Quality Results

In 2020, the ACO maintained 15 value-based contracts that required reporting on 60 unique quality measures. To track performance on a month-to-month basis, we selected 10 of these measures as overall markers of quality. We reported progress toward achieving these measures’ targets in what’s known as the MaineHealth ACO Quality Heat Map. Below are results for Quality Heat Map measures that have been established for at least four years. More recently established measures remained nearly flat in 2020.

Target

Results

Breast Cancer Screening

Percentage of female patients ages  50-74 at the end of the measurement period and age <74 at the beginning of the measurement period, with an office visit in the last 12 months.

Target

Results

Colorectal Cancer Screening 

Percentage of patients ages 50-75 at the beginning of the measurement period, with an office visit in the last 12 months. with one or more screenings documented for colorectal cancer: colonoscopy in the last 10 years; flexible sigmoidoscopy in the last 5 years; computed tomography (CT) colonography in the last 5 years; fecal immunochemical DNA test (FIT-DNA) in the last 3 years; fecal occult blood test (FOBT) during the measurement period.

Target

Results

Depression Screening

Percentage of patients age >=12 at the beginning of the measurement period, with an office visit in the last 12 months, with a PHQ2 or PHQ9 documented in the last 12 months.

Target

Results

Diabetic Eye Exam 

Percentage of patients with Diabetes (Type 1 or Type 2), ages 18-75 at the beginning of the measurement period diagnosed, and having an office visit during the measurement period, with documentation of a retinal or dilated eye exam in the last 24 months or last 12 months for patients with retinopathy.

Target

Results

Diabetes Not Controlled

Number of patients with Diabetes (Type 1 or Type 2), ages 18-75 at the beginning of the measurement period diagnosed, and having an office visit during the measurement period, whose most recent Hba1c in the last 12 months is > 9 or no Hba1c test was completed. (Lower percentage is better.)

 Target

Results

Hypertension Controlled  

Percentage of patients with hypertension, ages 18-85 at the beginning of the measurement period diagnosed, with an office visit in the last 12 months, with blood pressure < 140/90.

Cynthia Wade, RN
President, LincolnHealth
Co-chair, Value Oversight Committee, MaineHealth ACO
Commentary from Cindy Wade, RN:

Looking at three years of quality results reveals a positive long-term trend that was, unsurprisingly, disrupted by the pandemic.

The decrease in quality performance in 2020 was mainly due to curtailment of in-person visits with overall primary care volume down about 25 percent between 2019 and 2020.  When patients aren’t seen, screenings get delayed and chronic disease management is limited.  As expected, as in-person care began to rebound in the latter half of the year, we did see improvement in performance for a number of measures, including well-child visits, statin therapy, depression screening and annual wellness visits. However, the 2020 quality targets for most of the Heat Map measures remained out of reach. Fortunately, through ACO-led negotiations, many payers are allowing ACOs to report 2019 performance in lieu of 2020’s numbers to help providers focus on the public health emergency.

2020 Annual Report

Cynthia Wade, RN
President, LincolnHealth
Co-chair, Value Oversight Committee, MaineHealth ACO

Commentary from Cindy Wade, RN:

Looking at three years of quality results reveals a positive long-term trend that was, unsurprisingly, disrupted by the pandemic.

The decrease in quality performance in 2020 was mainly due to curtailment of in-person visits with overall primary care volume down about 25 percent between 2019 and 2020.  When patients aren’t seen, screenings get delayed and chronic disease management is limited.  As expected, as in-person care began to rebound in the latter half of the year, we did see improvement in performance for a number of measures, including well-child visits, statin therapy, depression screening and annual wellness visits. However, the 2020 quality targets for most of the Heat Map measures remained out of reach. Fortunately, through ACO-led negotiations, many payers are allowing ACOs to report 2019 performance in lieu of 2020’s numbers to help providers focus on the public health emergency.