Letter from the Executive Director: December 2017

Last week was an exciting one for the Alliance, as we released the eleventh version of the Community Checkup report. The report includes the third results for the Washington State Common Measure Set for Health Care Quality and Cost, a set of 56 measures used to track progress in our state and a key component of the Healthier Washington initiative.

The Community Checkup has evolved tremendously over the years. In 2008, we reported on 21 quality measures for 14 volunteer medical groups in 5 counties, encompassing 1.6 million insured lives. Our 2017 results include over 100 measures of quality and patient experience with results for 39 counties, 9 ACHs, 300 medical groups, 1000 clinics and over 90 hospitals and 16 health plans. Our voluntary All Payer Claims Database has 4 million commercial and Medicaid insured lives. This dramatic growth is the result of two key characteristics – trust and collaboration. Thanks to so many members who engage with us in our work and for the spirit of collaboration that is foundational in all that we do.

Let’s turn now to the results of the 2017 Community Checkup. Overall, our state results fall far short of our goal to be in the top 10% nationally on most important measures of quality. Additionally, variation in care remains a significant and persistent problem.

That said, it’s important to stay positive and celebrate our successes. Many people across our state are working hard to improve and make a difference. Collaboration, aligning efforts, shamelessly stealing and implementing effective strategies, and aligning payment with outcomes will help us move the needle faster and more dramatically than we have to date.

At the same time, let’s stay realistic about where we are and the distance we need to travel to reach our goal of being in the top 10%. Foster honest dialogue about the challenges ahead and what needs to change to drive improvement. Expand transparency to advance the work, but don’t stop there. ACTION is the critical next step.

Purchasers need to actively embrace benefit design strategies that encourage use of evidence-based care and discourage overuse of care that doesn’t add value and may increase the risk of harm. Providers need to change practice patterns to ensure that patients are receiving evidence-based care at the right time for the right reason. Health plans need to ensure provider payment is linked to value, not volume, and offer products that reward consumers for doing the right thing. And consumers need to take an active role in their own care to make sure that they are spending their health care dollars wisely.

The Community Checkup has become the go-to resource for unbiased, trustworthy data about the quality of health care in our state. The report has earned Washington state an “A” in physician quality reporting from a collaborative analysis done by two non-profit organizations, Altarum and Catalyst for Payment Reform. Washington is one of only three states to achieve such a grade.

What the Community Checkup underscores is that there remains too much waste in our health care system. For example, there were 140,000 potentially avoidable ER visits during the latest reporting period. In the coming months, the Alliance will be producing new results showing how many Choosing Wisely recommendations aren’t followed. Duplicative and unnecessary tests only add to the risks, including financial, that consumers and purchasers bear.

The Alliance is grateful to our data suppliers for providing the data needed to produce the Community Checkup. We would also like to acknowledge the many organizations that provided results for the Common Measure Set: the Washington State Hospital Association, CMS/Hospital Compare, the Washington State Department of Health, the Washington State Department of Social and Health Services, the Washington State Health Care Authority, the state’s health plans and the National Committee for Quality Assurance. Their contributions are critical to the Community Checkup and exemplify the collaboration we have in our state that is so critical to improving the health system.


Nancy A. Giunto
Executive Director
Washington Health Alliance

Published: December 12, 2017

About Nancy A. Giunto

Nancy A. Giunto is executive director of Washington Health Alliance. Ms. Giunto served 14 years as executive director of Foster Pepper law firm in Seattle. She has had a long career in health care, with experience at National Institutes of Health in Washington D.C., the American Hospital Association. She has held leadership positions at Intermountain Health Care and Providence Health & Services.

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