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Provider Peer Grouping

Numerous research studies have shown that there is wide variation in costs and quality across different health care providers, with no evidence that higher cost or higher use of services is associated with better quality or better health outcomes for patients.

In 2008, the Minnesota Legislature passed a groundbreaking law that, among other initiatives, charged the Commissioner of Health with developing a system - provider peer grouping - that would provide consumers, payers and providers with greater transparency about value in health care. The system will allow comparison of health care providers based on a combination of risk-adjusted cost and quality, for a provider's total patient population as well as for select specific health conditions. This method will be used to begin to change incentives for both health care providers and consumers in ways that encourage lower costs and higher quality. The state employee health plan, state public insurance programs, local units of government, and health plan companies may use these provider peer grouping results to strengthen incentives for consumers to choose high-quality, low-cost health care providers.

Over the past three years, MDH staff, contractors and community advisors have made important gains in developing key aspects of the state’s provider peer grouping (PPG) system. The 2011-2012 Legislature recognized and affirmed the importance of moving forward with the development and implementation of PPG by enacting changes in the PPG statute that would ensure robust community engagement in this work and set timelines that allow for adequate provider review of confidential results. Commissioner Dr. Ehlinger is strongly committed to realizing the state’s vision to move towards reporting of measures of value, with an emphasis on scientific rigor, actionable results and transparency of approach.

The initiative began when the Minnesota Department of Health (MDH) released a Request for Information (RFI) in March 2009 to identify key issues and questions. Responses to the RFI were synthesized into a set of issue papers.

This initiative has been guided by a number of technical advisory groups, including a previous Advisory Group, a Rapid Response Team, and a Reliability Workgroup. Their recommendations, including the final report of the 2009 Advisory Group, can be found under the Past Advisory Bodies link in the sidebar. In July 2012, Commissioner Dr. Ehlinger appointed an Advisory Committee to guide the system’s implementation over the next two years. Materials related to the 2012 Advisory Committee, including agendas for upcoming public meetings of the Committee, can be found here: Advisory Committee.

MDH has contracted with Mathematica Policy Research to perform the provider peer grouping analysis, distribute the results to providers and help providers understand their results.

Providers will have the opportunity to review their reports confidentially and appeal results based on any concerns related to the accuracy of the data used in the analysis or errors in the application of the standards or methodology established by the Commissioner in consultation with the Advisory Committee More information about appeals can be found under the Appeals link in the sidebar menu.

PPG Fact Sheet (PDF: 293KB/1 page)

Updated Friday, 14-Sep-2012 13:38:12 CDT