CMS Continues to Propose Additional Quality Measures

CMS is proposing to add four new outpatient measures for public reporting on the Hospital Compare website. The proposed measures target overuse of imaging services, such as mammography and CT scans. CAPH and SNI submitted comments to CMS about the last rule regarding value based purchasing, hospital acquired infections, public reporting, and racial and ethnic data collection, and will also respond to these proposed rule changes. Click here to access the proposed rule.

Contact: Lance Mageno, 510-874-7120.

The patients of the 20 public clinic teams participating in SNI’s SEED diabetes care improvement program are healthier already since their provider teams began tracking their health and implementing new reliable care processes in April 2007.

Highlights of their impressive results include:

• Thousands of patients are being tracked, using registries, by CAPH clinics statewide.
• Teams have improved care processes dramatically.  For example, the percentage of SEED patients with an annual foot exam rose from 27% to 55%; patients with a health-improving self-management goal increased from 13% to 54%.
• For the 3,000 patients in the pilot, the average HbA1c dropped from 7.86% to 7.76%, and the percentage of patients with controlled blood pressure improved from 39.5% to 45.5%.  In general, patient health outcome measures such as these take longer than one year to show improvement.

Contact: Hunter Gatewood or visit the SEED webpage

Study Suggests Reducing Disparities in Diabetes Outcomes Requires Culturally Specific Approaches & Monitoring Performance by Race

A recent study published in the Archives of Internal Medicine suggests that, even when minority patients receive the same recommended diabetic screening tests as their white counterparts, other physician-specific factors account for much of the disparities in outcomes. Researchers examined the electronic medical records of nearly 7,000 patients with diabetes and found that while African-American and white patients received the same diabetes screenings, African-Americans were less likely to maintain control of those same health indicators, such as blood pressure. The study’s lead researcher, a Harvard Medical School professor, stated that the research findings do not show that providers treated patients differently; rather, physicians treat all patients the same but do not take into consideration the patient’s individual needs such as cultural factors.  To reduce disparities, the study recommends educating providers about minority communities, tailoring treatment approaches, and using race-stratified performance reports.

Research Shows a Lull in Childhood Obesity Rate Increases, Though Disparities Remain for Minority Children

Researchers analyzing data from the National Health and Nutrition Examination Survey (NHANES) found that the prevalence of obesity among children and adolescents showed no significant changes between 2003-2004 and 2005-2006 versions of the survey. However, researchers found that there continue to be significant differences in obesity rates based on race. Among girls ages 12 to 19, approximately 27.7% of blacks and 19.9% of Mexican-Americans were obese, compared to 14.5% of their white counterparts. Experts are unsure whether the leveling off of childhood obesity rates is due to a “natural plateau” or rather the result of widespread anti-obesity initiatives to prohibit unhealthy foods and encourage exercise in schools.

More information on the issue of health disparities can be found on the SNI website. To view the article in its entirety click here.

Patient Visit Redesign Alumni Teams Sustain Improvements

SNI’s Patient Visit Redesign Program aims to improve the patient experience by increasing provider productivity and reducing patient waiting time, keeping a patient's primary care visit to under one hour. SNI proudly reports that alumni teams who have completed the formal program—some as long as three years ago—continue to maintain an overall average of 52 minutes per visit, which is a sustained 50% decrease from their original patient visit times. In April, 10 more teams joined the 33 public clinics statewide that have completed the formal collaborative, while five additional teams work to spread the model to other areas within their respective systems.

Contact: Hunter Gatewood