Request for Proposal: Evidence-based Technical Assistance for Multistakeholder, Community-based Quality Collaboratives: Chartered Value Exchanges (CVEs) Technical Assistance Needs (Text Version)

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The Comprehensive Technical Assistance Request Chart (continued)

#	Date	Source	Focus Area	Category	Originator of Request	Summary of Technical Assistance Request	Technical Assistance Request
76	2/4/08-3/31/08	1	Quality & Efficiency Measurement	Payment reform	MI-GDAHC/ LA/MA	Develop a measure of medical "homeness" (3)	Jerome Frankel, Greater Detroit Area Health Council, queried AHRQ about incorporating a measure of patient-centered medical home in the CAHPS clinician and group survey. He explained that it would be helpful to measure the extent to which a physician practice offers patients a 'medical home.' Louisiana Health Care Quality Forum and Massachusetts Healthcare Quality Partners also asked for help in implementing a measure of patient centered medical home.
77	2/4/08-3/31/08	1	Quality & Efficiency Measurement	Other	WA-PSHA	Help integrate alternative medicine into performance measurement	Puget Sound Health Alliance requested assistance with gathering evidence and integrating alternative/complementary medicine into performance measurement and quality improvement.
78	2/4/08-3/31/08	1	Quality & Efficiency Measurement	Cultural competency/ Literacy	LA	Health literacy measures through H-CAHPS	Health literacy measures through H-CAHPS
79	2/4/08-3/31/08	1	Quality & Efficiency Measurement	Patient experience	LA	Use of CAHPS for patient experience with providers.	Use of CAHPS for patient experience with providers.
80	2/4/08-3/31/08	1	Quality & Efficiency Measurement	Other	TN-HMCT	Help in moving away from claims aggregation	Healthy Memphis Common Table asked for technical assistance in moving from claims administration and aggregation to MD direct record submission.
81	2/4/08-3/31/08	1	Quality & Efficiency Measurement	Alignment	MN	Align health plan measures with CVE	Align health plan measures with CVE
82	2/4/08-3/31/08	1	Quality & Efficiency Measurement	Other	MN	Advice on NQF endorsement	Minnesota Healthcare Value Exchange asked for advice on how to get NQF's endorsement.
83	2/4/08-3/31/08	1	Quality & Efficiency Measurement	AHRQ Resources	PA-PRHI	Apply AHRQ software to PHC4 data currently available	Apply AHRQ software to PHC4 data currently available.
84	2/4/08-3/31/08	1	Quality & Efficiency Measurement	Standardization	MI-GDAHC/ MI-AFH	Develop more measures and standardize measures (2)	Greater Detroit Area Health Council asked for help identifying affordable next steps in ambulatory reporting, including moving from physician group level to individual physician level reporting. Standardized, nationally vetted efficiency and appropriateness measures in addition to more quality measures. Michigan's Alliance for Health also requested "standardization" in the area of quality and efficiency measurement.
85	2/4/08-3/31/08	1	Quality & Efficiency Measurement	AHRQ Resources	MA	HCUP session—questions related to outpatient care data	Does ambulatory data capture freestanding outpatient sites? Elixhauser responded that it varies by State. A Massachusetts Healthcare Quality Partners representative asked about ambulatory sensitive conditions. Since these conditions are reported as hospital measures, the representative reported that his organization is not able to link the indicator back to the relevant ambulatory care episode. In response, Elixhauser agreed that ambulatory sensitive condition indicators cannot be connected to the outpatient setting. However, these indicators can be used to identify areas where there are a high proportion of preventable admissions.
