Forming a Coronary Services Network on the Basis of Quality of Care

Pine, Michael; Berman, Joseph I.; Byrwa, Kimberly J.

doi:10.1097/00019514-199600420-00003

Cited by 3 publications

(1 citation statement)

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“…Five years ago, Anthem Blue Cross and Blue Shield created a competitive coronary services network because of the hospital-specific variations noted in critical quality-of-care measures, such as CABG mortality. In the baseline assessment year, the severity-adjusted mortality rates of hospitals in the network were 38% lower than in hospitals not in the network (2.9 vs. 4.4%, P < 0.01), and this lower rate remained stable during the 1st year of the program (12).…”

Section: Programs To Improve Cardiovascular Carementioning

confidence: 91%

Diabetes and the Promise of Managed Care

McDonald

1998

Diabetes Care

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The term managed care has a positive connotation to many people and a negative connotation to others. It implies a systematic approach to the provision of care supported by a managed care organization, the underlying values of which are efficiency in care delivery and continuous health improvement of the population being served. The recent advances in knowledge surrounding the treatment of diabetes, the codification of these advances into treatment guidelines, and the significant gap between recommended and real-world treatment patterns all suggest that there is an opportunity for managed care organizations to play a beneficial role in improving the treatment of people with diabetes. Typical strategies used by managed care organizations include dissemination of treatment guidelines and information feedback to providers and patients to suggest diagnostic measures or therapeutic interventions that should be repeated with regularity to maintain or improve the health of people with diabetes. Improvements in population-level measurement of health care quality will increase the focus on preventable long-term complications of diabetes and other chronic diseases and may establish increasingly quantitative quality metrics that should improve real-world treatment patterns. Models exist for a multifaceted approach to improve the care of people with diabetes through such mechanisms; this article reviews the experience of one health plan with such undertakings.

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Section: Programs To Improve Cardiovascular Carementioning

confidence: 91%

Diabetes and the Promise of Managed Care

McDonald

1998

Diabetes Care

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Improving the Quality of Care

Chassin¹

1996

N Engl J Med

187

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The Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) Collaborative Quality Improvement Initiative in Percutaneous Coronary Interventions

Moscucci

Kline–Rogers

et al. 2002

J Interven Cardiology

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The past decade has been characterized by increased scrutiny of outcomes of surgical and percutaneous coronary interventions (PCIs). This increased scrutiny has led to the development of regional, state, and national databases for outcome assessment and for public reporting. This report describes the initial development of a regional, collaborative, cardiovascular consortium and the progress made so far by this collaborative group. In 1997, a group of hospitals in the state Michigan agreed to create a regional collaborative consortium for the development of a quality improvement program in interventional cardiology. The project included the creation of a comprehensive database of PCIs to be used for risk assessment, feedback on absolute and risk-adjusted outcomes, and sharing of information. To date, information from nearly 20,000 PCIs have been collected. A risk prediction tool for death in the hospital and additional risk prediction tools for other outcomes have been developed from the data collected, and are currently used by the participating centers for risk assessment and for quality improvement. As the project enters into year 5, the participating centers are deeply engaged in the quality improvement phase, and expansion to a total of 17 hospitals with active PCI programs is in process. In conclusion, the Blue Cross Blue Shield of Michigan Cardiovascular Consortium is an example of a regional collaborative effort to assess and improve quality of care and outcomes that overcome the barriers of traditional market and academic competition.

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Forming a Coronary Services Network on the Basis of Quality of Care

Cited by 3 publications

References 0 publications

Diabetes and the Promise of Managed Care

Diabetes and the Promise of Managed Care

Improving the Quality of Care

The Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) Collaborative Quality Improvement Initiative in Percutaneous Coronary Interventions

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