On Tuesday, representatives from the Montefiore Medical Center in New York and Blue Cross Blue Shield of Michigan (BCBSM) discussed how regional collaborations can improve quality and reduce costs during a webinar sponsored by the Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange.
David Share, MD, senior vice president of Value Partnerships at BCBSM, and Lauren Henrikson-Warzynski, a healthcare analyst, shared how BCBMS went about improving healthcare through Collaborative Quality Initiatives (CQIs), which were developed and administered by Michigan physician and hospital partners, and were funded by BCBSM and its HMO, Blue Care Network.
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"Regional collaborations can provide incentives and infrastructure to systematically track and improve performance," said Share.
By measuring the quality of care within and across healthcare systems in Michigan and creating a feedback loop for continuous quality improvement with participating organizations, among other goals, the systems involved have been able to significantly improve quality, reduce costs and generate a positive return on investment, Share said. In a period of over two to three years, four participating programs produced $232.8 million in healthcare cost savings, he said.
In New York, Montefiore established an infrastructure based on ACO principles, explained Stephen Rosenthal, president and chief operating officer at the Montefiore Care Management Organization, and achieved improved management of diabetes, asthma and congestive heart failure, and reduced hospital admissions, readmissions and medical expenses among several key populations.
Montefiore's infrastructure is based upon their Integrated Provider Association (IPA), which is a physician and hospital partnership to accept and manage risk together, and their Care Management Company (CMO), which is a wholly-owned subsidiary of Montefiore Medical Center that performs care management delegated by health plans and other administrative functions.
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Rosenthal explained that on an individual level, their organization expands capability to work with participants face-to-face. On a provider level, they are able to improve access and availability, and on a system level, they are able to partner to identify vulnerable patients and create comprehensive care plans.
Rosenthal added that creating this type of infrastructure at Montefiore, which is located in the Bronx, was important in order to help bring down their higher-than-average diabetes and obesity rates and 20 percent higher per capita medical expenses.
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