86	2/4/08-3/31/08	1	Quality & Efficiency Measurement	AHRQ Resources		HCUP session—questions related to inpatient care data	Does AHRQ include both admission and discharge diagnosis? Only discharge, Elixhauser responded. How can you differentiate problems in hospitals if you do not know why patients presented? Elixhauser responded that starting in January, for Medicare, hospitals need to start submitting present on admission data to determine what presented during the course of stay. Many States will be starting to submit this data soon. The dollar values in administrative data are based on charges rather than cost. Can HCUP address this problem? Elixhauser: Yes, you're right. AHRQ has cost to charge rations that can get at an estimate of cost. What would be helpful is actually information on price, but that is considered proprietary. Maine is currently collecting information on price from all sites of care and that is where we want to go eventually. What diagnosis information is available? What does HCUP capture in terms of diagnoses? Elixhauser: HCUP captures principal discharge diagnosis and up to 29 secondary diagnoses. Does database capture any information on rehabilitation facilities? Elixhauser: At this point, HCUP does not capture any data on long term care. How about data on readmissions? Elixhauser: In order to look at readmissions, you have to track over time and not every State makes personal identifier available. While readmission may be a good proxy for quality, it has shortcomings. In response to a question regarding whether HCUP captures data on admissions from the emergency department, Elixhauser responded that the emergency department database only includes data on patients who are seen in the emergency department and released from the emergency department. If a patient is admitted from the emergency department, his/her data will appear in the inpatient database.
87	2/4/08-3/31/08	1	Quality & Efficiency Measurement	AHRQ Resources		HCUP Session—Questions Related to Data Collection and Validity	In response to a question about the validity of discharge abstracts vs. medical records, Elixhauser responded that AHRQ is now observing high correlations between discharge abstracts and medical records, especially for principal diagnoses. A question followed regarding two original HCUP indicators, AMI after surgery and pneumonia after surgery. Elixhauser explained that researchers at UCSF Stanford determined that these indicators are not ready yet for "prime time" and would have let through too many cases. Elixhauser indicated that soon, we will be able to use present on admission indicators and that these indicators will significantly enhance existing measures. A participant asked whether AHRQ has undertaken any work on developing emergency department indicators. Elixhauser responded that additional funding is needed in this area. In response to a question, Elixhauser indicated that AHRQ captures all ICD9 digits/characters. Janet Sullivan of the Hudson Health Plan posed a question regarding the age of HCUP data, noting that 2004 and 2005 appear to be the most recent years for which a full data set is available. Elixhauser responded that AHRQ now has national level data for 2005 and will be releasing 2006 data at the end of May. She noted that AHRQ can only go as fast as the slowest State and that the agency is exploring ways to do modeling so that earlier estimates can be generated for those States that have not submitted their data. In response to a question, Elixhauser stated that, until a full national data set becomes available, CVEs would need to request 2006 and 2007 data directly from those State organizations that are collecting this data. She noted, however, that data acquired directly from such organizations would lack the uniform definitions that AHRQ applies to the full national data set, thereby making across State comparisons difficult. A participant asked whether it would be possible to ask individual State organizations to add the hospital identifier to the database because HCUP does not allow users to access those identifiers. Elixhauser restated that the nature of AHRQ's agreements with State partners does not allow for individual hospitals to be identified deliberately or inadvertently. She stated "our philosophy is that it is up to the individual States to collect individual level quality data." She also indicated that AHRQ is exploring the feasibility of providing software to enable CVEs to collect individual hospital level quality data. She asked the audience whether such software would be helpful. About 15 individuals raised their hands to indicate it would be helpful to have software that would enable them to apply HCUP at the local level with hospital identifiers. Tennessee and Oregon were among those CVEs who indicated it would be helpful. Regarding the preventable hospitalization costs (PHC) tool, one individual asked if this data is risk adjusted or adjusted for insurance status. Elixhauser responded that there are breakdowns by age and sex, and by payer. Does the PHC tool allow you to look at charge data? Elixhauser: Yes. Mark Sonneborn, Minnesota Healthcare Value Exchange, shared his perspective that HCUP has been a very valuable tool in Minnesota. He noted that problems with ambulatory sensitive conditions are often access problems. Michael Young, Erie County Medical Center, commented that HCUP is valuable, noting that "there is no way a single hospital could pull this data together." He said that the HCUP data base acts as our "speedometer by giving us enough data to begin to learn." One health plan representative stated that it would be useful to have software that would enable the plan to identify patients. So, for example, if a health plan is having a disproportionate number of patients who have ambulatory sensitive conditions from a specific clinic, the plan would be able to share that information with the clinic's physicians. Elixhauser responded that the HCUP database is capable of doing this.
