Pam James, MS is the I-MPACT Program Manager
The Integrated Michigan Patient Centered Alliance in Care Transitions Collaborative (I-MPACT) is a Blue Cross Blue Shield Value Partnership collaborative quality initiative (CQI) which was established in 2015 and formally launched with an inaugural kick-off for cohort one in April 2016. This CQI has several aspects that make its approach to quality improvement unique. Hospitals and physician organizations (PO) are required to partner with each other to better coordinate care and ultimately improve patient outcomes and experiences; that partnership is called a “cluster”. Another unique feature of I-MPACT is the incorporation of patient or caregiver advisors on each cluster team. These patient advisors are an integral part of the team and, to encourage continued participation and ensure the patient’s voice is heard, the clusters have to provide information to I-MPACT how the patients are integrated into and utilized on any projects or initiatives. Lastly, each cluster is evaluated as one entity for the Pay for Performance Index (P4P) to encourage collaboration, equity and inclusion between them. The entire cluster, both hospitals and POs, can earn additional dollars based on their cluster’s score on the P4P.
The ultimate goal for I-MPACT is to help improve care transitions for patients. I-MPACT strives to accomplish this goal by focusing on three key areas:
- Increasing the frequency with which patients are seen by a provider within 7 days of discharge,
- Working on reducing readmissions,
- Working on reducing Emergency Department visits.
I-MPACT currently has 20 hospital and PO clusters which are divided into 4 groups or cohorts. Data extraction centers around key documents in the care transition process including the discharge summary, patient summary/after visit summary and the admitting history and physical. The goal is to understand more about processes and communication during the care transition and gain a better understanding of where gaps and challenges are occurring.
I-MPACT focuses on five specific patient populations which were strategically chosen to align with other collaboratives and Center for Medicare & Medicaid Services (CMS) initiatives. The five conditions are:
- Acute Myocardial Infarction (AMI),
- Congestive Heart Failure (CHF),
- Chronic Obstructive Pulmonary Disease (COPD),
- Patients transitioning from hospital to a skilled nursing facility (SNF).
I-MPACT helps their members understand the care transition process, especially from a patient perspective by performing an on-site observation of a patient’s discharge process and mapping the data gathered in a document called “the patient journey”.
Upon joining I-MPACT each new cluster, along with their patient advisors, attend a day long kick off where they work through mapping out a transition process, identifying gaps and challenges in their organizations’ care transitions and brain storming interventions aimed at addressing those gaps and challenges.
If you would like more information about I-MPACT check out their website at http://www.impactcqi.org/, contact Pamela James, the Project Manager at I-MPACTCC@med.umich.edu or contact the MVC Coordinating Center through Abeer Yassine (firstname.lastname@example.org ) or Deb Evans (email@example.com)
Jim Dupree, M.D., M.P.H. is the Director of MVC
The next MVC collaborative-wide meeting is coming up soon, November 3rd at Schoolcraft College http://www.schoolcraft.edu/vistatech/maps-parking
I wanted to take a minute to explain why I’m particularly excited for this fall’s meeting. In the six months since our last collaborative-wide meeting, the coordinating center has been hard at work across several fronts:
- We have expanded our peer-to-peer workgroups program to offer more hospitals a platform for learning from and teaching each other about best practices for improving care. This has included new workgroups about optimizing skilled nursing facility/extended care facility use for patients with congestive heart failure. We have also expanded these workgroups to cover topics such as palliative care and how to establish a heart failure clinic. For more information about joining these workgroups, please contact Abeer Yassine at firstname.lastname@example.org
- We have added two new services lines: Atrial Fibrillation and Nephrolithiasis. Atrial Fibrillation represents a common reason for inpatient admission and the service line data expands our ability to provide actionable data about medial admissions. Nephrolithiasis is a high-volume surgery, and we now have a window into emergency department (ED) visits and/or hospital admissions that occur after this outpatient procedure.
- In response to your comments, we have made several improvements to the registry website and its underlying data. For example, we have improved the accuracy of the National Provider Identification (NPI) number available on Blue Cross Blue Shield of Michigan (BCBSM) claims. In addition, we added patient age, gender and comorbidities (COPD, diabetes and ESRD) filters to the BCBSM claims. Finally, in response to your suggestions, we have added an index place of service indicator that allows users to identify episodes beginning in the hospital inpatient, outpatient, or ED settings.
On November 3rd, we will discuss the next opportunities for value improvement in Michigan. These include:
- A focus on the emergency department as a location for improving healthcare value. We will learn from Donna Fox from Michigan Medicine about their program that leverages social and medical supports to reduce ED visits and readmissions. We will also learn from Lauran Hardin about a population-based intervention to reduce ED utilization and cost for high-need patients.
- A special presentation from Dr. Keith Kocher Program Director for the Michigan Emergency Department Improvement Collaborative (MEDIC). MVC members have asked previously for increased collaboration with other BCBSM collaborative quality initiatives, and Dr. Kocher will introduce the PATH initiative to prevent avoidable hospitalizations after ED visit.
- The launch of an important new initiative aimed at improving safe births in Michigan. Many hospitals are working to reduce the use of C-section for low-risk births, and we now have new tools to assist in those efforts. Dr. Dan Morgan will discuss this initiative at the collaborative-wide meeting and seek your feedback.
The November 3rd meeting will offer the Collaborative a chance to decide how we, collectively, want to improve the value of health care in Michigan. We look forward to seeing you at Schoolcraft College (http://www.schoolcraft.edu/vistatech/maps-parking) on November 3rd . Please be sure to register by clicking here. And as always, contact us at email@example.com with any suggestions or questions.