A testimonial about the effectiveness of MARCQI
MARCQI’s work extends beyond Michigan

A consultant who has worked with different health systems across the country recently let us know about how data from the Michigan Arthroplasty Registry Collaborative Quality Initiative* has helped to lower costs and reduce variation in the area of total joint reconstruction.

Brad Nash, who has been providing quality improvement consulting services within the orthopedic segment for more than 15 years, is using MARCQI registry tools to encourage surgeons to consider some key changes in their care practices. The tools provide aggregate-level, nonhospital-specific findings, including the Summary of Arthroplasty Registry, or SAR, report, based on clinical data collected by Michigan hospitals and orthopedic surgeons over the past decade.

The SAR report presents the MARCQI hip and knee implant performance data as compared with other arthroplasty registries around the world in an organized format suitable for decision making, including implant selection. In late 2022, MARCQI released an interactive version of the SAR report, now known as the Global Arthroplasty Registry Report Exploration Tool.

“I have found the MARCQI SAR tool to be powerfully compelling,” Nash wrote in a testimonial about how MARCQIs work is extending beyond Michigan. “In many cases, it is the best tool I have because the information it condenses is both objective and deep. Furthermore, the fact that neither device makers nor industry venture capitalists sponsor it means the data are clean.”

Nash’s main areas of focus are total joint reconstruction and the application of bone cement. Throughout his career in supply chain, he has worked for more than 100 hospitals on the West Coast, primarily within California, Oregon and Washington.

Nash wrote that he has had considerable success lowering costs and reducing variation in the total joint reconstruction space. “By a conservative estimate, I have been able to reduce costs by approximately $50 million, most of which comes from renegotiations with suppliers and from surgeons’ voluntary implant changes,” he stated. “The MARCQI SAR (report) compilations provide ‘North Star’ directional pull to the work — along with a higher patient advocacy mandate.”

With suppliers and device makers competing for market share to increase their profits from new products, Nash wrote that he finds this tool more important than ever. “This can have a powerful impact on the surgeons and their patients,” he noted.

He added: “Because I can share the compilation of international registries and implant comparisons provided by MARCQI, it is much easier to effect changes that lower cost, reduce variation and improve quality.”

"Data registries have been the engine that fuels all of the quality improvement activity in the CQI portfolio,” said Faris Ahmad, M.D., medical director, Clinical Partnerships. “The SAR report that has been developed from the MARCQI registry is a great example of how credible, shared data can lead to not just engaging health care providers in quality improvement, but also our health system partners."

Background on MARCQI

Since 2012, MARCQI* has been working to improve the safety and quality of hip and knee joint replacement surgery procedures and reduce unnecessary costs of this care in the state of Michigan. MARCQI’s achievements stem from a data-driven collaboration that connects health care providers and health systems and is rooted in continuous quality improvement engagement. The development of high-value tools for physicians and patients has also contributed to its success.

MARCQI’s successes

In Michigan, from 2012 through 2022, MARCQI continually set new benchmarks for better care. Major milestones include:

• Reducing blood transfusions for hip and knee replacements by 85%
• Lowering post-procedure opioid usage by more than 45%
• Developing a statewide, patient-reported outcomes program that allows physicians to review patient feedback and recovery progress, then adapt care accordingly

Other milestones include post-market device surveillance and public reporting since 2017. The most recent report was published in 2022, and includes two-page summaries for hip and knee.

Blue Cross Blue Shield of Michigan and Blue Care Network provide support for MARCQI as part of the Value Partnerships program.

For more information

• To read more about MARCQI and other CQIs, see the recently posted blog, Collaborative Quality Initiatives Continue to Influence National Care Protocol on the Value Partnerships website.
• To learn more about Value Partnerships, visit valuepartnerships.com.

*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.