The WCHQ governance model and value streams can be replicated in any practice setting and geographic region that combines vision, foresight and will to pursue a multi-stakeholder, collaborative approach to systems change. As one concrete example, WCHQ has expanded its measurement and improvement work to dentistry, welcoming four dental practices to its membership in 2018. Their vision is to advocate for an integrated model of oral and systemic health, while leading dental providers down the now familiar path of initiating data collection, generating measures for benchmarking, facilitating improvement, and reporting publicly. The WCHQ model has spread outside Wisconsin “organically” by virtue of mergers involving health care systems based in other states as well as members that serve patients across the borders with Illinois, Iowa, Michigan and Minnesota. WCHQ is seeking to expand beyond adjoining states by pursuing franchise partnerships. WCHQ’s data repository can accept data from anywhere in the country and its intellectual property could be licensed to and adopted by a willing partner in another state.
Publicly reporting quality results requires trust, especially given that there is always a top and a bottom performer, even in a state with exceptional quality. WCHQ members recognize that improvement will result from the sharing of best practices once top-performing organizations can be identified through public reporting and benchmarking. WCHQ’s model brings health care leaders together to create a forum for discussions centered on public reporting, quality improvement and per capita cost, and appropriateness of care.
Evidence suggests that WCHQ has contributed to Wisconsin’s serial ranking as one of the top performing states in the country on meta-measures of health care quality. Some of the evidence is observational, as a review of the longitudinal data on the WCHQ web site shows steady and sustained improvement across the measure portfolio. WCHQ’s experiences have been contributed to the evidence base through several qualitative and quantitative studies published over the last decade.1-3