Alliance of Community Health Plans Advances New System for Measuring Health Improvement

Heart Disease is Benchmarks in Quality and Safety Program’s First Target

Washington, D.C. (February 16, 2000) – The Alliance of Community Health Plans (ACHP) today unveiled the Benchmarks in Quality and Safety (BIQS) program featuring a new framework to improve health outcomes and enhance patient safety. Heart disease, which takes more than 700,000 American lives each year and an annual economic cost of more than $90 billion, will be the initial focus of this population-based approach to address patients’ risks for developing specific diseases.

“We hope to focus the nation’s attention on improving health outcomes by championing a new accountability system. BIQS sets goals to improve the processes of medical delivery, empower patients, and enhance patient safety,” said ACHP President and CEO Daniel B. Wolfson.

Health plans meeting specific criteria included in the BIQS Surveyor Guideline tool will receive formal merit badge recognition. Two ACHP-member health plans which have already volunteered to undergo the BIQS review process this year are Minnesota-based HealthPartners and New York-based Univera Healthcare.

“Managed care organizations, which emphasize trustworthy partnerships with the community of health care providers actually delivering care, are well positioned to deliver improved health status and enhanced patient safety,” explained Wolfson.

The American College of Physicians, the Centers for Disease Control and Prevention, the employers’ Managed Health Care Association, the Washington Business Group on Health and other organizations helped shape the BIQS process.

“Any health plan that engages in successful population-based health improvement will now have the mechanism through BIQS to show how it has prevented progression of a disease in a targeted area. Proven best practices identified through the BIQS process can be shared with other health plans to achieve similar results for their members,” said George J. Isham, MD, Medical Director and Chief Health Officer for the not-for-profit, 800,000-member HealthPartners.

“Heart disease is just the first of several areas we will target. Our aim is to demonstrate systematic strategies that have the potential to identify and move individuals at high risk into lower risk categories and prevent individuals in low risk categories from moving into higher risk or actual active disease states. BIQS serves as a challenge to the rest of the healthcare industry to work to improve healthcare quality,” Wolfson added.

BIQS is the latest initiative created by ACHP to improve the nation’s healthcare delivery system. In 1990, ACHP spearheaded the development of HEDIS, which measures the effectiveness of healthcare plans and holds them accountable to the public. HEDIS is used by the National Committee on Quality Assurance’s (NCQA) to determine the quality of managed care plans nationwide. ACHP has initiated discussions with NCQA and other agencies to encourage broader adoption and third party ownership of BIQS program.

Established in 1984, ACHP’s mission is to support member plans’ efforts to improve the health of their members and the communities they serve. ACHP includes 23 leading not-for-profit and provider-based health plans serving more than 8 million Americans in 23 states and the District of Columbia. These plans work with approximately 100,000 physicians in thousands of local communities.