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October 15, 2010 Issue No. 7
Greetings!      

As we enter the final stretch of the year, we're excited about the work done and the work to be done. Below is a summary of that work:

  • Launch of the BTE Cardiovascular Recognition Program powered by the American College of Cardiology - after more than two years of design and testing, we're proud to launch this new recognition program that identifies cardiology practices, and their cardiologists, who meet high standards of care in managing patients with Heart Failure, Coronary Artery Disease, Hypertension and Atrial Fibrillation.  Many health plans have agreed to recognize these practices on their web sites, and all employers should make sure that their employees are aware of who, in their community, is practicing better cardiology care.
  • Recognition of over a dozen physicians under the new NYC Adult Primary Care Recognition Program - in collaboration with the NYC Department of Health's Primary Care Information Project, we've been developing a comprehensive way of measuring the quality of care in primary care practices.  These physicians must demonstrate they are delivering good outcomes for patients with Diabetes, Hypertension, Ischemic Vascular Disease, and adhering to routine preventive care recommendations.  This first of its kind in the country program relies on the automated push of scored measures by EMRs into a central repository, and demonstrates that EMRs can be widely used to assess quality of care and help physicians in improving outcomes.
  • Publication of a new paper in a special issue of Health Services Research on how chronic care costs across the country could be controlled if physicians were to reduce Potentially Avoidable Complications to the nationally observed 20th percentile rate.
  • Expansion of Prometheus Payment pilots in several states - building on the strength of the pilots that have been supported by a grant from the Robert Wood Johnson Foundation, we're working on two pilots in NY state supported by a grant from the NY State Health Foundation, three pilots in Colorado funded by the Colorado Health Foundation, and pilots in New Jersey, North Carolina, Missouri and Oregon.  And there are several more that are in the works as health plans and health systems are striving to move away from the traditional fee-for-service payments that have contributed so much to the massive inflation of medical costs.
  • Endorsement of our measures of Potentially Avoidable Complications for chronic care and acute hospitalization episodes - we're in the final stages of the National Quality Forum's measure endorsement process, having successfully gone through technical advisory panel reviews, a vote by the Steering Committee on Outcomes Measures, the Public Comment period and the NQF Member voting. If endorsed, these will become the country's first set of comprehensive measures of complications of care.
  • Agreements with MedAssets, Navigant Consulting and Gold Health Strategies - As hospitals and health systems across the country try to get ready for the payment and delivery system reform programs that will be launched by CMS in the next 18 to 48 months, they need help in understanding how to better manage the resources currently used to produce a good outcome for a procedure or a hospitalization.  We've reached agreements with a number of organizations to enable them to use our Evidence-informed Case Rate analytics as a way to measure the costs of episodes and, especially, the amount of resources consumed by Potentially Avoidable Complications.  These analyses can then lead provider systems to perform root cause analysis and launch process improvements that will reduce PACs over time and help deliver more affordable and higher quality care.


We still have a lot to do by the end of this year, and will continue to push as hard as we can to reform payment and improve the lives of all US residents.

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2009 Health Care Incentives Improvement Institute, Inc. All rights reserved.
 
HCI3 does not endorse any particular product or service or any physician or physician group.  HCI3 relies on third-party performance assessment organizations such as the NCQA and Quality Improvement Organizations to measure a physician or physician's group performance and ability to demonstrate that they meet certain measures of quality care.