Quality Measurement for Health Care Purchasing

Wisconsin Collaborative for Healthcare Quality

The Collaborative was Formed...

…on the principle that improving quality will result in better patient care and more rational costs

Business/Labor Partners

The Alliance

Appleton Papers

Badger Meter

Daimler Chrysler

Schneider National

Sentry Insurance

Serigraph, Inc.

The Trane Company

United Auto Workers

Wisconsin Manufacturers & Commerce (WMC)

The Collaborative will:

• Select a set of common measures

• Publish individual and comparative measures and performance data

• Research and share best practices

• Work with other stakeholders to improve healthcare performance

Measures of Quality*

• Safety

• Effectiveness

• Patient Centered

• Timeliness

• Efficiency

• Equity*Institute of Medicine

Measurement Selection Criteria

• Easily available and accessible

• Prevalence of the condition

• Potential for improvement

• Clinical evidence

• Comparability of data

• Interpretability of data

The Collaborative Difference

• Independent verification and public reporting of data

• Engagement of business and labor partners in developing useful measures

The Collaborative Difference

• Learning from the quality improvement experiences of our business and labor partners

• Open sharing of best practices

• Looking at entire spectrum of care (physicians, hospitals, clinics, etc.)

Example Inpatient Measure

Congestive Heart Failure

Org E Org B Org W Org N

Discharge Instructions

26% 78% 26% 32%

LVF Assessment 91% 100% 90% 78%

ACE Inhibitor for LVSD

70% 89% 0% 74%

Smoking Cessation Advice

74% 82% 40% 44%

Example Office Care Measure

Diabetes Org E Org B Org W Org N

HbA1c w/in 12 mon 90.20% 97.50% 88.56% 82.58%

LDL-C w/in 12 mon 83.21% 95.42% 83.21% 85.14%

Microalbumin w/in 12 mon

43.55% 77.50% 43.55% 51.82%

Example Patient Satisfaction

Patient Satisfaction

Org E Org B Org W Org N

Getting Care Quickly

83.74% 85.53% 83.74% 77.64%

How Well Doctor Communicates

93.15% 94.46% 92.41% 90.99%

Rating of Personal Doctor

79.32% 82.27% 72.88% 75.04%

Rating of Specialist Seen Most Often

72.38% 78.72% 72.38% 76.04%

Example Leapfrog

Leapfrog Categories

Org E Org B Org W

Evidence Based Hospital Referrals*

79.0% 83.0% 50.0%

Computerized MD Order Entry

25.0% 75.0% 25.0%

ICU Physician Staffing

50.0% 100% 25.0%

* Average across all categories

Why Publicly?

Take control, or be controlled -

• Payer pressure – Lack of evidence for high quality care

• Employer Efforts – Quality Counts and Pay for Performance

• Government Effort – Physician office data

Why Now?

• We can lead, or we can follow

• Provides strategic focus