期刊
ANNALS OF SURGERY
卷 246, 期 6, 页码 1100-1103出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SLA.0b013e31815c3fe5
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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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