1. Wisconsin Collaborative for Healthcare Quality
In Pursuit of Value
The Wisconsin Story
Chris Queram
President / CEO
WCHQ
March 20, 2017
Wisconsin Collaborative for Healthcare Quality

2. Defining the Scope of the Problem
Per Capita Healthcare Costs — International Comparison, Oct. 17, 2016
Wisconsin Collaborative for Healthcare Quality

3. Defining the Scope of the Problem
Health care cost rise in the U.S. relative to other countries, as measured by total expendi-ture on health as percent of GDP
“Exhibit 1” -
Wisconsin Collaborative for Healthcare Quality

4. Defining the Scope of the Problem

5. Defining the Scope of the Problem
Institute of Medicine
To Err is Human
1999
44,000 – 98,000 deaths per year due to medical errors
$17 - $29 billion in cost

6. Defining the Scope of the Problem
New England Journal of Medicine
“The Quality of Health Care Delivered to Adults in the United States”
2003
On average, U.S. adults receive recommended treatments only 55% of the time.

7. And, Lest We Forget About Health
Tobacco use
HEALTH BEHAVIORS (30%)
Diet & exercise
Alcohol use
Sexual activity
CLINICAL CARE (20%)
Access to care
Quality of care
SOCIAL & ECONOMIC FACTORS (40%)
Education
Employment
Income
Family & social support
Community safety
PHYSICAL ENVIRONMENT (10%)
Environmental quality
Built environment
HEALTH OUTCOMES
MORTALITY (LENGTH OF LIFE): 50%
MORBIDITY (QUALITY OF LIFE): 50%
HEALTH FACTORS
POLICIES & PROGRAMS
County Health Rankings model © 2012 UWPHI

8. Improved Health
Better Care
Lower Costs
National
Quality
Strategy

9. The WCHQ Mission Wisconsin Collaborative for Healthcare Quality
We publicly report and bring meaning to performance measurement information that improves the quality and affordability of healthcare in Wisconsin, in turn improving the health of individuals and communities.
Wisconsin Collaborative for Healthcare Quality

10. Who Participates in WCHQ
Board of Directors
Providers
Purchasers
Consumers
Members
Stakeholders
Wisconsin Healthcare Provider Organizations
Health Systems
Medical Groups
Hospitals
Local, Regional & National Collaborators
Purchasers
Consumers
Advocacy Organizations
Government Agencies
Research Institutions
Foundations
View our member and Board of Directors rosters on the WCHQ website.
Wisconsin Collaborative for Healthcare Quality

11. WCHQ Member Organizations
Wisconsin health systems, physician groups, and hospitals
Representing approximately 60% of Wisconsin primary care physicians and 60% of all Wisconsin physicians
Access Community Health Centers
Agnesian HealthCare
Ascension Wisconsin
Aspirus
Associated Physicians
Aurora Health Care
Bellin Health
Beloit Health System
Dean Clinic / SSM
Divine Savior Healthcare
Fort HealthCare
Froedtert Health
Group Health Cooperative of South Central WI
Gundersen Health System
Holy Family Memorial
Marshfield Clinic
Mayo Clinic Health System
Medical College of Wisconsin
Mercy Health System
Meriter Health Services
Monroe Clinic
Prairie Clinic
Prevea Health
Primary Care Associates of Appleton
ProHealth Care
Richland Medical Center
Sacred Heart Hospital
Sauk Prairie Memorial Hospital & Clinics
Sixteenth Street Community Health Centers
ThedaCare
UW Health
Wildwood Family Clinic
Wisconsin Collaborative for Healthcare Quality

12. WCHQ Stakeholders
These healthcare purchasers and organizations collaborate with WCHQ:
AARP Wisconsin
American Cancer Society
Business Health Care Group
Colony Brands
Greater Milwaukee Business Foundation on Health
MetaStar
Robert Wood Johnson Foundation
Rural Wisconsin Health Cooperative
Seats Incorprated
The Alliance
ThedaCare Center for Healthcare Value
UW Health Innovation Program
UW Population Health Institute
WEA Trust
Wisconsin Department of Health Services
Wisconsin Health Information Organization
Wisconsin Hospital Association
Wisconsin Medical Society
Wisconsin Primary Health Care Association
Wisconsin Statewide Health Information Exchnage
WPS Health Insurance
Wisconsin Collaborative for Healthcare Quality

13. Values and Guiding Principles
WCHQ members build consensus and drive improvement via:
Trust – Avoid using performance data for market advantage.
Participation – Engage in dialogue, capacity-building, and sharing of best practices.
Inclusiveness – Deliberate and make decisions in ways that represent all affected parties.
Shared Responsibility – Commit to enhancing capacity for individual growth and organizational improvement.
Openness – Transcend competitive / intellectual boundaries that diminish learning.
Adaptive Self-Governance – Encourage adaptability, diversity, flexibility, and innovation.
Intellectual Output – Use measurement data to benefit all.
Acknowledgement – Recognize intellectual contributions from inside and outside of WCHQ.
Transparency – Openly share data and processes among WCHQ members and the public.
Wisconsin Collaborative for Healthcare Quality

14. WCHQ Core Competencies
WCHQ publicly reports and brings meaning to healthcare performance information.
Performance Measures Priorities: We help to facilitate consensus on priority measures for assessing the quality and cost of healthcare in Wisconsin.
Collect and Validate Measurement Data: We guide the collection, validation and analysis of both administrative and clinical data.
Publicly Report Measurement Results: We publicly report comparative performance results for healthcare providers, purchasers and consumers.
Share Best Practices: We share the best practices of healthcare organizations that demonstrate high quality, enabling all providers to adopt successful methods.
Wisconsin Collaborative for Healthcare Quality

15. Performance & Progress Report www.wchq.org
Wisconsin Collaborative for Healthcare Quality

16. WCHQ Public Reporting of Performance at the Clinic Level
Wisconsin Collaborative for Healthcare Quality

17. Wisconsin Collaborative for Healthcare Quality
March 2013 Edition of
Health Affairs
“…Large Group Practices Will Engage In Quality Improvement Efforts In Response To Public Reporting, Especially When Comparative Performance Is Displayed…”
Geoffrey Lamb
Maureen Smith
William Weeks
Christopher Queram
Wisconsin Collaborative for Healthcare Quality

18. Performance Improvement
“Layered” Quality Improvement Model
WCHQ member scorecard to identify top performers
Wisconsin Collaborative for Healthcare Quality

19. Performance Improvement
“Layered” Quality Improvement Model
Shared Learning:
WCHQ Assembly meetings
Webinars
Affinity groups
Site visits
Wisconsin Collaborative for Healthcare Quality

20. The Business Case for Quality
“Public Reporting Helped Drive Quality Improvement in Outpatient Diabetes Care Among Wisconsin Physician Groups”
Maureen Smith
Alexandra Wright
Christopher Queram
Geoffrey Lamb
Wisconsin Collaborative for Healthcare Quality

21. V = Q + C Approriateness Health Care Value
Wisconsin Collaborative for Healthcare Quality

22. Efficiency Measure Prototype

23. Lessons Learned
Public reporting is an important driver of improvement priorities
Valid/reliable measures create trust and buy-in
Granular data are required for performance improvement
Social capital is critical to sustainability
Wisconsin Collaborative for Healthcare Quality

24. Wisconsin Collaborative for Healthcare Quality 608-826-6837
Chris Queram
President/CEO
Wisconsin Collaborative for Healthcare Quality
Wisconsin Collaborative for Healthcare Quality