Quality Insight Newsletter - Fall/Winter 2018

Fall/Winter 2018

	ISSUE
	No. 1

IN THIS ISSUE

Top Story | Local News | Regional News | Events

Getting to Affordability: Latest Total Cost of Care Benchmark Report Finds Wide Cost Variation Between States

Variation of the total cost of health care in six states, including Oregon and Utah, continues to be driven by local patterns of health care usage and pricing. The latest benchmark report by the Network for Regional Healthcare Improvement (NRHI) , "Healthcare Affordability: Data is the Spark, Collaboration is the Fuel," examines these differences by c omparing the total cost of care for those with private insurance in these different regions.

NRHI is a national nonprofit representing regional health improvement collaboratives (RHICs) and state partners working to achieve better health and high-quality, affordable care. As a participant and partner in this work, HealthInsight contributes data about the cost of care in Oregon and Utah for national benchmarking, allowing for comparisons of the total cost of care in different regions around the country.

"HealthInsight is often called upon as having local expertise across our communities in Oregon and Utah and for offering a tried and true methodology to understand the cost of care," stated Meredith Roberts Tomasi, HealthInsight Oregon Associate Executive Director.

Using the nationally standardized HealthPartners Total Cost of Care (TCOC) measures, t he benchmark report explores why costs differ and reveals how varied care delivery patterns and local prices contribute to the cost differences between Colorado, Maryland, Minnesota, Oregon, St. Louis, Mo., and Utah. With the publication of this report, NRHI now has three sets of regional cost comparisons, which allowed for additional trending and analysis. Oregon and Utah also participated in the 2014 and 2015 benchmark studies released in 2017 and earlier in 2018.

For the first time in 2018, Nevada and New Mexico also joined this project as development regions.

The national comparison detailed in NRHI's benchmark report is supported by practice-level reporting that each member organization conducts in its region. The Robert Wood Johnson Foundation provides support for the benchmark reports.

State-specific results- Utah

HealthInsight Utah has valued participation in the TCOC project as the project further expands the uses of the Utah All Payer Claims Database for the benefit of physician offices.
The national collaborative has allowed comparison and contrast of data quality and allowed Utah analysts to examine opportunities for improvement of submission and processing for future projects.
With one of the nation's highest birth rates per capita, Utah is tied for the highest inpatient (hospital) utilization/resource use index of the six states participating in the benchmark/study.
Utah's low risk score is 9.5 percent below average for those who participated in the benchmark. This can be attributed to a younger population and healthier lifestyle.

Learn more about NRHI's Getting to Affordability project here.

LOCAL

Guest Article: Utah Hospital Association Creates Committee to Address Behavioral Health Needs in Utah

By: Jordan Sorenson, UHA

The Utah Hospital Association (UHA) has convened the Behavioral Health Leadership Committee to streamline and make mental health services available to all Utahns in need. The committee comprises representatives from Utah's general and specialty hospitals and facilities, public and commercial insurers, state and local government mental health officials, community partners, and influential legislators. The committee met in May 2018 to determine which issues should be addressed and determined that we should retain a third-party contractor to research Utah's mental health delivery system, the accessibility of mental health services, the improvements needed and how expansion of services could be financed.

UHA is closely working alongside and supporting other Utah-based organizations and coalitions with similar aims. UHA has supported and facilitated efforts to improve crisis response and outreach including a state-wide 3-digit number for mental health crises, approval and budgeting from the state for an additional two, 23-hour mental health crisis assessment centers, promoted the integration of mental health and primary care service lines, and explored various digital platform services that would connect clinicians, community groups, law-enforcement/EMT's and case managers with real time information about at-risk patients.

In October, UHA held a well-attended fall leadership conference entitled "Picking Up the Pieces" that focused exclusively on the challenges facing behavioral health care, as well as emerging strategies that are addressing those critical needs. The keynote speaker was Jennifer L. Tomasik, Vice President of CFAR, who discussed Massachusetts' vast remodel of its mental health system and how they have designed and implemented a comprehensive and integrated systems approach that is currently being undertaken. The conference had two panel discussions that provided distinct perspectives and invaluable insight into the state of behavioral health care. The first featured clinicians and providers while the second included public health professionals.

