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Regional Quality Initiatives: Expanding The Partnership



December 9th, 2010

If you’re looking for a transformation in health care, look first to America’s cities, towns and communities. That’s where it happens, among local men and women who deliver and receive care, and the employers and consumers who pay for it.

That’s why the Robert Wood Johnson Foundation (RWJF) and the U.S. Department of Health and Human Services (HHS) are excited by what’s happening in communities coast to coast. The transformation toward better, more coordinated, safer and more efficient care has begun. Through efforts led by RWJF, HHS’s Office of the National Coordinator for Health Information (ONC), HHS’s Agency for Healthcare Research and Quality (AHRQ) and others, dozens of diverse regions of the country are benefiting from an unprecedented commitment of resources and technical expertise to help local leaders improve quality of care provided in their region, while also developing ways to lower costs and improve health.

Together our private and public efforts represent more than half a billion dollars invested in improving health care in regions. But money alone won’t improve quality and reduce costs. For that to happen, teams of local leaders from a range of perspectives must design and implement tailored changes in the way their region organizes, delivers and pays for health care.

Our initiatives have much in common, including the understanding that no single policy, clinical intervention, or stakeholder can achieve the needed level of change to fill the major gaps in quality and cost throughout our country.

RWJF’s Aligning Forces Program. Since Aligning Forces kicked off in 2006, it has essentially defined the field of regional quality improvement. When Aligning Forces began, the idea of diverse local stakeholders linking approaches to enhance quality and value was novel. Since then, the program’s emphasis on engaging consumers, measuring the performance of providers and reporting it publicly, and improving the quality, cost and equality of care being delivered has taken hold. The Aligning Forces regions are beginning to explore payment reforms to help sustain and increase local improvements in quality.

ONC’s Beacon Communities. In recent months, ONC’s Beacon Community program has joined the regional improvement effort with a large three-year grant, helping select regions use health IT as a community foundation on which to improve health and health care. Beacon Communities are at the cutting edge of electronic health record adoption and are equipped to deploy IT resources in combination with other reforms to support care coordination, quality improvement, payment reform and population health initiatives that in turn will improve health care quality and efficiency.  

Aid To Communities From AHRQ. For these and other national efforts, AHRQ has long offered a panoply of information to communities and individuals seeking to improve health care. Along with tools to build and sustain local collaborative leadership, engage the public and increase performance measurement, AHRQ offers unique products and insights to help communities develop ways to create incentives for quality and improve preventive services. AHRQ’s Chartered Value Exchange project (CVE), in particular, is helping 24 select regions systematically improve the quality and value of health care provided locally.

Having all spent a fair amount of time developing and leading these programs, what’s clear to all of us is that there is no silver bullet; no one way to get all these diverse communities to sustainable high quality, efficient care. That’s why coordinating our efforts is critical. Our programs involve complementary work. We’re even in some of the same regions, so working closely together enhances all of our efforts.

It’s also in the strong national interest that we work together, because of the importance of regional work to overall health care reform. We need to move quickly to identify and share “implementation lessons” so other communities can benefit from these communities’ experiences. We know the learning curve can be steep.  The nation cannot afford to relearn this wisdom over and over again, place by place.

A Call For Ideas From Community Leaders: How Can We Leverage Our Programs To Support Your Efforts?

Today we are pleased to be jointly kicking off a process to solicit ideas from leaders around the country – especially those not participating in our programs – about how our collaboration and its assets might enhance their own local health care improvement strategies. We urge community and other leaders to share specific ideas on our special forum website. We want to know how we can leverage our programs to support other regional efforts around the country, even if we are not able to fund a new round of additional awards. We will also host a series of Twitter and Facebook events, as well as more traditional briefings, to gather comments and ideas from regional leaders.

Over several weeks, we will begin acting upon these comments based on the ideas and feedback we receive. Although new grant monies are not available to fund additional communities, we promise robust resource support – and we will be swift in delivering on this promise.

We know that for health care reform to succeed, it must happen quickly and smartly, community by community.  We are committed to doing what we can to share the emerging knowledge about how to do that as widely and rapidly as possible.

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1 Response to “Regional Quality Initiatives: Expanding The Partnership”

  1. acavale Says:

    Finally, a positive-sounding post in quite a while. From my position as a solo practitioner, my suggestion is to approach this from the grass-roots, upwards. So far most of the efforts have been top-down, which unfortunately have too many negative effects – both real and perceptual.

    I would just like to say here that in spite of our small footprint, we have been quite successful in creating delivery models to suit the needs of individual patients in our community (entirely without any support from either governmental or private agencies). I will post some ideas to your website. Hope my ideas will be useful and will get appropriate attention.

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