Community-Based Health Plans and Regions Present Findings at Leadership Conference

Leading Health Policy Institutions Seek Insights from ACHP Members

Four regional, non-profit health plans that are members of the Alliance of Community Health Plans (ACHP) have been invited to address an audience of health care leaders and policy makers at a meeting entitled “How Will We Do That? Building Low Cost, High Quality Health Care Regions in America.”  The Institute for Healthcare Improvement, the Dartmouth Institute for Health Policy and Clinical Practice, the Brookings Institution Engelberg Center for Health Care Reform, and the Harvard School of Public Health are sponsoring the May 26-27 meeting in Washington, D.C.
Participating ACHP member plans include Priority Health in Grand Rapids, MI; Independent Health in Buffalo, NY; Capital Health Plan in Tallahassee, FL; and Martin’s Point Health Care in Portland, ME.  After a working session on May 26, press interested in joining the gathering on May 27 may contact Jessie duPont with the Institute for Healthcare Improvement, at             (212) 576-2700       x223 or

The conference is the successor to an event held last year, when the same sponsoring organizations examined the performance of ten US “hospital referral regions” (HRRs) with relatively low Medicare costs and above-average health care quality  (hospital referral regions define an area where people generally receive their care).  The event showed that even without national reform, some regions performed better on Medicare cost and quality measures than the country as a whole.  This year, the meeting will focus on actions taken in various regions to improve health quality while controlling cost.  Four regions that include ACHP member health plans have been chosen to showcase initiatives such as multi-stakeholder coalitions that are aligning their efforts to attain what IHI calls the “Triple Aim”– better health, better care, at a lower cost.

ACHP members serve as models because they have made substantial investments in quality improvement, reflected in their position at the top of the annual report by U.S. News & World Report/NCQA on “America’s Best Health Plans.”  In the 2009-2010 rankings of over 700 plans across the United States, five ACHP members rank among the list of the top ten highest performing commercial plans, and 9 of the top 10 Medicare plans are ACHP members.

Priority Health’s President and CEO, Kim Horn, Chief Medical Officer Jim Byrne, MD, and other regional leaders from Michigan will discuss how the entrepreneurial nature of their Grand Rapids community has been critical to their successes in lowering Medicare costs and improving health care quality.  They will describe a broad community collaborative that has addressed disparities in access and quality of care for disadvantaged children.  Priority Health will also present results of their efforts to coordinate care for their enrollees to manage a 28 percent reduction in lower back surgeries and simultaneously achieve higher member satisfaction ratings.

Michael W. Cropp, MD, President and CEO of Independent Health in Buffalo, will present with other leaders from western New York, focusing on how collaboration among hospitals and providers in the region has contributed to the region’s ability to improve quality and affordability of care. By centering their efforts on quality-improvement initiatives, they aim to coordinate care that is accountable and provides public transparency. One example of this is their diabetes management program—a multi-faceted quality improvement initiative that began with a physician pay-for-performance program to improve diabetic patient care and expanded into the community through an outcome based public reporting program to support transparency and engagement in diabetic care. A $16.1 million Beacon Community grant was recently received to coordinate diabetes management through an expanded electronic clinical information exchange, known as HEALTHeLINK.

John Hogan, Capital Health Plan (CHP) President and CEO, will join health care leaders from the Tallahassee area to focus on partnership initiatives underway in their community.  The partnership—which joins CHP, a local hospital and a local medical school—will attempt to reduce hospital readmissions with a new transitions of care program.  Starting in the fall, the participating organizations will work to bridge the gap between hospital discharge and post-acute care.  Focusing particularly on the population with no clear or accessible medical home, the effort will help patients with physician follow-up visits, proper management of medications, and other assistance designed to advance recovery and avoid rehospitalization.  CHP also shares regional Triple Aim goals of moderating annual per capita cost trends by keeping aggregate premium adjustments in the single digits.

David Howes, MD, President and CEO of Martin’s Point Health Care will be speaking as part of a group of health care leaders representing the Portland, Maine region.  His comments will focus on his organization’s work to improve care delivery through partnerships with employers and local community caregivers, as well as building a new delivery system built on the goals of IHI’s Triple Aim.  He and his Maine colleagues will explain how Martin’s Point Health Care and the Portland, Maine region are well positioned to advance health reform and lead an effective redesign of the health care system.

ACHP President and CEO Patricia Smith applauded the conference organizers and commented, “This conference will foster the development of community systems of care where all stakeholders—health care professionals, hospitals, patients, public health and civic leaders, and payers—recognize the importance of reforming the delivery of health care so that patients have a superior health care experience, our system is economically viable and sustainable, and we are continually improving the health of the whole community.  ACHP plans are taking the opportunity to explore and share with others what it means to deliver on the Triple Aim at the community level.”


ACHP is a national leadership organization that brings together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care in their communities. The non-profit, community-based and regional health plans and provider organizations from across the country that make up ACHP’s membership provide coverage and care for approximately 18 million Americans. These 21 organizations focus on improving the health of the communities they serve and are on the leading edge of patient care coordination, patient-centered medical homes, accountable health care delivery, use of information technology and other innovations leading to improvements in affordability and the quality of care. To learn more about ACHP, go to