88	2/4/08-3/31/18	1	Quality & Efficiency Measurement	Medicare data	ME/ MI-GDAHC/ PA-PRHI/ WA-PSHA/ WI/UT/MN/ TN-HMCT	Improved access to Medicare data (8)	Interest in access to raw Medicare data for physician groups ran high among participants. Maine CVE Alliance, Michigan's Greater Detroit Area Health Council, Pittsburg Regional Health Initiative, Puget Sound Health Alliance, Healthy Memphis Common Table, Wisconsin Healthcare Value Exchange, UPV, and Minnesota Healthcare Value Exchange all requested access to Medicare data, or clarification regarding the level of access that AHRQ will facilitate. (Wisconsin Collaborative for Healthcare Value Exchange reiterated this request for access to Medicare data during its March call with CHI. Similarly, during their March call with CHI, UPV asked for information on when Medicare data will be available so that the CVE could share this information with the health plans in the State. This information would be helpful because the CVE plans to quickly match the CMS physician level data with health plan data from the State). Participants noted that the agenda did not directly address this topic. Chris Queram, Wisconsin Healthcare Value Exchange, asked specifically regarding AHRQ's view on providing CVEs with access to this data. A similar question was raised on day two by Janice Whitehouse of Greater Detroit Area Health Council who asked Secretary Leavitt to elaborate on the availability of Medicare data to CVEs. Maine CVE Alliance noted that "we need CMS data—size of denominator makes a difference - providers will pay more attention with larger numbers of patients included in analysis."
89	05/08	2	Quality & Efficiency Measurement	Database/Data warehouse development	LA	Assistance with metrics and measures.	The Louisiana Health Care Quality Forum may need possible consultation on: Determining what special population health metrics will be useful to guide and evaluate specific areas of improvement to be targeted by LHCQF. Developing a "deep dive" capability to explore Louisiana's performance in the mortality amenable to health care measure, by specific causes.
90	05/08	2	Quality & Efficiency Measurement	Database/Data warehouse development	LA	Assistance with developing a multi-payer database	The Louisiana Health Care Quality Forum requested help in developing a multi-payer database in these areas: Prepare specifications, solicit data contributors, update and expand the 2005 data base, and select a vendor. Use the 2005 multi-payer database to produce a host of tables of information and an ad hoc query tool, within the parameters of the data use agreements. Establish a process to evaluate the cost, quality and availability of the health care system as it pertains to the uninsured, including the measurement of the uninsured population by region and potentially other key variables. Identify and organize useful information for measuring the cost, quality and accessibility of health care in Louisiana, which is already being assembled from other credible sources. (e.g., 30 day mortality rates following inpatient hospital stays). Update the 2005 multi-payer database with 2006 and 2007 data.
91	05/08	2	Quality & Efficiency Measurement	Data presentation	LA	Assistance on scorecards	The Louisiana Health Care Quality Forum asked for possible consultation on developing a starter set of health care supplier scorecards in the areas of: Establishing a conceptual basis for expanding on these starter sets by developing and applying appropriate criteria for "best practices". Establish an initial performance scorecard to be used for "medical homes". Developing a standardized composite quality rating based on the full set of specific measurements contained in the 'starter set' scorecard and anticipated additions to the scorecard. Establishing a schedule for recommending performance scorecards for other health care suppliers.
92	05/08	2	Quality & Efficiency Measurement	Data methodology	NYQA	Assistance in data methodology	The New York Quality Alliance asked for best practices and lessons from early adopters on methodology in scoring, data validation and appeals, and development of a formula for the hybrid claims data adjustment factor physician-patient assignments report card design and benchmarking.
