Hospital and Physician Update

July – August 2019

Blue Cross works with MDC to give POs and practices data to monitor and improve performance

Blue Cross Blue Shield is dedicated to helping physician organizations, practices and practitioners get the tools they need to manage their patient population. To that end, physician organizations and Organized Systems of Care participating in the Physician Group Incentive Program have access to the Michigan Data Collaborative. It provides practices with a wide array of services and health information support as part of PGIP.

What is MDC?

MDC is a data collection group headquartered at the University of Michigan. Formerly known as the PGIP Analytics Collaborative, it was formed to help PGIP POs and OSCs improve their performance in the Physician Group Incentive Program.

The collaborative provides data services to 42 POs, 35 OSCs and more than 19,750 providers across Michigan. It also supports the State Innovation Model* Patient-Centered Medical Home Initiative.

Below is an overview of some of the ways MDC assists PGIP POs and OSCs:

Essential services

• Finding and using information on the Blue Cross PGIP collaboration site
• Training employees to use PO and OSC data
• Helping POs investigate data irregularities and resolve data quality issues for reports
• Assisting with finding and selecting the best tool options

Analytic services

• Creating and using analytic reports to help POs monitor and improve PGIP and Patient-Centered Medical Home performance
• Providing ad hoc reports for custom data analysis
• Creating data analytics for such initiatives as Provider-Delivered Care Management and PCMH

Health Information Exchange support

• Creating and extracting patient lists from electronic systems for Active Care Relationship Service, or ACRS.
• Investigating admission, discharge and transfer, or ADT, data quality issues and incorporating Michigan Health Information Network ADT notifications into workflows
• Supporting the use of Direct Secure Messaging
• Supporting other statewide health information exchange uses

SIM PCMH Initiative

The State Innovation Model Patient-Centered Medical Home Initiative is the core component of the SIM strategy* for coordinated care delivery, focusing on the development and testing of multi-payer health care payment and service delivery models to achieve the following:

• Better care coordination
• Lower costs
• Improved health outcomes for Michiganders

Provider Delivered Care Management support

Blue Cross partners with the Michigan Institute for Care Management and Transformation and the Michigan Data Collaborative to enhance Provider Delivered Care Management reporting for PDCM providers. Here are a couple of ways it benefits providers:

• Improved reporting in 2020 and beyond will help providers identify members with emerging risk, including emergency department and hospital utilization that’s potentially avoidable though early identification and intervention.
• This new reporting supports the multidisciplinary team approach to care management by including information on multiple aspects of a patient’s health care needs, including emergency department utilization, medication adherence and social determinants of health.

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Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.