Jim Dupree

Jim Dupree, MD, MPH is the Director of MVC

At the start of the new year, I would like to share with you our thoughts and discuss our collaborative goals for 2018. As always, the Michigan Value Collaborative (MVC) Coordinating Center will continue to support MVC hospitals in their missions to improve patient care, and in 2018, we aim to achieve even more.

We discussed our 2018 goals at the November 3rd collaborative-wide meeting. We referred to these targeted goals as the Value Campaign Coalitions (VCCs) since they aim to increase health care value in Michigan.  We updated these VCC in response to your subsequent feedback, and you will be hearing more about them during our April 20th, 2018 collaborative-wide meeting.

Here, I would like to take a moment to explain what the VCCs are, why these goals were chosen, and how we hope to move forward.

What are the 2018 VCCs?   

  1. Optimizing post-discharge care utilization after joint replacement surgery. Most patients can be safely discharged home after elective lower extremity joint replacement, yet the use of inpatient post-acute care after arthroplasty varies widely around the state. The goals of this campaign are to identify opportunities to reduce low-value care after discharge and learn from hospitals that have safely identified patients who do not require inpatient rehabilitation and skilled nursing.
  2. Improving population-based disease management for chronic conditions.  After the November meeting, many MVC hospitals expressed strong interest in population-based disease management.  Chronically-ill patients often have high episode payments and require complex treatment.  Many hospitals are already focusing on improving in-hospital CHF care. Bringing these concepts together, MVC aims to help hospitals identify high-use CHF patients and better manage CHF in their population.
  3. Supporting vaginal birth and safely reducing cesarean delivery for low-risk pregnancies. The development and persistence of high cesarean delivery rates are important safety and quality issues. While sometimes absolutely necessary for the health of mother or child, cesarean delivery is associated with higher costs and increased rates of complications. The Obstetric Initiative’s first program is to safely lower the cesarean delivery rate among low-risk patients by improving safe birth practices.

Why these three focused areas were chosen?

Over the past several years, we have developed intellectual engagement and performed impactful work around MVC’s mission. To further drive change, these three VCCs were selected because they represented areas of strength for MVC and high value targets for quality improvement. In addition, these three VCCs are closely related to MVC hospitals’ current quality initiatives.

The VCCs are also connected to previous work at MVC and will therefore be supported with our resources, including analytical expertise and hospital engagement efforts. Our past collaborative-wide meetings have highlighted best-practice sharing around “post-discharge care” (April 2017), “episodes of hospital-based care” (November 2016), and “reducing ED utilization and unnecessary hospital readmissions” (November 2017). MVC’s synergies with other Collaborative Quality Initiatives (CQIs) will provide additional strengths. For example, the Michigan Arthroplasty Registry Collaborative Quality Initiative (MACQI), the Integrated Michigan Patient-centered Alliance in Care Transitions (I-IMPACT), and the Obstetrics Initiative (OBI) are all leaders in their fields.

How will we move forward?

Although MVC will continue our other work with hospitals, CQIs, and BCBSM, the Collaborative’s 2018 emphasis will be on these VCCs. In the short term, we hope to learn about hospitals’ best practices in these areas and share their stories. In the long term, we look forward to using claims data to evaluate hospitals’ spending trends.

If you have any questions, please do not hesitate to contact the MVC Coordinating Center or directly comment on this article. We welcome your comments and feedback.

Happy New Year, and we look forward to a great 2018 together.