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 EOrg BOrg WOrg N Discharge Instructions 26%78%26%32% LVF Assessment91%100%90%78% ACE Inhibitor for LVSD 70%89%0%74% Smoking Cessation Advice 74%82%40%44%

Example Office Care Measure DiabetesOrg EOrg BOrg WOrg N HbA1c w/in 12 mon90.20%97.50%88.56%82.58% LDL-C w/in 12 mon83.21%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 EOrg BOrg WOrg 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 EOrg BOrg 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