Improving value in health care – getting better health outcomes while making more efficient use of resources and improving affordability – is a holy grail in health policy. It’s widely agreed that value-based payment must be part of the solution. However, there are many technical challenges, ranging from figuring out how to measure meaningful concepts of quality and outcomes, to how to extract and analyze data with minimal burden on health care providers, to how to risk adjust outcome measures for factors that are beyond the influence of health care providers (including social risk factors).

In addition, the rise of value-based payment initiatives has led to a proliferation of performance reports generated by payers and sent to providers. While these efforts are well intended, in practice it has been difficult for these reports to gain the desired traction because there is simply too much fragmentation of data. Providers have difficulty integrating this information into a “whole population” view. Providers report that the lack of alignment across payers on performance measures and the lack of standardization of data sharing are barriers to transitioning to new models of care delivery that will yield success in alternative payment models.

Perhaps even more important than any of these technical challenges related to measurement and data sharing is the need for collaboration among stakeholders to agree on a focused set of priorities for improvement.

Minnesota Community Measurement (MNCM) and other regional health care improvement collaboratives (RHICs) are paving the way to value-based payment by tackling these challenges head on. MNCM is an independent nonprofit organization that engages stakeholders across the entire spectrum – health care providers, payers, employers, consumers, and government – to leverage the power of data to drive improvement. In addition to being a leading developer of health outcome measures (including patient reported outcomes), MNCM collects and publishes data on cost and quality of health care throughout Minnesota and neighboring communities. MNCM operates one of the most robust cost and quality transparency websites in the nation and has developed and implemented risk adjustment methods for outcome measures that are based on socioeconomic conditions in the communities where patients live. These activities have produced a rich and unique set of data on variation in quality and outcomes by patients’ race, ethnicity, language and country of origin that sheds light on the size of disparities and  allows the community to track progress toward eliminating them.

Earlier this year, AcademyHealth and the Network for Regional Healthcare Improvement (of which MNCM is a member) announced a strategic national partnership to improve health and access to high quality, efficient and effective health care at the local, regional and national levels. This partnership builds on previous work together highlighting the important role RHICs have to play in the move to value-based care. Health services researchers and RHICs have much to offer each other in terms of expertise, perspective, and the ability to drive real change.

From MNCM’s perspective specifically, we see many ways that stronger partnerships with health services researchers can enhance our work and enable us to achieve our mission of driving value in health care. For example:

  • MNCM has a wealth of existing data, especially on clinical quality and outcomes, that has great potential to inform health services research related to quality, cost, and disparities. We have a robust data collection infrastructure that can be leveraged to efficiently collect data for other initiatives or research projects, such as developing and testing new quality measures or data needed for other research. MNCM is modernizing this infrastructure to greatly reduce data collection burden for health care providers.
  • We have a desire to know more about what’s working in our efforts to drive improvement and what is not working or could be improved, and like other RHICs, we welcome opportunities to work with researchers to evaluate the impact of our work.
  • Advancing the field of measurement in partnership with health services researchers is also of interest – for example, by applying artificial intelligence and natural language processing to clinical data to improve our ability to measure important concepts that have been too difficult or burdensome to measure until now.
  • As multi-stakeholder entities with deep relationships in our communities, RHICs can offer researchers insight into the questions that matter most to stakeholders and the real-world problems they are most eager to solve. RHICs are uniquely positioned to convene stakeholders to collaborate on solutions.

As practical problem-solvers who bring real world perspective, RHICs such as MNCM exist at the intersection of data, research and policy. We are at the forefront of solving the technical challenges related to meaningful measurement, but our real “secret sauce” is collaboration. Because our stakeholders recognize that we can accomplish more together than we can individually, we can make real progress on important problems. We look forward to working more closely with the health services research community to leverage the best of both worlds and make faster progress toward achieving better value in U.S. health care. 

Julie Sonier headshot

Julie Sonier

President - MN Community Measurement (MNCM)

Julie Sonier is President of MN Community Measurement (MNCM), an independent non-profit organization that empo... Read Bio

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