCSI was awarded the RWJ AF4Q grant for QI work in 2011-21

Five west and southwest Michigan delivery systems have provided additional funding

Development Steering Committee MaryEllen Benzik, MD—Integrated Health Partners, Battle

Creek Frank Belsito, DO—Metro Health, Grand Rapids David Blair, MD—Advantage Health, Grand Rapids John MacKeigan, MD—Spectrum Health, Grand Rapids Phil Henderson, MD—Spectrum Medical Group, Grand Rapids Paul Ponstein, DO—Lakeshore Health Network, Muskegon Rem Sprague, MD—Mercy Health Partners, Muskegon Tom Ruane, MD—BCBSM Mike VanPutten—BCN Hugh Hufnagel—Independent Consultant Steve Williams—Independent Consultant

5 Mi-CCSI Overview

Mission and Vision

Mission Create a permanent multi-stakeholder

collaborative to promote health care value and patient-centered care and optimize the health of communities. Work to sustain an effective and efficient system of care consistent with the needs of people, employers, providers and payers.

Vision West Michigan will be a region with exceptional

healthcare experiences, optimal population health and financial sustainability.

6 Mi-CCSI Overview

Overview of ICSI-Minnesota ICSI brings together diverse groups to transform the

health care system so that it delivers patient-centered and value-driven care. It is comprised of 62 medical groups and sponsored by five Minnesota and Wisconsin health plans.

Programs Common clinical guidelines Statewide solution to high tech radiology authorizations Depression management program—DIAMOND Health care homes

www.icsi.org

7 Mi-CCSI Overview

Initial Program Agenda

Depression Adapt DIAMOND/Impact model implemented by ICSI in

Minnesota Build and expand elements of PCMH Focus on Triple Aim goals

CHF Develop common reporting of metrics for providers

participating in west Michigan demonstration project sponsored by BCBSM and BCN

Diabetes Focus is on ambulatory care for patients with

uncontrolled diabetes (hypothesis; still in development)

Mi-CCSI Overview8

Future Program Possibilities

Advanced care planning Palliative care High tech diagnostic imaging guidelines Public reporting (in collaboration with employer

alliances) Other chronic conditions

Mi-CCSI Overview9

Collaboration Opportunities

First, do no harm Second, do not duplicate effort Third, collaborate, cooperate, support (AFH, MPCC,

ICSI) Focus on reducing variation and common approaches Advance concepts like medical home and the chronic

care model (depression, diabetes) Share infrastructure wherever possible, but hold

parties accountable for achieving goals Create an environment where collaboration is the

norm

Mi-CCSI Overview10