Q&A A New Look at Cost in Oregon Q Corp Tackles the Total Cost of Care OMA’s Vice President of Practice Advocacy, Joy Conklin, interviewed Meredith Roberts Tomasi, Program Director with Q Corp. of reporting any new measure privately first, this spring we shared results with over 150 adult and pediatric primary care clinics throughout the state. Clinics with at least 600 attributed adult or pediatric patients meeting certain parameters received Clinic Comparison Reports. Q Corp staff have made themselves available to discuss results with individual clinics, and have gotten positive feedback. For many, this is the first time they have seen reports that reflect their performance across several health plans. How does Q Corp’s work on this compare to the state’s Sustainable Healthcare Expenditures Workgroup (SHEW) efforts? Both efforts are important, but look at costs differently. The SHEW intends to total all healthcare expenditures in the state. On the other hand, Q Corp’s reports show a clinic’s performance in relation to an Oregon average to highlight areas of variation. It is important to note that this first round of reporting only includes commercial patients, which follows the NQF-endorsed methodology. The report says that reducing cost by 2% could net significant savings for Oregon and ties savings to other expenditures. Why? We included those numbers in our Statewide Report, which we published in September. We believe this kind of context is really important. While health care is an important place to invest dollars in the economy, it’s also useful to make the connection with what might go QUALITY FOCUS What makes the Q Corp Cost of Care reporting work noteworthy? This project is the culmination of over two years of work by multi-stakeholder committees: it truly is the result of the healthcare community in Oregon coming together to do something new. It uses the National Quality Forum (NQF)-endorsed measures developed by HealthPartners that have been in use for over a decade, and it represents healthcare costs across a variety of settings including professional, inpatient, outpatient, and pharmacy. The reports also include data on resource use, utilization, and quality. How many clinics have been included in the reporting so far? Is it public? Following Q Corp’s long-standing practice The Oregon Health Care Quality Corporation (Q Corp) is an independent, nonprofit organization that leads community collaborations and produces unbiased information. Q Corp’s database includes nine years of historical claims data, representing care for more than three million Oregonians since 2006. Q Corp and four other regional multistakeholder health improvement collaboratives are piloting production of cost of care measures which can be reported to primary care clinics and the public and compared across regions. The two measures are the Total Cost Index (TCI) measure which looks at the overall cost effectiveness of managing patient health, and the Resource Use Index (RUI) measure which looks at the frequency and intensity of services used to manage patient health. This chart shows the variation of the clinics across Oregon based on quality* and cost measures for adult patient attributed to the clinic. High Cost High Quality Low Cost High Quality Low Cost Low Quality High Cost Low Quality * Oregon’s quality scores are based on seven quality measures that Q Corp reports at the clinic level, using each clinic’s commercial population. For more information on how the quality composite was calculated, see the Composite Measure Methodology document online. The measurement year for this data is January 1, 2013–December 31, 2013. 22 Medicine in Oregon www.TheOMA.org
OMA Medicine in Oregon Fall 2015
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