st. louis msa health stats · % of population with no claims 22.7% 22.2% 22.7% 25.0% % of the...
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Midwest Health Initiative (MHI), Missouri’s regional health improvement collaborative, is pleased to share with you its 2019 St. Louis Community Scorecard.
This Community Scorecard provides regional benchmark information to support our community in identifying opportunities to improve the health of our population. Additionally, it provides measures by which we can gauge our collective progress toward making St. Louis a national leader in the quality and value of its health care services.
The results included here are mostly from MHI’s database of approximately 1.6 million commercially-insured lives supplemented by information from other sources. To learn more about MHI, find available national benchmarks or submit ideas for future areas of focus, please visit midwesthealthinitiative.org.
ST. LOUIS MSA HEALTH STATS
AUGUST 2019
A Community Scorecard for Commercial PopulationsProvided by the Midwest Health Initiative
Linda BradyHealthcare Strategy and PolicyThe Boeing Company
Dave CookPresidentUnited Food Workers, Local 655
Joseph A. Craft III, MD, FACCCardiologist & MemberSt. Louis Metropolitan Medical Society
Frank D’AntonioPresidentAetna
Julie DavidsonChief Financial OfficerUnitedHealthcare
Tom Hastings, MDPrimary Care PhysicianEsse Health
Matthew HerzbergRegional Managing PartnerSenn Delaney Culture Shaping
Justin Huynh, MDClinical Leader, Engagement at HomeMercy Virtual Care Center
Karen JohnsonVP, Healthcare Insights & PartnershipsBlue Cross and Blue Shield of Kansas City
Jeff KarrenbrockDirector, Finance IntegrationCore & Main, LP
Marla LangenhorstDirector, BenefitsAmeren Corporation
Ron LaudelBenefit Plans AdministratorCarpenters’ Benefit Plans
Lisa MassaVice President HR, Global Total RewardsBayer
J.C. McWilliamsVice President of Managed CareBJC HealthCare
Lynne Nowak, MDPhysician, VP, Clinical & Provider StrategyExpress Scripts, Inc.
Beverly PropstSenior Vice President, Human ResourcesGraybar Electric Company, Inc.
Chad Sackman RN, BSN, MBAChief Operating OfficerSignature Medical Group
Ed StrouthDirector, Health & WellbeingBarry-Wehmiller Companies, Inc.
Randall Williams, MD, FACOGDirectorMO Department of Health & Senior Services
Amadou YattassayePresidentAnthem Blue Cross and Blue Shield, Missouri
John ZieglerSenior VP & Chief Administrative OfficerArch Coal, Inc.
Midwest Health Initiative Board of Directors
Physician Leadership CouncilDr. Bryan BurnsPrimary Care, Esse Health
Dr. J. Collins CorderPrimary Care, West County Medical Associates
Dr. Elyra Figueroa-EspanaAllergy and ImmunologyAllergy, Asthma & Immunology Institute of St. Louis
Dr. Beth GearhartOB/GYN, Private Practice
Dr. Christine HachemGastroenterology, SLUCare
Dr. Tom HastingsInternist, Esse Health
Dr. George KichuraCardiology, St. Louis Heart and Vascular
Dr. Paul SpeziaOrthopedics, Advanced Bone and Joint
Non-Voting Participants
Dr. Michael DurkinWashington University
Dr. Peggy PetraliaAetna
Dr. Jay MooreAnthem Blue Cross Blue Shield, Missouri
AcknowledgementsThis Community Scorecard is made possible through the support of MHI’s friends and its Champions for Health Care Value. MHI is grateful for their generous support of its vision and work.
• Aetna• Anthem Blue Cross and Blue Shield of Missouri• Blue Cross and Blue Shield of Kansas City• The Boeing Company
• Signature Medical Group• St. Louis Area Business Health Coalition• UnitedHealthcare
MHI Champions for Health Care Value
• Arch Coal, Inc.• Graybar Electric Company, Inc.
Friends of MHI
11.7%Decline (2015-2018) in patients readmitted
to the hospital in 30 days
21.4%Decline (2015-2018) in Opioid Scripts
Per 1,000 People
$4,833Total Annual Spend
Per Person
11.9% Percent of Medical Services
Paid for by Patient
14.2%Decline (2015-2018) in Total Emergency
Dept. Visits Discharged Home
7.2Rate per 100,000 people with
Annual Spending over $500,000
The Scorecard is organized in four domains: Population Health, Care Quality, Cost and Affordability and Utilization.
The indicators included were chosen and refined with input from the Midwest Health Initiative Physician Leadership Council and Board, including representatives from hospitals, health plans, employers, labor unions and the public.
