A Brief History of WCHQ

Since its inception in 2002, the Wisconsin Collaborative for Healthcare Quality (WCHQ) has sought to improve healthcare quality in the state of Wisconsin through the development and public reporting of a comprehensive range of healthcare performance measures. Its first public report of evidence-based measures for inpatient and outpatient care, issued in October 2003, largely reproduced data available through CMS and other sources. Since then, the creativity and success of WCHQ's approaches to the daunting challenges of healthcare data collection, audit and validation, analysis, and reporting have been recognized nationally. Today, WCHQ's Performance and Progress Report is a rich source of information about healthcare quality and is refreshed regularly with new results and measures.

• October 2002: Healthcare CEOs from noncompetitive markets in Wisconsin meet to explore the idea of forming a collaborative for quality improvement.
• February 20, 2003: A voluntary consortium of nine quality improvement-driven healthcare organizations holds its first formal meeting at Dean Healthcare in Madison. They commit to learning and working together to improve the quality of health care in the State of Wisconsin. They agree to develop common set of healthcare quality outcomes and publicly report the performance of their delivery organizations against the measures. They are: Bellin, Dean, Froedtert, Gundersen Lutheran, Marshfield Clinic, Medical College of Wisconsin, St. Mary's Medical Center and ThedaCare are represented at the first meeting. St. Joseph's Hospital - Marshfield later joins as the hospital partner of Marshfield Clinic.
• March 20, 2003: Employer and business representatives are invited to participate in the formulation of meaningful measures of healthcare quality outcomes. They are: The Alliance, Appleton Papers, Badger Meter, DaimlerChrysler, Schneider National, Sentry Insurance, Serigraph, Inc., The Trane Company, United Auto works and Wisconsin Manufacturers & Commerce.
• March 24, 2003: The Collaborative adopts a Position Statement:

  The purpose of the Collaborative is three-fold:

  1. For a small group of culturally compatible providers and employers to work together to develop common measures of quality that have meaning and value to providers, payers and consumers
  2. To work together to share and develop "best practices" in a manner that improves healthcare outcomes
  3. To publicly share measurements and best practices in a manner that offers these as benchmarks for other health systems, government agencies, payers and consumers

  To accomplish these goals, the Collaborative members must work together with employers in a non-competitive atmosphere of trust. This is difficult, if not impossible, to accomplish with anything but a small group with mutually assured privacy/confidentiality during development.

  However, the Collaborative is committed to broad participation in its efforts to create both meaningful measurements and best practices. As such, once the baseline measurements are chosen, the Collaborative will develop a mechanism by which other providers can participate in the measurement process and engage in shared process improvement and development/implementation of best practices.

  We hope to be able to develop this system with our quality-improvement partner by 2004.

