When State Leaders and Regional Health Improvement Collaboratives Come Together

It stands to reason that states and regional health improvement collaboratives (RHICs) have a lot in common. Both are committed to population-based health reform. Both are trying to improve provider and health system performance. Both are using insurance claims data to do it. So what happens when you bring together state leaders and team them up with representatives from their own state’s local private sector improvement collaborative? Can closer collaboration between state and regional efforts help to advance mutual health care improvement goals?

The Fund, with the help of the Network for Regional Health Improvement (NRHI), had a meeting to find out. Teams from eight states gathered to share information about collecting and reporting claims and clinical information—and to work together on state-level planning.

Some important insights emerged:

• Even as states proceed with planning and implementing all- or multi-payer claims data bases (APCDs), some RHICs already have their own. Reasons are many: they started before the states, they wanted more control and speed, or they had specific goals.
• RHICs are using these databases to give feedback to providers on cost and quality measures and to build local cultures of collaboration and improvement.
• States are thinking about their APCDs in much broader and more systematic ways, using them to support state policy priorities or improve inter-agency activities, such as rate review and provider and patient identifier development.
• Claims information is limited in what it can tell researchers and policymakers. We are a long way away from integrating richer, but more fragmented clinical records.
• State-led planning processes may be cumbersome, but are the only way to develop public consensus on sensitive issues such as information privacy, usage priorities, and sustainability models.

These insights, and more, will be captured in an upcoming Milbank Memorial Fund publication, produced in collaboration with the NRHI.

See Christopher Koller’s reflections on the challenges of public-private partnerships, triggered by this session.