In an effort to boost healthcare delivery, physicians at Children's Hospital Boston are partnering with Massachusetts' major health plans to develop new technologies and integrated care models.
Health plans including Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care and Tufts Health Plan will be advisors for and target funds toward the effort. The Massachusetts Medicaid Program has also agreed to participate.
"The complexity and uniqueness of pediatric care compared to adult care requires an extra level of effort to measure and improve quality," said Kathy Jenkins, MD, chief quality and safety officer at Children's. "By creating a common platform for discussion in Massachusetts with all major payers, we should make significant progress in improving quality and effectiveness of care while contributing to the state's position as a healthcare 'learning laboratory' for the rest of the nation."
To fund the innovations, Children's and its physicians have volunteered a cut in fiscal year 2010 payment rates – in some cases reopening contracts to cut rates of increase, and in others agreeing to reduce rates of increase during current contract negotiations.
Those savings will support technology for SCAMPs (Standardized Clinical Assessment and Management Plans), which provide clinicians with immediate feedback on the success of their treatments, and for developing the first patient-controlled health record.
"Children's and its doctors believe that the new framework will become the standard for quality improvement processes – how to create in real time widespread, continuous, data-driven quality improvement, including appropriate utilization and potential cost savings, and will quickly spread to other pediatric and adult care delivery," said James Lock, MD, chief of cardiology at Children's and one of the project's architects.
The fund will also expand and accelerate pilots centered around the family-centered medical home, such as coordinating care for children and youths with complex and chronic conditions.
"Over the past several years we've made patient quality and safety our top priority, invested in our clinical health information systems and tackled hospital-wide operational improvement," said Sandra Fenwick, president and COO at Children's.
"Those efforts have provided the confidence and platform on which to launch this next generation of clinical effectiveness tools and models, which the hospital and its physicians believe hold promise for transforming the healthcare system nationally," added Paul Hickey, MD, president of the physicians' organization at Children's.
A 10-member advisory panel, with equal representation from Children's and participating insurers, will provide guidance.