1. The Path to Quality Care

2. Presentation Overview
> Our “theory of change” and the critical
role for employers
> QualityPath™ as a way to accelerate
progress
> Quality improves with full transparency
and incentives
> A real-life example

3. Aim: Improve health care value
High quality, safe care at the lowest possible cost
Consumers choose high
quality low cost providers.
Employers reward high quality,
low cost providers
• Reimbursement (P4P)
• Network composition (tiering)
• Benefit plan design (steerage)
Providers improve value
of care
Employers see business case
for rewarding high value
providers
Employers are aware of cost
and quality differences
Cost and Quality Transparency
Consumers are motivated to
use information (or barriers
to use are removed)
Consumers are aware of
cost and quality differences
Providers see business case
to improve and have knowledge
and resources to change
Providers are aware of their
performance (cost and quality)
and perceive information
is valid

4. QualityPath™
> High-cost elective procedures
 Cardiology and orthopedics, to start
> Quality evaluation
 Clinician + hospital pairing
 Best available data and measures with input from
clinicians and hospitals
> Appropriate in the first place
> Physician and patient shared decision
> Track record for high-quality outcomes
 All who meet or exceed threshold for quality will
qualify for next phase

5. QualityPath™ (Continued)
> Lower negotiated price available to
employers who implement plan designs to
encourage employees to use QualityPath™
physician + hospital
> Support from The Alliance
 Employee communication and support
 Plan design options
 Evaluation – what’s the impact?

6. Quality improves when
providers compete
> An individual practice is a unique ‘production’ line
> Interventions aimed at all patients
> Incents strategies to re-engineer care
> Embed care management processes
> Quality improves for all patients
> Robust quality measures
Getting better outcomes requires
new thinking, leadership,
collaboration and courage.

7. All-or-None Colonoscopy
Quality Index
> Each of the measure’s nine elements is part of the
complex process of performing colonoscopy. They
ALL have an integral role in high quality colonoscopy.
> Taken together, a high Colonoscopy Quality Index
score reflects high process reliability.
> This is analogous to Atul Gawande and Peter
Provonost’s work on surgical checklists to improve
the reliability of surgical processes that has
demonstrably saved lives and decreased costs.

8. www.qualityquest.org

9. Transparency Prompts Action
Colonoscopy Quality Index Trend
Transparency provides recognition
for those doing well and motivation
for those who are not.
Public reporting begins

10. Trek’s journey to quality care
> Trek is committed to managing health
benefits & improving employee
wellness
> Yet that approach is “not enough”
> Exploring QualityPath™:
 Paying for better outcomes
 Gaining C-suite support
 Changing the marketplace

11. HTTP://WWW.THE-ALLIANCE.ORG
Join us on the QualityPath™

12. If you would like to Learn more about The Alliance please visit our
website at: www.the-alliance.org
Call us at 1.800.223.4139 or email us at
thealliance@the-alliance.org
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