UHA secured a $100,000 grant from the state legislature to perform a system-wide analysis of Utah's mental health and substance abuse services as mentioned above. UHA has contracted with The Kem C. Gardner Policy Institute to perform the analysis of Utah's mental health care system. It is currently underway. The initial results of the study will be available in February 2019. Depending on the outcome of the study, the Committee has tentatively planned to hold a summit with influential policy makers and mental health care professionals to discuss the study's findings and to propose plans to improve the access, quality and affordability of behavioral health care for the citizens of Utah.

HealthInsight Utah Begins Work with Utah Dentists to Ensure Safe Prescribing of Opioids

HealthInsight Utah in partnership with Intermountain Healthcare and the Utah Department of Health Violence and Injury Prevention Program has begun an important project designed to ensure best-practice prescribing of pain medication with Utah's dental providers.

In a recent publication by the Bree Collaborative, dentists are estimated to provide 31 percent of all opioid prescriptions to patients age 10-19 years of age and are important to impacting the nation's opioid misuse crisis. Over the next year, HealthInsight will work with dental offices across the Wasatch front and in Carbon county to streamline query of the Utah Controlled Substances Database, ensure appropriate prescribing for pain for all types of patients and incorporate screening and treatment processes that engage the whole office to support best care. HealthInsight will partner with Roseman University faculty, the Utah Dental Association, and public health partners.

If you are interested in participating, please contact Adrienne Butterwick.

GWEP Program Kicks Off Fourth Year with Nurse Residency Boot Camp

In collaboration with the Utah Geriatric Education Consortium (UGEC), a Geriatric Workforce Enhancement Project (GWEP) funded by HRSA, HealthInsight Utah has assisted with the implementation of a nursing residency program for long-term care nurses. This program includes nurses from skilled nursing facilities belonging to Avalon Healthcare and Mission Health Services. Specifically for the nurse residency strand of UGEC, the goal is to improve the skill set of nurses that work directly with the residents of these facilities. The program is now in its fourth year.

To kickoff year four of the program a nurse residency boot camp was held on Sept. 29, 2018. This meeting was held to provide introductions and training for year-four nurse residents and mentors from Avalon and Mission, and newly assigned staff from the University of Utah College of Nursing and HealthInsight Utah. A demonstration on completing the modules was provided, and presentations introducing HealthInsight as a QIN-QIO, the basic of quality improvement, mentoring, and the Interact program. Team building activities were also a part of this day. A total of 16 nurse residents, and 11 mentors were able to participate.

The project work will be completed over the next nine months. The nurse residents have already completed the Interact 4.0 training, which was presented by Pathway Health and have already attended the mentoring for retention conference, which was conducted by June Marshall, DNP who is an expert on the art of mentoring in the clinical setting. Next up, the nurse residents will complete weekly modules online that address several topics to better equip them to work in nursing facilities. They will also be trained on conducting a quality improvement project and assisted with implementing quality improvement project that is specific to the needs of the facility where the currently work. The mentors will be participating in online modules and coaching calls with the Colorado Center for Nursing Excellence over the next six months to ensure that they are capable of providing the necessary support for the nurse residents as they work through this project. The GWEP team at HealthInsight is grateful for this opportunity that we have had to work the UGEC, and we are looking forward to continued success in the fourth year.

REGIONAL

HealthInsight Tackling Disparities in Type 2 Diabetes Care and Self-management Education through Unique Partnerships

According to Centers for Disease Control and Prevention (CDC), more than 30 million Americans have been diagnosed with diabetes, and an estimated 1 in 3 adults (84 million) have prediabetes. CDC recognized structured lifestyle change programs can help those with prediabetes reduce their risk for developing the Type 2 diabetes, whereas self-management is key for people recently diagnosed with Type 2 diabetes or who have poorly controlled diabetes.

HealthInsight is helping to spread diabetes prevention and self-management education programs to underserved areas and populations through two different initiatives: Everyone with Diabetes Counts, part of the QIN-QIO work for CMS, and Scaling the National Diabetes Prevention Program in underserved areas of New Mexico, Oregon and Utah through a cooperative agreement with CDC.