Spotlight on Minnesota
Thursday, November 20, 2014
Aligning Forces for Quality (AF4Q) is the Robert Wood Johnson Foundation’s signature effort to lift the quality of health care in 16 diverse communities, reduce racial and ethnic disparities, and provide models for national reform. AF4Q brings together people who get care, give care, and pay for care to work together toward the shared goal of better health and health care.
Today's issue of Spotlight features the work of AF4Q's Minnesota Alliance.
Composite Measures: A New Gold Standard in Diabetes Care
Type II diabetes has become a national public health threat. In the United States, approximately 25.8 million people meet the criteria for a diagnosis of diabetes. Diabetes often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. As rates of diabetes increase, so, too, do associated direct and indirect costs. In 2007, diabetes cost $174 billion in the United States, both in terms of direct costs (such as hospitalizations, medical care, and treatment supplies) and indirect costs (such as disability payments and lost time from work).
MN Community Measurement, leader of the Aligning Forces for Quality Alliance in the state, set a goal to improve quality of care for patients with diabetes using a composite measure. A composite score is a combined metric useful in assessing quality of care. Physicians and health plans worked together with MN Community Measurement to develop the D5 composite measure to set guidelines for providers and consumers on optimal diabetes care. The D5 indicators include:
  1. a blood pressure reading lower than 130/80, 
  2. a low-density (LDL), or bad cholesterol, reading lower than 100 mg/dL, 
  3. blood sugar or HbA1c reading of less than 8 percent, 
  4. living tobacco-free, 
  5. and taking a daily dose of aspirin as appropriate.
The diabetes composite measure has a ripple effect in Minnesota—the incidence of diabetes-related complications decreased over time. “The composite model captures more critical data during a single visit so you're less likely to lose people through the cracks because one practice checked for cholesterol while another did not," said Jim Chase, president of MN Community Measurement.
Keeping Mental Health Readmissions RARE
The RARE (Reducing Avoidable Readmissions Effectively) Campaign has been highly successful in Minnesota. Data from the third quarter 2013 show that participants have helped prevent 7,030 avoidable readmissions since 2011 and allowed patients in Minnesota to spend 28,120 nights of sleep in their own beds instead of in the hospital.
The RARE Campaign embarked upon a yearlong mental health care transitions collaborative to support the reduction of readmissions for patients in inpatient mental health units. This expansion into the area of mental health builds upon existing successes and established processes to treat an area of health care that has recently garnered significant national attention. Mental health is also an area with a high incidence of readmission; in 2010, depression was the fourth most common diagnosis for readmissions in Minnesota, according to Minnesota Hospital Association’s Potentially Preventable Readmissions (PPR) data.
Crafting a Measuring Stick for Health Care Costs

Minnesota health care leaders are building on quality measurement and improvement efforts—including reductions in avoidable hospital readmissions that led to $70 million in savings—to tackle the important, but tough, task of measuring how much an individual health care episode costs. These efforts are led by MN Community Measurement, one of RWJF’s Aligning Forces for Quality communities, which has convened disparate health care stakeholders over the years to measure everything from the management of diabetes to the patient experience.

Aligning Forces for Quality (AF4Q) is the Robert Wood Johnson Foundation’s (RWJF) signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities in health care and provide models for national reform. Alliance teams represent the people who get care, give care, and pay for care.
See the newsletter archive
Aligning Forces for Quality
Robert Wood Johnson Foundation
Join our group Connect with us Follow Aligning Forces for Quality on RSS Follow us Subscribe to our channel
© 2015 Aligning Forces for Quality