The Minnesota Academy of Family Physicians (MAFP) and Minnesota Medical Association (MMA) sent a joint letter to the Minnesota Department of Health (MDH) on February 11, 2020, opposing the proposed update to Minnesota Rules, Chapter 4654 on health care quality measures.
A Cap on State Quality Measures
In the 2017 legislative session, changes were made to the Statewide Quality Reporting and Measurement System, including a requirement that MDH implement a cap on the number of measures collected by the state by 2020.
According to Minnesota Statutes 62U Subdivision 1 (b): No more than 6 statewide measures shall be required for single-specialty physician practices and no more than 10 statewide measures shall be required for multi-specialty physician practices.
Proposed Change to Asthma Quality Measures
To meet the measure cap, MDH proposes to arbitrarily lump the previously separate asthma education measure (a process measure) and optimal asthma control measure (an outcome measure) and count them as one measure.
In a memo, dated January 13, 2020, MDH wrote: “Two priorities govern MDH’s current measurement strategy concerning quality of care in Minnesota: (1) aiming to identify what matters most for our state in terms of health care quality, impact and improvement; and (2) reducing reporting burden, as much as possible, through aligning measurement with other federal and local initiatives.”
The MAFP and MMA oppose MDH’s proposed changes and submit that lumping these two measures into one is in direct conflict with the measure cap required under the law. Arbitrarily including the asthma education plan measure as part of the optimal asthma care outcome measure disregards how these measures have been counted and categorized for five years and, most importantly, violates the legislatively-mandated cap of six statewide measures.
Background on Asthma Education & Control Measures
Physician clinics began reporting the Optimal Asthma Care composite measure under the Statewide Quality Reporting and Measurement System in 2011. At the time, the Optimal Asthma Care composite measure included three component measures: control, risk and education.
Beginning in 2015, the measure steward, Minnesota Community Measurement (MNCM), removed the education component and changed the name of the composite measure to “Optimal Asthma Control.” MDH accepted MNCM’s recommendation to modify and retain the Optimal Asthma Control measure and rejected MNCM’s recommendation to abandon collection of the asthma education element.
Instead, MDH retained the asthma education component as a distinct, additional measure—one neither fully endorsed by the community nor reflected in the asthma control measure.
These measures have been treated as stand-alone measures since 2015. We strongly urge MDH to continue its long-standing practice of counting these asthma measures as two distinct measures.
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Post author: Lisa Regehr, director of student, resident and professional education