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Collaborative Quality Initiatives: A strategy that works for improving health care quality & cost

Can better health care and cost savings go hand in hand? Michigan physicians and hospitals working together in collaborative quality initiatives (CQIs) sponsored by Blue Cross Blue Shield of Michigan and the Blue Care Network (BCBSM/BCN) are proving that collaboration is indeed a powerful model for saving both lives and dollars for patients throughout Michigan.

For example:

  • In one Michigan CQI, hospital deaths following angioplasty and other minimally invasive heart procedures declined 32 percent over five years.
  • Another Michigan CQI saved more than $13 million in one year by reducing the rate of ventilator-associated pneumonia by 29 percent.

Physicians from BCBSM/BCN and the University of Michigan Health System (UMHS) showcased the successes and strategies behind these initiatives at a June 4 health care quality symposium sponsored by the Center for Healthcare Research & Transformation (CHRT).

Each CQI focuses on a particular type of health care delivery: specific heart procedures, or types of surgery, for example. Participating hospitals submit procedure- or condition-specific data to a coordinating center that analyzes the data, identifies best practices, and guides improvement efforts. While the funding for the programs comes from BCBSM/BCN, hospitals submit data for patients who are covered by all payers (BCBSM/BCN, Medicare, Medicaid, self-pay, other commercial health plans, etc.) so quality improvements and cost savings benefit all Michigan residents. And, publication of results from the various CQIs can provide a model for hospitals nationwide.

“President Obama has outlined an ambitious agenda for health care reform,” said Marianne Udow-Phillips, director of the Center for Healthcare Research & Transformation. “As the President and Congress move forward on strategies to change the health care financing system, it is models like this-with real world experience and results-that should inform the dialog on how to reduce cost and improve care.”

“Quality improvement initiatives like these require funds to run and sustain, but the investment pays considerable dividends in improved patient outcomes,” said Tom Simmer, chief medical officer at BCBSM. “These collaboratives have shown we can improve the quality of care and lower the cost, leading to better health care for Michigan residents.”

BCBSM/BCN convened the first collaborative- the BCBSM Cardiovascular Consortium or BMC2-in partnership with UMHS, in the late 1990s, in an effort to improve the quality of angioplasty in Michigan. Today, there are eight CQIs, each with a different clinical focus. UMHS is the coordinating center for seven of the eight; Beaumont Hospital in Troy coordinates the eighth. Some initiatives have national partners; for example, the MSQC, which focuses on general and vascular surgery, partners with the American College of Surgeons’ National Surgery Quality Improvement Program. A full list of CQIs is available on the CHRT website at chrt.test, or on www.valuepartnerships.com.

“When a regional group of hospitals gets together in a collaborative way, it’s possible to identify the best practices behind good results and help the entire group improve,” said Darrell (Skip) Campbell, Jr., M.D., chief of clinical affairs at the University of Michigan Health System and the clinical lead for the Michigan Surgical Quality Collaborative. “When quality improves, costly complications are avoided, and patients get better. That’s what it’s all about.”

Speakers at the June 4, 2009 symposium included:

  • Marianne Udow-Phillips, MHSA, Director, Center for Healthcare Research & Transformation
  • Tom Simmer, M.D., Senior Vice President and Chief Medical Officer, BCBSM
  • David Share, M.D., MPH, Senior Associate Medical Director, Health Care Quality, BCBSM; clinical lead for the CQIs
  • John D. Birkmeyer, M.D., Professor of Surgery, UMHS; representing the Michigan Bariatric Surgery Collaborative
  • Hitinder Singh Gurm, M.D., Assistant Professor of Internal Medicine, UMHS; representing the Blue Cross Blue Shield of Michigan Cardiac Consortium
  • Darrell (Skip) Campbell, Jr., M.D., Chief of Clinical Affairs, Professor of Surgery, UMHS; representing the Michigan Surgical Quality Collaborative

A webcast of the symposium is available on the CHRT website.


The University of Michigan Health System (www.med.umich.edu) is a major academic medical center that includes the U-M Hospitals and Health Centers, the U-M Medical School and its Faculty Group Practice, and the clinical practices of the U-M School of Nursing. UMHS is consistently ranked among the nation’s top institutions for clinical care, biomedical research and medical/life sciences education.

