Reform Update: Synergies seen with RWJF, Innovation Center initiatives

An eight-year initiative aimed at improving healthcare quality and lowering costs has entered its final phase, and its director says the project's lessons could serve as best practices for healthcare providers across the nation.

Launched in 2006, Aligning Forces for Quality is a Robert Wood Johnson Foundation-funded effort involving 16 communities, including Albuquerque, N.M.; Detroit; Cleveland; Puget Sound, Wash.; and Kansas City, Mo. The program focuses on developing local solutions to common healthcare quality problems, such as easing emergency department throughput, improving transitions of care, reducing healthcare disparities and aligning payment incentives.

This month kicks off the last two-year phase of the collaborative program, in which participating communities will focus on ways to sustain interventions after funding ends, said Dr. Robert Graham, national program director of the initiative and a research professor in the department of health policy at George Washington School of Public Health and Health Services, in Washington.

Also, communities will have more flexibility to identify specific cost and quality goals they want to tackle during this final phase, he added.

“For each alliance, the priorities will be different,” Graham said in an interview. “What works in one community, where the major payers are open to working with one another, for instance, may not work in another.”

Over the course of the past six years, the communities have seen jumps in consumer engagement, improvements in patient safety and advances in the development of new payment models, such as patient-centered medical homes, Graham said.

According to data released in July 2012, 60% of participating hospitals saw reductions in their 30-day readmission rates and three-quarters improved heart failure patients' adherence to care plans.

Aligning Forces communities have also benefitted from other locally tailored programs, including those funded by the Center for Medicare and Medicaid Innovation, Graham said. The Innovation Center supports hundreds of projects across the country, addressing topics such as readmissions, accountable care and chronic disease management.

“Most of the 16 alliances have Innovation Center efforts in their midst,” he said. “The projects have been very synergistic.”

On May 8, representatives from the communities gathered in Chicago for the initiative's annual three-day meeting. The mood was optimistic, Graham said. “There was a sense that folks were very focused on what they could accomplish in the next two years.”

He also said the work of the Aligning Forces participants could provide blueprints for other communities looking for ways to adapt to seismic changes in the healthcare industry.

“Part of the foundation's intent is to understand how to achieve higher quality and lower costs in a given community,” Graham said. “At the end of the eight years, we want to be able to look back and say, 'This worked in every community,' or 'This worked here and it will probably work in a similar place.'”

A group of medical-specialty and patient-safety groups—including the Association for Professionals in Infection Control and Epidemiology, the Society for Hospital Medicine and the SAFE Care Campaign—has called on Congress to boost funding for the Centers for Disease Control and Prevention's National Healthcare Safety Network. The NHSN, an online infection surveillance and reporting system, serves a critical role in preventing healthcare-associated infections, the groups argued in a letter to the Senate and House appropriations subcommittees. They called for $31.5 million in additional funding for the NHSN in 2014. The CMS requires hospitals to report their incidences of several different types of healthcare-associated infections using the NHSN, as do many states.

WellCare Health Plans, a Tampa, Fla.-based managed-care company that works with government-sponsored health programs, announced a program to boost the development of patient-centered medical homes within its Georgia Medicaid network. That network serves more than 570,000 people, WellCare said in a news release. The program will include the use of targeted payments for medical-home recognition and ongoing pay-for-performance bonuses.