HQID offers Miami system chance to benchmark against top hospitals
Baptist Health South Florida is the largest faith-based, not-for-profit healthcare organization in the region. Its service network extends throughout Miami-Dade and Monroe counties with Baptist, Baptist Children's, South Miami, Homestead, Mariners and Doctors hospitals and the Baptist Cardiac & Vascular Institute. Outpatient services include diagnostic and urgent care facilities, including convenient Baptist Medical Plazas, as well as surgical facilities and home health care services. The International Center of Miami is one of the largest hospital-based international programs in the U.S. www.baptisthealth.net
Situation:
Are economic incentives to hospitals – also known as pay-for-performance or value-based purchasing – an effective way to improve the quality of inpatient care?
Solution:
In 2003, The Centers for Medicare & Medicaid Services (CMS) and the Premier healthcare alliance teamed up to launch the Hospital Quality Incentive Demonstration™ (HQID) – the first national project of its kind designed to answer that question. More than 250 hospitals from across the nation joined the project initially. A long-time Premier Healthcare Informatics products user, Baptist Health South Florida chose to participate in HQID.
Results1
As politicians and policymakers search for models of healthcare payment and reform, fourth-year results reveal the HQID project is helping patients live longer and receive recommended treatments more frequently.
- Participating hospitals have raised overall quality an average of 17.2 percent over four years based on delivery of 30-plus nationally standardized and widely accepted care measures to patients in five clinical areas.
- The improvements have saved the lives of an estimated 4,700 heart attack patients, according to a Premier analysis of mortality rates at participants.
- During the same time, the more than 1.5 million patients treated in five clinical areas at the 230 hospitals also received about 500,000 additional recommended evidence-based clinical quality measures, such as smoking cessation, discharge instructions and pneumococcal vaccination.
- In addition to significant incentive payments, Baptist Health South Florida’s four participating hospitals won 24 out of 30 possible awards including eight “Top Performer” awards in the fourth year of the HQID project.
1From an article by Susan D. DeVore, President and CEO, Premier healthcare alliance, “Results from the First 4 Years of Pay for Performance” in the January 2010 edition of HFM Magazine.
“One of the major issues
hospitals are facing from a clinical standpoint is sustaining resources to
maintain ever-growing quality measures responsibilities. The challenge is
not to just sustain performance at a high level, but to instead drive toward
perfect care. Participation and success in the HQID project has allowed us
to address this issue, and we’ve benefited from a number other project
aspects.
“The collaborative nature of the project offered us a chance to benchmark
against other leading hospitals, as well as learn from them as to how
they’re improved quality. And the opportunity to prepare for likely
government regulations has been invaluable. As HQID participants, we have
had six years experience with value-based purchasing, well before a plan is
implemented across the country!
“But ultimately, it’s the opportunity for continuous quality improvements
that really drives us. HQID is consistent with our goal of providing the
highest quality, highest value care we can.
“This quality improvement road has had its share of bumps. As a physician, I
am well aware that some of my peers are not big believers in the
pay-for-performance model. HQID measures are ultimately hospital-centric
measures and not necessarily physician-centric measures. So, we included
HQID in a larger context of improvement across our enterprise - the need to
focus on the big picture of true patient outcomes and improved collective
patient care. We didn’t just focus on measures, as we knew we’d run into
opposition. By accommodating for the physician viewpoint, and letting them
own the process, the outcome has been improved patient care1”
Thinh Tran, MD
Corporate Chief Quality Officer
Baptist Health South Florida, Coral Gables, FL
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