• April 2, 2003: WCHQ files Articles of Incorporation with the Wisconsin Department of Financial Institutions and is formed as a Limited Liability Company (LLC) with the nine sponsoring healthcare entities named as partners and board of directors. Each healthcare entity contributes start-up funds.
• May 14, 2003: WCHQ's Quality Improvement/Performance Committee (representatives include the quality managers and physicians from each of the healthcare entities and employer-business partners) hold their first meeting to:
  1. assemble a set of evidence-based quality healthcare outcomes measures organized around the Institute of Medicine's six aims for improvement: safety, effectiveness, patient-centeredness, timeliness, efficiency, and quality
  2. develop shared definitions based on rationale, numerator/denominator definitions and availability of data for public reporting before the end of the year
• October 9, 2003: WCHQ files a Certificate of Conversion with the Wisconsin Department of Financial Institutions, dissolving the LLC and converting to a Chapter 181 Nonstock Corporation under Chapter 181 of the Wisconsin Statutes, with its nine partners serving as the board of directors. The stated purpose of the conversion is "...to allow the business entity to better promote healthcare quality improvement and the development and implementation of healthcare quality measures and standards."
• October 9, 2003: The Collaborative files application for Recognition of Exemption under section 501(c)(3) of the Internal Revenue Code.
• October 21, 2003: WCHQ releases its 2003 Performance & Progress Report at a Healthcare Summit in Milwaukee attended by over 200 business, healthcare and government stakeholders. The centerpiece of the Report is a set of 42 evidence-based measures of healthcare quality outcomes with agreed-upon definitions covering the continuum of care from outpatient visit to hospital stay. The measures document the performance of seven hospitals, six multi-specialty physician groups and four health plans. The Report is hailed as an important first step in determining a widely accepted set of measures of healthcare quality for public reporting.
• October 21, 2003: WCHQ announces the hiring of an executive director to manage day-to-day operations.
• December 19, 2003: The WCHQ Board of Directors holds its first strategic planning retreat to establish direction for 2004.
• January 13, 2004: WCHQ signs a contract with MetaStar, Inc. of Madison, Wisconsin to serve as a quality improvement partner and independent auditor of the initial set of 42 performance measures to be publicly reported in the 2005 Performance & Progress Report.
• February 12, 2004: WCHQ receives designation as a "Charitable Organization in the State of Wisconsin" from the Department of Regulation and Licensing.
• February 13, 2004: WCHQ publicly invites Wisconsin-based healthcare provider organizations to participate in its public reporting initiative.
• April 16, 2004: WCHQ receives final determination from the IRS designating its status as a publicly supported organization described in sections 501 (a) (1) and 170 (b)(1)(A) (vi), retroactive to the Advance Ruling Period beginning October 9, 2003 and ending December 31, 2007.
• May 11, 2004: WCHQ's Board of Directors approves a resolution to expand its board of directors to fulfill its commitment to broadened provider participation and elects nine new healthcare executives and two business partner representatives to its board.
• August 10, 2004: WCHQ's Board of Directors Roster expands to 23 with the election of three additional board members, and its Executive Committee expands to six with the election of two additional members.
• November 12, 2004: The Collaborative hosts WCHQ Forum 2004: The Excellence Within, a best practice-sharing forum attended by 157 physicians, clinicians and process improvement specialists of the Collaborative's healthcare provider members.
• December 14, 2004: The WCHQ Board of Directors approves and adopts a Shared Vision For Public Reporting with the Wisconsin Hospital Association and commits to the development of a common Web-site for their respective public reports.
• January, 2005: WCHQ founder and Board member Donald Logan, MD, CMO Dean Health System, and Board Member Clyde "Bud" Chumbley, MD, CEO of Medical Associates, are appointed to serve on Technical Advisory Panels of the National Quality Forum to endorse national voluntary consensus standards for standardizing, measuring and reporting quality of care in physicians' offices.
• April 7, 2005: WCHQ launches its new, interactive Web site and Web-based Performance & Progress Report, featuring 45 measures of healthcare quality performance. The highlights of the Report are the five Ambulatory Care System measures for Diabetes. Developed exclusively by WCHQ and the first outpatient measures of their kind in the country, the Diabetes measures incorporate the latest evidence-based standards across the entire health system population.
• May 10, 2005: WCHQ is officially elected a member of the National Quality Forum, with Donald Logan, MD, as the delegate.
• June 23, 2005: WCHQ developed and published a series of economic efficiency analyses - comparison measures that combine quality processes and outcomes data with severity-adjusted data for charges and length of stay. There are six "quadrant" measures for three different conditions-heart attack, heart failure and pneumonia.
