State Quality Improvement Institute

State Quality Improvement Institute

Frequently Asked Questions

• How will the Quality Institute be structured?

The Quality Institute will begin in the spring of 2008 with site visits, but will officially kick-off with an intensive 2½ day meeting that will require four to eight state team members from each of the nine states to convene for an active, working discussion of major issues of health care quality improvement. Each state selected will participate in a highly interactive, team-based process for developing policy and program recommendations. Participant teams will meet with experts (faculty) to assess current challenges, analyze strategic policy options, and revise or refine current state-specific plans. During subsequent months, teams will benefit from a variety of tailored technical assistance activities and a final in-person meeting in the spring of 2009.

• How will the Quality Institute benefit states?

State teams will have access to targeted technical assistance for quality improvement that includes specialized consultations with staff and faculty. The Institute also provides states with the opportunity to coordinate internally, and learn from peers in other states. The in-person meetings will facilitate both learning and networking. The Final Meeting also presents an opportunity for states to take stock of their progress on the objectives outlined in their respective action plans, and learn more about the activities undertaken by others during the course of the Institute.

• In the application do you want us to address all of the domains (e.g.,value-based purchasing, data collection and transparency, care coordination and disease prevention and wellness promotion)?

It is not necessary for applicants to address all four of the policy domains. If you have activities ongoing in all four areas, or if your team is interested in pursuing all four of those domains as part of a quality improvement plan, then we'd be interested in hearing about your approach.

• Which dimensions from the State Scorecard are we allowed to choose from in our application?

The applications are limited to those measures found under the Quality and Avoidable Hospital Costs dimensions. This includes efficiency.

• Is it acceptable to focus the state's quality improvement efforts on a subset of the population, for example the Medicaid population?

Ideally we are looking for state-wide action on measures. The reason the application comes from the Governor's designee is because we're looking for cross agency and cross public/private stakeholder collaboration in this project.

However, if you do choose to focus your efforts on a sub-population, that would be acceptable as long as the results of the Quality Institute work were to be shared with other stakeholders in the state.

• What is the financial award to the states?

There is no financial award to the states, other than the financial support of 4 team members to attend the Kick-off Meeting, as well as the Final Meeting in Spring 2009. The award to the states is their participation in the Quality Institute meetings and the technical assistance offerings. There is no additional grant support provided.

• What are the details of the state team composition?

Ideal teams will be composed of some or all of the following state-level officials: the governor's health policy advisor, the health and/or health services department secretary, the Medicaid director, the insurance commissioner, legislators (or staff), and the state employee health plan administrator. The team may also include decision makers from key private payers, major purchasers/employers, and the advocacy community, as well as representatives from the medical provider community, including hospitals, physicians, and other practitioners. The key in the application is to be able to demonstrate that the core team in attendance includes some key decision makers.

Though the Quality Institute will financially support the participation of 4 team members, states may bring up to 8 people total to the Kick-off Meeting and the Final Meeting provided they can cover their costs with state dollars. Also, we envision that there will be a much larger group of people who remain in the state as part of the team working towards quality improvement.

• What will the on-site visits look like?

The on-site visits will essentially be a half day meeting, with as many members of your state team as possible. AcademyHealth and Commonwealth Fund staff will come to one location in the state to meet with as many state team members as possible (but at least all of those planning to attend the kick-off meeting) to assure that all members of the state team have an opportunity to review and discuss the state's quality improvement goals and strategies in preparation for the Kick-Off Meeting. Additionally, your team may be asked to provide more specifications about some of the components of your application (e.g., a draft work plan, additional state data). The visits are designed to help state teams prepare to get as much as possible out of the Kick-off Meeting and to ensure that the team lays the groundwork to make that happen.

• Who will be on the faculty?

The specific faculty members have yet to be chosen. We will be looking closely at applicant proposals to see which measures surface most often as areas of focus, and then choosing faculty with expertise that aligns with those measures. We anticipate a blend of faculty with proficiency in each of the relevant policy domains, as well as process and measurement expertise.

• What will the technical assistance consist of?

Aside from the 4 cyber-seminars, the technical assistance provided may include background research, access to reports, and expert consults. To some extent, however, the nature and kind of technical assistance offered will depend on the needs expressed by the participating states.

We expect the faculty at the Kick-off Meeting will continue to follow up as needed or as requested by the states, which could entail additional phone or in-person meetings. It also may become apparent at the Kick-off Meeting that we need to bring in additional faculty to address certain unmet needs.

We also plan to make good use of the Quality Institute Web site – possibly creating bulletin boards, a consolidated reference center, and other resources.