AIM Delivering Quality Outpatient Care For Excellence © 2005 Dallas-Fort Worth Business Group on...

AIMDelivering Quality Outpatient Care

For Excellence

© 2005 Dallas-Fort Worth Business Group on Health

AIM for Excellence –A collaborative initiative to promote

health care quality in theoutpatient setting


For Excellence


AIM Project Collaborators

• Dallas-Fort Worth Business Group on Health

• American Airlines

• UnitedHealthcare

• Primary Care Physicians in N. TX


For Excellence


What “AIM” Stands For:

A - Awareness

I - Improvement

M - Measurement


For Excellence


• Coalition of 120 employers (55 Corporate & 65 Allied)

• Represents over 800,000 DFW-based employees and their dependents

• Members spend >$2.1 billion on employee health care in DFW

• Member of Texas Business Group on Health and National Business Coalition on Health

• Mission: Promote health care quality, accountability and cost effectiveness

Empower employers and their employees to make informed health care purchase decisions

DFW Business Group on Health


For Excellence


• Employs approximately 22,000 workers in DFW area

• Purchases health care services for over 55,000 DFW-based employees and their dependents

• Spends over $15 million/year on health care in DFW

• Offers worksite wellness, health promotion and disease management programs to employees

• Uses UnitedHealthcare as its third party administrator for self-insured claims

• Board Member of Dallas-Fort Worth Business Group on Health

American Airlines


For Excellence


• Second largest health insurer in Texas

• Claims administrator for American Airlines’ self-insured plans

• Evaluates physicians against evidence-based medical quality standards

• Provides performance report cards to individual physicians

• Recently rolled out UnitedHealth Premium Program in 20 markets (including Austin, Dallas, Houston, San Antonio)

• Premium designation based on quality and efficiency standards

United HealthCare


For Excellence


Project Goals

• Ensure quality care for AA employees with heart disease, stroke and diabetes

• Evaluate purchaser influence on clinical practices


For Excellence


Physician Participants

• Test Group: PCPs in UHC’s N.TX network who treated >100 DFW-based AA employees and/or dependents in 2004

• Control Group: All PCPs in UHC’s N.TX network


For Excellence


Performance Measures*• Heart Disease & Stroke:

– LDL Cholesterol– Beta Blockers– ACE Inhibitors

• Diabetes:– HgA1c– LDL Cholesterol

* Evidence-based Medical standards


For Excellence


Physician Task Force• Ad hoc committee of 5 Aim physicians

• Provide feedback to project leaders regarding physician communications

• Provide physician to physician advocacy for proactive participation in project

• Review aggregate performance data and help identify opportunities for improvement


For Excellence


AIM Interventions• Clinical Practice Toolkit:

Diabetes & CAD educational materials; EBM checklist; Chart flow-sheet; Resources list

• CME Workshops

• Quarterly Teleconferences

• Performance Feedback

• Personal Visits by UHC Medical Director


For Excellence


AIM Baseline Measures(July 2004 – June 2005)

AIM FP AIM IM Control FP Control IMHEDIS2004

LDL-CAD 96% 91% 91% 93% 82%

HgA1C 94% 94% 92% 92% 87%

LDL-Diabetes 91% 85% 87% 87% 91%


For Excellence


AIM Baseline MeasuresAIM Baseline Performance Measures Jul 2004 - Jun

2005

70%75%80%85%90%95%

100%

AIM FP AIM IM ControlFP

ControlIM

HEDIS04

AIM Measures

Perf

orm

ance

Rat

e

LDL-CAD

HgA1C

LDL-Diabetes


For Excellence


Opportunities For Improvement

Number of Aim FP< 85%

ImplementationNumber of Aim IM

< 85% Implementation

LDL-CAD 5 of 63 (8%) 4 of 21 (20%)

HgA1C 9 of 77 (12%) 2 of 21 (10%)

LDL-Diabetes* 16 of 77 (21%) 9 of 21 (43%)

* Biggest opportunity for improvement


For Excellence


Physician Recognition• Framed plaque recognizing physician as AIM

participant

• AIM participants recognized on DFWBGH and AA websites*

• “Star” next to physician names in UHC Directory

• AIM participants names included in Project Report*

* With AIM participant’s permission


For Excellence


Expected Outcomes• Better quality care for AA employees with diabetes

and heart disease

• Stronger relationship between DFW employers and physicians

• Recognition and promotion of AIM physicians

• An effective model for similar employer-led QI initiatives in other communities

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