Features  |   December 2014
The Data Is the Beginning, Not the End
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Quality Improvement / Features
Features   |   December 2014
The Data Is the Beginning, Not the End
ASA Monitor 12 2014, Vol.78, 26-28.
ASA Monitor 12 2014, Vol.78, 26-28.
“Reimbursement rates,” “pre-authorization,” “coverage.” When most anesthesiologists consider their relationship with their primary payer, they are likely to focus on these phrases. However, a novel partnership between anesthesiologists and Blue Cross Blue Shield of Michigan (BCBSM) hopes to change these phrases to include “partner,” “advocate” and “catalyst.” Building upon the mature infrastructure of the BCBSM Value Partnership portfolio (www.bcbsm.com/providers/value-partnerships/value-partnerships-overview.html) and the Michigan Surgical Quality Collaborative (MSQC, www.msqc.org), anesthesiologists in Michigan are embarking on a quality improvement journey that breaks down historical competitive barriers across payers, hospitals, surgeons and anesthesiologists.
As described in other articles in this issue of the ASA NEWSLETTER, the Collaborative Quality Initiatives (CQIs) funded by the BCBSM Value Partnerships program have transformed the payer-provider relationship in Michigan. The CQIs enable motivated physicians and hospitals to assess variation in practice, identify local/regional best practices, and measure process adherence and patient outcomes. By funding the majority of data collection costs, BCBSM overcomes one of the greatest obstacles to widespread benchmarking and QI. More importantly, BCBSM does not request access to the data itself, creating the honest, “safe” environment needed for meaningful self-assessment and practice improvement.
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