93	05/08	2	Quality & Efficiency Measurement	Data presentation	NYQA	Lessons in physician measurement reports	The New York Quality Alliance asked for best practices and pitfalls other projects have experienced in physician measurement reports.
94	05/08	2	Quality & Efficiency Measurement	Database/Data warehouse development	NY-Niagara	Assistance with use of new data sets	New York—Niagara Health Quality Coalition noted that as new data sources emerge, TA on integration and use of data sets would be helpful. The CVE also stated that it would be happy to provide TA to other CVEs on integration, cleaning and manipulation of existing data sets.
95	05/08	2	Quality & Efficiency Measurement	Efficiency/ Cost	NY-Niagara	Reporting on progress of Leapfrog and other efforts to develop efficiency metrics	Reporting on progress of Leapfrog and other efforts to develop efficiency metrics.
96	05/08	2	Quality & Efficiency Measurement	Data presentation	NY-Niagara	Best practice information on reporting tools and web sites.	Best practice information on reporting tools and Web sites.
97	05/08	2	Quality & Efficiency Measurement	National standards	NY-Niagara	Updates on AQA, NQF, and other performance measures.	Updates on AQA, NQF, and other performance measures.
98	05/08	2	Quality & Efficiency Measurement	Data presentation	NY-Niagara	Best practices in presenting data	Best practices in presenting data.
99	05/08	2	Quality & Efficiency Measurement	Efficiency/ Cost	WA-PSHA	Advice on best practices for efficiency measurement	Washington—Puget Sound Health Alliance requested best practices for efficiency measurement. The CVE wanted practical suggestions for how this information (or possibly "price" or "cost" data) can be presented in ways that are useful to providers, purchasers and health plans, in addition to being relevant to patients and other consumers.
100	05/08	2	Quality & Efficiency Measurement	Patient experience	WA-PSHA	Information on best practices for ambulatory patient experience measurement and reporting	Washington—Puget Sound Health Alliance requested advice on best practices for practical ways to measure and report on patient experience in ambulatory settings in the following areas: How should it be done (methodology) and how should it be paid for (initially and over time)? Other issues include appropriate minimum sample size, how to address impact on legacy approaches in place within clinic systems, how diversity is handled (language and ethnic issues), etc. Explore ways collaboration across coalitions on this could reduce the workload and cost for everyone involved.
101	05/08	2	Quality & Efficiency Measurement	Data presentation	WI	Measurement terminology.	The Wisconsin Healthcare Value Exchange requested information about other communities/initiatives regarding standard nomenclature for "efficiency" and "cost of care."
102	05/08	2	Quality & Efficiency Measurement	Other	LA	Metrics to monitor quality improvement	Metrics to monitor quality improvement.
103	2/4/08-3/31/08	1	Quality & Efficiency Measurement	Medicare	PA-PRHI	Access to Medicare data	Pittsburgh Regional Health Initiative asked for access to Medicare data because it will be credible and would open up the way to obtain information from local insurers. With credible data, the CVE would also be able to encourage physicians to improve.
104	2/4/08-3/31/08	1	Public Reporting	Data presentation	MN	A continuum of public reporting	Minnesota Chartered Value Exchange asked for information on creating a continuum of public reporting.
105	2/4/08-3/31/08	1	Public Reporting	Efficiency/ Cost	MN	Reporting cost	Minnesota Chartered Value Exchange requested assistance in determining a strategy on how to report cost. The CVE may or may not do it through public disclosure. They must check to see that public disclosure drives peer-to-peer improvement. They are also sorting out how they want the information to be used, whether it is an issue of moving the market as a whole or by individual choice. Regarding cost data, how payment is aligned to support these initiatives will be important to them.
106	2/4/08-3/31/08	1	Public Reporting	Data presentation	MN	Displaying data on a Web site	Minnesota Chartered Value Exchange asked for information on how to display data on the Web site for consumers.
