The Michigan surgical quality collaborative - Will a statewide quality improvement initiative pay for itself?

Objective: In this article, we detail a unique collaboration between hospitals in Michigan and a major third party payer, using a "pay for participation model." The payer has made a significant investment in this regional surgical quality improvement (QI) program and funds each center's participation. Results: Based on the documented costs and incidence of surgical complications at our center, we estimate that a 1.8% annual reduction in complication rates is required for the payer to recoup its investment in this regional QI program. If we achieve our goal of a 3% reduction in complications per year over the 3-year program, the payer will save $2.5 million in payments. Our findings suggest that only a very modest improvement in surgical results, of a magnitude that seems realistically achievable based on similar QI initiatives, is necessary to financially justify payer involvement in a statewide quality improvement initiative. Conclusion: The framework of this program should be used by surgeons to attract private payers into QI collaboratives, facilitating improved patient outcomes and decreased health care expenditures.