Strengthening Multipayer Collaboration: Lessons From the Comprehensive Primary Care Initiative

Anglin, Grace; Tu, H A; Liao, Kristie; Taylor, Erin Fries

doi:10.1111/1468-0009.12280

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…It seems to me to be a reasonably accurate and terse summary of what we know about the evidence base for achieving and maintaining a healthy weight. Perhaps given the accumulated experience of practice facilitation, 8 large multipayer initiatives, 9 academic initiatives, 10 Eviden-ceNOW, and others, we might be ready, with all due requisite humility, for a parsimonious set of tenets for primary care practice transformation. These few rules, adapted by practices for use in their community context, could boil down to: "Build whole change together, pace yourself, focus on what matters most, practice quality improvement hygiene" (Table 1).…”

mentioning

confidence: 99%

Finding a Parsimonious Path for Primary Care Practice Transformation

Bitton

2018

Ann Fam Med

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confidence: 99%

Finding a Parsimonious Path for Primary Care Practice Transformation

Bitton

2018

Ann Fam Med

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“…Short of statutory compulsion, payer participation in a multipayer quality program is voluntary. Our method represents the first step of an iterative process, which would ideally be facilitated by a neutral convener with a clearly defined role, guided by a shared mission, and include trusted stakeholders with appropriate decision‐making authority 41 . Stakeholder interests, capabilities, and needs may differ from our assumptions.…”

Section: Discussionmentioning

confidence: 99%

Development of An All‐Payer Quality Program for the Pennsylvania Rural Health Model

Herzog

Fried

Liebers

et al. 2020

The Journal of Rural Health

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Purpose Measuring rural health care quality is challenging, and payer and government reporting requirements are frequently misaligned. The Pennsylvania Rural Health Model, a multipayer global budget demonstration for rural hospitals, initially required the proposal of an All‐Payer Quality (APQ) Program in which participating payers would have held participating hospitals accountable for performance on a common set of quality measures. We sought to identify quality measures appropriate for use in APQ measurement and reporting programs for globally budgeted rural hospitals. Methods A method was devised to identify, assess, and select quality measures from an environmental scan of core measure sets. An initial screen identified measures that were relevant, valid, and reliable. Four reviewers then independently assessed measures that passed the initial screen on a Likert scale of 1‐5 for relevance, validity, reliability, responsiveness, alignment, and feasibility, and they selected a proposed measure set guided by prespecified measure set criteria. Results The 4 reviewers selected 10 quality measures from a list of 344 measures drawn from 8 core measure sets. One hundred twenty‐five measures satisfied screening criteria and were assessed. The mean total score was 21.5/30 (95% CI: 17.0‐26.0). Inter‐rater reliability was moderate (intraclass correlation coefficient range 0.544‐0.656). Conclusion A formal performance measure selection methodology can generate a set of rural‐appropriate health care quality measures for a multipayer rural hospital global budget program. This methodology could be replicated to select quality measures for inclusion in rural multipayer quality measurement and reporting programs.

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“…Payers in 3 CPC regions overcame concerns about sharing proprietary data and chose to work collaboratively throughout the protracted process of aggregating the data. 11 Although more time is needed to see whether these arrangements will be sustained, the research team notes that in CPC+, which was designed based on CPC and includes 18 regions, several additional regions are pursuing data aggregation.…”

Section: Discussionmentioning

confidence: 99%

Aggregating Claims Data Across Payers: Approaches, Challenges, and Lessons Learned From the Comprehensive Primary Care Initiative

et al. 2019

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The Comprehensive Primary Care (CPC) initiative fueled the emergence of new organizational alliances and financial commitments among payers and primary care practices to use data for performance improvement. In most regions of the country, practices received separate confidential feedback reports of claims-based measures from multiple payers, which varied in content and provided an incomplete picture of a practice’s patient panel. Over CPC’s last few years, participating payers in several regions resisted the tendency to guard data as a proprietary asset, instead working collaboratively to produce aggregated performance feedback for practices. Aggregating claims data across payers is a potential game changer in improving practice performance because doing so potentially makes the data more accessible, comprehensive, and useful. Understanding lessons learned and key challenges can help other initiatives that are aggregating claims or clinical data across payers for primary care practices or other types of providers.

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Strengthening Multipayer Collaboration: Lessons From the Comprehensive Primary Care Initiative

Cited by 7 publications

References 8 publications

Finding a Parsimonious Path for Primary Care Practice Transformation

Finding a Parsimonious Path for Primary Care Practice Transformation

Development of An All‐Payer Quality Program for the Pennsylvania Rural Health Model

Aggregating Claims Data Across Payers: Approaches, Challenges, and Lessons Learned From the Comprehensive Primary Care Initiative

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