Indicators 2015 2016 2017 2018 TrendDiabetes Care for Patients with a Regular Source of Primary Care
HbA1C 75.1% 79.0% 83.0% 84.8%
Kidney Test (Nephropathy) 79.5% 80.0% 77.7% 80.7%
Cholesterol Test 70.4% 68.0% 72.0% 72.5%
Blood Pressure Medications Refilled on Time 64.7% 71.0% 65.0% 67.8%
Women’s Health
Breast Cancer Screening 67.6% 67.0% 63.1% 60.9%Chlamydia Screening 37.1% 42.0% 47.0% 46.7%Cervical Cancer Screening 66.7% 66.0% 66.0% 60.9%
Patients Readmitted to the Hospital in 30 Days for Any Reason n/a 9.4% 9.1% 8.3%
CARE QUALITY
Indicators 2015 2016 2017 2018 Trend
Average Age of Population 37 37 36 36
% of Population with a Chronic Illness
Asthma & COPD 5.6% 5.5% 5.5% 5.2%
Diabetes 6.1% 6.3% 6.0% 5.9%
Arthritis 6.8% 6.7% 6.7% 6.6%
Hypertension 12.1% 12.4% 11.9% 11.9%
Depression 5.6% 5.4% 5.5% 5.7%
POPULATION HEALTH Commercially Insured St. Louisans 64 and under
Indicators 2015 2016 2017 2018 Trend
Generic Fill Rate 82.6% 83.8% 84.8% 85.2%
Scripts Per Person 9.7 11.1 10.7 10.6
Opioid Scripts Per 1,000 People 386.7 386.4 325.4 304.1
Professional Services 2.5 2.5 2.5 2.3
Ratio, Primary Care Visits to Speciality Visits 1-1 1.2-1.3 1-1 1.1-1.2
Primary Care Professional Fees as a % of Total Spending 5.8% 5.6% 6.0% 6.1%
Imaging Per 1,000 - OutpatientX-Ray 855.1 856.5 812.1 799.7CT 116.2 118.8 122.3 125.3MRI 80.7 81.6 83.7 83.4PET 4.0 4.0 3.7 3.7
% of Potentially Avoidable Imaging Studies for Low Back Pain
23.6% 29.3% 31.1% 26.2%
Outpatient Surgeries Per 1,000 107.1 107.7 102.0 97.3
Total Surgeries Per 1,000 Lives 159.7 162.9 152.5 160.4Heart Surgery: CABG Per 1,000 Lives 6.8 6.4 5.0 6.0Heart Surgery: PCI Per 1,000 Lives 2.0 2.0 1.7 1.8Total Hip and Knee Replacement Per 1,000 Lives 4.2 4.2 4.2 4.3Hysterectomies Per 1,000 Lives 6.6 6.7 5.1 6.3
Acute Care Admits Per 1,000 53.5 51.9 49.3 49.2
Acute Care Length of Stay 4.2 4.3 4.1 4.1
Total ED Visits Per 1,000 188.0 186.8 175.9 162.1
ED Visits Per 1,000, Admitted 19.8 18.7 17.4 17.0ED Visits Per 1,000, Held for Observation 18.2 19.6 17.3 16.2ED Visits Per 1,000, Discharged Home 150.3 148.5 140.9 128.9ED Visits Per 1,000, Among people with an established PCP relationship
102.5 102.3 101.1 97.1
Percent of Potentially Avoidable ED Visits n/a 15.8% 16.5% 13.6%
Urgent Care Visits Per 1,000 129.4 146.4 174.8 179.9
UTILIZATION
Indicators 2015 2016 2017 2018 Trend
Total Annual Medical Spend Per Person $4,380 $4,573 $4,681 $4,833
% of Total Annual Spend Paid by Patient 12.2% 11.8% 11.0% 11.9%
Annual Spend per Person as a % of St. Louis MSA Per Capita Income
15.1% 15.3% 15.0% 13.6%
People Per 100,000 with Annual Spend Over:
$50,000 975.8 1,068.6 1,033.1 1,051.0
$100,000 290.9 325.2 308.0 332.1
$250,000 43.7 50.4 48.9 51.6
$500,000 5.1 6.2 5.7 7.2
$1,000,000 1.2 0.4 0.7 0.3
% of Population with No Claims 22.7% 22.2% 22.7% 25.0%
% of the Population that Accounts for 50% of Annual Spend 3.5% 3.5% 3.1% 3.3%
% of the Population that Accounts for 80% of Annual Spend 15.1% 14.9% 13.0% 14.4%
COST AND AFFORDABILITY
MHI is a regional health improvement collaborative that brings together those that provide, pay for and use health care to improve the region’s health and the quality and affordability of its health care. The strength of MHI sits with the collective power of its partners, each working within their own spheres of influence to achieve change.
About the Midwest Health Initiative 8888 Ladue Road, Suite 250 St. Louis, MO 63124 314-721-7800 www.midwesthealthinitiative.org