The Quality Alliance is a program through which independent physicians and employed Cleveland Clinic physicians can collaborate around quality and value in healthcare.
 
The goals of the Quality Alliance are to develop a network, led by its physician members, which will improve quality and consistency of care; reduce costs and increase efficiency; and provide access to data analytics and professional expertise. By practicing in accordance with evidence-based clinical protocols and gaining performance feedback, physicians in the Quality Alliance will document and provide higher-quality, more efficient care, making the Quality Alliance the best value healthcare network in Northeast Ohio.

Independent physicians will benefit from joining the Quality Alliance by gaining the ability to differentiate themselves based on demonstrably higher quality clinical care through the adoption of evidence-based clinical protocols. Independent physicians will also be able to deliver more efficient care through shared participation in a common data repository and reporting system. The Quality Alliance offers independent physicians the opportunity to collaborate with Cleveland Clinic in achieving high quality standards while still maintaining their private practice.

Through participation in the Quality Alliance, physicians will have the ability to deliver higher quality, more efficient health care, potentially leading to recognition by Northeast Ohio health plans and employers.
 
Additional benefits include:

• recognition in the community as a physician practice network based on technology, innovation and extraordinary quality of care
• access to the most complete history of medical care available for your patient – at the time of initial visit
• electronic tools to streamline common taskssuch as, maintaining and accessing patient records, referrals, admitting patients, utilizing disease registries, prescribing medicine.ability to ease into new IT systems with minimal disruption to existing office systems and protocols
• gaining IT equipment necessary to link centralized information
• reduced medical errors
• improved patient outcomes and satisfaction
• more efficient provision of care
• assistance in monitoring and patient compliance
• enhancedquality of physician-patient relationships
• easy access to “best practice” Clinical Care Guidelines, community disease programs, case management programs
• ability to create our own Clinical Guidelines and monitor members for compliance
• ability to sell combined services to insurers and other payers
• assistance - both medical and technological - to succeed in pay-for-performance, quality- based incentive programs and value-based pricing
• Receive support needed to keep independent physician practices in business, providing an alternative to the employed physician model
• access to ongoing education and training as needed to meet higher patient outcomes
• a higher degree of interdependence, cooperation, and seamless care among primary care physicians, specialty care physicians and other providers such as hospitals, labs, and radiologists.

“Clinical Integration” is a legal and regulatory term. The Federal Trade Commission and the Department of Justice define Clinical Integration as:
 
“...the network implementing an active and ongoing program to evaluate and modify practice patterns by the network’s physician participants and create a high degree of interdependence and cooperation among the physicians to control costs and ensure quality.” (Source: DOJ and FTC, Statements of Antitrust Enforcement policy in Health care, Statement 8).
 
The Quality Alliance has been designed to meet the FTC’s four primary requirements for a clinically integrated independent physician network, as follows:

• Physician-developed clinical protocols
• Common data repository and reports
• Physician-led care review
• Mechanisms assuring adherence to protocols

Cleveland Clinic hospitals will benefit from membership in the Quality Alliance by further aligning the care provided with the objectives of independent physicians in Northeast Ohio, which enables the organization to continue to provide the highest quality care and value to the community. By improving alignment with independent physicians, Cleveland Clinic also gains the ability to better manage the additional risk prescribed by alternative payment models, such as episode-based payment, that may result from healthcare reform initiatives.

The Quality Alliance requires participating physicians to refer within the network, if possible, as referrals outside of the network will impact the Quality Alliance’s ability to capture a complete data set. Because the network includes Cleveland Clinic employed Physicians, there should be a Quality Alliance participating physician available to meet patient needs. An outside referral may be made if there is not a physician or specialist participating in the network or if patient preference is a factor.

Evidence-based clinical protocols are an essential component of the Quality Alliance. Regardless of participation in the Quality Alliance, it is certain that measures will be mandated in every part of a physicians practice as Medicare, Medicaid, and commercial payers struggle with ways to improve the quality of care while managing costs.
 
The clinical measures are designed by Quality Alliance physician members, and establish standards of quality and safety. They are created for each specialty represented in the network.
All Quality Alliance physician members are expected to contribute to the development of clinical measures either through a comment forum, or by participation in Quality Alliance governance committees.

 
All Physicians who participate in the Quality Alliance will utilize the same, physician-developed protocols and be monitored for compliance against these protocols. Results will be shared on a regular basis with each member physician so that physicians can compare their own performance with that of their peers and national benchmark data. Aggregate results will also be reported to the Quality Alliance Finance and Quality Committee as well as the Board of Trustees. In addition, results will be shared on an aggregate basis with Quality Alliance customers such as health plans and employers.
 
Regular reporting and feedback will allow member physicians to measure and compare clinical outcomes, efficiency, patient safety and satisfaction, ultimately driving the overall quality of care provided by the Quality Alliance.

Yes, Members of the Quality Alliance are now required to be on an OHIP (Ohio Health Information Partnership) preferred EMR.

The requirements to support the Quality Alliance’s data repository and reporting system include technology that most physician practices already have in place, such as computers, printers and internet connectivity. The 2009 American Reinvestment & Recovery Act (ARRA) provides money for meaningful use of electronic health records. The IT and Finance Subcommittees are working to ensure that CMS requirements are met so that member physicians will be eligible to receive ARRA funds based on the stimulus plan’s requirements should they need to purchase the items mentioned above. If you have questions about costs for your specific practice. We can set an appointment with MyPractice Community to come to your office and provide an estimate.

Internal Medicine, Family Practice, and Geriatrics.

Access to a common clinical data infrastructure is critical to the Quality Alliance’s ability to demonstrate, track and improve its performance. The QA contracts with a third-party vendor to implement a data repository and reporting system that collects and stores information from the various independent practice management systems and electronic medical records (EMR). This will enable member physicians to access clinical information, data and reporting through a secure portal which is protected by the third-party vendor.

Your office will need to share information on disease conditions, lab work and imaging. You will also need to record data on patient vital signs and compliance. Clinical measures will be available on the QA web site, and our goal is to make them helpful and effective rather than onerous. Implementation and ongoing support will require minimal interruption of day-to-day workflow in your medical office.