1. Kristin Gallagher, BS 1, Jenny Camponeschi, MS 2, Charlanne FitzGerald, MPH 1, Leah Ludlum, RN, CDE 2, and Patrick Remington, MD, MPH 1 1 University of Wisconsin Population Health Institute; 2 Wisconsin Department of Health Services, Division of Public Health The Wisconsin Collaborative Diabetes Quality Improvement Project: Effective Statewide Collaboration BackgroundResults Discussion Improvement Over Time: All performance measures improved Variation between plans decreased Figure 1: Selected Diabetes Care Measures Mean and Variation Over Time (Data from HEDIS ® 1999 and 2010) *Lower percentage desired Selected Chronic Disease Results: Plans report other HEDIS  measures in addition to Comprehensive Diabetes Care Measures Table 1: Performance on HEDIS  Select Chronic Disease Measures (care provided in 2008, 2009)* * Categories are: Low<15 percentage points, Medium 15-24 percentage points, and High ≥25 percentage points Wisconsin and National Comparisons: HEDIS  has expanded the number of Comprehensive Diabetes Care measures from four to eight since 1999. Wisconsin continues to exceed the national average and perform comparably with the national 90 th percentile. Key Publications and Initiatives: As a result of the continued collection and analysis of HEDIS  measures, the WCDQIP has produced several publications/ reports and supported several initiatives targeting continued quality improvement in selected areas. Some of these include: The Wisconsin Collaborative Diabetes Quality Improvement Project 2010 report Implementation of the 2008 Wisconsin Diabetes Mellitus Essential Care Guidelines Production of a bilingual DVD: Protect Your Vision: The Dilated Eye Exam, (in collaboration with the Wisconsin Lions Foundation) Production of a bilingual DVD: The Links to Chronic Kidney Disease: Diabetes, High Blood Pressure, and Family History, (in collaboration with the Wisconsin Lions Foundation and the National Kidney Foundation) Publication of the Cardiovascular Care Performance report Bringing statewide partners together to implement and evaluate diabetes care initiatives continues to be successful Discussion of performance on the HEDIS  measures helps focus initiatives. Collaborators can: Assess whether change is occurring Determine where further work is needed Share successful quality improvement strategies Non-competitive atmosphere encourages open discussion among collaborative members Quality of diabetes care has improved overall University of Wisconsin POPULATION HEALTH INSTITUTE Translating Research into Policy and Practice Methods Collected HEDIS  measures, including: Comprehensive Diabetes Care Cardiovascular Care, Cancer Screening, Asthma Care, Smoking Cessation, Weight Assessment, Antidepressant Medication Management, and Arthritis Care Conducted analyses: Trends in collective performance since 1999 Trends in individual performance over time, reported confidentially to each organization Collaborative and national performance comparisons Met to discuss: WCDQIP meets quarterly to discuss quality improvement initiatives, best practices, and trends in diabetes care Contact Information and References Kristin Gallagher, BS, CHES Project Assistant UW Population Health Institute, School of Medicine and Public Health 5901 Research Park Blvd, Cube E; Madison, WI 53719 Phone: 608-263-5243; Email: klgallagher@wisc.edu A list of references is available upon request. Limitations Conclusions Future Directions HEDIS  specifications sometimes change, which can limit ability to track trends Over time, some plans have merged, dissolved, or stopped participating. Other plans have joined the collaborative To address this, averages are calculated two ways: average of all plans and average of continuously participating plans A causal relationship cannot be established between collaborative initiatives and overall improvement in HEDIS  measures Wisconsin’s performance continues to exceed national averages for all HEDIS  Comprehensive Diabetes Care measures Diabetes quality improvement initiatives have been undertaken, both by the WCDQIP and by participating organizations Project is a model for quality monitoring and improvement in other programs, states, and communities Chronic Disease Program Integration: Chronic disease program addendum reports (Arthritis, Asthma, Cancer, Tobacco Control, Heart Disease & Stroke Prevention, Nutrition, Physical Activity, & Obesity Prevention) Evaluation of integration efforts can be used to design and implement new initiatives to improve care for chronic disease RRU (Relative Resource Use) data collection and reporting to measure the efficiency and value of services rendered by plans Eye ExamLDL-C screeningHbA1c testing HbA1c poor control* 1999 2010 1999 2010 Medical attention for nephropathy Blood pressure control (<140/90 mmHg) Blood pressure control (<130/80 mmHg) Eye examHbA1c poor control (lower value desired) HbA1c testing LDL-C control (<100 mg/dL) LDL-C screening Goals: Evaluate trends in diabetes care Promote collaboration Provide a forum to share best practices Enhance diabetes quality improvement measures WCDQIP members include: Participating Wisconsin HMOs and health plans Wisconsin Diabetes Prevention and Control Program Wisconsin Division of Health Care Access and Accountability Wisconsin Diabetes Advisory Group University of Wisconsin Population Health Institute (UWPHI) Group Mean (2008) Group Mean (2009) Direction of Trend (2008- 2009) Variation among Plans* National Mean (2009) Group vs. National Mean Breast Cancer Screening 77% No Change Medium Range=16 71% Better than National Controlling High Blood Pressure (for patients with CV conditions) 67%68%Increase Medium Range=16 64% Better than National Anti- Rheumatic Drug Therapy (for patients with arthritis) 91%94%Increase Medium Range=15 86% Better than National Weight Assessment: Adult Body Mass Index No data59%No dataHigh Range=34 41%Better than National