Making Michigan Health Care Safer, Better and More Effective
By: Debbie Reinheimer
National Healthcare Quality Week is a time to recognize the advances made among health care professionals and researchers toward improving health outcomes, including one of the nation’s largest, most successful quality collaborations right here in Michigan.
Through the Value Partnerships portfolio of programs, Blue Cross Blue Shield of Michigan has partnered with hospitals and physicians across the state in initiatives that have improved clinical quality, efficiency, and health outcomes; saved lives; and prevented over $2.2 billion in health expenses.
“Nearly every BCBSM member is cared for by providers who participate in these quality initiatives. However, the quality and care improvements benefit all patients,” said James D. Grant, M.D., senior vice president and chief medical officer at Blue Cross Blue Shield of Michigan. “Physician partners have changed their processes, so that all patients receive the benefit of these improved care models, regardless of their insurance type, or whether they have insurance.”
In the collection of value-based initiatives, roughly 20,000 physicians and care providers in 100 hospitals statewide work together to share and implement best practices. The collaborative model helps quality and safety improvements to occur quicker and on a larger scale than similar initiatives that involve only one site or group.
“As a result of efforts like these, our state’s hospitals and health systems are internationally recognized for being cutting edge and providing the highest quality, safest care,” said Brian Peters, CEO, Michigan Health & Hospital Association.
CONNECTING INFORMATION SYSTEMS TO IMPROVE QUALITY
Clinical quality improvement often requires the ability to access and exchange patient health data through electronic medical records and other sharing technology. That’s why one of the initiatives encourages participation in statewide electronic registries and information technology systems that enable connectedness among health care providers.
“Blue Cross incentive programs are a key ingredient in the MiHIN Use Case Factory methodology to mass produce data exchange. This transparent process facilitates hospital and provider information sharing into the Michigan Health Information Network, with great success,” said Dr. Tim Pletcher, executive director, Michigan Health Information Network Shared Services. “In fact, participating hospitals send all-payer all-patient notifications for about 99% of statewide admissions, discharges, transfers and ER visits for many years now as a result.”
These notifications enable physicians to receive real-time information when their patients have a hospital interaction, which allows them to more quickly follow up to see that their patients’ care is coordinated.
QUALITY IMPROVEMENT THROUGH COOPERATION AND IDEA SHARING
Michigan Medicine has a longstanding partnership with Blue Cross to serve as the clinical coordination center for most of the Collaborative Quality Initiatives within the Value Partnerships portfolio. University of Michigan Medical School faculty physicians lead most of the CQIs. Each CQI focuses on a specific type of care, from trauma care to prostate cancer to minimally invasive heart procedures.
“The initiatives work because they encourage cooperation among practitioners and clinical leaders in the state. They serve every patient in the state,” said Michael Englesbe, M.D., CQI medical director at Michigan Medicine. “The initiatives’ successes and failures contribute to the shared knowledge of the entire healthcare community through peer-reviewed research, so care transformation goes far beyond the state of Michigan.”
Value Partnerships programs also include one of the nation’s largest Patient Centered Medical Home designation programs, a team-based care model that has reduced patient ER visits and hospital admissions and improved patient outcomes. This can be attributed to the unique model of information sharing and transformed practices among participants.
“The program allows us to learn from each other and hear what’s going on in different parts of the state,” said Jenifer Hughes, executive director, Oakland Southfield Physicians. “This structure gives us valuable outreach that we otherwise wouldn’t have.”
Together, this collection of quality improvement programs has generated positive change in Michigan health care for nearly two decades.
“Patients in Michigan are experiencing safer, higher quality care because of the clinical quality initiatives sponsored by Blue Cross Blue Shield of Michigan,” said Thomas Leyden, director of Value Partnerships at Blue Cross. “These collaborations are producing best practices that benefit our members in Michigan and across the country. We are very proud of the transformative work that was accomplished with Michigan’s provider community.”
This article originally appeared in MI Blues Perspectives, the source for Blue Cross Blue Shield of Michigan news.