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New Measures Plot Process/Outcome Information
with Charge and Length-of-Stay Data
MILWAUKEE (June 23, 2005) – Calling it a work in progress, the Wisconsin Collaborative for Healthcare Quality today released its first version of a comparison measure that combines quality processes and outcomes data with severity-adjusted data for charges and length of stay.
There are six measures of three different conditions—heart attack, heart failure and pneumonia. The new measures are available online at www.wchq.org.
“The graphic representations we are publishing represent a step forward. We know much work remains to create a true value index that shows the relationship between quality and cost,” said John S. Toussaint, M.D., the Collaborative’s chairman and president/CEO of Appleton-based ThedaCare.
The graphs will be published on a quarterly basis. Eventually, the Collaborative hopes to add trend data to the measures as well. The organization also will continue to refine and update the way the measure is calculated.
“This is a good faith attempt by the Collaborative to demonstrate the concept of value,” said Christopher Queram, Collaborative board member and CEO of the Alliance, an employer-owned and directed healthcare purchasing group. “That the Collaborative’s provider members are willing to take this step forward, in spite of the preliminary nature of these measures, demonstrates their commitment to working with the business community and their willingness to take risks.”
There currently are no nationally recognized ways to measure or demonstrate the relationship between quality and cost. The Collaborative is one of only a few organizations in the country attempting to develop such a measure.
“While we readily acknowledge the limitations in these graphs, we made the decision to publish this intermediate step because we believe it is important to demonstrate our ongoing commitment to developing useful, meaningful measures. This is vital to our efforts to drive internal improvement and help businesses and patients make informed choices,” said Jeff Thompson, M.D., president and CEO of La Crosse-based Gundersen Lutheran.
“For so long, our employees and families were just users of healthcare. They didn’t understand how much their healthcare cost or what they were getting for that cost,” said Mike Bilbrey, director of health and wellness programs and deferred compensation, Sentry Insurance. “Now we’re trying to transform our employees from users of healthcare to informed consumers who make decisions based on cost and quality. This is a fledgling step toward that goal.”
The Collaborative’s goal is to develop efficiency measures for hospitals and clinics that go beyond the reporting of charges, and provide fair and meaningful comparisons between organizations. The Collaborative is researching the best ways to adjust the measures for teaching organizations, different charge structures and severity of patients treated. The organization will continue to improve the measure. However, due to its complexity, a final version may not be available for several years.
“We still hope to develop more meaningful efficiency measures that go beyond the charge data that currently is available,” said William D. Petasnick, chief executive officer of Milwaukee-based Froedtert & Community Health. “However, this is a difficult, complicated task. As a group we are committed to developing credible measures that are easily understood and meaningful to our patients and business partners.”
The Collaborative is working with Wisconsin purchasers to develop a central insurance claims data repository that can be used to develop more robust data on outcomes and cost for the entire spectrum of care, from the physician’s office to the pharmacy counter to the hospital bed.
Toussaint said, “A statewide insurance claims data repository is important to achieve our ultimate goal of a robust, meaningful efficiency measure. We are working to identify the structure and the funding necessary to support such a project, and will be reporting regularly on our progress.”
“Value is at the core of the benefits strategy being developed by many employers. It is also at the heart of the mission of many business coalitions,” said Queram. “In the absence of information on value, purchasers gravitate toward cost as a basis for decision making. Creating a claims data repository and using it to develop value indexes that measure quality and cost over an episode of care will give purchasers the reliable information they need to make decisions based on value.”
In April, the Collaborative published its second full Performance & Progress Report. The Web-based report includes data on 45 measures from 19 hospitals, 14 multi-specialty physician groups and seven health plans from across the state. The measures are based on the Institute of Medicine’s Six Aims for Improvement, including Timeliness, Efficiency, Patient-Centeredness, Effectiveness, Safety and Equity.
Throughout 2005, the Collaborative will be publishing quarterly data updates for some hospital-based measures. In addition, the organization will continue its work to develop and publish data on additional clinic-based measures similar to the new diabetes measures included in the 2005 Report.
The Collaborative’s Performance & Progress Report is the first:
· To engage business and labor partners in developing useful measures
· To learn from the quality improvement experience of its business and labor partners
· To measure care in the physician clinic and hospital setting
The Wisconsin Collaborative for Healthcare Quality is a group of multi-specialty physician groups, hospitals, health plans, employers and labor organizations from geographically diverse areas of the state that have come together to develop and share best practices and quality outcomes. The Collaborative was founded in 2003 on the principle that by focusing on improving quality, better care for patients and more rational costs will result.
Collaborative participants are: Advanced Healthcare, Milwaukee; Affinity Medical Group, Oshkosh; Aspirus Wausau Hospital, Wausau; Bellin Health, Green Bay; Columbia St. Mary’s, Milwaukee; Dean Health System, Madison; Franciscan Skemp Healthcare, La Crosse; Froedtert & Community Health, Milwaukee; Gundersen Lutheran, La Crosse; Luther Midelfort, Eau Claire; Marshfield Clinic, Marshfield; Medical Associates Health Centers, Menomonee Falls; Medical College of Wisconsin, Milwaukee; Meriter Hospital & Physicians Plus Insurance Corporation, Madison; Prevea Health Services, Green Bay; Sacred Heart Hospital; Eau Claire; Saint Joseph’s Hospital, Marshfield; St. Marys Hospital Medical Center, Madison; ThedaCare, Appleton; University of Wisconsin Hospitals and Clinics, Madison; and University of Wisconsin Medical Foundation, Madison;.
Business partners include The Alliance, Appleton Ideas, Badger Meter, Inc., DaimlerChrysler Corp., GE Healthcare, Schneider National, Sentry Insurance, Serigraph, Inc., The Trane Company, United Auto Workers and Wisconsin Manufacturers and Commerce.