To make the application process transparent for becoming a Chartered Value Exchange, Frequent Questions, the Scoring Form, and the Guide to Scoring applications are available.
Contents
General Instructions
Submission Information
Questions
Cover Page
Part I: Community Characteristics
Part II: Collaborative
Characteristics
Part III: Functional Capacity/Plans
General Instructions
The information requested in this
application can be supplied in narrative sentences or bullets. There is no word
limit for the cover page and Part I. The
combined word limit for Parts II and III is 3,000 words. One letter of support from each of the
following stakeholder groups is required:
- Purchaser.
- Health plan.
- Provider.
- Consumer advocacy organization.
Additional supporting documents are
allowed but not required. Submit your
response using Microsoft® Word or a comparable word processing program, using 12-point type. Please review the Frequent
Questions document for additional information.
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Submission
Information
E-mail completed responses to:
Nancy Wilson at nancy.wilson@ahrq.hhs.gov
and
Jaime Zimmerman at jaime.zimmerman@ahrq.hhs.gov
You will receive an E-mail
acknowledging receipt of your application within 48 hours.
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Questions
Questions regarding this process
should be directed to Nancy Wilson by E-mail at nancy.wilson@ahrq.hhs.gov or by
phone at (301) 427-1310.
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Cover
Page
Provide the following information
as a cover sheet to your document.
Name of Collaborative:
Name of Contact Person:
Job Title of Contact Person:
Street Address:
City, State, ZIP Code:
E-mail Address:
Phone Number:
Fax:
HHS-Designated Community Leader: Yes_________ No__________
By submitting an application to
become a Chartered Value Exchange, the applicant affirms the statement below:
We are committed
to advancing a high-quality, patient-centered, cost-effective health care
system. At its core, health care is
local. We believe it is critical for
community stakeholders to identify and work together on shared health-related
community priorities. We also believe it
is critical to use standard performance information to engage providers to
improve, facilitate consumer decisionmaking through public reporting, and
promote effective public and payment policies and consumer incentives that
reward or foster better provider performance. This will provide a foundation to assess, improve, monitor, and manage
health care within and across communities. As such, we wish to become a Chartered Value Exchange and advance the
four cornerstones of value-driven health care:
- Transparency of quality information.
- Transparency of price information.
- Adoption of interoperable health information standards.
- Use of positive incentives that reward value in health care.
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Part I: Community Characteristics
Please provide the following
information:
- Describe the geographic area covered by the proposed
collaborative. Include the size of the population and the distribution of
population ages, races, and insurance status.
- Describe the provider community. Include descriptions
of hospitals, health care systems, the physician practice community,
community health centers, and free-standing clinics.
- List the health plans and the proportion of the
population covered by each within the community.
- List the major health care purchasers and/or
employers in the community.
- List consumer advocacy organizations active in the
community.
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Part II: Collaborative Characteristics
- List the collaborative's membership. Include provider groups, health plans,
public and/or private purchasers, consumer advocacy organizations, and any
other community stakeholders, such as health information exchanges,
quality improvement organizations, and State data organizations.
- Describe how the collaborative makes decisions. List
the stakeholder groups involved in making decisions. Include structural and process elements,
such as consensus or number of votes and attendance required for decisions
to be made.
- State whether the collaborative is an informal or
formal incorporated entity. Provide
information on the collaborative's financial structure, including any
history of raising funds or in-kind support from multiple stakeholders,
ability to manage projects and finances, and staff or consultant
arrangements to provide needed expertise.
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Part III: Functional Capacity/Plans
In describing the collaborative's
current activities and/or plans to address the following functions, please note
where a specific member has the lead for that function. Note that the Chartered Value Exchange
designation applies to the collective work of the collaborative and can
therefore be comprised of multiple organizations.
Engage
Stakeholders in Collaboration
Describe the collaborative's
approach for engaging and maintaining ongoing effective collaboration among
public and private purchasers, health plans, providers, and consumer advocacy
organizations on health-related community priorities. Describe how the collaborative will align or
facilitate coordination with health information exchanges, quality improvement
organizations, State data organizations, and any other relevant community
stakeholders.
Obtain or Generate Standard Performance Information:
Optimally, standard performance
information would be constructed by pooling information from all relevant
sources, such as public and private health plans and providers within the
community. List with whom the
collaborative currently works and/or plans to work to obtain or generate the
information.
Uses of standard
performance information would be to:
- Engage providers to improve.
- Facilitate consumer decisionmaking through public reporting.
- Promote effective public and payment policies and consumer incentives that foster better provider performance.
Each of
these uses should be addressed in the following sections. Describe the collaborative's approach to
getting nationwide consensus-based principles (such as the AQA Alliance Principles for Public Reporting),
standards (such as the American Health Information Community, or AHIC,
interoperability standards), and measures (such as those of the National
Quality Forum, or NQF) adopted and used within the community.
Engage Providers to Improve:
Describe the collaborative's process and/or
plan for engaging providers to
use the standard performance information obtained or generated to improve. At a minimum, describe the process by which
providers are engaged in ongoing dialogue about improving information accuracy
and interpretability.
Facilitate Consumer Decisionmaking:
Describe the collaborative's
approach to facilitating consumer use of standard performance information. At a minimum, address the collaborative's
approach to public reporting. (For
example, use of public Web sites, employer guides to health plan enrollment, or
other venues.)
Promote Policies and Incentives for Better Performance:
Describe how the collaborative will use or promote
the use of standard performance information to reward and foster better provider performance. (For example, what will the collaborative do
if its focus is to influence regional or
national plan and purchaser policies? What will the collaborative do if its focus is to influence or implement
local policies?)
Promote Health Information Technology and Health Information Exchange:
Describe how the collaborative
will:
- Facilitate the use of interoperable health information technologies and health information exchange, either directly or through alignment with regional health information networks.
- Promote the ongoing migration of measure calculation based solely on aggregated claims data to measure calculation that includes aggregated electronic clinical data and fosters real-time patient care improvement.
Support Transparency and Conduct Ongoing Improvement of Efforts:
Describe how the collaborative
demonstrates or plans to share lessons learned with the community and
others. Describe how the collaborative
will review its effectiveness in accomplishing stated goals.
|
Public reporting burden for
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response, the estimated time required to complete the survey. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to:
AHRQ Reports Clearance
Officer—Attention: PRA, Paperwork Reduction Project (0935-0134)
Agency for Healthcare Research and Quality
540 Gaither Road,
Room #5036
Rockville, MD 20850 |
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Current as of April 2008
Internet Citation:
Chartered Value Exchange Application, 2008. April 2008. Agency for
Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/value/cveapp2008.htm
540 Gaither Road Rockville, MD 20850