Considerations When Partnering with Health Care Organizations
To help decide whether and how to collaborate with providers or plans, consider your answers to the following questions.
Whose quality are you planning to report, and what kinds of measures are you planning to use?
Your need to partner depends in part on what you want to report. For example, if your goal is to report on the effectiveness of care for local medical groups, you will need their cooperation to get access to medical record data. You will also want them to “sign off” on the analytical methods you use so that they will not question the validity of the information in the reports. If, on the other hand, you wish to report on members’ experiences with health plans, you can get that information from the National Committee for Quality Assurance (NCQA), which maintains a database with this kind of information. (Learn more about NCQA’s database.) While you may still want to invite the health plans to participate in the development of the report, their involvement is not as necessary.
Who else has a stake in the information?
Health care organizations are often eager to see information on other organizations. For example, if you wish to report on the quality of medical groups, you may find that health plans are interested in the project because they also track quality at this level.
Because of their contractual relationships, health plans can also help to exert pressure on providers to participate in voluntary initiatives. In California, for example, some major health plans have rewarded hospitals for participating in a statewide reporting project sponsored by the California HealthCare Foundation.
What’s your past history with the relevant health care organizations?
Organizational and personal connections often play an important role in deciding the feasibility of partnerships. Some sponsors have cultivated good relationships with health care providers and plans, while others maintain (or are placed in) a more adversarial position.
But even when past dealings have been positive, some health care organizations will refuse to support consumer reporting projects. In those cases, sponsors may need to choose between abandoning the project and revamping it to avoid the need for input from the health care organizations.
Is quality improvement (QI) one of your goals?
If one of the purposes of your reporting efforts is to drive health care organizations to improve their quality, you may want to engage them in your planning process so that you can explore the possibility of producing more detailed information that meets their QI needs as well.
In addition to offering information providers can use for QI, you can encourage their participation by offering opportunities to share best practices and learn about useful tools or strategies that could help them improve their performance.
In Wisconsin, for example, The Alliance has hosted webinars that focus on how hospitals can use the metrics in the QualityCounts report to improve quality of care. They invite the measure creators to present and field questions. Topics have included:
- The Agency for Healthcare Research and Quality Patient Safety Indicators.
- Inpatient mortality measures using APRDRG’s.
- The Joint Commission Heart Failure Measures.
- The Leapfrog Group Safe Practices.