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The Business Case For Quality: Case Studies And An Analysis
Sheila Leatherman,
Donald Berwick,
Debra Iles,
Lawrence S. Lewin,
Frank Davidoff,
Thomas Nolan and
Maureen Bisognano
The financial implications of implementing quality improvements are often poorly understood. Simply put, does improving quality yield a return on investment? We examine four casesmanagement of high-cost pharmaceuticals, diabetes management, smoking cessation, and wellness programs in the workplaceto understand the financial and clinical implications of improving care. We explore costs and benefits, in both the short and the long term, to four stakeholders with different and sometimes conflicting interests: providers, purchasers and employers, individual patients, and society. Finally, we recommend policy changes to better align financial incentives for superior quality of care.

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November 16, 2009;
339(nov16_2):
b4638 - b4638.
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|
 |
|

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|
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[PDF]
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V. Cooke, G. Arling, T. Lewis, K. A. Abrahamson, C. Mueller, and L. Edstrom
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Gerontologist,
October 21, 2009;
(2009)
gnp140v1.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
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T. Zuiderent-Jerak
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Social Studies of Science,
October 1, 2009;
39(5):
765 - 792.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
G. Arling, C. Job, and V. Cooke
Medicaid Nursing Home Pay for Performance: Where Do We Stand?
Gerontologist,
October 1, 2009;
49(5):
587 - 595.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. A. Brownson, T. J. Hoerger, E. B. Fisher, and K. E. Kilpatrick
Cost-effectiveness of Diabetes Self-management Programs in Community Primary Care Settings
The Diabetes Educator,
September 1, 2009;
35(5):
761 - 769.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. K. Jha, D. C. Chan, A. B. Ridgway, C. Franz, and D. W. Bates
Improving Safety And Eliminating Redundant Tests: Cutting Costs In U.S. Hospitals
Health Aff.,
September 1, 2009;
28(5):
1475 - 1484.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. K. Jha, E. J. Orav, A. Dobson, R. A. Book, and A. M. Epstein
Measuring Efficiency: The Association Of Hospital Costs And Quality Of Care
Health Aff.,
May 1, 2009;
28(3):
897 - 906.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. W. Painter and R. Lavizzo-Mourey
Aligning Forces For Quality: A Program To Improve Health And Health Care In Communities Across The United States
Health Aff.,
September 1, 2008;
27(5):
1461 - 1463.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Needleman
Is What's Good for the Patient Good for the Hospital? Aligning Incentives and the Business Case for Nursing
Policy Politics Nursing Practice,
May 1, 2008;
9(2):
80 - 87.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
L. Chang and J.-H. Hung
The effects of the global budget system on cost containment and the quality of care: experience in Taiwan
Health Serv Manage Res,
May 1, 2008;
21(2):
106 - 116.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. Lurie, S. A. Somers, A. Fremont, J. Angeles, E. K. Murphy, and A. Hamblin
Challenges To Using A Business Case For Addressing Health Disparities
Health Aff.,
March 1, 2008;
27(2):
334 - 338.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. L. Wald and A. M. Kramer
Nonpayment for Harms Resulting From Medical Care: Catheter-Associated Urinary Tract Infections
JAMA,
December 19, 2007;
298(23):
2782 - 2784.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. S. Wang, G. E. Simon, J. Avorn, F. Azocar, E. J. Ludman, J. McCulloch, M. Z. Petukhova, and R. C. Kessler
Telephone Screening, Outreach, and Care Management for Depressed Workers and Impact on Clinical and Work Productivity Outcomes: A Randomized Controlled Trial
JAMA,
September 26, 2007;
298(12):
1401 - 1411.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. E S Brown, M. H Chin, and E. S Huang
Estimating costs of quality improvement for outpatient healthcare organisations: a practical methodology
Qual. Saf. Health Care,
August 1, 2007;
16(4):
248 - 251.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. L. Fairchild and A. Alkon
Back to the Future? Diabetes, HIV, and the Boundaries of Public Health
Journal of Health Politics Policy and Law,
August 1, 2007;
32(4):
561 - 593.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
S. M. Mohammadi, S. F. Mohammadi, J. R. Hedges, M. Zohrabi, and O. Ameli
Introduction of a quality improvement program in a children's hospital in Tehran: design, implementation, evaluation and lessons learned
Int. J. Qual. Health Care,
August 1, 2007;
19(4):
237 - 243.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. J. Homer
For Love, for Money, or for Both?: Which Way Will We Choose to Transform Children's Health Care?
