Health Management Associates (grant originally awarded to the Economic and Social Research Institute)
$233,863
U.S. Hospitals' Quality and Efficiency Profiles Over the Past Five Years
Although data on hospital quality and efficiency are now available, most of the information consists of a limited number of care measures taken at one point in time. The next challenge is to identify hospitals that demonstrate high performance consistently over time for a broad spectrum of measures-those that can 'guarantee' high quality to all patients and high efficiency to payors. This project will explore the dynamics of hospital performance and the factors that contribute to its sustainability. In addition, the investigators will assess the factors and interventions that have enabled four hospitals to attain a high level of performance.
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Sharon Silow-Carroll
Senior Vice President
2100 M Street, NW, Suite 605
Washington, DC 20037
(201) 836-7136
silow@optonline.net
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Johns Hopkins University
$266,731
Assessing the Functional Capabilities, Quality and Costs of Clinical Information Systems in Texas Hospitals
While use of clinical information technology (CIT) to improve quality and efficiency is on the rise, achieving the full promise of these tools remains a challenge. For this project, the investigators will survey about 6,000 physicians in 156 Texas hospitals to assess the structural and functional capabilities of their CIT systems and determine whether these capabilities translate into improved quality and lower costs. Project staff will examine the relationship between the performance of hospitals' information systems and their clinical and financial outcomes. Project results will be presented to executives of the hospitals involved in the study to help guide their decisions about investment in CIT infrastructure.
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Neil R. Powe, M.D.
Professor of Medicine, Epidemiology and Health Policy
Bloomberg School of Public Health
2024 E. Monument Street, Suite 2-600
Baltimore, MD 21205-2223
(410) 955-6953
npowe@jhmi.edu
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Massachusetts Health Quality Partners, Inc.
$322,832
Measuring and Reporting on the Quality and Resource Use of Physicians in Massachusetts
For this demonstration project in Massachusetts, a research team will create profiles of the state's physicians in order to assess the quality of the care they provide and their use of resources. The team will then test the utility of the profiles with focus groups and explore how the profiles might be used by health insurers to select plan doctors; by purchasers to develop pay-for-performance programs; and by physician practices and other health care providers to improve physician performance. The investigators will also establish a process for creating a statewide, all-payer data registry of all physician claims from commercial plans, Medicare, and Medicaid.
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Janice Singer, M.P.H.
Director of Operations
705 Mt. Auburn Street, 3-E
Watertown, MA 02471
(617) 972-9056
singer@mhqp.org
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Park Nicollet Institute
$153,378
Developing, Evaluating, and Pilot-Testing Electronic Health Record-Based Quality Indicators for Ambulatory Care
By significantly enhancing the measurement and evaluation of medical care, electronic health records (EHRs) have the potential to improve care processes and patient outcomes. This project will address the need for standard methods of assessing performance through EHR-based data by developing a framework for EHR-based measures of quality. Through review of the professional literature and interviews with key informants, the investigators will identify a set of core quality indicators. A compendium of these measures will result, along with case examples comparing the utility of typical HEDIS quality indicators with that of the new EHR-based indicators. Throughout the project, investigators will work closely with national organizations engaged in quality measurement to disseminate project results to the public and private sectors.
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Jinnet B. Fowles, Ph.D.
Senior Vice President and Executive Director
Division of Health Research Center
Institute for Research and Education
3800 Park Nicollet Blvd., PPW Suite 210
Minneapolis, MN 55416
(612) 993-1949
jinnet.fowles@parknicollet.com
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President and Fellows of Harvard College
$253,719
Strategies to Improve the Value of Health Benefit Spending for Low-Wage Workers
Performance-based payment is attracting attention within both Medicare and the private health care sector as a means of improving the quality of physician care. At its April retreat, the Board recommended that the Fund devote resources to evaluating promising pay-for-performance models and disseminating findings to health care providers, purchasers, policymakers, and others. The proposed study will examine how a set of financial incentives targeting both physicians and patients affects cost and quality in a Preferred Provider Organization (PPO) model plan that insures low-wage workers in a single metropolitan area. The findings will be useful in developing policies to improve the quality and cost-efficiency of care in PPO arrangements and for low-income populations.
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Meredith B. Rosenthal, Ph.D.