Blue Cross Blue Shield of Michigan, a nonprofit organization, provides and administers health benefits to 4.7 million members residing in Michigan in addition to members of Michigan-headquartered groups who reside outside the state. The company offers a broad variety of plans including: Traditional Blue Cross Blue Shield; Blue Preferred, Community Blue and Healthy Blue Incentives PPOs; Blue Care Network HMO; BCN Healthy Blue Living; Flexible Blue plans compatible with health savings accounts; Medicare Advantage; Part D Prescription Drug plans, and MyBlue products in the under-age-65 individual market. BCBSM also offers dental, vision and hearing plans. Blue Cross Blue Shield of Michigan and Blue Care Network (BCBSM/BCN) are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. For more company information, visit www.bcbsm.com

Health care crisis hurts kids

CHRT Director Marianne Udow-Phillips discusses how the health care crisis impacts children in her May 22, 2009, op-ed in the Traverse City Record-Eagle.

Health-care reform: A shot in the arm for Detroit 3?

CHRT director Marianne Udow-Phillips and vice-chair and U-M associate VP for medical affairs Dr. John E. Billi are quoted in a recent Detroit Free Press story about the potential for national health care reform to boost the recovery of Detroit’s automakers.

Center for Healthcare Research & Transformation releases Cover Michigan — a report on healthcare coverage and access

Cover Michigan, a report on healthcare coverage released today by the Center for Healthcare Research & Transformation (CHRT) shows that while Michigan compares well to the country as a whole, the state is losing ground in critical areas, including the number of Michigan’s children and adults who are uninsured and the percentage of the population covered by private insurance.

“Cover Michigan shows a state under stress,” said CHRT director Marianne Udow-Phillips. “More and more Michigan residents – especially our most vulnerable populations – are facing hardships in obtaining and affording health care. Our health care delivery system is destabilizing as more people are underinsured and uninsured.”Continue Reading Center for Healthcare Research & Transformation releases Cover Michigan — a report on healthcare coverage and access

Covering the Uninsured: Who Has the Will and Who Has the Way?

On Friday, May 2, 2008, the Center for Healthcare Research & Transformation (CHRT) will convene a panel of experts to explore the problem of America’s 47 million uninsured.

“In this election year, voters, candidates and the media are increasingly focused on the issue of healthcare and the uninsured – and rightfully so,” said Marianne Udow-Phillips, CHRT’s director. “We know the public is very concerned about access to health care but when it comes to specifics, it can be hard to find common ground.”

Panelists Catherine McLaughlin, Professor of Health Management & Policy and director of the Economic Research Initiative on the Uninsured, U-M School of Public Health; Kevin Seitz, executive vice president of Health Care Value Enhancement, Blue Cross Blue Shield of Michigan; and Ellen Rabinowitz, executive director of the Washtenaw Health Plan will share their views and join Udow-Phillips to respond to audience questions. Tracy Davis of the Ann Arbor News will moderate.Continue Reading Covering the Uninsured: Who Has the Will and Who Has the Way?

Other Voices

CHRT director Marianne Udow-Phillips’ op-ed.

U-M Health System and Blue Cross Blue Shield of Michigan announce Marianne Udow as director for joint venture

The board of directors of the joint venture between the University of Michigan Health System and Blue Cross Blue Shield of Michigan has named Marianne Udow as the organization’s first director. Called the Center for Healthcare Quality & Transformation, the joint venture is dedicated to improving the quality of Michigan’s health care, and transforming the way patient care is delivered in the state and beyond. Udow will begin in September.

Udow will be an employee of UMHS, which is providing staffing for the Center. BCBSM is providing seed funding, allocating up to $10 million.

Udow is currently the director of the Michigan Department of Human Services, a post she has held since being appointed by Governor Granholm in January 2004. From 1992 to 2004, she served in several executive positions at Blue Cross Blue Shield of Michigan, including senior vice president of health care products and provider services. She was senior vice president of plans and operations at Mercy Alternative and Care Choices from 1986 to 1988. She holds a master’s degree from the University of Michigan’s School of Public Health.Continue Reading U-M Health System and Blue Cross Blue Shield of Michigan announce Marianne Udow as director for joint venture

BCBSM and U-M Health System launch Michigan HealthQuarters, a new organization devoted to improving Michigan’s health care

A new Michigan organization is dedicated to improving the quality of the state’s health care system, and transforming the way patient care is delivered in the state and beyond. Called Michigan HealthQuarters LLC, it is a joint venture of Blue Cross Blue Shield of Michigan and the University of Michigan Health System.

In recent weeks, the organization held the first meeting of its board of managers, launched a national search for its first executive director, and chose the first project that it will undertake: evaluating if lower prescription drug co-payments for people with diabetes can improve the processes and outcomes of diabetes care.Continue Reading BCBSM and U-M Health System launch Michigan HealthQuarters, a new organization devoted to improving Michigan’s health care