Wisconsin Collaborative for Quality Healthcare

Measurement Approach

Through the Performance & Progress Report on this website, WCHQ publicly reports a broad and growing collection of healthcare performance measures that evaluate ambulatory and hospital care.

WCHQ member organizations — which include Wisconsin health systems, medical groups and hospitals — voluntarily collect and submit data related to the services that they provide. WCHQ validates the data, ensuring that it accurately reflects evidence-based standards. WCHQ then publishes the results, so that healthcare providers, purchasers and consumers alike can compare the performance of member organizations.

This comparison spurs quality improvement and greater efficiency among healthcare providers.

WCHQ's Unique Approach: All Patients, All Payers

Many other healthcare reporting organizations rely exclusively on administrative claims from commercial insurers to create their performance measures. Such claims-based reports exclude Medicare, Medicaid and self-pay patients, which account for nearly 50% of clinical practice.

Physicians, data analysts and quality specialists from the WCHQ membership have developed ambulatory care specifications that capture all patients and all payers. By uniting claims, clinical and patient data, WCHQ tracks each provider's entire practice. This comprehensive approach enables WCHQ to create a sophisticated measure set that evaluates both clinical processes and intermediate outcomes, such as A1c and blood pressure.

Innovative Data Submission

WCHQ has created an innovative "Repository Based Data Submission" (RBS) tool, which allows WCHQ member organizations to directly submit patient level data files for processing and reporting.

RBS provides important benefits for WCHQ members:

  • Time savings when querying and aggregating data
  • Increased efficiency during data validation
  • Reduced programming burden
  • Ready access to patient level data for internal testing and reporting
  • CMS data submission vendor for the Physician Quality Reporting System (PQRS) as well as the clinical quality measure component of the Medicare Electronic Health Record Incentive Program

When using RBS, WCHQ member organizations create a global file of patient demographic, encounter and clinical data. This global file encompasses data from all available sources, including electronic health record software, billing systems, lab information and medication lists.

Once WCHQ members upload their global data, the RBS system's centrally programmed measure specifications calculate performance results for both public reporting on the WCHQ website and custom reporting within member organizations. RBS also generates measure results for individual providers participating in the Centers for Medicare & Medicaid Services Physician Quality Reporting System (PQRS).

The RBS data submission and storage processes comply with HIPAA regulatory requirements, as verified by independent audit.