Value, 2005

Premier, Inc.

August 2005

Premier, Inc., a not-for-profit U.S. health care alliance of hospitals and health care systems, is using AHRQ research and data in multiple efforts to improve patient safety and evaluate hospital performance. First, Premier has incorporated selected AHRQ Quality Indicators in its Perspective Suite of products to provide member hospitals with timely access to comparative quality data. Another effort is a pilot pay-for-performance program with the Centers for Medicare & Medicaid Services (CMS).

Former AHRQ senior research scientist for quality indicators, Denise Remus, PhD, RN, is now Vice President of Premier's Clinical Informatics. Remus says that Premier is using the AHRQ Patient Safety Indicators (PSIs) to provide member hospitals and clients with details on potential adverse events and complications.

"Reports provide hospitals with comparative data to assist in prioritization of improvement efforts. Within the secure reporting environment, hospitals can then drill down to the individual patient level to examine diagnoses and procedures, care processes, and other variables to assist in identifying opportunities in clinical quality and efficiency," Remus explains.

In another effort, CMS and Premier have partnered in the first national project to examine the impact of economic incentives on quality of care. With the Hospital Quality Incentive Demonstration Project, CMS and Premier developed a program that pays incentives to top-performing hospitals and establishes a performance baseline to encourage the lower performers to improve.

Remus notes, "Across the country, more than 270 hospitals are participating in the pilot program, representing all types of facilities: rural, urban, teaching, and non-teaching. Hospital sizes vary from those with fewer than 50 beds to some with more than 700."

Hospitals participating in the demonstration project will be eligible for increased Medicare payments in five clinical areas if they are among the top performers. The top 10 percent of hospitals in each clinical area will receive a two-percent increase in Medicare payments. The next 10 percent will receive a one-percent increase.

The clinical areas being evaluated are heart attack, coronary artery bypass graft, heart failure, community-acquired pneumonia, and hip-and-knee replacement. The project uses 34 quality measures for these clinical areas, including four of the AHRQ PSIs. Other quality measures were incorporated from the National Quality Forum, JCAHO, CMS, the American Hospital Association, and the Leapfrog Group.

Premier is based in San Diego, California. The 200 hospitals and health care systems that own Premier operate or are affiliated with 1,500 hospital facilities and hundreds of other care sites. Premier's resources support health services delivery, including group purchasing, insurance programs, and performance improvement services of many kinds.

Impact Case Study Identifier: CDOM 05-02
AHRQ Product(s): Healthcare Cost & Utilization Project—Quality Indicators (HCUP-QI), CMS Pilot
Topic(s): Patient Safety, Quality
Scope: National

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