Aligning Forces for Quality

An Initiative of Quality Counts in Partnership with Maine Quality Forum and Maine

Health Management Coalition

Ted Rooney, RN, MPH

AF4Q Project Leader

PTE Project Leader

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Aligning Forces for Quality Vision

By 2010, because of the efforts of QC in partnership with MQF & MHMC, and through activities funded by the AF4Q initiative, organizations and individuals in Maine (e.g. consumers, providers, employers, health plans, government, etc.) are aligned and working together to achieve best health outcomes for people in Maine. Mainers are healthier because we have changed the culture of healthcare in Maine and achieved the following:

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All entities in Maine are working together collaboratively to improve health care

The Care Model is widely adopted and great care is delivered

People recognize and identify measurable differences in quality of health care, and understand what they can do to improve their care

People are responsible for self-management of their conditions

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AF4Q Core Activities Performance Measure & Public Report

• IOM: Safe, Timely, Effective, Efficient, Patient Centered and Equitable

Quality Improvement Capacity• Ambulatory & Inpatient

Consumer Engagement• Choosing high performing providers• Partnering with providers to improve health

Analyze population & diversity data• Plan interventions

Develop nurse led QI initiatives in hospitals• E.g. RWJ Transforming Care at Bedside

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 Maine 2007

MaineCare All Members 2007

  N  % N  %

African American 12,860 0.98% 9,109 2.55%

Asian 11,815 0.90% 2,933 0.82%

Caucasian 1,271,356 96.52% 288,881 80.89%

Hispanic 15,656 1.19% 742 0.21%

Native American 7,623 0.58% 4,528 1.27%

Pacific 462 0.04% 287 0.08%

Unknown N/A 50,658 14.18%

Total 1,317,207 357,138 100.00%

Racial Distribution for Maine and MaineCare Members, 2007

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Comparison of MaineCare Access and Prevention Composite Measures by Race,

CY2007

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Comparison of Mainecare Health and Chronic Condition Composite Measures by

Race, CY2007

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Overall Care Not Different

Overall, Non-Caucasian members do not appear to experience any lower rate of care and in fact have a higher rate of care on many measures.

However, 26,493 members had unknown background (vs. 14,691 non Caucasian)

These were only process measures.

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What to Do Next? Better documentation

• More accurate process measures• Have to get to outcomes

Work with MHA and Hospitals• Hospitals and others

EMR pilot• Physician practices

Focus QI on MaineCare overall• With a few exceptions, MaineCare members had

lower use of required health screenings and chronic care than National commercial and Medicaid averages as well as Maine specific plan averages (where available).