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It Takes a Region: Creating a Framework to Improve Chronic Disease Care

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Publication Date: November 2006

Publisher(s): California HealthCare Foundation

Author(s): Ed Wagner; Brian Austin; Catherine Coleman

Series: Issue Brief

Topic: Health (Health care planning)

Type: Brief


In the absence of a concerted national effort to improve the affordability and quality of health care, particularly for chronic diseases, many communities and regions across the country are taking steps to collaboratively improve health care for local populations. This CHCF-funded report explores how to build an effective collaboration to improve health care and reduce costs. It examines strategies and the potential for success of regional efforts, including analyses from nine prominent initiatives, to identify actions and structures that maximize improvement across a geographic area. The result is a "Framework for Creating a Regional Health Care System." This practical model identifies four essential strategies: sharing data to measure performance, engaging customers, supporting delivery system improvement, and aligning benefits and finances. It also discusses employing multiple strategies for regional transformation, and offers a road map for getting started. The report concludes that while there is a significant amount of qualitative information about regional improvement activities, there is relatively little quantitative information about program impact. To build a stronger foundation for future regional efforts, better evidence is needed about successes and failures, along with more sharing of experience among coalition leaders. Lessons from a National Conference on Better Ideas for Chronic Disease Care The MacColl Institute and CHCF gave the networking process a major boost by convening a national conference near San Francisco in November 2006. About 80 leaders of 40 organizations in 17 states spent a day and a half together, sharing lessons learned and challenges and exploring ways to strengthen their individual and collective efforts. The conference helped crystallize a national perspective on quality improvement, grounded in the practical experience of these diverse participants.