To improve chronic care throughout a region or state, key stakeholders in the health care marketplace must implement coordinated strategies at the purchaser, health plan, provider, and consumer level. When this health care system alignment occurs, major breakthroughs in improving health care quality can be achieved.
With this in mind, the Center for Health Care Strategies (CHCS) launched the Regional Quality Improvement (RQI) initiative. The RQI initiative sought to leverage Medicaid’s significant purchasing power to improve care for people with chronic conditions through partnerships with other health care leaders in four regions — Arkansas; North Carolina; Rhode Island; and Rochester, New York — including commercial insurers, employers, providers, and consumer organizations. RQI was funded by the Robert Wood Johnson Foundation, which is also testing regional coalitions though its Aligning Forces for Quality initiative.
To create regional systems-level changes, multiple coordinated strategies must be implemented. Regional participants in the RQI initiative implemented the following approaches to drive regional quality improvement in health care:
- Cross-Payer Data Aggregation and Reporting of Performance Measures: Developing common measures to assess quality of care and aggregating and sharing data with providers that reflect performance across multiple purchasers and insurers.
- Quality Improvement Infrastructure: Helping providers improve their care delivery by using quality improvement tools, such as evidence-based guidelines, health information technology, and chronic care innovations.
- Consumer Engagement: Engaging and educating consumers in self-management techniques and informed decision-making.
- Realigning Resources and Creating Financial Incentives: Aligning provider payment and performance outcomes to support higher quality and more efficient care.
Each region received up to $200,000 for the two-year initiative, as well as expert technical assistance from CHCS and its faculty.