World Health Congress Session Focuses on Value Based Contracting

Culture Change and Quality
In a person-centered culture, guess who's in the center!!! And when they are better quality results. Marc Rosenthal

Amy Burnett, Vice President, Provider Networks Innovations and Partnerships, Blue Cross Blue Shield of South Carolina and Wendy Warring, Senior Vice President, Network Development and Strategic Partnerships, Boston Children's Hospital presented a session at the World Health Care Conference entitled "Value-Based Contracting: Determine Measures of Quality Affecting Payments.

Burnett talked about the Blues work in South Carolina.

Interestingly when they started to develop their model for bundled payments they first went to the quality staff not the payment staff so that they could understand what was important to reward and where to place incentives. Lesson to long term are providers - if you are going to partner with hospitals in an ACO and bundled payment scenario, you need a seat at the table to talk about the quality measures important to your residents and patients.

More and more reimbursement will be tied to quality. And then payers will share quality data with consumers so that they can make informed decisions.

Warring talked about how Massachusetts has been on an accelerated path with risk contracting. Boston Children's benchmarks 75 measures covering safety, effectiveness, patient-centeredness, efficiency, teaching and community involvement. So while they are prepared for risk only 3% of their payments are tied to it.

She concluded with a great point. The use of quality measures allows them to differentiate themselves from other providers. That can be risky if your quality is not good but it also reflects a willingness to be transparent.

Fostering Quality Innovation

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) recently partnered with the Brown University School of Public Health to create the Long Term Care Quality and Innovation Center, an effort to continue finding innovative ways to improve quality of care in skilled nursing centers across the country.

While the Center will have several objectives, one of the most critical is to research and test best practices that improve quality in long term and post-acute care. The Center is charged with translating those best practices into real-world training and leadership programs that staff in skilled nursing centers across the country can use.

"Our profession is fortunate to have the opportunity to partner with a renowned academic and research institution to help develop and refine methods to improve quality in long term and post-acute care," said Leonard Russ, Chairman of AHCA's Board of Governors. "Quality is a top priority for providers. Through this center, we will disseminate valuable information that can help caregivers make real improvements in their centers."

Much of the outreach efforts will initially focus on providers that are still striving to meet important quality milestones. The Center will aim to link providers with high performers and offer leadership programs within the profession.

The Center will be housed in the Centers for Gerontology and Healthcare Research at Brown, where more than 20 faculty members and their students collaborate to study care for the elderly and chronically ill. Over the years their efforts have produced numerous nationally influential findings.

The new center will be governed by a five-person independent advisory board, with representation from the profession and Brown University.

To help launch the center, AHCA/NCAL provided $1 million in initial funding. The Center will seek projects supported by government and private sector resources, with the goal of becoming self-sustaining over a period of three to five years.

There are many quality initiatives being pursued in the aging services sector. Many overlap. Often you will see many of the same quality organizations in long-term care and aging services cooperating on these initiatives. Sometimes there are separate initiatives being pursued. Being versed in the healthcare players can jump start your education around quality and aging services.


Healthcare quality improvement has traditionally been focused on the clinical aspects of care whether in a nursing home, hospital or in the home. Many skip over the fact that healthcare quality starts with culture change. And that is based in people. Empowered people led by inspiring leaders are the key to quality improvement in aging services. In short healthcare quality improvement and culture change are tied at the hip.

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