Currently Viewing:
The American Journal of Managed Care October 2017
Low-Value Antibiotic Prescribing and Clinical Factors Influencing Patient Satisfaction
Adam L. Sharp, MD, MS; Ernest Shen, PhD; Michael H. Kanter, MD; Laura J. Berman, MPH; and Michael K. Gould, MD, MS
Countywide Physician Organization Learning Collaborative and Changes in Hospitalization Rates
Brent D. Fulton, PhD, MBA; Susan L. Ivey, MD, MHSA; Hector P. Rodriguez, PhD, MPH; and Stephen M. Shortell, PhD, MPH, MBA
Boosting Workplace Wellness Programs With Financial Incentives
Alison Cuellar, PhD; Amelia M. Haviland, PhD; Seth Richards-Shubik, PhD; Anthony T. LoSasso, PhD; Alicia Atwood, MPH; Hilary Wolfendale, MA; Mona Shah, MS; and Kevin G. Volpp, MD, PhD
Use of Patient-Reported Outcomes and Satisfaction for Quality Assessments
Anne P. Ehlers, MD, MPH; Sara Khor, MS; Amy M. Cizik, PhD, MPH; Jean-Christophe A. Leveque, MD; Neal S. Shonnard, MD; Rod J. Oskouian, Jr, MD; David R. Flum, MD, MPH; and Danielle C. Lavallee, PharmD,
Trends in Hospital–Physician Integration in Medical Oncology
Jeffrey D. Clough, MD, MBA; Michaela A. Dinan, PhD; and Kevin A. Schulman, MD
Improving Care Transitions: Complex High-Utilizing Patient Experiences Guide Reform
Nancy Ambrose Gallagher, PhD, APRN-BC; Donna Fox, RN; Carrie Dawson, MS, RN; and Brent C. Williams, MD, MPH
The Option Value of Innovative Treatments for Non–Small Cell Lung Cancer and Renal Cell Carcinoma
Julia Thornton Snider, PhD; Katharine Batt, MD, MSc; Yanyu Wu, PhD; Mahlet Gizaw Tebeka, MS; and Seth Seabury, PhD
Currently Reading
Statewide Data Infrastructure Supports Population Health Management: Diabetes Case Study
Craig Jones, MD; Mary Kate Mohlman, PhD; David Jorgenson, MS; Karl Finison, MA; Katie McGee, MS; and Hans Kastensmith
A Health Plan's Investigation of Healthy Days and Chronic Conditions
Tristan Cordier, MPH; S. Lane Slabaugh, PharmD; Eric Havens, MA; Jonathan Pena, MS; Gil Haugh, MS; Vipin Gopal, PhD; Andrew Renda, MD; Mona Shah, PhD; and Matthew Zack, MD

Statewide Data Infrastructure Supports Population Health Management: Diabetes Case Study

Craig Jones, MD; Mary Kate Mohlman, PhD; David Jorgenson, MS; Karl Finison, MA; Katie McGee, MS; and Hans Kastensmith
The use of statewide data infrastructure is effective at identifying criteria for diabetes outreach and management at the whole-population level.
The authors want to acknowledge Vermont’s policy leaders who in 2008, in a bipartisan effort, initiated a health information technology fund and sustainable path for developing state data infrastructure. Those with key roles include Governor Jim Douglas, Secretary of Civil and Military Affairs Heidi Tringe, Secretary of Administration Mike Smith, Director of Healthcare Reform Susan Besio, Chair of Senate Appropriations Susan Bartlett and subsequent Chair of Senate Appropriations Jane Kitchel, Member Senate Health Committee Kevin Mullin, and Chair of House Health Committee Steve Maier. They also want to recognize the vision, leadership, and passion provided by Vermont’s Director for Health Information Technology at the time, their recently deceased and dearly missed friend, Hunt Blair. Most importantly, they want to acknowledge the deep commitment by the clinicians and office staff in Vermont’s patient-centered medical home practices to complete, high quality data. The authors especially want to highlight the work of Laurel Ruggles, Joyce Dobertin, MD, and the providers in St. Johnsbury, Vermont, who worked with the Blueprint on the first data quality “sprint” in Vermont, an effort planned for 4 weeks that took 26. Finally, they want to acknowledge the information technology staff working in Vermont’s hospitals and health centers, who have worked diligently to improve the completeness and quality of clinical data that is being transmitted into VITL’s HIEN and the Blueprint’s registry.

Author Affiliations: Vermont Blueprint for Health, Department of Vermont Health Access (CJ, MKM), Waterbury, VT; Onpoint Health Data (DJ, KF), Portland, ME; Capitol Health Associates (KM, HK), Washington, DC.

Source of Funding: State of Vermont appropriations for Vermont Blueprint for Health annual budget.

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article. 

