The Premier Healthcare Alliance has announced its plans to pilot a patient safety and healthcare quality program.
The Charlotte, NC-based alliance, representing 1,700 hospitals, announced the program late last week. It's called QUEST, an acronym for quality, efficiency, safety and transparency.
Premier looking for additional supporters as it tests the viability of QUEST, which rewards top performers with extra payments.
Based on many of the principles used in the Hospital Quality Incentive Demonstration Project, which Premier operated jointly with the Centers for Medicare & Medicaid Services, the new program hopes to select 100 hospitals to participate in the three-year project, Premier executives said. As of last week, 60 facilities already have expressed interest.
Premier hopes to use data from the hospitals to augment information already in its data warehouse, said Richard Norling, Premier's president and CEO. Participating facilities would agree to develop and share best practices, which then could be widely disseminated to other hospitals.
The effort is seeking to enlist broad industry support, Norling said. QUEST will be guided by an oversight committee comprised of leaders from the Institute for Healthcare Improvement, Premier and charter member hospitals. It also will get advice from an advisory member that includes representation from the Blue Cross and Blue Shield Association and CMS.
In addition, the American Hospital Association is supporting the initiative, and Premier is seeking endorsements from other professional groups.
Many of the details had not been worked out as of last week. Executives said the program would pay additional reimbursement, at the end of the three-year program, to hospitals that achieved top quartile performance among participating hospitals. Additional payments will be on the order of those of the Hospital Quality Incentive Demonstration Project, which paid hospitals in the top decile of the group an additional 2 percent bonus on top of their Medicare payments; the next highest decile received a 1 percent bonus.
"We learned with HQID that the bonuses were a nice reward and important, but they actually may not have been the key thing that drove performance improvement," said Susan DeVore, Premier's chief operating officer. There's a lot of interest among hospitals in determining best practices and using that to improve care and drive down its costs, she said.
Premier and its membership will be absorbing a significant amount of the startup cost of the project. The organization also is talking with BCBSA about how to fund the reward pool, and it hopes to get other insurers to participate as well.
The five measurement areas for QUEST are expected to be:
- mortality ratio, which will be risk-adjusted to attain the goal of eliminating all avoidable deaths
- appropriate care, measuring the percentage of patients receiving "perfect care"
- efficiency, which will measure severity-adjusted cost per discharge
- harm avoidance, for which measures will be developed over time
- patient satisfaction, which will use patient satisfaction measures previously developed by CMS.