107	2/4/08-3/31/08	1	Public Reporting	National standards	NYQA	Nationally vetted measures	New York Quality Alliance requested assistance in obtaining nationally vetted measures on efficiency, clinical quality, and patient experience measures.
108	2/4/08-3/31/08	1	Public Reporting	National standards	NYQA	National formats and standards.	New York Quality Alliance requested nationally accepted public reporting formats and standards for public dissemination for quality reports.
109	2/4/08-3/31/08	1	Public Reporting	Data presentation	OR	Information from experts	Oregon Health Care Quality Corporation requested information on what experts see as effective (e.g., information from Shoshanna Sofaer).
110	2/4/08-3/31/08	1	Public Reporting	AHRQ resources	OR	AHRQ-ready tools	Oregon Health Care Quality Corporation requested everything that AHRQ can provide that is tested and ready.
111	2/4/08-3/31/08	1	Public Reporting	Data presentation	OR	Ease of accessibility to information	Oregon Health Care Quality Corporation asked for assistance on how to make information interpretable for the public.
112	2/4/08-3/31/08	1	Public Reporting	Confidentiality/ Security	WA-PSHA	Confidentiality and security	Puget Sound Health Alliance asked for assistance with issues regarding confidentiality and security.
113	2/4/08-3/31/08	1	Public Reporting	Efficiency/ Cost	WA-PSHA	Aggregating cost information	Puget Sound Health Alliance asked for information on how communities have worked together to aggregate cost information for public reporting, and what type of cost data to report.
114	2/4/08-3/31/08	1	Public Reporting	Medicare	WA-PSHA	Using Medicare data	Puget Sound Health Alliance expressed concern that Medicare data may come in a form that is difficult to use that does not allow the CVE to blend it with commercially insured data (e.g., measures are not identical to the CVE's measures, the time period is not in sync with what is being reported in the CVE community). Should this happen, the CVE asked for assistance on how to best use the information.
115	2/4/08-3/31/08	1	Public Reporting	Medicare	TN-HMCT	Reporting by geographic region	Healthy Memphis Round Table asked for information on what geographic region to do reporting on. While the CVE has focused on Shelby County, how broad the report effort will be depends on what data are made available to the CVE.
116	2/4/08-3/31/08	1	Public Reporting	Data presentation	UT/ WI	Lessons learned (2)	UPV simply asked for "lessons learned in this area." The Wisconsin Collaborative for Healthcare Value Exchange made a similar request, for information on how other communities are distributing data and how to help consumers use this information for decisionmaking.
117	2/4/08-3/31/08	1	Public Reporting	Data presentation	UT/MN	Offer more tools (2)	UPV asked simply for "more tools, and education to help construct relevant, actionable messages." Similarly, Minnesota Healthcare Value Exchange asked for more sharing of evidence and practical advice on public reporting and its application for consumers and providers.
118	2/4/08-3/31/08	1	Public Reporting	Data presentation	OR	Advice on disseminating quality data	Oregon Health Care Quality Corporation stated "we'll use every bit of help about disseminating quality data."
119	2/4/08-3/31/08	1	Public Reporting	Data presentation	TN-HMCT/ ME	Make experts available to CVEs	Healthy Memphis Common Table asked for consumer communication counseling, such as Dr. Sofaer, to advise its public reporting team so that they develop useful reports for audiences.
120	2/4/08-3/31/08	1	Public Reporting	Cultural competency/ Literacy	TN-HMCT	Address literacy	At the conclusion of the HCUP presentation on day one, a CVE representative noted that while this information is "fantastic," she wondered about the person using this information to make a choice. Specifically, she raised the issue of literacy. "I am not sure that most people would be able to look at this information and appreciate its value." Irene Fraser indicated that AHRQ has contracted with Shoshanna Sofaer to examine how best to present information and has created two templates. Peggy McNamara indicated that those templates are available on AHRQ's Web site. This comment regarding literacy was echoed on day two of the meeting during the session led by Dr. Sofaer, when Denise Bollheimer, Healthy Memphis Common Table, asked the panelists if they had suggestions for public reporting literature that is aimed at populations with a low level of literacy.
