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2018 BACO MassHealth PC Group Quality Bonus Program

Starting in 2018, MA Executive Office for Health and Human Services will generate a Quality Score for each ACO participating in the new MassHealth ACO program. This Quality Score will determine our ACOs share of any surplus or deficit accrued. The amount of surplus or deficit will be based on the difference between our ACO’s state-assigned spending budget and the actual total cost of care for the patients attributed to BACO.

The state’s Quality Score will be based on both claims-based data and our submission to MassHealth of chart-based information. In Performance Year 1 (2018), to receive a quality score of 100%, our ACO is only required to submit all requested data (referred to as “pay for reporting”). Beginning in 2019, our score will be based on our performance on the various metrics, making it essential that BACO begins to build infrastructure across the ACO to enable optimal metric performance.

The amount of the Primary Care Group Quality Bonus, tied to $2 per member per month, awarded to each group will be determined by the group’s performance in three distinct areas:

Complete submission of requested MassHealth beneficiary clinical data to BACO to enable successful BACO pay for reporting in 2018.
Performance by the group on a BACO-created Ambulatory Visit Quality Metric, which is success in maximizing the number of BACO patients seen in the ambulatory setting. Only 60% of BACO patients were seen between 3/1/17 and 12/31/17.
Performance by the group in the BACO-created Diagnosis Identification Program Screening for homelessness and depression which can be performed by any office staff. Based upon historical performance, that screening rates of 80% are feasible for both homelessness and depression. The bonus, however, will be based upon each group’s performance normalized to the BACK mean performance rate. Screening for homelessness should be done as part of a larger social determinants of health screen using a screening tool such as THRIVE. Screening for depression should be done with a screening tool such as PHQ2 or 9. Groups should make every effort to capture an appropriate diagnosis code with appropriate documentation in the medical record whenever a screen yields a diagnosis (e.g. homeless or major depressive disorder). Groups should also ensure that positive screens are addressed by clinical providers during the encounter to ensure appropriate care of patients.

If you would like more details about the BACO MassHealth Primary Care Group Quality Bonus or any of the metrics, please contact Dr. Brian Jacobson at brian.jacobson@bmc.org.

BMC Quality Goals FY 19

1. 10% reduction in preventable harm events. The Preventable Harm Index includes 16 Hospital-Acquired Conditions (HACs), such as clostridium difficile infections, central line associated bloodstream infections (CLABSI) and catheter associated urinary tract infections (CAUTI), and Patient Safety Indicators that are tied to external reputation and reimbursement. BMC is predicted to meet goal for Preventable Harm Index Observed/Expected for FY18 <0.90, representing a 10-15% reduction in events from FY17. FY19 goal will be < 0.90.

2. Achieve top 25th percentile nationally in mortality with an Observed/Expected (O/E) mortality ratio of <0.845. BMC FY18 met goal at 0.789.

BMC Physician Quality Leaders

In July 2016, BMC reorganized the Physician Quality Leaders, funding fewer quality leaders but giving each more responsibility and time to actually get things done. They report to Dr. James Moses, BMC Chief Quality Officer, and address patient safety events as well as promote hospital quality initiatives. They are also tasked specifically to work with residents and help mentor resident projects and ideas!! Faculty and housestaff, please reach out to the physician Quality Leader or the Medical Directors in your area of interest. The current physician Quality Leaders are:

Chris Andry, PhD — Lab and Pathology
Willie Baker, MD — Emergency Medicine
Glenn Barest, MD — Radiology
Lisa Caruso, MD, MPH — Medicine (including Family Medicine, Neurology, Psychiatry, and all subspecialties)
Ron Iverson, MD, MPH — Obstetrics/Gynecology
Bernadette Levesque, MD — Pediatrics
David McAneny, MD — Surgery (including all subspecialties)
Juhee McDougal, MD — General Internal Medicine, Ambulatory
James Murphy, MD — Critical Care (MICU, SICU, CCU), Medical Director of Inpatient Quality
Lauren Nentwich, MD — Emergency Medicine
Susan O'Horo, MD — Interventional Radiology
Susannah Rowe, MD, MPH — Ophthalmology

Hem/Onc Section Partners with Bristol-Myers Squibb for Cancer Research

Street Insider publishes article "Bristol-Myers Squibb (BMY) Announces Research Collaboration with Boston Medical Center to Investigate Markers of Immuno-Oncology Response & Resistance"

The hematology/oncology section at Boston Medical Center is partnering with Bristol-Meyers Squibb to investigate biomarkers in a variety of cancers to predict Immuno-Oncology I-O responses.

"We look forward to partnering with Bristol-Myers Squibb on this study to identify and assess biomarkers across a diverse patient population, providing us with a deeper and more comprehensive understanding of I-O resistance.” - Dr. Matt Kulke, BMC Chief of Hematology/Oncology Section

"Retinoic Acid Signaling is Essential for Airway Smooth Muscle Homeostasis"

Felicia Chen, Fengzhi Shao, Anne Hinds, Sean Yao, Sumati Ram-Mohan, Timothy A. Norman, Ramaswamy Krishnan, and Alan Fine

Team led by Dr. Felicia Chen of the BU Pulmonary Center demonstrates that "Retinoic Acid signaling maintains airway smooth muscle homeostasis by preventing excessive activation of the TGF-β pathway. We conclude that tonic RA signaling is critical for postnatal airway health."

