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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.

The 2008 health reform law charges the Commissioner of Health with developing a method for comparing 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 must use these provider peer grouping results to strengthen incentives for consumers to choose high-quality, low-cost health care providers.

During the summer of 2009, the Commissioner convened an advisory group comprised of health care providers, health plan companies, state agencies and organizations that work to improve health care quality to develop recommendations on the provider peer grouping methodology. This advisory group's final report recommended a methodological framework for comparing providers on cost and quality. The group's final report can be found at Provider Peer Grouping – Advisory Group.

MDH used the advisory group's report as the basis of a competitive procurement process to hire an analytical vendor to implement the peer grouping system. MDH signed a two-year contract 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.

Fact sheet

Provider peer grouping fact sheet - January 2011 (PDF: 47KB/1 page)

Hospital Total Care Report Distribution

Hospitals in Minnesota received the first reports produced under MDH's Provider Peer Grouping system on September 27, 2011. MDH and its analytical contractor, Mathematica Policy Research, convened a webinar and a series of public meetings to review the reports with hospitals. Since the confidential release of this information to hospitals, MDH received many comments and questions from hospitals through these public venues, as well as an electronic feedback process. A summary of questions raised and answers provided is available below:  

MN Peer Grouping Hospital Total Care Report - Frequently asked questions and answers (PDF: 224KB/8 pages)

Please note, in reaction to the many thoughtful and constructive comments and questions raised by hospital representatives during the 30 day review period, MDH and Mathematica Policy Research have opted to make some revisions to the initial analysis, which will be available for confidential hospital review in early 2012.

MDH held a public meeting for hospital representatives on Tuesday, January 10, 2012. The slides from this meeting are available below.

Slides for January 10, 2012 presentation, (PDF: 1056KB/26 pages)

Additional Documents for Hospitals

Detailed Methodology
As referenced in the hospital's report, additional information about data sources and the calculation of quality and payment statistics is available in the detailed Methods report available below:

2011 Hospital total care provider peer grouping methodology (PDF: 133KB/18 pages)

Appeals Process
Hospitals may appeal their results if they are concerned about the accuracy of the data. Additional details about the appeals process can be found in the document below:

Provider peer grouping report review and appeals process (PDF: 133KB/3 pages)

Conference call information

MDH will hold monthly conference calls to share information about the provider peer grouping initiative on the second Monday of each month from 7:30-8:15 a.m.

The next call is scheduled for Monday, February 13. The presentation slides for this call will be available on February 13.

Dial-in number: 888-742-5095
Conference code: 9247084406

Updated Thursday, 09-Feb-2012 11:30:38 CST