As a purchaser-driven nonprofit organization, Leapfrog's mission is to arm employers and other purchasers of health care with the tools they need to spark improvements in their market. Of all the organizations that have put Leapfrog's principles into practice, there is perhaps no greater example of the power of value-based purchasing than the Maine State Employee Health Commission, the organization responsible for managing health insurance for all employees of the State of Maine.
A Lesson in Value-Based Purchasing
Ten years ago, the Maine State Employee Health Commission adopted a value-based purchasing strategy to:
- Encourage consumers to make informed decisions about their care,
- Provide incentives for consumers to seek higher-value care, and
- Reward providers who demonstrate better value.
Using Leapfrog data on quality and safety, Maine set a threshold for which hospitals would be considered "top tier." Then, the organization encouraged the use of these hospitals by waiving patient out-of-pocket expenses for preferred hospitals. For the patients choosing which hospital to go to, this was a big deal. It quickly caught the attention of providers, and immediately amplified a discussion of safety and quality among purchasers and patients throughout the state.
Making Safety and Quality a Priority in Maine
Maine hospitals have taken the program to heart. It is the first, and only, state where all acute care hospitals report to the Leapfrog Hospital Survey. Maine is the top-ranked state for percentage of A’s on the Hospital Safety Score, and had six hospitals represented on Leapfrog’s 2015 Top Hospital list.
Following the State Employee Health Commission example, other large Maine statewide purchasers have adopted hospital benefit tiering programs linked to patient safety and quality. The success of the Commission’s tiering initiative was the catalyst for the Maine Health Management Coalition’s Pathways to Excellence (PTE) program. PTE is a multi-stakeholder program that publicly reports hospital performance on safety, quality and patient experience measures.
Living the Vision
Maine's longtime commitment to pursuing value has ensured that the citizens of Maine receive the safest, highest-quality hospital care. To honor their unique achievements, Leapfrog awarded the Maine State Employee Health Commission with its 2015 Living the Vision award in the category of Value. Frank Johnson, Christine Brawn, and Joyce Oreskovich were there to accept their award, presented at the 15th Anniversary Living the Vision Gala.