Read Full Article

Presented by Dr. Chen at Grand Rounds, December 14, 2018

This is the first installment in the Dept of Medicine series, Discovery of the Month. Recent projects are recognized and featured during a special monthly grand rounds for significant findings and publications.

Elevated Blood Pressure in People Under 40 Poses Hazard of Developing Cardiovascular Diseases Prematurely

High blood pressure or hypertension is a major health problem that affects more than 100 million people in the U.S. (using the current 130 systolic or 80 diastolic) and over one billion worldwide. Despite being considered a disease of older adults, there are two new studies in the Journal of the American Medical Association (JAMA) that are reporting the association of high blood pressure with the risk of premature cardiovascular disease (CVD) in adults younger than 40. In an accompanying JAMA editorial, Vasan Ramachandran, MD, FACC, Professor of Medicine in the Department of Medicine, mentions that major gaps exist in the current knowledge regarding the epidemiology, diagnosis, risk stratification and management of higher blood pressure levels in young adults.

American Thyroid Association Names Elizabeth Pearce, MD, BoD President

Professor of Medicine in the Section of Endocrinology, Diabetes and Nutrition, Elizabeth Pearce, MD, MSc, has been named president of the Board of Directors of the American Thyroid Association. Her one-year term began in October 2018 and has served as president-elect for the past year.

Dr. Pearce received her undergraduate and medical degrees from Harvard University and a masters’ degree in epidemiology from BU School of Public Health. She completed her residency in internal medicine at Beth Israel Deaconess Medical Center, and her fellowship in endocrinology at BU under the mentorship of Dr. Lewis Braverman. Read more: http://www.bumc.bu.edu/busm/2018/11/07/american-thyroid-association-names-elizabeth-pearce-bod-president/

Nina Lin, MD and Manish Sagar, MD, Receive NIH Award to Combat HIV-induced Chronic Inflammation

Congratulations to Nina Lin, MD, Assistant Professor in the Section of Infectious Disease and Manish Sagar, MD, Associate Professor in the Section of Infectious Disease, who along with their colleague Suryaram (Rahm) Gummuluru, PhD, Associate Professor of Microbiology, received a five-year, $3.8 million RO1 Award from the National Institute of Aging (NIA)/National Institutes of Health (NIH). They will be researching whether persistent HIV RNA expression in older HIV+ individuals contributes to chronic inflammation and immune exhaustion resulting in an accelerated aging phenotype. The findings from this study could eventually allow for the development of effective strategies to decrease or reverse the persistent HIV RNA expression dependent induction of inflammation that drives disease pathogenesis in the growing population of older individuals living with HIV.

AY18 Faculty Awards and Honors

Congratulations to the following Department of Medicine faculty members for their achievements during 2017-2018!

The Center for Regenerative Medicine (CReM) earned the 2017 Sharing Research Resources Award from the Association of American Medical Colleges (AAMC), established “to recognize successful models for sharing biomedical research resources.”

Caroline Apovian, MD, FACP, FACN, FTOS, Professor of Medicine and Pediatrics, will serve as the new president of The Obesity Society (TOS).

David Center, MD, Gordon and Ruth Snider Professor of Pulmonary Medicine, Research Professor of Biochemistry, Associate Provost for Translational Research, was named as treasurer of the 2018-19 board of directors for Association for Clinical and Translational Science (ACTS).

Shoumita Dasgupta, PhD, Assistant Dean of Admissions, Associate Professor of Genetic/Molecular Medicine, Associate Professor of Medical Sciences and Education, was elected president-elect of the Association of Professors of Human and Medical Genetics (APHMG). She will serve as president-elect from 2018-20 and president from 2020-22.

Jessie M. Gaeta, MD, Assistant Professor of Medicine, was the 2018 recipient of the Massachusetts Medical Society’s Special Award for Excellence in Medical Service. The award honors a physician who has made a distinguished demonstration of compassion and dedication to the medical needs of his or her patients and the general public.

Karsten Lunze, MD, DrPH, MPH, Assistant Professor of Medicine, was recognized by the American Public Health Association for his work serving victims of war and terrorism with the Victor Sidel and Barry Levy Award for Peace. He received this award with his wife Fatima Lunze, MD, ScD, PhD, a pediatrics instructor at Harvard Medical School and Boston Children’s Hospital.

Gustavo Mostoslavsky, MD, PhD, Associate Professor of Medicine and Microbiology, received the Innovator of the Year award from the BU Technology Development office. Dr. Mostoslavsky produced a tool, STEMCCA, which makes it simpler and more efficient to generate iPS. The award is given to a faculty member whose research yields inventions or innovations benefiting society.

Katya Ravid, DSc, Founding Director of the Boston University Interdisciplinary Biomedical Research Office and the Evans Center for Interdisciplinary Biomedical Research and Professor of Medicine, was named a fellow and new president of the Massachusetts Academy of Sciences (MAS).

Jeffrey H. Samet, MD, MA, MPH, FACP, has been awarded the American College of Physicians (ACP) Richard and Hinda Rosenthal Award #1 from the Rosenthal Family Foundation for his innovative work in the field of addiction medicine.

Robert Witzburg, MD, Former Associate Dean of Admissions, Professor of Medicine at BUSM and Health Policy and Management at BUSPH, and a general internal medicine physician at Boston Medical Center (BMC), was named the 2017 recipient of the Jerome Klein Award for Physician Excellence. Dr. Witzburg retired July 1, 2018.