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Competition may be a thing of the past in the Minnesota health care market. All the major health plans, including Blue Cross and Blue Shield of Minnesota, Medica, UCare Minnesota, and PreferredOne, have agreed to sponsor the Institute for Clinical Systems Improvement (ICSI) — a quality improvement consortium whose members include Nicollet Health Services, Mayo Clinic, and the HealthPartners Medical Group — and use the protocols it develops.
"The latest Institute of Medicine report calls for cooperation among clinicians, use of evidence-based best practice care guidelines, improvements in access and chronic illness, and monitoring of care outcomes," says Gordon Mosser, MD, ICSI executive director.
"These principles exist in everything that ICSI does. We are on the cutting edge of quality improvement, and with the addition of these new health plan sponsors, we are going to be able to affect the quality of care across the entire state," he adds. "We believe this kind of collaboration among health plans and providers should encourage similar acceleration of care improvement around the country."
Blue Cross and Blue Shield of Minnesota, HealthPartners, and Medica will equally provide the majority of ICSI’s funding. Those organizations will name physicians to serve on the ICSI board of directors. PreferredOne and UCare Minnesota, which are associate sponsors, will fund ICSI at a lower level. ICSI was previously funded solely by HealthPartners.
ICSI guidelines will be reviewed every 12 to 18 months, depending on the guideline. Physicians can access them on-line easily. In the past, access to ICSI guidelines has proved beneficial to patients. For instance, a cardiac care study of Medicare patients with a diagnosis of heart attack showed that only 21% were found to have received beta-blockers within 90 days of discharge. The mortality rate for patients with beta-blocker treatment was 43% below that of patients without beta-blocker treatment. In Minnesota, care systems that participate in ICSI have achieved a 95% success rate in prescribing beta-blockers for heart attack victims. That treatment results in a 40% reduction in future heart attacks and nearly a 25% reduction in deaths within two years.
ICSI now plans to broaden its membership by seeking out primary care and specialty medical groups and hospitals throughout Minnesota. Any medical group or hospital with a contract with any of the sponsoring health plans is eligible to apply to join ICSI, which means virtually all physicians in the state could participate.
ICSI also will seek out other health plans in the state and adjacent areas to become associate sponsors. Additionally, ICSI plans to measure the effect of the collaboration on the population served.