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Regional collaboration as a model for fostering accountability and transforming health care.
Semin Thorac Cardiovasc Surg. 2009 Spring; 21(1):12-9.ST

Abstract

An era of increasing budgetary constraints, misaligned payers and providers, and a competitive system where United States health outcomes are outpaced by less well-funded nations is motivating policy-makers to seek more effective means for promoting cost-effective delivery and accountability. This article illustrates an effective working model of regional collaboration focused on improving health outcomes, containing costs, and making efficient use of resources in cardiovascular surgical care. The Virginia Cardiac Surgery Quality Initiative is a decade-old collaboration of cardiac surgeons and hospital providers in Virginia working to improve outcomes and contain costs by analyzing comparative data, identifying top performers, and replicating best clinical practices on a statewide basis. The group's goals and objectives, along with 2 generations of performance improvement initiatives, are examined. These involve attempts to improve postoperative outcomes and use of tools for decision support and modeling. This work has led the group to espouse a more integrated approach to performance improvement and to formulate principles of a quality-focused payment system. This is one in which collaboration promotes regional accountability to deliver quality care on a cost-effective basis. The Virginia Cardiac Surgery Quality Initiative has attempted to test a global pricing model and has implemented a pay-for-performance program where physicians and hospitals are aligned with common objectives. Although this collaborative approach is a work in progress, authors point out preconditions applicable to other regions and medical specialties. A road map of short-term next steps is needed to create an adaptive payment system tied to the national agenda for reforming the delivery system.

Authors+Show Affiliations

Virginia Cardiac Surgery Quality Initiative, Falls Church, Virginia, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19632558

Citation

Speir, Alan M., et al. "Regional Collaboration as a Model for Fostering Accountability and Transforming Health Care." Seminars in Thoracic and Cardiovascular Surgery, vol. 21, no. 1, 2009, pp. 12-9.
Speir AM, Rich JB, Crosby I, et al. Regional collaboration as a model for fostering accountability and transforming health care. Semin Thorac Cardiovasc Surg. 2009;21(1):12-9.
Speir, A. M., Rich, J. B., Crosby, I., & Fonner, E. (2009). Regional collaboration as a model for fostering accountability and transforming health care. Seminars in Thoracic and Cardiovascular Surgery, 21(1), 12-9. https://doi.org/10.1053/j.semtcvs.2009.03.005
Speir AM, et al. Regional Collaboration as a Model for Fostering Accountability and Transforming Health Care. Semin Thorac Cardiovasc Surg. 2009;21(1):12-9. PubMed PMID: 19632558.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regional collaboration as a model for fostering accountability and transforming health care. AU - Speir,Alan M, AU - Rich,Jeffrey B, AU - Crosby,Ivan, AU - Fonner,Edwin,Jr PY - 2009/03/30/accepted PY - 2009/7/28/entrez PY - 2009/7/28/pubmed PY - 2009/9/18/medline SP - 12 EP - 9 JF - Seminars in thoracic and cardiovascular surgery JO - Semin Thorac Cardiovasc Surg VL - 21 IS - 1 N2 - An era of increasing budgetary constraints, misaligned payers and providers, and a competitive system where United States health outcomes are outpaced by less well-funded nations is motivating policy-makers to seek more effective means for promoting cost-effective delivery and accountability. This article illustrates an effective working model of regional collaboration focused on improving health outcomes, containing costs, and making efficient use of resources in cardiovascular surgical care. The Virginia Cardiac Surgery Quality Initiative is a decade-old collaboration of cardiac surgeons and hospital providers in Virginia working to improve outcomes and contain costs by analyzing comparative data, identifying top performers, and replicating best clinical practices on a statewide basis. The group's goals and objectives, along with 2 generations of performance improvement initiatives, are examined. These involve attempts to improve postoperative outcomes and use of tools for decision support and modeling. This work has led the group to espouse a more integrated approach to performance improvement and to formulate principles of a quality-focused payment system. This is one in which collaboration promotes regional accountability to deliver quality care on a cost-effective basis. The Virginia Cardiac Surgery Quality Initiative has attempted to test a global pricing model and has implemented a pay-for-performance program where physicians and hospitals are aligned with common objectives. Although this collaborative approach is a work in progress, authors point out preconditions applicable to other regions and medical specialties. A road map of short-term next steps is needed to create an adaptive payment system tied to the national agenda for reforming the delivery system. SN - 1043-0679 UR - https://www.unboundmedicine.com/medline/citation/19632558/Regional_collaboration_as_a_model_for_fostering_accountability_and_transforming_health_care_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1043-0679(09)00033-1 DB - PRIME DP - Unbound Medicine ER -