CMQCC Meeting Notes

Dates
Topic	Notes	Action Items

Dates
Topic	Notes	Action Items

Dates
Topic	Notes	Action Items

Dates
Topic	Notes	Action Items

Date 30 Jun 2023
Topic	Notes	Action Items
	Northstar “Expending Comprehensive Postpartum Care in California” Critical - link between birth and next step in care Arlene attended a Fed meeting on evidence for post partum… convened CA Dept of Healthcare Services… AHRQ and NIH were the feds with the evidence review.




	Where is the definition of risk? There is a clinician group that will do that - at the CA state level. Clinical experts will join in. AllianceChicago and OCHIN could be a resource on risk evaluation.	Julia or Andrea will send email to introduce ac and ochin to arlene and leslie.

	Discussion re: centering model. Arlene is an expert in it. She will look at learning from Centering that could be further integrated.
	Arlene has an extensive evidence table.
Leslie	Next Steps - working with a clinical care workgroup and … meetings will start in July. The Pathway will be operationalized … in health plans. it involves public health outside health plan… discussion with us as outpatient world, connection.
Julia	Our work - minimal project this year. We would like to find more funding to execute a more formal model and look at the outcomes. We can help connect CA PCA to encourage health centers to implement this, we have the high risk conditions. Leslie - there is difficulty in getting clinic data because of data sharing issues. Hospital has no clinic data; cannot get clinic data… how can we collect data to make a difference - to do QI on it. Julia - PP quality side - last year we added working PQCs in states…. we can help accelerate that work… MMRC data shows x… working on inpatient and outpatient linkage. PQCs are hospital groups focused on inpatient interventions to prevent maternal mortality - CA is also working with march of dimes for low-dose aspirin and outpatient initiatives…
	The big five states Julia - we are working with partners in those states TX and NY… we could do a focus on those five states. They meet monthly.
	CMQCC will send slides… as they are now. Next steps - Implementatoin.	Julia to look at it and share back thoughts or places we can help.
		Andrea will send formal note saying we accept your deliverables.

20 Jan 2023

Topic

Notes

Action Items

Task 2.1 through 2.3

Review existing guidelines and identifying guidelines that could be reasonably turned into measures. We do not anticipate validated and deployed measures in a few months. Framed for quality improvement rather than value based care etc.

There are 2 established postpartum measures in circulation – HEDIS and Postpartum depression screening (2 versions CDC and NCQA).

Run a measure for a year or two to make sure it runs well and then include in incentives.

Notification of clinic that birth has occurred. Electronic transfer is ideal but not required. Maybe a phone call?

Immediate issues/probably need to be seen earlier within 2 weeks: substance abuse, hypertension, cardiovascular disease.

Create a high risk definition – these patients need follow up prior to the routine 6-week postpartum visit.

CMQCC provides human readable measures. Ray will work on terminology stuff.

Task 2.4Task 2.4 –

Have we identified sites for Task 2.4? – OCHIN has sites in California. RCHC has sites in California.

Satisfied by existing knowledge of the work in California. Opportunity to review measures with Redwood and OCHIN.

13 Oct 2022

Topic	Notes	Action Items
No cost extension	In progress as of last week Friday It was sent to Stanford and Leslie had some questions. NCE has to go through to Stanford Finance. Is the SOW still the same? Yes. End date? July 31, 2023 Payment schedule? Invoice when work is done.
SOW	Task 1.4 - Share and discuss the environmental scan at the kickoff. Then this is complete. Task 2.1, 2.2, 2.3 - CMQCC needs clarification on expectations. Per Julia, do we have a good definition already? And if we don't, what does that look like? Elliot suggests focusing on the postpartum period Task 2.4 -
Measures and ideas for next year	Measure Documentation and High Risk Pregnancies - Women's Health Post Partum CDS, GDM, eCQM - Confluence (atlassian.net) AllianceChicago has local high-risk definitions Would it be helpful to partners (for clinical quality improvement component) to create this plan of care? Elliot mentions that pregnancy episode is in most EHRs which includes prenatal and postnatal care. Codes are pregnancy related rather than lifetime. AllianceChicago recently implemented Pregnancy Episode. Epic has implemented pregnancy episode in the pregnancy chart - but problem list may not transfer to patient's overall chart. Look at PAMR report or national datasets (PMSS)	Crystal Nwachuku (Deactivated) will send the measure documentation page to CMQCC
Kickoff	CMQCC can present 5-10 minutes on the importance of the postpartum period and transitions to care. Also, share the environmental scan. AC can present their high-risk definitions.	Crystal Nwachuku (Deactivated) will send the agenda on Monday .
Environmental Scan walkthrough	NACHC Guidelines.docx	Adding links if they exist? Terri isn't sure if others would be able to access the links

Date	Agenda	Notes, decisions and action items
16 Sep 2022	SOW: WHPP CMQCC	Crystal Nwachuku (Deactivated) will schedule a meeting in the beginning of October to review the environmental scan document. Elliot will send his availability along with the contract document. Crystal Nwachuku (Deactivated) will ask Hasna and Stacia about the no cost extension?
16 Sep 2022	Deliverable 1 - Task 2.1 - Environmental scan is almost complete. Task 2.4 - This would need to be completed after we receive funding for Year 5 and kickoff. Deliverable 2 - Much of this could be resolved in a future meeting. No deadlines for invoicing. Invoice as the work gets done. Miko already invoiced but he will retract.
28 Jun 2022	Admin NACHC is waiting for updated W-9, Leslie will speak with Michael Invoicing - Please send invoices any time - no end date. SOW https://nachc.atlassian.net/l/c/msfPkGUd
	CMQCC role: Expertise and assistance on developing measures.
	Work for March of Dimes - Use of Aspirin 2. Working with Medi-Cal - establishing metrics for managed care organizations Room for pilot projects in postpartum C-section measures Big driver is Medicaid
12 Apr 2022	OCHIN and AllianceChicago are nimble enough to get us some data on the new measures. Admin Contract - It is in CMQCC/Stanford’s court Redwood is still not on contract - CDC has not approved their addition to the project. NCQA has specs for PP Depression screening - but costs $400-500 https://www.ncqa.org/wp-content/uploads/2019/02/20190208_08_Perinatal_Depression.pdf https://www.ncqa.org/hedis/measures/postpartum-depression-screening-and-follow-up/ What does CMQCC need to create the measures? First step help from Ray on what code sets they DO use. Help the CHCs document date of delivery Focus on 3 diabetes severe HTN Second Step Make them more finished via NCQA measure - if positive.	Andrea Price (Deactivated) put the question of contraception policies and catholic hospitals for our next all partners call. Get a limited data pull to see what codes are being used; for CMQCC to work on to refine the measures and create flow diagrams.