The performance measurement and public reporting for the Maine AF4Q alliance is spearheaded by the Maine Health Management Coalition (MHMC) and provides a great example of using community-level quality measurement to create a health provider tier program. The plan sponsor members of MHMC use the MHMC quality measures to create benefit design incentives such as co-pay waivers to direct consumers toward high quality primary care physician practices and hospitals. In 2011, the MHMC is adding a cost measure for hospitals, and some of the plan sponsors are using the quality and cost measures to group hospitals based on value for use in the benefit design incentives. This program is designed to enhance the health of a community while simultaneously reducing cost, something that any community nationwide would benefit from.
Read the full report and the many lessons learned here.