Winter 2018
No. 12
*Correction- There was an error in the previous issue of the Quality Insight Newletter naming Qualis Health as Quality Health in the headline below. The error has been fixed in this error. 

HealthInsight and Qualis Health Announce Intent to Merge topstory

The governing boards of HealthInsight and Seattle-based Qualis Health have executed a letter of intent to merge the two organizations and their operations across the United States, seeking to achieve greater scale and synergy in improving population health and enhancing the quality and value of health care.
HealthInsight and Qualis Health share a 40-year history as community-based, nonprofit health care quality consulting organizations, assisting front-line providers and engaging stakeholders to improve health care and outcomes. The organizations are roughly comparable in size and complementary in scope of operations. They are committed to creating a new, merged organization that builds on the successes, strengths and cultures of both companies.
The merger is expected to become final later this spring. Our clients and partners can rest assured that HealthInsight will provide uninterrupted service and collaboration throughout the merger process and beyond, and we don't anticipate any changes to the contacts and teams you are already working with. We'll update you on our progress as the merger moves forward.
Read our press announcement for more details.

Healing Utah's Nursing Gap

Utah is facing a critical nursing shortage that is only expected to become more acute in the future. The problem is highlighted by the more than 1,200 unfilled, full-time registered nurse (RN) positions currently open in Utah, along with a nurse-per-population ratio that ranks 47th in the United States. In addition, Utah's population is growing and Utah's nursing workforce is aging, as nearly half of Utah's nurses plan to retire with the next 15 years. With schooling requirements and critical on-the-job experience, it can take up to five years to educate and train a well-qualified nurse.

The Utah Nursing Consortium, a collaboration of the eight publicly-funded nursing programs and the health care industry, have joined together to help solve this problem by increasing the number of new RNs licensed in Utah each year in order to meet projected nursing workforce demands. This year, the Utah Nursing Consortium is requesting a general fund appropriation from the Utah State Legislature of $1.9 million to hire new nursing faculty in the publicly funded schools beginning in fiscal year 2019 to educate 275 new registered nurses per year. There is also capacity for ongoing funding for future years' nursing needs through Senate Bill 147.

The Utah Action Coalition for Health (UACH), charged with implementing the 2011 Institute of Medicine's report on the future of nursing, is concerned about Utah's current nursing shortage and the pressing need for highly educated nurses in the future. The UACH is currently working collaboratively with the Utah Nursing Consortium to increase awareness of the state's nursing shortage and the associated legislative request.
Counties with higher RN-to-population ratios are healthier in the following areas:
  • Lower rate of fair or poor health
  • Higher mammography screening rates
  • Lower rate of teen births
As a catalyst for health care improvement in our community, HealthInsight recognizes the importance of having enough nurses in Utah's workforce to continue the state's legacy of high quality and cost-effective nursing care. The UACH will be closely following the work of the Utah Nursing Consortium during this legislative session. Every life is touched by a nurse and it is in the best interest of the state to heal Utah's nursing gap now. For more information on the UACH, please contact Joan M. Gallegos at


HealthInsight Partnering with Local Stakeholders to Bring Patients and Researchers Together at Unique Conference 

For the third year in a row, HealthInsight is partnering with local stakeholders, including Intermountain Healthcare, the University of Utah, Community Faces of Utah, Salt Lake Interfaith Roundtable and the Utah Health Policy Project to host the 2018 Health Services Research Conference: Partnering for Better Health by Doing What Works on Thursday, March 22, 2018, at the Health Sciences Education Building on the University of Utah campus. This innovatively blended conference brings together researchers, health care providers and health professionals with patients, caregivers and community members to engage in discussion and presentations around improving patient-centered research and health care in Utah. 

Read more about the conference and get registration information here

Guest Article: 
Breaking Down Health Care Silos Leads to Better Patient Care 
By: Tom Dickinson, MD, Board Member and Past President of Revere Health 

For several decades, specialists in the health care industry have operated mostly in silos. Each specialty functioned independently, treating the symptoms of patients who entered their practices according to their own expertise.
Although this model provided an opportunity for providers to refine their knowledge and skills within their specialty, a silo mentality could be harmful to patients because it excludes the element of coordination and collaboration--something both providers and patients need to achieve optimal health outcomes. When specialists break down silos by addressing comorbidities, gaps in care and the entirety of their patient's health, it can lead to better quality care and lower costs.
How Value-Based Care Breaks Down Silos
Value-based care--the process of reducing the cost of care while improving its quality--is a step in the right direction toward eliminating the silo mentality. Key components of value-based care include patient engagement, care coordination and data analytics to identify unnecessary costs and gaps in care, such as overdue preventive screenings.
As part of Revere Health's efforts to implement value-based care and break down silos in medicine, Kurt Bodily, MD of Revere Health Gastroenterology started ordering mammograms for patients who were in need of one-something he had never done before in his practice.
"I'm a gastroenterologist. Worrying about mammograms is not something I frankly ever thought about before," said Dr. Bodily. "But value-based care means treating the patient's needs as a whole, not just their gastrointestinal conditions."
In the 18 months since implementing this process, his efforts have resulted in early detection of breast cancer for two of his patients.
The extra few minutes it takes Dr. Bodily to identify the need and coordinate his patient's care by scheduling a mammogram may have saved the lives of two patients who caught and could treat this disease in its earliest stages.
"I think most of us went into medicine to be physicians, not necessarily [specialists]," said Dr. Bodily. "I'd like to think that we can and want to provide care for the entire person, and it's gratifying to be able to do something that's helpful to the patient, even if it doesn't fall directly within my specialty."
Patients expect high-quality care at a reasonable price, illustrating the need for change on the part of providers and health care systems. This is especially true as health care costs continue to skyrocket without any noticeable improvement in patient outcomes. The solution to the current system of high-cost care isn't about providing less care, but instead providing smarter care that produces results for patients. Better cooperation and coordination between all members of a patient's care team is not always easy, but it is an essential step on the path to value-based care.
The Path to Sustainable Improvement: As HealthInsight Sees It 

