Blue Cross CQIs Gaining National Attention

Since the cardiovascular consortium, the very first collaborative quality initiative, was launched in 1997, with funding from the BCBSM Foundation, Blue Cross has since launched more than 20 consortiums across areas of surgical and medical care, all looking at ways to improve safety, quality and processes for procedures that are high cost and have high practice variation.

The CQIs have been largely successful, and are earning attention from other sites nationally. For example, Blue Shield of California is providing funding for the Fresno Heart and Surgical Hospital to join the Michigan Bariatric Surgery Collaborative. It’s the first time a hospital from another state will contribute their data to any of the CQI programs.  The Fresno hospital surgeons will be held to the same participation standards as in Michigan.

Bariatric surgeons from the Fresno hospital attend quarterly meetings in Michigan to learn from our physicians here and share experiences and ideas from their practice. MBSC program managers will travel to California to audit their data to ensure quality and accuracy. Additional California hospitals have expressed interest in MBSC and may join the collaborative in the future.  Having data from another state will increase the number of cases in the registry, and is likely help to generate new findings that will improve outcomes for bariatric surgeries nationally.

In another national nod to the Michigan CQIs, the Joint Commission has included a toolkit from the Michigan Anticoagulation Quality Improvement Initiative in its compendium of resources for blood clot preventions. The Compendium was developed as part of an 18-month research project by The Joint Commission’s Department of Health Services Research, to find current and reliable education and materials for patients who leave the hospital on blood thinners. MAQI2 created a comprehensive toolkit, developed from the data collected and the best practices developed in the CQI.

 A key component of the CQI’s success is the payer-provider partnership model. Funding from the Blues enables hospitals and physicians to work in a collaborative environment, providing resources for data collection and physician leadership of the initiative. This work is carried out in a separate coordinating center, which serves as a data warehouse, conducts data audits, performs data analyses and generates comparative performance reports.

Hospital and physician participants direct and execute the clinical work, share information and data, and develop new findings based on data and discussion. The Blues also provide reimbursement rewards for participation and performance.

After hearing about the successes of the CQIs here in Michigan, physicians and health plans in other states have asked Blue Cross to help them start similar initiatives. To date, five other states have launched initiatives modeled off the Michigan CQI model – South Carolina, Pennsylvania, California, Illinois and Tennessee. 

Michigan’s CQI model also is being studied as a Center of Excellence. The Center of Excellence for Collaborative Quality Improvement is exploring how to grow these initiatives across state lines. Health professionals from across the nation gathered at a national summit where they learned from the successes of the Michigan CQIs and discussed strategies for launching collaborations in other states.