Arch Pediatr Adolesc Med,
July 1, 2007;
161(7):
715 - 717.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. M. Davidson and J. Heineke
Toward an Effective Strategy for the Diffusion and Use of Clinical Information Systems
J. Am. Med. Inform. Assoc.,
May 1, 2007;
14(3):
361 - 367.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. P. Casalino, G. C. Alexander, L. Jin, and R. T. Konetzka
General Internists' Views On Pay-For-Performance And Public Reporting Of Quality Scores: A National Survey
Health Aff.,
March 1, 2007;
26(2):
492 - 499.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. L. Kane and G. Mosser
The challenge of explaining why quality improvement has not done better
Int. J. Qual. Health Care,
February 1, 2007;
19(1):
8 - 10.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. L. Kane, G. Arling, C. Mueller, R. Held, and V. Cooke
A Quality-Based Payment Strategy for Nursing Home Care in Minnesota
Gerontologist,
February 1, 2007;
47(1):
108 - 115.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. L. Reiter, K. E. Kilpatrick, S. B. Greene, K. N. Lohr, and S. Leatherman
How to develop a business case for quality
Int. J. Qual. Health Care,
February 1, 2007;
19(1):
50 - 55.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. S. Wang, A. Patrick, J. Avorn, F. Azocar, E. Ludman, J. McCulloch, G. Simon, and R. Kessler
The Costs and Benefits of Enhanced Depression Care to Employers
Arch Gen Psychiatry,
December 1, 2006;
63(12):
1345 - 1353.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. P. Scanlon, M. Chernew, S. Swaminathan, and W. Lee
Competition in Health Insurance Markets: Limitations of Current Measures for Policy Analysis
Med Care Res Rev,
December 1, 2006;
63(6_suppl):
37S - 55S.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
T. Plochg, D. M. J. Delnoij, W. V. G. Hogervorst, P. van Dijk, S. Belleman, and N. S. Klazinga
Local health systems in 21st century: who cares?--an exploratory study on health system governance in Amsterdam
Eur J Public Health,
October 1, 2006;
16(5):
559 - 564.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Mattke, A. M. Epstein, and S. Leatherman
The OECD Health Care Quality Indicators Project: history and background
Int. J. Qual. Health Care,
September 1, 2006;
18(suppl_1):
1 - 4.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. C. Miller, S. B. Gruber, B. K. Hollenbeck, J. E. Montie, and J. T. Wei
Incidence of initial local therapy among men with lower-risk prostate cancer in the United States.
J Natl Cancer Inst,
August 16, 2006;
98(16):
1134 - 1141.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. A. Petersen, L. D. Woodard, T. Urech, C. Daw, and S. Sookanan
Does Pay-for-Performance Improve the Quality of Health Care?
Ann Intern Med,
August 15, 2006;
145(4):
265 - 272.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
W. N. Kelly and T. D. Rucker
Compelling features of a safe medication-use system.
Am. J. Health Syst. Pharm.,
August 1, 2006;
63(15):
1461 - 1468.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Berg, F. de Brantes, and W. Schellekens
The right incentives for high-quality, affordable care: a new form of regulated competition
Int. J. Qual. Health Care,
August 1, 2006;
18(4):
261 - 263.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. M. Mangione, R. B. Gerzoff, D. F. Williamson, W. N. Steers, E. A. Kerr, A. F. Brown, B. E. Waitzfelder, D. G. Marrero, R. A. Dudley, C. Kim, et al.
The Association between Quality of Care and the Intensity of Diabetes Disease Management Programs
Ann Intern Med,
July 18, 2006;
145(2):
107 - 116.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
W. M. Sage and D. N. Kalyan
Horses or Unicorns: Can Paying for Performance Make Quality Competition Routine?
