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  • Title: The Michigan surgical quality collaborative: will a statewide quality improvement initiative pay for itself?
    Author: Englesbe MJ, Dimick JB, Sonnenday CJ, Share DA, Campbell DA.
    Journal: Ann Surg; 2007 Dec; 246(6):1100-3. PubMed ID: 18043116.
    Abstract:
    OBJECTIVE: In this article, we detail a unique collaboration between hospitals in Michigan and a major third party payer, using a "pay for participation model." The payer has made a significant investment in this regional surgical quality improvement (QI) program and funds each center's participation. RESULTS: Based on the documented costs and incidence of surgical complications at our center, we estimate that a 1.8% annual reduction in complication rates is required for the payer to recoup its investment in this regional QI program. If we achieve our goal of a 3% reduction in complications per year over the 3-year program, the payer will save $2.5 million in payments. Our findings suggest that only a very modest improvement in surgical results, of a magnitude that seems realistically achievable based on similar QI initiatives, is necessary to financially justify payer involvement in a statewide quality improvement initiative. CONCLUSION: The framework of this program should be used by surgeons to attract private payers into QI collaboratives, facilitating improved patient outcomes and decreased health care expenditures.
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