U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality created the Comparative Health System Performance Initiative to study how health care delivery systems promote evidence-based practices in delivering care and to understand the connections between the dissemination of patient-centered outcomes research (PCOR), patient outcomes, and the effective use of resources.
The initiative established three Centers of Excellence to Study High-Performing Health Care Systems. These centers identify, classify, track, and compare health systems to reveal the factors that affect the use of evidence-based medicine and to identify best practices in the dissemination and implementation of PCOR.
The initiative also established a Coordinating Center, led by Mathematica, to leverage the expertise, infrastructure, and resources across the Centers of Excellence, with the goal of speeding the adoption of PCOR to improve care and efficiency within health systems. To achieve this goal, the Coordinating Center is doing the following:
Facilitating coordination and collaboration
The Coordinating Center promotes collaboration between the Centers of Excellence to help align the concepts, data, methods, and measures needed to compare health system performance. This ensures that evidence collected is comprehensively examined to contribute to a synthesis of the initiative’s findings.
Convening experts and stakeholders
The Coordinating Center is convening a technical expert panel. These experts will meet regularly to advise AHRQ and the Centers of Excellence about data and performance measures, types of evidence that will be most useful to stakeholders, research gaps, dissemination products, and effective strategies for reaching stakeholders.
Synthesizing and disseminating research on health system performance
The Coordinating Center will synthesize and disseminate the evidence produced by the Centers of Excellence to speed the adoption of practices that can improve the performance of health systems. These syntheses will include journal articles, issue briefs, fact sheets, and data visualizations. They will help clarify the types of systems, processes, incentives, and environments or markets that speed the diffusion of PCOR findings into practice to produce the best patient-centered outcomes. Results from the initiative will be published as they become available, culminating in the release of final findings in fall 2020.
Producing a compendium on U.S. health care systems
The Coordinating Center created a compendium that enables users to access health system data and information about practices for achieving evidence-based and patient-centered care. The compendium is a valuable resource for those interested in (1) understanding the characteristics of health systems, (2) comparing and contrasting the performance of different health systems, and (3) examining the performance improvement approaches of various health systems.
The compendium includes a data library that links descriptive statistics collected by the Centers of Excellence and the Coordinating Center. These data resources provide tools that allow users to identify characteristics of diverse established health systems; make comparisons across systems and communities; and graphically depict key health system characteristics and other environmental factors that may contribute to higher quality care. Thus, it provides potential users with both high-level “snapshots” and “deep dives” into the evolution of health systems in the United States to help stakeholders promote higher-value care.
Visit the Comparative Health System Performance Initiative website to learn more about this work and access the Compendium.
Evidence & Insights From This Project
Consolidation of Providers Into Health Systems Increased Substantially, 2016–18
We found substantial consolidation of physicians and hospitals into vertically integrated health systems from 2016 to 2018. The share of physicians affiliated with health systems increased from 40 percent to 51 percent in just two years.Learn More