Chapter 1. Introduction
Value-Driven Health
Care
The Value-Driven Health Care Initiative launched
by the Department of Health and Human Services (HHS) is designed to help
achieve high-quality, cost-effective care for patients. Through a collaborative
process that brings together community stakeholders, such as providers,
employers, health plans, and consumers, the initiative will drive clinical
quality improvement by providing the public and providers with reliable and
consistent health data.
An essential component of implementing
value-driven care is creating a national network of regional coalitions. By
making comparable information widely available at the local level, regional
coalitions are crucial to helping stakeholders make informed health decisions
and improve health care quality on a broad, systemic level. They accomplish
this important goal by fostering collaboration across multiple stakeholders in
the community and facilitating four national cornerstone actions designed to
enhance the effectiveness of our health care system:
- Connecting the system through health information technologies.
- Measuring and publishing quality data based on agreed-upon standards.
- Measuring and publishing price information for specific services to
patients.
- Creating positive incentives that reward high-quality, cost-effective
care and encourage consumers to actively choose the care that meets their
needs.
The Community Leader's Role
An important first step to forming a regional
coalition for this initiative is for HHS to recognize a community group as a
community leader. These local, multiparticipant organizations are designated
Community Leaders because they demonstrate the capacity for developing key characteristics
of a regional coalition, including:
- Actively engaging with critical stakeholders in the community.
- Facilitating the collection of provider-level measurement across
the six Institute of Medicine performance domains (safe, timely, effective, efficient,
equitable, and patient-centered).
- Using, or promoting the use of, performance measures for:
- Publicly reporting costs and consumer satisfaction.
- Rewarding and fostering better performance.
- Provider improvement.
- Fostering collaboration across multiple stakeholders and serving
as a hub for sharing information and dialogue.
The initial stages of forming and maintaining
these and other aspects of a regional coalition can be challenging for
Community Leaders. This guide is a compilation of insights and lessons learned
culled from six established regional coalitions to help guide Community Leaders
as they begin to formulate strategies for developing their own coalitions.
The
Better Quality Information Project
Several regional coalitions currently are
operating around the country. The Ambulatory Care Quality Alliance and the
Agency for Healthcare Research and Quality (AHRQ) selected the six groups
represented in this document to participate in the Better Quality Information
(BQI) to Improve Care for Medicare Beneficiaries Pilot Project. The pilot sites
in this national project sponsored by the Centers for Medicare & Medicaid
Services are:
- The California Cooperative Healthcare Reporting Initiative, San Francisco, California.
- The Center for Health Information and Research-Arizona State University, Tempe, Phoenix, Arizona.
- The Indiana Health Information Exchange, Indianapolis, Indiana.
- Massachusetts Health Quality Partners, Boston, Massachusetts.
- Minnesota Community Measurement, St. Paul, Minnesota.
- The Wisconsin Collaborative for Healthcare Quality, Madison, Wisconsin.
Before the Ambulatory Care Quality Alliance and
AHRQ selected these coalitions as BQI sites in 2006, each community group had
independently brought together a variety of constituencies to combine public
and private data for measuring and, ultimately, reporting on physician practice
in its geographical region.
Lessons
Learned From BQI Sites
As a way to capture and share with Community
Leaders the rich knowledge these six pilot sites have gained through
successfully building and managing regional coalitions, AHRQ has collaborated
with the Delmarva Foundation to produce this broad compilation of essential
lessons learned.
Because each coalition is unique in its specific
regional setting, this guide is not intended to be a one-size-fits-all toolkit
or a detailed "how-to" guide. Rather, the information captured from the BQI
sites is organized around key issues of interest to Community Leaders that are
in the process of forming a coalition. Community leaders will need to apply
these general lessons on leadership skills, establishing the coalition's
credibility, building trust among stakeholders, and communication to their own
circumstances. For further reference, the appendices include overviews for each
BQI site, a chart comparing the sites, the framework behind the site visits,
summaries of the site visits, a list of mentors who Community Leaders may
contact for advice, and resources.
This guide will assist Community Leaders in
taking the crucial first steps in creating and sustaining a regional coalition.
It is through the vision, leadership, and hard work of Community Leaders that
the Value-Driven Health Care Initiative will successfully transform American
health care into a truly value-driven system.
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