Measuring health care value in Oregon: Ambulatory care
As consumerism in health has gained momentum these past few years, so has the list of organizations attempting to identify, quantify, report and reward quality health care delivery. At present, several hundred programs that use measurements for public reporting and value-based purchasing are being implemented in the United States. Concerns about quality care appear to be valid. We are by now very familiar with the quality chasm report from the Institute of Medicine, and the RAND Corp. study showing that basic health care is delivered according to generally accepted evidence-based guidelines only about 54 percent of the time.

There are many complex challenges associated with the measurement of quality in health care. But one challenge that we must seek to avoid is the proliferation of multiple sets of quality measurement standards among different payers, employers or miscellaneous consumer groups that leads to confusion and dilutes the intended effect these programs have among providers. In an attempt to meet the challenges, Regence, based upon its four years experience at the leadership level of national organizations and in the Northwest, is providing expert advice to the Oregon Health Care Quality Corp (QCorp). QCorp has enlisted an expert committee charged with deriving a shortlist of ambulatory quality measurements for primary care in Oregon. The expert committee consists of clinicians and non-clinicians representing many of the payers, medical professional associations, employer associations and the public-sector with the hope that a single set of standards can be derived through consensus. Widespread input from the provider community on the process is being sought, as this is essential and fundamental to engagement of providers in the improvement cycle. Thus far, provider feedback has ranged from understanding skepticism to enthusiastic engagement.

From my vantage point, it has been very exciting to see this high-energy, collaborative effort rapidly gain momentum. Input from the entire community of health care stakeholders is being sought and generously provided. Over the next few months, we will be hosting meetings with many provider groups in an effort to gather as much feedback as possible. I hope that you will take advantage of these opportunities, or contact me directly to learn more or to provide input. You may call me at (503) 225-5170 or send your e-mail to rmprows@regence.com.

You can read our 2005 Community Relations Summary to find out more about what Regence is doing to make a difference in our communities.