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

June 4, 2009 | CHRT Event

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

“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 ( 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