• July 22, 2005: WCHQ added three new member organizations including Covenant Medical Group in metro Milwaukee and All Saints Medical Group in Racine, joining under their parent organization, Wheaton Franciscan Services; Agnesian HealthCare in Fond du Lac; and ProHealth Care Medical Centers in Waukesha.
• November 7, 2005: WCHQ hired Christopher Queram as President and CEO of the Collaborative. Formerly, Chris was CEO of Health Care Alliance Cooperative in Madison, WI.
• November 11, 2005: WCHQ released an impressive new measure of physician performance in the management of Uncomplicated Essential Hypertension. High blood pressure is a leading risk factor for coronary heart disease, congestive heart failure, renal disease and stroke. This groundbreaking ambulatory measurement, which measures the control of blood pressure in patients with Uncomplicated Hypertension, follows the "Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)."
• November 11, 2005: WCHQ held its second annual Fall Forum. Over 220 healthcare providers, medical directors, quality improvement staff, and healthcare purchasers attended the event in attendance. All had the opportunity to learn from two nationally recognized keynote speakers and gain a better understanding of the strategies, struggles, and secrets of the highest performing hospitals and physician groups on a variety of topics.
• December 19, 2005: WCHQ released a new measure of physician performance in the important area of Women's Health. The new Postpartum Measure assesses the percentage of women who had a visit with their health care provider after giving birth. Every year, there are over 4 million births in the United States. Early and adequate prenatal care, and appropriate and prompt care post-delivery can help prevent a number of problems including hemorrhaging, high blood pressure, and infections; clinical guidelines recommend women see their health care provider shortly after giving birth.
• February 2006: The Ambulatory Care Quality Alliance (AQA) today announced six sites for a pilot project that will, for the first time, combine public and private information to measure and report on physician practice in a meaningful and transparent way for consumers and purchasers of health care. The organizations selected by AQA as initial pilot sites are the following:
  • California Cooperative Healthcare Reporting Initiative, San Francisco CA
  • Indiana Health Information Exchange, Indianapolis, IN
  • Massachusetts Health Quality Partners, Watertown MA
  • Minnesota Community Measurement, St. Paul, MN
  • Phoenix Regional Healthcare Value Measurement Initiative, Phoenix, AZ
  • Wisconsin Collaborative for Healthcare Quality, Madison WI
• June 2006: Aurora Medical Group joined the Wisconsin Collaborative for Healthcare Quality, further increasing the value of the organization's comparative healthcare quality data provided to businesses and consumers in the state.
• July 25, 2006: The Wisconsin Collaborative for Healthcare Quality released results for physician group performance in preventive cancer screening. These new ambulatory measures represent every patient in these physician groups eligible for the following screenings:
  • 362,430 women who should have had at least one mammogram in the past two years;
  • 554,420 women who should have been screened for cervical cancer (i.e., Pap smear) during the previous three years;
  • 524,048 men and women who should have been screened for colorectal cancer at least once in the past decade.
  More than 100 medical directors, physicians, and QI staff attended an all-day quality-sharing event to coincide with the launch of the results on www.wchq.org. Now that these baseline rates have been established, Wisconsin providers are partnering with the American Cancer Society and the Wisconsin Comprehensive Cancer Control to begin increasing the number of patients screened.
• November 9, 2006: WCHQ held its third annual Fall Forum with over 200 healthcare providers, medical directors, quality improvement staff, and healthcare purchasers in attendance. All had the opportunity to learn from nationally recognized speakers who shared insights and perspectives on the leading edge issues in healthcare quality and performance measurement and public reporting. And with more than 20 improvement projects showcased, attendees were able to exchange ideas on a variety of topics.
• November 9, 2006: WCHQ released updated data points for all diabetes and hypertension measures, as well as impressive measures of overall WCHQ performance for each of the ambulatory care measures.
• February 1, 2007: WCHQ received a $600,000 grant from Aligning Forces for Quality, The Regional Market Project, a national program of the Robert Wood Johnson Foundation (RWJF), designed to help Wisconsin improve the quality of care provided to people with chronic illnesses.
• March 2007: Synergy Health - West Bend Clinic, Lakeshore Medical Clinic, and Mercy Health System join WCHQ.
• April 2007: Receipt of a demonstration grant from the GMBFH in support of the goal of developing a business model to engage and sustain support of small practices.