Authorship Information: Concept and design (CJ, DJ, MKM, KF); acquisition of data (CJ, DJ, KF, KM, HK); analysis and interpretation of data (CJ, DJ, MKM, KF, KM, HK); drafting of the manuscript (CJ, MKM, HK); critical revision of the manuscript for important intellectual content (CJ, DJ); statistical analysis (DJ); provision of patients or study materials (CJ); obtaining funding (CJ); administrative, technical, or logistic support (CJ, MKM, KM, HK); and supervision (CJ, KF). 

Address Correspondence to: Mary Kate Mohlman, PhD, Agency of Human Services, 280 State Dr, Waterbury, VT 05671. E-mail: marykate.mohlman@vermont.gov.
REFERENCES

1. Alley DE, Asomugha CN, Conway PH, Sanghavi DM. Accountable health communities—addressing social needs through Medicare and Medicaid. N Engl J Med. 2016;374(1):8-11. doi: 10.1056/NEJMp1512532.

2. McClellan M, Kent J, Beales SJ, et al. Accountable care around the world: a framework to guide reform strategies. Health Aff (Millwood). 2014;33(9):1507-1515. doi: 10.1377/hlthaff.2014.0373.

3. Bates DW, Saria S, Ohno-Machado L, Shah A, Escobar G. Big data in health care: using analytics to identify and manage high-risk and high-cost patients. Health Aff (Millwood). 2014;33(7):1123-1131. doi: 10.1377/hlthaff.2014.0041.

4. Diamond CC, Mostashari F, Shirky C. Collecting and sharing data for population health: a new paradigm. Health Aff (Millwood). 2009;28(2):454-466. doi: 10.1377/hlthaff.28.2.454.

5. Zhang Y, Padman R. Innovations in chronic care delivery using data-driven clinical pathways. Am J Manag Care. 2015;21(12):e661-e668. 

6. King J, Patel V, Jamoom E, DesRoches C. The role of health IT and delivery system reform in facilitating advanced care delivery. Am J Manag Care. 2016;22(4):258-265. 

7. Razavian N, Blecker S, Schmidt AM, Smith-McLallen A, Nigam S, Sontag D. Population-level prediction of type 2 diabetes from claims data and analysis of risk factors. Big Data. 2015;3(4):277-287. doi: 10.1089/big.2015.0020.

8. Institute of Medicine. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: National Academies Press; 2013.

9. Vermont Information Technology Leaders website. https://www.vitl.net/. Published 2016. Accessed May 5, 2016.

10. Vermont Blueprint for Health 2015 annual report. Vermont Blueprint for Health website. http://blueprintforhealth.vermont.gov/sites/blueprint/files/BlueprintPDF/AnnualReports/Vermont-Blueprint-for-Health-2015-Annual-Report-FINAL-1-27-16.pdf. Published January 31, 2016. Accessed April 25, 2016.

11. Blueprint Hospital Service Area (HSA) Healthcare Data Profiles. Vermont Blueprint for Health website. http://blueprintforhealth.vermont.gov/reports_and_analytics/hospital_service_area_profiles. Published November 2015. Accessed April 15, 2016.

12. Diabetes statistics report, 2017. CDC website. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html. Published July 17, 2017. Updated July 17, 2017. Accessed September 17, 2017.

13. Diagnosed Diabetes. CDC website. https://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html. Accessed September 17, 2017.

14. Nathan DM, Genuth S, Lachin J, et al; Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329(14):977-986. doi: 10.1056/NEJM199309303291401.

15. Wagner EH, Sandhu N, Newton KM, McCulloch DK, Ramsey SD, Grothaus LC. Effect of improved glycemic control on health care costs and utilization. JAMA. 2001;285(2):182-189.

16. Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359(15):1577-1589. doi: 10.1056/NEJMoa0806470.

17. Rao Kondapally Seshasai S, Kaptoge S, Thompson A, et al; Emerging Risk Factors Collaboration. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med. 2011;364(9):829-841. doi: 10.1056/NEJMoa1008862.

18. Prevention quality indicators overview. Agency for Healthcare Research and Quality website. http://www.qualityindicators.ahrq.gov/modules/pqi_overview.aspx. Accessed September 17, 2017.

19. Thompson S, Kohli R, Jones C, Lovejoy N, McGraves-Lloyd K, Finison K. Evaluating health care delivery reform initiatives in the face of “cost disease”. Popul Health Manag. 2015;18(1):6-14. doi: 10.1089/pop.2014.0019.

20. Jones C, Finison K, McGraves-Lloyd K, et al. Vermont’s community-oriented all-payer medical home model reduces expenditures and utilization while delivering high-quality care. Popul Health Manag. 2016;19(3):196-205. doi: 10.1089/pop.2015.0055.