121	2/4/08-3/31/08	1	Public Reporting	Data presentation	MI-AFH/UT/ WA-PSHA/ PA-PRHI/ ME	Standardize reporting. (5)	Michigan's Alliance for Health requested assistance with "structuring formula for content/standardization" in the area of public reporting. In a similar vein, Scott Williams, UPV, challenged CVEs during the session led by Dr. Sofaer to develop standardized reporting language so that the CVEs "do not spin our wheels for another ten years." Sofaer responded by noting the importance of standardizing measures first, then scoring, and only then can we begin to standardize reporting language. Puget Sound Health Alliance also noted the need for a common platform or approach to effective presentation of data that works for many population segments. Pittsburgh Regional Health Initiative echoed this request, noting the need for help in developing a consistent presentation of information across CVEs. During its baseline call with CHI, Maine CVE Alliance made a similar request, for standardization of reporting formats based on what resonates better with consumers.
122	2/4/08-3/31/08	1	Public Reporting	Patient experience	TN-HMCT	Integrate physician satisfaction surveys.	During an earlier session, Denise Bollheimer, Healthy Memphis Common Table, noted that physician groups are using Press Ganey as well as national and regional comparatives. How is AHRQ integrating these surveys into the CAHPS family of surveys? Chuck Darby noted that there is not as much penetration at the physician and group level with any of these surveys. There is a serious issue regarding trending of this data.
123	2/4/08-3/31/08	1	Public Reporting	Patient experience	UT	Determine efficacy of patient satisfaction surveys by mail vs. by phone	Scott Williams, UPV, asked for AHRQ's perspective on the implementation of patient satisfaction surveys via mail vs. via survey. Chuck Darby noted that there is a third alternative, key phone activated surveys. There is a large scale effort to look at the efficacy of these various modalities. Research has shown that respondents tend to offer a more positive response by phone than by mail, leading survey administrators to adjust responses by the modality used.
124	2/4/08-3/31/08	1	Public Reporting	Patient experience	MA	Identify costs of electronic patient satisfaction surveys.	Dana Gelb-Safran, Massachusetts Healthcare Quality Partners, commented that the ability to use email surveys would help alleviate the burden of cost. In addition electronic surveys would eliminate the 'mode' effect of phone vs. mailed surveys. She is interested in the experience of others in collecting email addresses and the stability of those addresses over time.
125	2/4/08-3/31/08	1	Public Reporting	Patient experience	NYQA	Improve accessibility of CAHPS.	Barbara Kupferman, New York Quality Alliance, applauds the Massachusetts effort and commented that they are trying to start a similar effort in New York. She commented that they had to go through the expense of hiring a vendor to implement the survey. She would like to see ideas for improving the accessibility of the CAHPS survey for their members. She noted that they are working to implement telephonic and internet patient experience surveys. She noted that (responding to the comment above from Massachusetts Healthcare Quality Partners) for those patients who do not receive electronic surveys, they will need to follow up by phone.
126	2/4/08-3/31/08	1	Public Reporting	Other	PA-PRHI	Provide appropriate feedback	Pittsburgh Regional Health Initiative asked assistance in providing feedback that is appropriate, reliable and actionable to employers, providers, and consumers. How do we determine what they need and when they need it?
127	2/4/08-3/31/08	1	Public Reporting	Other	LA/TN-HMCT	Offer help in creating simulator video (2)	Healthy Memphis Common Table asked for technical assistance in creating a simulator video/webinar/trainer to give audiences a chance to test drive use of Web site. Similarly, Louisiana Health Care Quality Forum asked for assistance in designing a web portal for viewing reported information.
