Let’s face it, nobody really loves change unless it
doesn’t mess with your world or you are assured of being a big winner -- no
risks, please. In most circumstances, the status quo is comfy. Change is pain.
Okay, okay, I could rightfully be diagnosed as either a disruptive innovator or
a being who is drinking too much coffee.
While a majority of physicians and hospitals, and a good
number of cardiology practices, are digging in their heels to protect against the looming and threatening-appearing changes afoot in
health system reform, others are entrepreneurially moving forward to be
positioned as winners in the future. Betting on those kinds of practices and
innovators now will be the CMS' Center for Medicare and Medicaid Innovation (CMI) in the
grants they will soon be awarding. They are already sponsoring a two dozen accountable care organization (ACO)-like pilot projects for group and solo practice volunteers.
And now, the Robert Wood Johnson Foundation, AHRQ (the HHS
Agency for Health Care for Research and Quality), and the ONC (the HHS
Office of the National HIT Coordinator) have teamed up in aligning their grant-giving to foster the same thing, but in this case the focus is on improving
care and health status at lower costs in entire geographic communities,
and in both private and public health care services.
David Blumenthal, Carolyn Clancy, & Risa Lavizzo-Mourey write about these plans as directors of ONC, AHRQ,
and the RWJF in a Health Affairs blog this month. They point out that
“if you’re looking for a transformation in health care, look first to
America’s cities, towns and communities. That’s where it happens, among local
men and women who deliver and receive care, and the employers and consumers
who pay for it.”
They are together now funding more than half a billion dollars in various
regions. They point out that money alone won’t improve quality and reduce
costs. Rather, for that to happen, teams of local leaders from a range of
perspectives must design and implement tailored changes in the way their
region organizes, delivers and pays for health care. Each of the projects is
- RWJF’s Aligning Forces Program kicked off in 2006, and has engaged consumers and providers to measure the
performance of docs and hospitals, reporting it publicly, and
improving the quality, cost and equality of care being delivered. The
Aligning Forces regions are beginning to explore payment reforms to help sustain
and increase local improvements in quality.
- ONC’s Beacon Communities has joined the regional
improvement effort with a large three-year grant, helping select regions use
health IT as a community foundation on which to improve health and health
care by being on the cutting edge of electronic health record adoption and
IT-supported care coordination, quality improvement, payment reform and
population health initiatives.
- Aid To Communities From AHRQ
funds tools to build and sustain local collaborative leadership, engage the
public and increase performance measurement, and create incentives for
quality and improve preventive services. AHRQ’s Chartered
Value Exchange project (CVE), in particular, is helping 24 select regions
systematically improve the quality and value of health care provided locally.
If your practice, hospital, or community isn’t involved
in one of these efforts, or isn't preparing for a CMI innovation grant, sitting
around griping about change isn’t going to position you well in the future.
The ACC is using NCDR and PINNACLE, FOCUS (imaging AUC), and other programs
in CV care to give any of you who really are ready for needed change to be a
the forefront on those communities and groups ready to get involved in
creating a better future.