21. HEDIS 2015. National Committee for Quality Assurance website. http://www.ncqa.org/hedis-quality-measurement/hedis-measures/hedis-2015. Published 2014. Accessed April 25, 2016.

22. Classification of overweight and obesity by BMI, waist circumference, and associated disease risks. National Heart, Lung, and Blood Institute website. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_dis.htm. Accessed April 26, 2016.

23. Olsson M, Schnecke V, Cabrera C, Skrtic S, Lind M. Contemporary risk estimates of three HbA1c variables for myocardial infarction in 101,799 patients following diagnosis of type 2 diabetes. Diabetes Care. 2015;38(8):1481-1486. doi: 10.2337/dc14-2351.

24. Hailpern SM, Santel F, Mazurek JA, et al. Hemoglobin A1c less than 6.5% on admission increases risk for in-hospital and 1-year mortality in patients with diabetes and chest pain. Cardiovasc Endocrinol. 2014;3(3):85-91. doi: 10.1097/XCE.0000000000000033.

25. Quality indicator user guide: Prevention Quality Indicators (PQI) composite measures. Agency for Healthcare Research and Quality website. https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/V43/Composite_User_Technical_Specification_PQI_4.3.pdf. Published August 2011. Accessed September 17, 2017.

26. Bradley CJ, Penberthy L, Devers KJ, Holden DJ. Health services research and data linkages:
issues, methods, and directions for the future. Health Serv Res. 2010;45(5, pt 2):1468-1488. doi: 10.1111/j.1475-6773.2010.01142.x.

27. Vermont all-payer model term sheet proposal: companion paper. Green Mountain Care Board website. http://gmcboard.vermont.gov/sites/gmcb/files/documents/APM-Companion-Paper-Formatted%20FINAL2.pdf. Published January 25, 2016. Accessed April 25, 2016.

28. Garber AJ, Abrahamson MJ, Barzilay JI, et al; American Association of Clinical Endocrinologists; American College of Endocrinology. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm—2016 executive summary. Endocr Pract. 2016;22(1):84-113. doi: 10.4158/EP151126.CS.

29. Sacks DB, Arnold M, Bakris GL, et al. Executive summary: guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2011;57(6):793-798. doi: 10.1373/clinchem.2011.163634.

30. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405-412. doi: 10.1136/bmj.321.7258.405.

31. Menzin J, Langley-Hawthorne C, Friedman M, Boulanger L, Cavanaugh R. Potential short-term economic benefits of improved glycemic control: a managed care perspective. Diabetes Care. 2001;24(1):51-55. doi: 10.2337/diacare.24.1.51.

32. Stephens JM, Botteman MF, Hay JW. Economic impact of antidiabetic medications and glycemic control on managed care organizations: a review of the literature. J Manag Care Pharm. 2006;12(2):130-142. doi: 10.18553/jmcp.2006.12.2.130

33. Shetty S, Secnik K, Oglesby AK. Relationship of glycemic control to total diabetes-related costs for managed care health plan members with type 2 diabetes. J Manag Care Pharm. 2005;11(7):559-564. doi: 10.18553/jmcp.2005.11.7.559.

34. Oglesby AK, Secnik K, Barron J, Al-Zakwani I, Lage MJ. The association between diabetes related medical costs and glycemic control: a retrospective analysis. Cost Eff Resour Alloc. 2006;4:1. doi: 10.1186/1478-7547-4-1.

35. Degli Esposti L, Saragoni S, Buda S, Sturani A, Degli Esposti E. Glycemic control and diabetes-related health care costs in type 2 diabetes; retrospective analysis based on clinical and administrative databases. Clinicoecon Outcomes Res. 2013;5:193-201. doi: 10.2147/CEOR.S41846.

36. Aagren M, Luo W. Association between glycemic control and short-term healthcare costs among commercially insured diabetes patients in the United States. J Med Econ. 2011;14(1):108-114. doi: 10.3111/13696998.2010.548432.

37. Juarez D, Goo R, Tokumaru S, Sentell T, Davis J, Mau M. Association between sustained glycated hemoglobin control and healthcare costs. Am J Pharm Benefits. 2013;5(2):59-64. 

38. National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the diagnosis and management of asthma: full report 2007. National Heart, Lung, and Blood Institute website. https://www.nhlbi.nih.gov/files/docs/guidelines/asthgdln.pdf. Published August 28, 2007. Accessed September 17, 2017.

39. Pauwels RA, Buist AS, Calverley PMA, Jenkins CR, and Hurd SS; GOLD cientific ommittee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) workshop summary. Am J Respir Crit Care Med. 2001;163(5):1256-1279. 

40. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128(16):1810-1852. doi: doi: 10.1161/CIR.0b013e31829e8807.
PDF
 
Copyright AJMC 2006-2017 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up
×

Sign In

Not a member? Sign up now!