Community Leadership in 

Value-Driven Health C

The Wisconsin Collabo

for Healthcare Qual

W
WISCONSIN COLLABORATIVE FOR HEALT

WISCONSIN COLLABORATIVE FOR HEALT

WE ARE . . .. . . A voluntary Consortium of organizations learning together to improve the quality and cost-effectiveness the people of Wisconsin.

WHAT WE DO . . .We will develop and publicly report measures of healtto drive improvement in care; design and promote quainitiatives; and, advocate for enlightened policy which WHAT WE ASPIRE TO BE . . .We will be a recognized and respected national leadereporting; an organization of integrity and trust; transpin its governance and core process; and, willing to inncontinuously improve.
• Aurora Advanced Healthcare

• Affinity Health System• Aspirus Wausau Hospital• Aurora Healthcare• Aurora UW Medical Group• Bellin Health• Columbia St. Mary’s• Dean Health System• Franciscan-Skemp Healthcare – 

Mayo Health System

• Froedtert & Community Health• Gundersen Lutheran• Hospital Sisters Health System • Lakeshore Medical Clinic • Luther Midelfort-Mayo Health 

System

• Marshfield Cl• Medical Asso• Medical Colle• Mercy Health • Meriter Hospi• Monroe Clini• Prevea Health • ProHealth Car• St. Joseph’s H• St. Mary's Ho• West Bend Cl• ThedaCare• UW Hospital • UW Medical • Wheaton Fran

MEMBER ORGANIZAT

40% of all WI physicians; 50% of WI primary care 
Business And Purchaser Pa

The AllianceAppleton PapersBadger MeterChryslerGE HealthcareSchneider NationalBusiness Healthcare Group of 

Southeast WI

Serigraph, Inc.

WebCraftersWisconsin Man

& Commerce 

Greater Milwau

Foundation o

Wisconsin Depa

Trust Funds

Wisconsin Depa

Family Servi
A BRIEF HISTORY OF W

10/2002: CEOs gather to discuss working together for qual02/2003: First meeting of WCHQ10/2003: WCHQ releases Performance & Progress Report 

04/2004: Launch of WCHQ Ambulatory Measure Workgro08/2004: Diabetes ambulatory measure created11/2004: Diabetes ambulatory data collected11/2004: First WCHQ “Fall Forum”04/2005: Launch of WCHQ.org; diabetes data published06/2005: Hospital Quadrant Analysis Published11/2005: Second WCHQ “Fall Forum”; HTN data publishe12/2005: Postpartum data published01/2006: WCHQ selected as initial pilot by AQA07/2006: Colorectal, Pap, Mammo measures published 11/2006: Third WCHQ “Fall Forum”02/2007: WCHQ selected as “AF4Q” Community05/2008: CAD, Pneumococcal Measure Published 
The WCHQ Model of Direct Data 

• Key Characteristics

– Voluntary data collection by provider organizat– Administrative data (denominator) combined w

information (numerator) 

– Performance Measurement at the group level, a

regardless of payer
What’s The Value?

• System view of performance with ability to dri

level

• All patients within a system are included in the • All payers are represented• Delivers roadmap for improvement• Foundation for pay-for-performance
www.wchq.org
Ambulatory Care Measu

Process and Outcome

Chronic Care

– Diabetes Care

• A1c screening • A1c control• LDL-C screening• LDL-C control• Nephropathy monitoring• Blood pressure control

– Control of Uncomplicated Essential Hypertens

• Blood Pressure Control

– Cholesterol Management of Patients With Car

• LDL-C Screening• LDL-C Control
Ambulatory Care Meas

Process and Outcom

• Preventive Care

– Breast Cancer Screening– Cervical Cancer Screening– Colorectal Cancer Screening– Pneumococcal Vaccinations

• Episodic Care

– Postpartum Follow-up

New Measures Coming

• Adult Screening for Tobacco Use – Fall 2008• Screening for Osteoporosis – Spring 2009
WCHQ Consumer Engagemen

Key Tenets, 2004-Prese

• Primarily designed to support provider benchma

improvement

• Report unadulterated information and allow the 

his/her own conclusions

• Design web site for maximum flexibility in organ

displaying information (trends, ranking)

• Encourage business partners to incorporate WCH

open enrollment and decision support materials
WCHQ Consumer Engagemen

Experience and Emerging T

• Website utilization statistics reveal primary users 

researchers, public agencies (federal and state)

• “Aligning Forces” / RWJ – sponsored research

– Low level of awareness of WCHQ and other W

transparency sites

– Patient activation (“Ask Me 3”, teach back) m

complementary strategy
Near-Term Evolution of t

WCHQ Measures Portfol

• Resource Use / Cost-of-Care Measures• Ambulatory Quadrants• Specialty Measures• Practice-Site Granularity
Thoughts on Physician-Level R

• Numerous unresolved policy and methodological i

– Care process and systems emphasize teamwor

– Significant issues with reliability of performan

specialties

– Basic questions of “fairness” to those being me– Usefulness of data that offers questionable reli

consumers

• “Patient Charter” represents significant mechanis

stakeholder interests
LESSONS LEARNED 

• Multiple stakeholder involvement • Shared Vision• Importance of “sweat equity”• Physician leadership helps foster physician en• Credible, reliable data