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“JOINING BQA”
Health care is in crisis. The cost of health care now approximates two thirds of the unfunded debt obligation of the
US government, and the rate of increase is widely regarded as unsustainable. Additionally, the quality of care is not
what it should be. Patients commonly receive too little care, too much care, and wrong care. In many
communities these quality and cost problems are associated with care delivered in the framework of nonintegrated physicians and hospitals operating in separate silos.
In the Dallas-Fort Worth metroplex, physicians and hospitals have long been successful in a strong fee-for-service
environment recognized nationally as one of the higher cost areas of the US with overall clinical outcomes no
better than those evident in areas which deliver care at lower cost. Solutions to this crisis are badly needed.
Solutions imposed by public and private payers are likely to come in forms of significant rate cuts and regulatory
controls. An opportunity exists for physicians and hospitals working together to produce better value: health care
that is higher quality, with lower cost, through a well-integrated delivery system.
What is BQA?
1.
Baylor Quality Alliance is a developing clinically integrated accountable care organization, that realizes the
nation’s health care system is moving in a clear direction away from payment for volume to payment for
value. As such, BQA represents a commitment to deliver the highest quality health care possible, in an
efficient, integrated manner for the patients and communities we serve. We believe that accountable,
evidence-based, collective, proactive, value-driven efforts will lead to a better health care system for the
future. We believe that clinical integration around these principles offers the best solution to the health care
system crisis.
2.
BQA has a physician-led board of directors and management team focused upon:
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Best Care & Quality Improvement processes, designed by physicians
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Strong Clinical Integration across all points of care
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Best Population management
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Best Health Information Technology (HIT) and analytical reporting
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Best Provider Performance Reward system
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BHCS-aligned Contracting, Network Development, Legal and Finance support
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Efficiently reducing rate of increase in the cost of care
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BQA leverages its strong relationship with Baylor’s physicians to support both primary and specialty care
physicians in delivering the highest quality of care at the greatest value for payers, and produce the
opportunity of “shared savings” and other new payment methods for physicians.
4.
BQA will have a strong Primary Care base, with a foundation of Patient-Centered-Medical Homes.
What are some advantages of being in BQA?
As a participant in BQA’s system of clinical integration, I will be supported in
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Being a member of a successful integrated system of care and referral, aligning incentives of all providers
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Access to a subsidized electronic health record (EHR).
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Enhancing my practice, and reducing the variations in care for my patients while increasing their overall
satisfactionand health.
Joining BQA/ final/9/20/11
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Clinical decision support, helping me be a better physician and providing access to infrastructure
throughout the continuum of care.
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Coordination of care for my patient in all care settings, with state of the art electronic information
integration.
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Practice management and innovation resources will be available to reduce practice costs and provide
opportunities for market share growth regionally.
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If I am a primary care physician, I will be supported in attaining highest level of certification and potential
rewards as a patient-centered medical home.
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If I am a specialist, my patient will have a strong medical home as well with state-of-the-art referral
coordination, thus aligning me with other providers through clinical integration.
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Access to Best Care evidence-based process, protocols, clinical pathways, created by BQA physicians.
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Access to actionable data for continuous quality and efficiency improvement, offering the potential for
shared contract participation with employers and payors.
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Leadership opportunities in a physician led and governed Network including Committee participation and
workgroups.
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With the strong capital support of Baylor Health Care System and its organizational commitment to
becoming an accountable care organization by 2015, best in class technology and resources will be
available to build a world class care delivery system
Most people ask the question: “What’s in it for me?” Perhaps a comparison might be of use.
As a participant in BQA I may expect:
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Joining a physician led organization focused on
successful clinical integration
Broad, committed physician leadership, including
integration with the highest quality hospital
system in DFW
Strong integrated delivery system, committed to
funding clinical integration infrastructure,
including robust IT resources
A greater probability of clinical practice and
economic success in the uncertain future
The opportunity to design and influence network
performance
A clinically integrated referral network -- a
“medical neighborhood” – devoted to a common
mission
A strong sense of leadership and control over
future practice
Participation in quality and efficiency rewards as
they may become available
Joining BQA/ final/9/20/11
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Remaining Independent of BQA I may expect:
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Fewer resources for independently developing
required measurements which would enable me
to improve quality and cost effectiveness.
Stresses and burdens of individually attempting
to deal with health care changes, rising costs, and
shrinking reimbursements within solo or small
group environment
Less capital for necessary infrastructure and
technology linkage
Challenging competition from committed
accountable care organizations
Individually responsible for meeting reform
mandates and new patient care methods
Independently responsible for arranging all care
coordination
Accept the changes required with little
voice.
Continue in a model which may not be eligible
for quality/efficiency rewards and unprepared for
payment methodology changes.