Metrics for Transformation –
Higher Quality Providers
What are Higher Quality Providers?
By definition, providers, such as clinicians and hospitals, that provide higher quality of care than average, are of higher quality. While there are a lot of data collected by public sector agencies, in particular Medicare, on hospitals, there are far less collected on physicians. To compound the problem, research from Hibbard and Sofaer has shown that it’s important that quality ratings of hospitals and clinicians be consumable to average patients. To-date, most of the hospital quality data has been difficult to consume, despite heroic efforts from the Commonwealth Fund in its Why Not The Best web site.
In 2000, in response to “To Err is Human”, large employers created the Leapfrog Group and instituted a voluntary reporting mechanism for hospitals on patient safety. However, and despite years of focused incentives and encouragement, the number of hospitals reporting barely budged. In response to the growing availability of more systematically reported quality data, Leapfrog launched a composite patient safety scoring system for all hospitals for whom data is available. This simple score, A through F, reveals the higher quality hospitals – those for whom patient safety is very clearly a priority.
In 2003, as a follow-up to the creation of the Leapfrog Group, large employers turned their sights on clinicians and launched Bridges To Excellence, an organization focused on assessing and rewarding higher quality in the management of patients with chronic conditions. The result was the creation and implementation of a number of quality measurement programs that result in the award of a Recognition for physicians and nurse practitioners. Much research has shown that clinicians that achieve a Bridges To Excellence Recognition deliver higher quality and lower costs of care than their non-recognized peers, especially for patients with a chronic condition.
We can therefore assume that clinicians recognized by BTE for the quality of their chronic care management and hospitals receiving an A for patient safety by the Leapfrog Group are all delivering higher quality care than average, and are also helping to reduce the excedent in preventable health care-related deaths in the US.
What We Are Doing To Impact These Measures
HCI3 launched the Bridges To Excellence program ten years ago, in 2003, and since then thousands of clinicians across the U.S. have become recognized for the quality of care they deliver. We support communities and health plans across the country that continue to encourage physicians to become recognized by providing a variety of financial and non-financial incentives.
In addition, HCI3 is working with certain medical specialty societies, such as the American College of Cardiologists and the American Gastroenterological Association, to develop new Recognition programs that their members can apply for. We’re also working closely with EHR vendors to facilitate the collection and submission of clinical data by physicians who want to apply for Recognition. In summary, we wrote the book on identifying physicians that deliver higher quality care and we’re continuing to add new chapters to that book every day.
Beyond physicians, HCI3 has supported the efforts of the Leapfrog Group since its inception, using hospital safety standards as essential components in value-based payment implementations. We will work to improve the level of quality in hospitals by different methods. First, we will work closely with the Leapfrog Group to incorporate their data into our BTE Recognition app and display for consumers looking for Recognized physicians the patient safety ratings of proximate hospitals. Second, our ECR Analytics are designed to help identify patient safety failures in claims data and provide feedback to hospitals and health systems about the frequency and cost of these failures, as well as comparisons to peers. Third, our bundled payment implementations will continue to encourage hospitals to reduce all defects that harm patients and increase the costs of care.
Measures and Data Sources
- All BTE Recognized physicians for any of the BTE chronic care programs, de-duplicated
- All A-rated hospitals as reported on www.hospitalsafetyscore.org
Health Care Incentives Improvement Institute’s database of all recognized clinicians and the Leapfrog Group’s database of hospital patient safety ratings.