CHARLOTTE, NC – The Premier Healthcare Alliance is looking for additional supporters as it plans to launch a project to test the viability of a program intended to increase patient safety and healthcare quality, while rewarding top performers with extra payments.
The Charlotte, N.C.-based alliance, representing 1,700 hospitals, announced the program in late July. It’s called QUEST, an acronym for quality, efficiency, safety and transparency.
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.
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 details had not been worked out at the time Premier unveiled the program. 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. The QUEST reward pool is expected to pay a flat amount per hospital, with targets such as $25,000 for top quartile performance in one measurement area, $50,000 for top quartile performance in two areas, and $150,000 for for top quartile performance in three areas. Premier said the reward won’t be based on current reimbursement payments made by a payer.
“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 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, measures for which will be developed over time; and patient satisfaction, which will use patient satisfaction measures previously developed by CMS.