Quality—it’s an essential and often-tracked measure of how effectively hospitals and clinicians provide patient care across the United States and around the world. Quality is so often cited that it’s at risk of becoming no more than a buzzword; for this reason, local and state governments are getting creative in how they reward hospitals and their staff for providing value-based care.

Although the U.S. government promotes quality and value-based care through various regulations from the Centers for Medicare & Medicaid Services, state and local governments also deserve a nod for their innovative approaches to transform traditional fee-for-service systems into value-based care programs.

California’s Award-Winning Quality Collaboration

The Golden State maintains an online tool that allows residents and visitors to easily compare hospitals based on clinical quality, patient experience and patient safety. “Some hospitals are better than others,” the site points out; it uses public data to rank hospitals from poor to superior. The site is free to use and visitors can search by hospital name, city or zip code.

Cal Hospital Compare is a performance reporting initiative managed by a multi-stakeholder Board of Directors, with representatives from hospitals, purchasers, health plans, and consumer groups.

California rewards hospital quality through its Hospital Quality Institute (HQI), a coalition formed in 2013 that aims to improve patient safety and quality care statewide. The HQI could be a model for other states—the American Hospital Association awarded the organization the 2017 Dick Davidson Quality Milestone Award for Allied Association Leadership for its work to improve health care quality. The award recognizes, in part, how the state formed a partnership among the state and three regional hospital associations to decrease multiple reporting requirements and to streamline quality, patient safety and hospital improvement initiatives.

New Jersey Significantly Slashes Readmissions

The 2017 AHA awards included an honorable mention for the New Jersey Hospital Association. During the past 24 months, New Jersey saw significant, measurable improvements across all healthcare-associated condition areas, as well as readmissions. More than 31,000 cases of patient harm and adverse events were avoided in 2015 and 2016, resulting in an estimated cost savings of at least $261 million, the AHA reports.

The state also turned around its 30-day readmission rate, a major measure of quality of care used by many federal, state and local organizations The rate dropped from 20.3% in 2010, the second highest in the country, to 17.6% in 2015, vaulting New Jersey to a #2 slot among the 50 states.

Ohio’s Quality Initiative Saves Lives and Billions of Dollars

The Ohio Hospital Association also earned an honorable mention from the AHA for its quality improvement programs. Overall, from 2012 to 2016, the collaboration the association formed among more than 100 Ohio hospitals and community partners saved an estimated $8.5 billion. Highlights include a statewide quality collaborative to reduce sepsis mortality. In a 2017 update on the program, the state reports participating hospitals have saved 1,486 lives, for a greater than 13% reduction in sepsis mortality.

Ohio rewards the hospitals participating in the sepsis reduction initiative by naming names and listing them online in a publicly available report.

Rhode Island Revs Up Infection Control Quality

Not to be outdone by larger states, the Rhode Island Department of Health has mandated a healthcare quality public reporting system for all licensed hospitals statewide. Since 1998, Rhode Island has required all these facilities to report clinical outcome and patient satisfaction data. 

In 2009, Rhode Island added a HAI Subcommittee to the program to help track and compare quality based on rates of healthcare-acquired infections. Funding from the CDC has allowed the comparison of nosocomial infections among hospital patients to continue.

The state in a sense rewards hospitals that make significant strides in curbing various types of infections through its public-facing online comparison site.

Four States and Puerto Rico Join Forces to Award Quality

The TMF Health Quality Institute is conducting the Hospital Quality Improvement Award program to recognize hospitals in Arkansas, Missouri, Oklahoma, Texas and Puerto Rico that launch innovative quality improvement initiatives. The main strategy is to publicly acknowledge hospitals that improve patient care and their performance on specific national quality measures.

Goals of the award program include improving patient quality of care for patients through the reliable delivery of inpatient and outpatient services and maximized use of effective care management strategies; and encouraging hospitals to align with the TMF Health Quality Institute and state hospital association quality improvement efforts.

Performance data were collected between April 2016 and September 2017. The gold, silver and bronze award winners will be announced in the third quarter of 2018 and winning initiatives promoted through media campaigns as well.

Helping Consumers Find Value-Based Care

Overarching themes of these state-driven initiatives to improve the quality of care provided by hospitals include data transparency, user-friendly comparison sites, and award programs that recognize facilities that excel in terms of quality. The hope is that public recognition will not only encourage more consumers to choose a high-quality hospital for their care, but to encourage hospitals that need improvement to redouble their efforts and thereby elevate the overall state of healthcare delivery across their state.

Although U.S. agencies will continue to push for quality improvement and increased patient satisfaction through federal regulations, individual states—and consortiums among states—will also strive to make a difference in patient outcomes on the more local level.