CQIs continue to improve health care delivery in the state: Find out how

Collaborative Quality Initiatives continue to do important work that benefits everyone in Michigan.

“CQIs are important for several different reasons,” said Tom Leyden, director, Value Partnership Programs. “For Blue Cross Blue Shield of Michigan, they address areas of care that are high cost. They also collect data on surgical cases that helps the Michigan provider community identify the link between the processes of care, or procedures, and the outcomes – all things that ultimately benefit our members, and beyond that, every patient receiving care in the state of Michigan.”

These statewide quality improvement initiatives, developed and executed by Michigan physicians, engage thousands of doctors and more than 100 hospital partners. They utilize comprehensive clinical registries, which include patient risk factors, processes of care and outcomes of care.

Leyden said that CQIs are unique to Michian.

“These initiatives don’t happen in most states,” he said. “We have the largest collection of clinical registries in the country, if not the world. We also have the largest hospital quality improvement program in the nation.”

Michigan’s CQI programs have been profiled on five continents and in more than 35 countries.

“This is great because it positively impacts our ability to give our members in other states improved care as best practices spread to doctors and surgeons across the country,” Leyden said. “But it’s Michigan members that get the benefit first when it comes to best practices.”

Value Partnerships administers 17 CQIs, covering various areas of care with high costs or high variation in treatment. There are more than 12 million Michigan cases currently captured in CQI databases.

CQIs tackle COVID-19

CQIs typically address various areas of care that are highly technical and rapidly evolving, such as COVID-19 care.

“Because the platform works seamlessly and smoothly, when COVID arrived, the immediate reaction of our hospital CQI leaders was ‘Most of our elective surgeries are on hold, so what can we do now?’” said Sarah Lanivich, senior health care analyst, Value Partnerships. “We saw several of our CQIs coming together and working very quickly with 40 hospitals across Michigan to collect data on hospitalized COVID patients. About five weeks later, they launched the Mi-COVID-19* registry.”

Lanivich said that when the number of COVID cases went down, the hospitals pivoted back to performing elective surgeries again with the help of utilization resource reports generated by another CQI, the Michigan Value Collaborative.*

“And when COVID cases began to resurge, the CQIs pivoted once again and initiated an ICU help line for all Michigan hospitals that was staffed 24/7,” she said. “Hospitals had a hotline to call if they have questions, as well as have access to resources, when complex ICU patients started pouring in. This was in addition to maintaining the Mi-COVID-19 registry efforts. CQIs are always looking at what they can do to make health care in Michigan better.”

Leyden noted that the Michigan COVID-19 registry is one of the largest in the country, with data on more than 3,800 COVID-19 patients collected.

“We’ve been sharing the COVID findings with the American Heart Association and the New York Hospital Association,” he said. “We’ve already released information in the peer-reviewed literature and much of this information has been picked up internationally. If we didn’t have this CQI platform, I’m not sure how we could have responded to COVID as well as we did as a state.”

Other CQI successes

Other recent CQI successes include addressing opioid use after surgery.

“Our general surgery CQI has been able to reduce the use of opioids for a number of surgical procedures post-surgery by 75%,” Leyden said. “Reducing the use of opioids prescribed post-surgery greatly reduces the risk of causing a situation where an individual develops a resulting long-term opioid use disorder as a complication of surgery."

Through the knee and hip replacement collaborative, it was determined that while there were many providers using extended care facilities because it was thought to provide a better outcome for patients, they actually didn’t produce any notable difference in outcomes. Sharing this data with the CQI members helped reduce extended care facility utilization post-surgery.

A win-win situation

For Leyden, Collaborative Quality Initiatives are a win-win for everyone involved.

“It’s a win for our customers, members and providers,” he said. “CQIs reduce cost and complications, while creating an overall quality improvement health care delivery mechanism for our provider partners. Most of all, CQIs have helped the state of Michigan by providing the best health care possible.”

More information on individual CQI programs can be found on the Collaborative Quality Initiatives section of the Value Partnerships website.

*Blue Cross Blue Shield of Michigan doesn’t own or control this website.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.