HealthInsight has worked with providers and patients for more than 40 years to improve health and health care. We seek to be a thought leader, helping to shape improvement strategies in our communities and nationally. We are continually evaluating the best ways to help our system work better. In that spirit, we'd like to share some of our latest thinking.
Fundamentally, we believe that sustainable improvement will happen only when patients, providers, payers and purchasers come together at the community level to promote, demand and support transformation based on these change principles:
  1. Aligned payment system reform
  2. Collaboration and coordination across settings and systems of care
  3. Credible, transparent information about system performance
  4. Empowering patients and their families
This blog column by Marc Bennett, president and CEO of HealthInsight, expands on those principles.
The Medicare Quality Improvement Organization (QIO) program, directed by the Centers for Medicare & Medicaid Services (CMS), has long been a pacesetter and incubator for change. We believe CMS can propel the health care system toward meaningful transformation by applying the Regional Health Improvement Collaborative model to the work performed by Quality Innovation Network-QIOs in the 2019 - 2024 contract period.

Geography Makes a Difference in the Cost of Health Care 

A new report from the Network for Regional Healthcare Improvement (NRHI) shows once again that geography makes a difference in how much commercial insurance plans pay for health care. The report, Healthcare Affordability: Untangling Cost Drivers, follows up on NRHI's previous groundbreaking work on health care costs.
A number of factors can explain why costs may vary within and among states, including the health of the population, service utilization (how often people visit health care providers or fill prescriptions) and the price of those services. The Total Cost of Care project, funded by the Robert Wood Johnson Foundation and led by NRHI, is the first to measure those factors in a standardized way across multiple states. HealthInsight participates in the project.
NRHI's latest benchmark study compared private payers' 2015 risk-adjusted spending in five states: Colorado, Maryland, Minnesota, Oregon and Utah. Results showed that the cost of care for comparable populations ranges from 17 percent above average in Colorado to 16 percent below average in Maryland.
Bringing the higher-than-average-cost states down to the average of the participating states could save more than $1 billion for investment in other sectors of the economy - including infrastructure, education and public health programs, which are known to improve health in the long term.
"With one of every six dollars in the American economy going to health care, it's imperative that we determine what is driving health care costs," said Elizabeth Mitchell, president and CEO of NRHI. "With reliable and actionable information on cost drivers, we can enable health care stakeholders to make the changes needed to bring down the cost of care."

Read more about the key takeaways and state highlights here

Meeting of the Minds: Better Health Through Community Partnerships 
March 21, 2018 6 to 8 p.m. 
Calvary Baptist Church - Salt Lake City, Utah 
Join this networking event to learn about diverse communities in Utah including their unique health needs and challenges and current opportunities to become engaged in patient-centered research. Event by Intermountain Healthcare, the University of Utah, Community Faces of Utah, Salt Lake Interfaith Roundtable and the Utah Health Policy Project.
2018 Health Services Research Conference: Partnering for Better Health by Doing What Works 
March 22, 2018 8 a.m. to 4 p.m.
University of Utah Health Sciences Education Building - Salt Lake City, Utah
The event will be co-designed with stakeholders from Intermountain Healthcare, the University of Utah, Community Faces of Utah, Salt Lake Interfaith Roundtable, and the Utah Health Policy Project, and will feature presentations and facilitated discussion. Participants will engage in breakout sessions to address health services research questions as well as provide community member input into patient centered outcomes research design, inquiry, and ongoing participation. 

Health Care Affordability Boot Camp 
April 17, 2018 8 a.m. to 4:45 p.m. 
LDS Hospital - Salt Lake City, Utah
Join this collaborative community event to promote health care affordability in Utah. Patient advocates, community members, health care providers, insurers and policymakers are invited to participate in interactive discussions to address specific needs and solutions to improve health care transparency and affordability in Utah.

End of Life Care: Are You Ready? 
April 26, 2018 8 a.m. to 1:15 p.m. 
Doty Education Center lMC Campus - Murray, Utah
Join us for this collaborative event to promote end of life care awareness and the importance of communicating. Patients, families, researchers, providers, policymakers, payers and community members are invited. We will address end of life care issues in Utah and encourage input on planning conversations, addressing communication barriers and more.

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HealthInsight is a recognized leader in convening and partnering with communities to improve health and health care by advancing quality, efficiency and value for patients and providers. We are leading experts in quality improvement; transparency and public reporting; use of health information technology; engaging patients to improve their health; and redesigning how care is paid for and delivered. Learn more at

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