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Purchaser-Provider Synergies Overview

Fact Sheet

In this program, the Agency for Healthcare Research and Quality (AHRQ) helps purchasers and providers enhance quality improvement, public reporting, and pay-for-performance programs. The effort is designed to help purchasers and providers understand the science behind early efforts and benefit from the experience of incentive programs.

Introduction

Purchasers have become acutely aware of the link between quality and the rising cost of health care. As a result many purchasers have begun to develop a variety of quality improvement incentive programs with plans and providers to both improve quality and reduce the cost of care. These incentives include 'paying for performance' and various report card schemes.

The Purchaser-Provider Synergies program is designed to help purchasers and providers understand the science behind these early efforts and benefit from the experience of purchasers who have already implemented or are contemplating incentive programs.

What Is AHRQ Doing?

AHRQ is assisting purchasers and providers in enhancing their quality improvement (QI), public reporting, and pay-for-performance programs by using quality measures, tools, and related research findings. We will provide:

  • Information and support to 15 purchaser and community coalitions on quality-based purchasing (QBP) measures and tools through a combination of technical assistance workshops, Web conferences, and peer-assist learning networks.
  • Intensive technical assistance for three local purchasing coalitions, Medicaid/State Children's Health Insurance Program (SCHIP) programs, provider groups, or all-payer groups to support collaborative community QI efforts through local workshops, technical assistance, and peer-assist learning networks.
  • Targeted national dissemination of new AHRQ findings and tools relevant to QBP—as well as lessons learned by coalitions and local collaborations while implementing the PPS strategy—through presentations at major meetings, briefings, and Web conferences.

With Whom?

  • Selected public and private purchasers and coalitions.
  • National Business Coalition on Health.
  • National Business Group on Health.
  • State Medicaid directors.
  • General Motors.
  • AHRQ's partner is the Centers for Medicare & Medicaid Services.

Why?

QBP approaches have the potential to increase the use and effectiveness of QI efforts by plans and providers. This could lead to better quality of care and lower cost to purchasers but only if the most appropriate measures are applied in consistent, well-conceived programs. AHRQ can help purchasers and providers use the right measures and tools at the local level.

How Are AHRQ Resources Being Used?

  • Develop and facilitate technical assistance interventions, workshops, and Web-assisted communication.
  • Position AHRQ as a knowledge broker and science partner within stakeholder networks.
  • Provide timely information and tools to AHRQ stakeholders.

How Will We Know Success?

  • Coalitions and purchasers will mount more effective incentive programs using appropriate measures and tools.
  • Provider organizations will use more AHRQ and other measures and tools in response to purchaser incentive and other QBP programs.
  • Purchasers and providers in local communities will align their use of incentives and measures creating larger quality and cost reduction effects in those communities.

Synergies with Other AHRQ Programs

  • Supporting business coalitions on diabetes QI (Center for Quality Improvement and Patient Safety).
  • National Healthcare Quality Report.
  • Decision guide and the Medical Care Research and Review research-to-practice supplement.
  • AHRQ Quality Indicators.
  • Healthcare Cost and Utilization Project.

When Will We Reassess?

An ongoing internal evaluation will provide process and outcome data on each project within the strategy. The data will be reviewed informally for use in making mid-course corrections. Formal analysis of evaluation data at the end of the 2-year project will provide information for development of subsequent strategies.

Page last reviewed August 2005
Internet Citation: Purchaser-Provider Synergies Overview: Fact Sheet. August 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/factsheets/ppsynergies/index.html