The fact that health care costs vary sharply around the country is becoming well known; less understood is that there is also wide regional variation in health care quality. Some regions enjoy low cost, high quality care while others report high cost, lower quality care. Some people have ready access to providers and good care; others may not be receiving necessary care or may be receiving unnecessary, health-endangering care. The root cause of these differences has been the subject of many studies and discussions.
Stakeholders in dozens of communities around the nation have chosen to take action and improve quality locally by engaging in one or more collaborations. These collaboratives include: purchasers, such as employers, employer coalitions, and Medicaid agencies; consumers and consumer organizations; health plans, including regional and national commercial plans and Medicaid health plans; providers, such as hospital executives, physicians, state medical societies and academic medical centers; and others.
Many are engaged in one or more of such initiatives as Aligning Forces for Quality, a Robert Wood Johnson Foundation initiative; Chartered Value Exchanges, sponsored by the Agency for Health Care Research and Quality (AHRQ); and the Beacon Community Program, run by the Office of the National Coordinator for health information technology.
What does each program offer? How are these initiatives organized? What goals do they have in common? How do they relate to a larger, national quality strategy? What is the role of leadership in the start-up of a community collaborative? Is there evidence that the initiatives are improving quality, or is it too soon to tell? What, if anything, should the federal government be doing to help?
To address these questions and more, the Alliance for Health Reform and the Robert Wood Johnson Foundation sponsored an April 15 briefing. Panelists were: Robert Graham, National program director, Aligning Forces for Quality; Carolyn Clancy, AHRQ; James Chase, Minnesota Community Measurement; and David Kendrick, Greater Tulsa Health Access Network. Anne Weiss of the Robert Wood Johnson Foundation and Ed Howard of the Alliance co-moderated.
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