Journal of Health Politics Policy and Law,
June 1, 2006;
31(3):
531 - 556.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
R. T. Ackermann, D. G. Marrero, K. A. Hicks, T. J. Hoerger, S. Sorensen, P. Zhang, M. M. Engelgau, R. E. Ratner, and W. H. Herman
An Evaluation of Cost Sharing to Finance a Diet and Physical Activity Intervention to Prevent Diabetes.
Diabetes Care,
June 1, 2006;
29(6):
1237 - 1241.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. W. Ford, N. Menachemi, and M. T. Phillips
Predicting the Adoption of Electronic Health Records by Physicians: When Will Health Care be Paperless?
J. Am. Med. Inform. Assoc.,
January 1, 2006;
13(1):
106 - 112.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Needleman, P. I. Buerhaus, M. Stewart, K. Zelevinsky, and S. Mattke
Nurse Staffing In Hospitals: Is There A Business Case For Quality?
Health Aff.,
January 1, 2006;
25(1):
204 - 211.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. Edwards
Using markets to reform health care
BMJ,
December 17, 2005;
331(7530):
1464 - 1466.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. H. Woolf and R. E. Johnson
The Break-Even Point: When Medical Advances Are Less Important Than Improving the Fidelity With Which They Are Delivered
Ann. Fam. Med,
November 1, 2005;
3(6):
545 - 552.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. M. Berwick
My Right Knee
Ann Intern Med,
August 2, 2005;
143(3):
237 - 238.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. E. Kilpatrick, K. N. Lohr, S. Leatherman, G. Pink, J. M. Buckel, C. Legarde, and L. Whitener
The insufficiency of evidence to establish the business case for quality
Int. J. Qual. Health Care,
August 1, 2005;
17(4):
347 - 355.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. Bodenheimer and A. Fernandez
High and Rising Health Care Costs. Part 4: Can Costs Be Controlled While Preserving Quality?
Ann Intern Med,
July 5, 2005;
143(1):
26 - 31.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. L. Leape and D. M. Berwick
Five Years After To Err Is Human: What Have We Learned?
JAMA,
May 18, 2005;
293(19):
2384 - 2390.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M Weiner, T E Stump, C M Callahan, J N Lewis, and C J McDonald
Pursuing integration of performance measures into electronic medical records: beta-adrenergic receptor antagonist medications
Qual. Saf. Health Care,
April 1, 2005;
14(2):
99 - 106.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R Q Lewis and M Fletcher
Implementing a national strategy for patient safety: lessons from the National Health Service in England
Qual. Saf. Health Care,
April 1, 2005;
14(2):
135 - 139.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. DiPiero and D. G Sanders
Condition based payment: improving care of chronic illness
BMJ,
March 19, 2005;
330(7492):
654 - 657.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M L Millenson
Pay for performance: the best worst choice
Qual. Saf. Health Care,
October 1, 2004;
13(5):
323 - 324.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
The Child Health Business Case Working Group
Exploring The Business Case For Improving The Quality Of Health Care For Children
Health Aff.,
July 1, 2004;
23(4):
159 - 166.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. C. Smith and N. York
Quality Incentives: The Case Of U.K. General Practitioners
Health Aff.,
May 1, 2004;
23(3):
112 - 118.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Schoenbaum, K. Kelleher, J. R. Lave, S. Green, D. Keyser, and H. Pincus
Exploratory Evidence on the Market for Effective Depression Care in Pittsburgh
Psychiatr Serv,
April 1, 2004;
55(4):
392 - 395.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. N. Lohr
Rating the strength of scientific evidence: relevance for quality improvement programs
Int. J. Qual. Health Care,
February 1, 2004;
16(1):
9 - 18.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. L. Berry, K. Seiders, and S. S. Wilder
Innovations in Access to Care: A Patient-Centered Approach
Ann Intern Med,
October 7, 2003;
139(7):
568 - 574.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. P. Steinberg
Improving the Quality of Care -- Can We Practice What We Preach?
N. Engl. J. Med.,
June 26, 2003;
348(26):
2681 - 2683.
[Full Text]
[PDF]
|
 |
|
|