Looking at Care Quality Progress

They ran concurrently for a while; but at a certain point in time, though it was being developed concurrently, HQID ended, and QUEST is moving forward, and we’re planning for the third iteration soon.
Will the various factors around trust in Premier that might be missing in other settings, such as lack of trust, be barriers in other contexts?

There might be some barriers. I think the most important thing is for hospitals to be engaged with their hospital associations or other entities; it’s important to find a partner with whom you can create best practices to accelerate action. So any way you can do that, with whatever trusted partner you have, is the way to go. I think inevitably, we’ll have to look at the entire continuum of care. And it won’t be enough to provide good enough inpatient care; sometimes, it will require keeping people out of the hospital and emergency rooms. And right now, that data is lacking among providers unless they own their own plans.

That data typically resides at CMS or with the commercial payers, because they can see the whole claims history. And historically, there’s been a lack of trust there, and it’s required a negotiation in terms of getting the pieces of the pie in terms of the payment dollar. So it’s going to be important to establish that trust. And we’ve now seen forward-thinking institutions engaging with payers, and it’s called the Partnership for Care Transformation. It’s a Premier program, explicitly set up for systems that want to test different payment models. So we have a number of institutions that will be going after the Medicare Shared Savings Program; some that will go into the bundled payments program; some that will go in with employers and payers in their market to collaborate; some that are working to improve their medical home programs or resource utilization. That program is fairly new and fairly broad, and really represents the forward-thinking institutions.

How can CIOs and CMIOs be facilitators and leaders in their organizations, in working with programs like this one?

That’s a very good question. The advice, I would say, is to lead by example. And what we’ve found in all successful organizations is that the leadership is fully engaged. And for CIOs CMIOs, that would mean being very strong proponents of finding out what is important to measure; and if they can lead by that example, the successes will build on each other. And CIOs play a very big role in terms of the planning of this. And some institutions may be in denial about this, and believe that change will blow over. But forward-looking CIOs should be very involved in looking for partners and trying to find where they can collaborate, and not waiting to where they can be compelled by the federal government or whoever, because if you wait that long, you’re often too late.