Assistant Professor of Health Economics and Policy
Department of Health Policy and Management
Harvard School of Public Health
677 Huntington Avenue
Boston, MA 02115
(617) 432-3418
mrosenth@hsph.harvard.edu
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The Regents of the University of California
$249,936
Analysis of Physician Group Practices' Management of Chronic Illness
Results from the first National Survey of Physician Organizations in 2000 indicated that medical groups' use of care processes to manage chronic illness-although known to improve quality-was fairly low. They also showed that external incentives and information technology (IT) were associated with greater use of such processes. This project will resurvey large physician group practices to evaluate progress made toward improving the management of chronic illness, as well as the effectiveness of interventions and tools, such as payment incentives and IT. Data from this follow-up survey will be critical in evaluating incentive programs currently under way and in guiding future plans.
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Stephen M. Shortell, Ph.D.
Blue Cross of California Distinguished Professor of Health Policy and Management
140 Earl Warren Hall, Room 19v
Berkeley, CA 94720-7360
(510) 643-5346
Shortell@uclink.berkeley.edu
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The Urban Institute
$245,564
Evaluating the New York State Medicaid Managed Care Quality Improvement Incentive Program
In 1997, the New York State Department of Health began enrolling an estimated 1.7 million Medicaid beneficiaries into fully capitated managed care plans. That initiative was linked to the Quality Improvement Incentive program, a pay-for-performance approach. The proposed project will evaluate the impact of two interventions within that program: 1) the automatic assignment of Medicaid beneficiaries to managed care plans, whereby plans with better performance receive a higher percentage of auto-assignees; and 2) the adjustment of capitation rates based on plans' performance on 10 quality-of-care measures and five consumer satisfaction measures. As the first study of its kind to evaluate the impact of pay-for-performance in the public sector, it will help guide the evolution of performance-based payment programs in the state, while also providing information to other states about the value of this approach.
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Robert Berenson, M.D.
Senior Fellow in Health Policy
2100 M Street, N.W.
Washington, DC 20037
(202) 261-5886
rberenso@ui.urban.org
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Trustees of Boston University
$326,195
Survey to Assess the Current State and Impact of Quality Improvement Activities in U.S. Hospitals
Frances Cooke Macgregor Grant
In a seminal 2001 report, the Institute of Medicine called for redesigning the U.S. health care system to make it better able to deliver care that is safe, effective, timely, patient-centered, efficient, and equitable to all. Numerous public and private organizations heeded this call by developing and supporting broad-based quality improvement and patient safety initiatives. Not much information is available, however, about the activities hospitals are undertaking. This project will survey 500 hospital CEOs and 3,000 physicians and nurses to determine the progression and breadth of change. Using quality-of-care data from the Centers for Medicare and Medicaid Services and the Joint Commission on Accreditation of Healthcare Organizations, project staff will analyze the relationship between quality improvement activities and quality of care.
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Alan B. Cohen, Sc.D.
Professor and Executive Director, Health Policy Institute
53 Bay State Road
Boston, MA 02215-1704
(617) 353-9222
abcohen@bu.edu
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Small Grants—Health Care Quality Improvement and Efficiency
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Harris Interactive, Inc.
$15,000
Strategic Health Perspectives 2006
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Jordon Peugh
Research Director
161 Sixth Avenue
New York, NY 10013
(212) 539-9706
jpeugh@harrisinteractive.com
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Health Systems Research, Inc.
$34,996
Colloquium on Aligning Payment Incentives with Quality: A Review of Current Programs and Evidence of Impact
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Lawrence Bartlett, Ph.D.
President
1200 18th Street, N.W., Suite 700
Washington, DC 20036
(202) 828-5100
lbartlett@hsrnet.com
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National Committee for Quality Assurance
$26,650
Developing Measures of Ambulatory Care Efficiency: an Expert Working Group
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L. Gregory Pawlson, M.D.
Executive Vice President
2000 L Street, N.W., Suite 500
Washington, DC 20036
(202) 955-5170
pawlson@ncqa.org
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Society of General Internal Medicine
$31,269
Initiative to Advance the State of the Art on Assessing Quality of Care for Patients with Multiple Complex Comorbidities
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David Karlson, Ph.D.
Executive Director
2501 M Street, NW, Suite 575
Washington, DC 20002
(202) 887-5150
karson@sgim.org
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The Regents of the University of California
$44,350
Using Electronic Health Records to Improve Care for Underserved Populations: A Case-Study of the Institute for Urban Family Health
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Robert H. Miller, Ph.D.
Associate Professor of Health Economics in Residence
University of California, San Francisco, Institute for Health & Aging
3333 California Street, Suite 340
San Francisco, CA 94118
(415) 476-8568
millerr@itsa.ucsf.edu
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