Colorado

ORIGIN AND MISSION
The Center for Improving Value in Health Care (CIVHC) was established by an executive order signed by Governor Ritter on February 13, 2008, as part of the “Building Blocks to Health Care Reform” plan. CIVHC was created to establish an interdisciplinary, multi-stakeholder entity to identify and pursue strategies for quality improvement and cost containment. Led by the Colorado Department of Health Care Policy and Financing, CIVHC brings consumers, businesses, health care providers, insurance companies, and state agencies together to develop long-term strategies to identify, integrate, implement, and evaluate quality improvement strategies. The goals are to ensure a better value for the $30 billion spent on health care each year in Colorado and to improve the service delivery systems, which will improve quality and drive down costs.

CIVHC’s vision is to optimize the health care system by “improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations,” as identified by the Triple Aim initiative, which was created by the Institute for Healthcare Improvement.  To avoid duplication of effort, CIVHC intends to coordinate the various organizations and initiatives that involve cost containment and quality improvement.

GOVERNANCE
A planning committee of health care providers, advocates, quality experts, and state officials was formed in January 2008 to make decisions about governance structure and scope of work.  This group met monthly to discuss quality improvement initiatives underway throughout the state and to identify opportunities for increased collaboration among these initiatives. The group, which also addressed the areas in which Colorado health care is in greatest need of improved quality outcomes, was charged with making recommendations to the Department of Health Care Policy and Financing.

In April, 2008 the Department received a $51,500 grant from The Colorado Trust to contract with JSI Research and Training Institute to help research both quality improvement efforts in other states and options for Colorado to explore, and to help facilitate planning committee meetings.

In its December 2008 report to the governor, the planning committee (under the Department’s leadership) recommended that the CIVHC Board consist of 7 to 15 members “who are highly influential in the business, civic and health care communities, are passionate about improving value in health care, and possess a strategic perspective.”  The planning committee also recommended that the CIVHC structure add 1.5 dedicated FTE – a 0.5 FTE director and 1.0 FTE support/program staff position.

In April 2009, the governor appointed 17 community members and 5 ex-officio members to the board and named the first interim director of CIVHC, whose position is supported by a grant from the Caring for Colorado Foundation.  Board members represent a variety of entities, including state agencies and departments (e.g. Division of Insurance, Department of Health Care Policy and Financing, Department of Human Services, Department of Public Health and Environment); CMS; health plans; providers, such as hospitals, community health centers, clinics, and health care systems; HIT organizations; consumers; and foundations.  Chairs of the CIVHC’s five workgroups also serve as ex-officio members of the Board.
ACTIVITIES AND ACCOMPLISHMENTS

•    Infrastructure building: developed a mission, vision, and strategic imperative; established a governance structure; hired a director; formed five workgroups (aligning benefits and finances, consumer engagement, improving health care delivery, data sharing for performance measurement, and end of life care); and appointed board members and board chair.

•    Completed a Report to the Office of Governor in December 2008, which lays out the progress, recommendations, and goals and strategies for CIVHC and its workgroups.

•    Selected to participate in The Commonwealth Fund and AcademyHealth’s State Quality Improvement Institute – an intensive, competitively selected effort to help states plan and implement concrete action plans to improve performance across targeted quality indicators.