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Right Care Initiative
Objective
To measurably improve clinical outcomes through enhancing the practice of patient-centered, evidence-based medicine.
Data from NCQA, The Integrated Health Care Association, the Agency for Health Care Quality and Research, the Commonwealth Foundation, the Centers for Disease Control indicate three trouble spots where evidence‐based clinical quality improvement will significantly enhance and save lives.
With an expert-based, public-private, multi-year collaborative, the Right Care Initiative focuses on:
2011 California Statewide Goals: Preventing Strokes, Heart Attacks, and Hospital Acquired Infections
- Achieve National HEDIS 90th Percentile Targets:
- 73% of hypertensive patients with blood pressure controlled <140/90 MMHG
- 70% of patients with cardiovascular conditions with lipids controlled LDL-C < 100 Mg/Dl
- 70% of diabetic patients with blood sugar controlled HbA1c < 8
- 55% of diabetic patients with lipids controlled LDL-C < 100 Mg/Dl
- Reduce Hospital Acquired infections
- Median of zero central line infections
- Significantly reduce infections designated by the Right Care Initiative work group
San Diego Demonstration Goals
- Heart attack and stroke prevention focused on heart disease, hypertension and diabetes patients through lipid, blood pressure, and blood sugar management.
- The Right Care Initiative will support medical directors of San Diego through its "University of Best Practices" luncheons
Thanks to an NIH GO grant, the Right Care Initiative and its partners have initiated a
community focused effort in San Diego centered on the Right Care goals of preventing heart attacks, strokes, and diabetes related complications. This grant provides a special opportunity to launch intensive efforts toward achieving the national 90th percentile of HEDIS performance in hypertension, cardiovascular disease, and diabetes prevention. For more information, view the statistical brief, the San Diego: Preventing Heart Attacks, Strokes and Diabetes-Related Complications.
View a presentation on the California Right Care Initiative given by Robert Kaplan, PhD: http://videocast.nih.gov/summary.asp?live=10001&debug=0 . Dr. Kaplan formerly led the Right Care Initiative as its NIH GO Grant Principal Investigator. He is currently the NIH Office of Behavioral and Social Sciences Research (OBSSR) Director.
Promising Interventions to Reach HEDIS Control Targets for Heart Attack and Stroke Prevention
Project Inspiration
NCQA estimates that improving the cardiovascular disease and diabetes measures among California’s 15 million commercial managed health plan enrollees to the national HEDIS 90th percentile could result in 1,694 to 2,818 Californian lives saved annually. It would also avoid $118 million in yearly hospital costs, 766,401 sick days and $125.56 million in lost productivity. Hospital acquired infections are estimated to kill more than 10,000 Californians per year, and are mostly preventable.
Heart disease, hypertension, diabetes, and prevention of hospital acquired infections are increasingly well understood
scientifically. Like the “100,000 Lives” national campaign for reducing medical errors, this project will improve the
lives of tens of thousands of California enrollees by catalyzing the work of experts and applying evidence based
medicine in the coordinated, managed care model.
Key Partners
- CA Dept. of Managed Health Care
- California health plans and medical groups
- CA Chronic Care Coalition
- University of California
- RAND
- Stanford University
- American College of Cardiology
- American Diabetes Association
- American Heart/Stroke Association
- CA Hospital Association
- CA Medical Association Foundation
- CA Pharmacy Foundation
- CA Quality Collaborative
- Veteran’s Affairs, SD Medical Center
- Integrated Healthcare Association
- Pacific Business Group on Health
- Ralphs Grocery Company
- Pharmaceutical Companies
- San Diego Medical Society Foundation
- Office of the Patient Advocate
- Our colleagues in public health
Implementation Action and Goals
Through periodic meetings, research, quality improvement support for medical groups, and collaborative
action, the statewide goal of the Right Care Initiative is to reach the 90th percentile in heart and
diabetes HEDIS control measures of blood pressure, lipids, and glucose, and to cut the rate of death
from hospital acquired infections.
Four summits have been held since March 2008—the first annual Clinical Quality Improvement Leadership
Summit—when DMHC launched the Right Care Initiative jointly with NCQA and the Deans of UCLA and UC
Berkeley Schools of Public Health. Each Right Care gathering is a collaborative effort with the
community, leading health plan and medical group medical directors, as well as thought leaders in
evidence-based medicine. For more information from past Right Care meetings, including agendas and
selected slideshows, view Meeting Agendas, Presentations & Notes.
Research Questions
- What are the most promising interventions for quickly bringing patients into safe control?
- What barriers are preventing improvement, and what are the best strategies for overcoming them?
- What are the best strategies for California to expedite a focused re-engineering effort to refine the implementation of evidence-based medicine to quickly meet these goals that are estimated to save thousands of lives annually?
- What strategies are needed to improve clinical outcomes in light of health disparities in California’s diverse population?
Contact
Hattie Rees Hanley, MPP, Right Care Initiative Project Director, hattiehanley@post.harvard.edu, (916) 323-2704
State-Wide Right Care Technical Expert Steering Committee Chair, and Vice Chair, and Founding Principal Investigator:
Stephen Shortell, PhD, MPH, Professor and Dean, University of California, Berkeley, School of Public Health
Carol Mangione, MD, MSPH, Professor of Medicine and Public Health, UCLA Schools of Public Health & Medicine
Robert Kaplan, PhD, Director , Office of Behavioral and Social Sciences Research (OBSSR), NIH
San Diego Demonstration Project Steering Committee Chair and Co-Vice Chairs:
Anthony DeMaria, MD, Chair, Judith and Jack White Chair in Cardiology and Director, UCSD Sulpizio Family Cardiovascular Center; Editor-in-Chief, Journal of American College of Cardiology
Judith and Jack White, Co-Chairs; San Diego Heart Attack and Stroke Prevention Champions
Jim Dudl, MD, First Vice-Chair, Clinical Lead, Care Management Institute, Kaiser Permanente and practicing endocrinologist
James Dunford, MD, Second Vice-Chair, City of San Diego Medical Director; President of the Board of the Greater San Diego American Heart Association
Cardiovascular Disease and Diabetes Principal Investigators
Carol Mangione, MD, MSPH, Professor of Medicine and Public Health, UCLA Schools of Public Health & Medicine
Allen Fremont, MD, PhD, RAND, Director, Action Consortium to Accelerate Change, Practicing Physician, Department of Veterans Affairs
Hospital Acquired Infections (HAI) Principal Investigators
Helen Halpin, PhD, Professor and Director, Center for Health and Public Policy Studies, UC Berkeley School of Public Health
Arnold Milstein, MD, Medical Director, Pacific Business Group on Health; National Health Care Thought Leader, Mercer; Director, Stanford Clinical Excellence Research Center
Funding
This project has been made possible by the generosity of the following supporters: Judith and Jack White, Johnson & Johnson, the National Heart, Lung and Blood Institute (National Institutes of Health), the California Office of the Patient Advocate, Blue Shield of California Foundation (HAI), California Health Care Foundation (“hot spot” identification), Novartis, and Sanofi Pasteur. This funding enables UC, RAND, and the California Chronic Care Coalition to provide external support for meeting the Right Care Initiative goals.
The views expressed in the documents by the presenters to the Department of Managed Health Care should not be interpreted as an endorsement by the Department.
