Identifying the Highest Performing Hospital Referral Regions in the US
The How Will We Do That? meeting in May 2010 was the successor to an event in July 2009, when IHI and our partners examined the performance of ten US Hospital Referral Regions (HRRs) with relatively low Medicare costs and above-average health care quality. That July 2009 event focused broad attention on regional differences in cost effectiveness, and showed that, even without national reform, some regions were doing better on cost and quality than the country as a whole.
In 2010, the same group of partners is seeking to generate a deeper and more action-oriented discussion about what regions are doing, and will do, to advance health and quality while controlling cost. For the May 2010 How Will We Do That? event, we chose 13 sites that demonstrate evidence of intentional action at a regional level, such as active multistakeholder coalitions that are aligning their efforts to attain what IHI calls the Triple Aim ― better health, better care, at lower cost.
In addition to Medicare per capita cost data, we obtained per capita cost and utilization data from a large sample of commercially insured individuals, deepening our understanding of cost and patterns of utilization for a larger segment of the population. We also gathered data related to experience of care and population health.
The 13 highlighted sites illustrate a broad mix of past performance, but all show evidence of strong will and intentionality for regional improvement going forward. We consulted with leaders from organizations working in the field, such as the Agency for Healthcare Research and Quality, the National Quality Forum, the Robert Wood Johnson Foundation, Quality Improvement Organizations, regional business coalitions, major health plan leaders, and others, seeking recommendations for sites with evidence of regional, cross-organizational intentionality with respect to cost reduction and quality improvement.
Regions Participating in the May 2010 How Will We Do That? Meeting
We recognize that other sites may be just as ready to tackle ambitious regional improvement as the ones we selected and our aim is that the conversation generated at the How Will We Do That? event in May 2010 will contribute to broader regional and national efforts to make our health system perform better for all Americans.
Thirteen HRRs that met the cost and quality criteria ― and are representative of communities across the US ― were selected to participate in the May 2010 How Will We Do That? meeting in Washington, DC:
- Grand Junction, Colorado
- Tallahassee, Florida
- Cedar Rapids, Iowa
- Portland, Maine
- Grand Rapids, Michigan
- Asheville, North Carolina
- Newark, New Jersey
- Manchester, New Hampshire
- Buffalo, New York
- Rochester, New York
- Bend, Oregon
- Everett, Washington
- La Crosse, Wisconsin
Participants in the July 2009 How Do They Do That? Meeting
The How Do They Do That? meeting in July 2009 was the predecessor to the May 2010 How Will We Do That? event. Ten Hospital Referral Regions (HRRs) that met the identified cost and quality criteria, and were representative of communities across the US, were invited to participate in the initial July 2009 meeting:
- Sacramento, California
- Tallahassee, Florida
- Cedar Rapids, Iowa
- Portland, Maine
- Asheville, North Carolina
- Sayre, Pennsylvania
- Temple, Texas
- Richmond, Virginia
- Everett, Washington
- La Crosse, Wisconsin
How Will We Do That?™ was a joint initiative of the Institute for Healthcare Improvement, The Dartmouth Institute for Health Policy and Clinical Practice, the Harvard School of Public Health, the Engelberg Center for Health Care Reform at Brookings. Financial support was provided by the Peter G. Peterson Foundation and the Fannie E. Rippel Foundation.
