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 E Org B Org W Org N
Discharge Instructions
26% 78% 26% 32%
LVF Assessment 91% 100% 90% 78%
ACE Inhibitor for LVSD
70% 89% 0% 74%
Smoking Cessation Advice
74% 82% 40% 44%
Example Office Care Measure
Diabetes Org E Org B Org W Org N
HbA1c w/in 12 mon 90.20% 97.50% 88.56% 82.58%
LDL-C w/in 12 mon 83.21% 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 E Org B Org W Org 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 E Org B Org 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
