Elizabeth Mitchell, President & CEO, Network for Regional Healthcare Improvement, (NRHI).
Can you tell us more about NRHI (pronounced EN-ree)?
NRHI is a national network of 40 regional health improvement collaboratives — we call them “RHICs” for short — working in their communities, states or regions to improve health and health care. These are organizations similar to the Quality Institute. They work with all stakeholders, including employers, insurers, consumers and providers, to improve health care quality, reduce costs, and provide patients with a better experience.
How does the Quality Institute benefit from being part of NRHI?
NRHI’s network exists across the nation. So New Jersey can benefit by learning what innovations are working in Washington or Minnesota or New Mexico and elsewhere. By learning from its peers, New Jersey can leapfrog over obstacles and barriers to improvement it might be facing. And vice versa – other communities can learn about the great work being done here. The idea is that no one has to reinvent the wheel. Changing how we deliver, pay for and receive care can be tough work, so by tackling it collectively, we can move further and faster together. So NRHI is the connective tissue helping organizations like the Quality Institute understand what’s happening in other communities.
RHICs also benefit from being part of this network by participating in NRHI initiatives. With support from various philanthropies, including the Robert Wood Johnson Foundation, and federal contracts like the Agency for Healthcare Quality and Research, NRHI members are testing innovations in an aligned and consistent manner across multiple communities or states.
And lastly, NRHI is elevating local innovations of RHICs to a national level. We have relationships with leaders at HHS, CMS, CMMI and ONC and are demonstrating how RHICs are necessary partners for implementing federal policies, like value-based purchasing, at a local level.
Why not just rely on federal levers to implement health reform? Why do we need a regional or local approach?
Great question. True transformation does not happen from Washington DC. HHS has shown great leadership to set our direction and develop a framework but true transformation of how we deliver, get and pay for health and health care happens in communities. It happens on the ground — through convening community conversations where all stakeholders are represented, through investing in relationships and building trust with local providers, and through understanding each community’s pain points and priorities. Regional collaboratives such as the Quality Institute are well positioned to play this unique and trusted role in their communities. That’s critical for transformation.
What role does government play?
Government plays a vital role, absolutely. We’ve seen strong leadership at CMS, particularly with advancing alternative payment methodology and moving the country away from paying for volume to paying for value. I often hear the phrase, ‘Where Medicare goes, others follow.’ And it’s quite true, so having leadership at the federal level is immensely important.
Tell me about one thing that New Jersey might learn from its peers in NRHI’s network, and vice versa.
New Jersey might be interested to learn how other regions are advancing transformation through greater transparency of quality and cost information, including how outcomes vary within a state. And NRHI is interested in learning about how the Institute works closely with its local governments – specifically mayors – to convene local conversations about challenging topics, such as end of life care.