128	05/08	2	Public Reporting	Data presentation	PA-PRHI	Assistance with developing regional health report.	Pennsylvania—Pittsburgh Regional Health Initiative requested assistance in developing its quarterly/semi-annual series of "State of Region's Health" reports through identification of research material sources, second set of eyes for potential topics and approaches, and comparable regional/State/national reports (e.g. KFF polls).
129	05/08	2	Public Reporting	Patient experience	NY-Niagara	Assistance with patient experience data	New York—Niagara Health Quality Coalition would like TA from the AHRQ CAHPS Team contractors on alignment of fields and data management strategies, as well as use of Implementation Guide as model. This is in regards to patient experience data.
130	05/08	2	Public Reporting	Other	PA-PRHI	Assistance on developing a roundtable on performance reporting	Pennsylvania—Pittsburgh Regional Health Initiative is convening a regional or perhaps statewide stakeholder roundtable about health care performance reporting and would like a sounding board for speakers, invitees, and agenda scope of participant information packets/reading.
131	05/08	2	Public Reporting	Other	PA-PRHI	Information for consumers.	Pennsylvania—Pittsburgh Regional Health Initiative would like assistance in developing additional personal health information content and sources for consumers.
132	05/08	2	Public Reporting	Other	PA-PRHI	Information about consumer acceptance/ responses to quality information	Pennsylvania—Pittsburgh Regional Health Initiative requested information about consumer acceptance/ responses to quality information about health plans, hospitals, and physicians. Best-in-class examples of online and printed consumer resources.
133	05/08	2	Public Reporting	Other	PA-PRHI	Assistance in developing national conference on health care performance reporting	Pennsylvania—Pittsburgh Regional Health Initiative would like help in thinking through the development of a significant, national conference on consumer health care resources and health care performance.
134	05/08	2	Public Reporting	Data presentation	PA-PRHI	Lessons on publishing physician performance reports	Pennsylvania—Pittsburgh Regional Health Initiative would like information on experience/lessons learned from other CVEs and organizations that publish physician performance reports (i.e. how other CVEs have succeeded in enlisting cosponsors/ partners?)
135	05/08	2	Public Reporting	Other	PA-PRHI	How to assess impact of public reports	Pennsylvania—Pittsburgh Regional Health Initiative would like to know how to measure effectiveness/attribute change to information (i.e. PCP performance report) provided to health care consumers.
136	05/08	2	Public Reporting	Data presentation	WA-PSHA	How to publicly report coalition data	Washington—Puget Sound Health Alliance would like advice on how to publicly report for coalitions using data that is de-identified, including exploring ways this might be done jointly to help many coalitions address the issue.
137	05/08	2	Public Reporting	Other	WI	Enhance consumer use of performance Web sites	The Wisconsin Healthcare Value Exchange asked for information on models used to drive the largest number of consumers to Web sites (1 Web site vs. many linked) and market segments most likely to use performance reporting Web sites.
138	05/08	2	Public Reporting	Patient experience	WA-PSHA	Information on best practices for ambulatory patient experience measurement and reporting.	Washington—Puget Sound Health Alliance requested advice on best practices for practical ways to measure and report on patient experience in ambulatory settings in the following areas: How should it be done (methodology) and how should it be paid for (initially and over time)? Other issues include appropriate minimum sample size, how to address impact on legacy approaches in place within clinic systems, how diversity is handled (language and ethnic issues), etc. Explore ways collaboration across coalitions on this could reduce the workload and cost for everyone involved.
139	2/4/08-3/31/08	1	Provider Incentives	Anti-trust	MN	Offer advice on anti-trust concerns	Minnesota Healthcare Value Exchange asked for advice on how to avoid health plan antitrust.
140	2/4/08-3/31/08	1	Provider Incentives	Engaging providers	OR	Engaging physician community	Oregon Health Care Quality Corporation asked for assistance with engaging the physician community. Having a webinar for the physicians' committee might be helpful, although the CVE is unsure as to whether the physicians would participate.

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