Cost, value, and policy in quality: Evolving relationship of payers and providers.

Abstract

44 Background: Cancer Treatment Centers of America (CTCA), a network of five hospitals, has multiple pay for performance contracts. Some apply to all hospitals, while others are unique to individual facilities. While many metrics are managed by site, some metrics are collected and measured centrally by corporate. Varying levels of oversight were required from site quality teams, executive teams and externally-facing corporate departments. In order to coordinate these efforts, CTCA implemented a real-time tracking system for monitoring pay for performance metrics. Methods: CTCA’s corporate Quality department designed a central repository for monitoring metrics that is populated monthly using customized workbooks submitted from each site. The central repository compiles monthly data and displays it in several formats broken down by timeframe, site and contract. The repository incorporates features allowing easy sharing and data accuracy. An accompanying process for collecting data was created to ensure timely, efficient updates to the repository. Results: The monthly monitoring process was implemented in January 2014 and continues to operate successfully. For one enterprise-wide contract cycle closing on April 31, CTCA met requirements and outperformed the contract-specified goal for each by an average of 19.8%. Pre-implementation, metrics were monitored quarterly. Although two metrics showed a small (<2.5%) decrease in average performance, given the intensified focus, the remaining metrics showed an average 7.95% improvement in performance during the second six months with monthly monitoring. Metrics associated with the remaining contracts are on track to meet or exceed specified performance standards. Conclusions: The new tool and monthly reporting process successfully monitored pay for performance metrics at CTCA. Most importantly, the system allowed for close to real-time assessment and therefore promoted ongoing intervention if warranted. The repository created a single source of data sharing and visibility for these important elements of performance. As CTCA continues to participate in pay for performance activities, this method will be adapted to accommodate more contracts and metrics.