QualityPath designate quality doctors to change healthcare ‘where we live and work’
The Alliance, a cooperative of employers that self-fund their health benefits, is creating a path to high quality care at a lower cost to transform the local marketplace.
The Alliance QualityPath program is one of few nationwide that measures the performance of a specific doctor at a specific hospital. Other innovative elements include:
- Focusing on high-stakes procedures: total hip replacement, knee replacement and coronary artery bypass graft (heart bypass surgery).
- Using national measures of quality to assess hospital-and-doctor pairings.
- Requiring participating doctors and hospitals to adopt processes that lead to better care for patients. For example, doctors and hospitals must use technology to prevent overuse of imaging, which exposes patients to harm. They engage in shared decision-making so patients weigh the potential benefits and harms of the procedure.
- Applying bundled pricing, which means a fixed price is charged for the entire surgical procedure. Employers have the option to include follow-up care, such as physical therapy or cardiac rehabilitation, as part of the bundle or to cover it separately at local providers.
- Offering a 90-day warranty to protect patients from costly complications or re-operations.
- Eliminating out-of-pocket costs or deductibles when using QualityPath.
- Providing a patient experience manager to offer personal guidance.
“We are changing health care where we live and work,” said Alliance President and CEO Cheryl DeMars. “We’re answering the key questions everyone has when the stakes are high: Which doctor should I use? And which hospital?”
The Business Health Care Group, a coalition of large and small employers in southeastern Wisconsin, is a co-developer of the project.
