2018 Acclaim Award Honoree
An AMC's Tale of High Quality Care Across the Continuum
Michigan Medicine is one of the largest health systems in Michigan and one of the nation’s leading academic medical centers. The organization employs more than 2,700 physicians across 19 clinical specialties, including primary care. It provides both inpatient and outpatient care through three hospitals (adult, pediatric, and women’s) with 1,000 inpatient beds, and 40 ambulatory locations with 140 clinics, specialty centers for cancer, depression, and cardiovascular care, and home care services. In 2016, the organization had approximately 50,000 admissions, 100,000 emergency room visits, and 2.3 million ambulatory visits. The system also trains more than 1,200 house-officers and 700 medical students.
The organization has incorporated the AMGA’s High-Performing Health System Attributes into their multispecialty practice in the following ways:
Organized System of Care
- Michigan Medicine led 17 statewide quality collaboratives with other hospitals and physician organizations as well as several national collaboratives sponsored by specialty societies or the federal government.
Quality Measurement and Improvement Activities
- It continuously surveys patients on their experiences across the institution using the Hospital Consumer Assessment of Healthcare Providers and Systems Hospitals Survey (HCAHPS) and the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS), with ratings publicly reported via the organization’s website.
- It developed a Complex Care Management Program for……..
- It uses an adaptation of the Geriatric Resources for the Assessment and Care of Elders (GRACE) program, originally developed at Indiana University, to provide in-home care management services to frail elderly patients.
Use of Information Technology and Evidence-Based Medicine
- Michigan Medical developed registries for more than 200,000 primary care and specialty patients focused on asthma, Chronic Kidney Disease, Chronic Obstructive Pulmonary Disease, use of controlled substances, Corornary Artery Disease, diabetes, heart failure, and hypertension; preventive services (screening for breast, colon, and cervical cancer; chlamydia, depression and fall risk; post-partum visits); immunizations (childhood immunizations, chlamydia, influenza, pneumovax); and recommended visits (post-partum and well care visits including Welcome to Medicare). Clinical staff builds these activities into their workflow and they are integrated in the EHR.
- It participated in the Centers for Medicare & Medicaid Services (CMS) Physician Group Practice (PGP) Demonstration. The organization was able to achieve success by focusing on high-risk patients that are dual eligible (i.e., receiving Medicare and Medicaid) and high utilizers. Through the PGP Demonstration, they experienced key learning around transitional care, complex patients, frail elders, sub-acute care, and community-based care linkages.
- It is participating in Medicare’s Shared Saving Program through the Physicians of Michigan Accountable Care Organization (POM-ACO) which includes nine physician organizations.
- A portion of each primary care clinic’s budget is tied to the number and complexity of patients they see and the quality of care they provide, as measured through patient registries and external pay-for-performance programs.
Efficient Provision of Services
- In 2012, the health system established a Population Health Office that is charged with managing the organization’s efforts to improve total cost of care, care coordination, and the health of populations.