Drawn from the report, States' Roles in Shaping High Performance Health Systems.
States shape the health system in many ways, influencing key components such as insurance coverage, quality of care, and information and provider infrastructures. This report presents findings from the State Health Policies Aimed at Promoting Excellent Systems project, undertaken by the National Academy for State Health Policy, with support from The Commonwealth Fund. After conducting surveys of multiple agencies in states across the country, as well as review of related literature, this study found that states are pursuing system improvements across the full spectrum of their authority, including health care purchasing, regulation of providers, reporting of performance data, integration of public health with health care approaches, and improving the availability and affordability of health insurance. Despite this activity, this study finds room for states to do much more. Ongoing efforts to track, study and diffuse information on state activities could accelerate adoption of promising polices and practices.
In Maine's pursuit of quality improvement, it is using measurement, public reporting of data, and identification of high achievers to understand its health care delivery systems and improve outcomes. Several entities provide Maine residents with a wide variety of information on the quality of care provided by the state's doctors, hospitals, and health care payers.
The Maine Quality Forum (www.mainequalityforum.gov), established by the state legislature in 2003 as part the health care reform effort, seeks to improve public health care data, promote best practices, and present findings to consumers and the legislature. It reports on geographic variations in 34 different measures of disease prevalence and hospital performance, measuring variations by community on conditions ranging from adult diabetes to knee replacements. In 2006, it launched the In a Heartbeat project to develop a set of evidence-based best practices for fast, effective treatment for patients who are suspected of having suffered a heart attack. It also administers the Safety Star program, which recognizes Maine hospitals that meet thresholds of performance on safety practices, and publicly identifies hospitals that are working to be among the safest.
The Maine Health Management Coalition (www.mhmc.info), a 34-member coalition of providers, insurers (including the state employee health plan), and public and private employers, seeks to measure and report on the value of health care services. It provides rankings of the state's doctors and hospitals and uses an easy-to-read "blue-ribbon" system to help consumers select health care providers. Its Pathways to Excellence projects seek to identify and reward providers that demonstrate high quality care and reductions in medical errors.
The Maine Health Data Organization (http://mhdo.maine.gov/imhdo/) was established by the legislature in 1996 as an independent executive agency with a public–private board. It maintains a publicly accessible database of health information and provides access to quality measures as well as detailed data from hospital and emergency department claims through the HealthWeb for Maine Web site (http://www.healthweb.maine.gov/).
Sources: Maine Governor's Office SHAPES survey response, and agency Web sites noted above.