Li. Solberg et al., COMPETING HMOS COLLABORATE TO IMPROVE PREVENTIVE SERVICES, The Joint Commission journal on quality improvement, 21(11), 1995, pp. 600-609
Background: In July 1993, an unusual collaboration developed between c
ompeting managed care plans and with competing primary care clinics as
part of a federally funded research grant (IMPROVE from the Agency fo
r Health Care Policy and Research). The goal of this collaboration is
to scientifically test the ability of an health maintenance organizati
on (HMO) to improve the delivery of eight adult preventive services by
training and facilitating the use of continuous quality improvement a
nd prevention systems by contracted private primary clinics. Methodolo
gy: In order to conduct this effectiveness study, it was necessary two
HMOs to come to a structural and functional understanding of how to o
perate jointly. Investigators recruited 44 private clinics for a rando
mized controlled trial in which 22 are being assisted in improving the
process used to deliver these preventive services and 22 are being le
ft alone as comparison clinics. The intervention is a train-the-traine
r and consultation approach focused on clinics as collaborating custom
ers. The comparison will be based on repeated surveys of patients and
clinic personnel as well as chart audits to measure changes in systems
and prevention rates. Summary: Although this project was made possibl
e by a number of unusual favorable factors, it can serve as a model fo
r support of the clinician leadership that is essential to true health
care delivery reform.