QURE has worked with a variety of clients, small and large, across a wide variety of market sectors. We strive to be a strategic partner with our clients by leveraging our expertise and experience to provide innovative, responsive and cost-effective solutions.
Payers & Providers
The goal of a large northwest healthcare system-wide study was to answer two urgent questions at the center of U.S. healthcare reform:
- Can payers and plans implement a new risk-bearing payment model for specialists (cardiologists) that lowers costs ?
- Does the new payment model effectively disseminate evidence based cardiovascular practice that raises quality?
This study hypothesizes that a quality-based payment model will significantly improve quality, patient satisfaction, while lowering costs. This prestigious healthcare system consists of 8 hospitals, and 8 clinics and facilities, and wanted disease-specific measures for the three most common cardiovascular diseases: coronary heart disease, heart failure and atrial fibrillation. The study will:
- Experimentally introduce a new quality-based payment model into one of two large cardiology practices the NW.
- Conduct a large scale pre-and post-payment data collection effort that brackets the intervention and measures: a) physician clinical practice data using our CPV™ vignettes, b) patient satisfaction data using Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores; and c) health plan cost data, collecting group-based per patient per year (PPPY) costs of total cardiology care.
- Evaluates whether the experimentally introduced payment model results in higher quality, as measured by greater compliance to CPV™ vignette scoring criteria and lowers costs, as measured by changes in utilization in curative and preventive care, diagnostic testing and therapeutic interventions.
Lifesciences & Medical Technology
For a biotechnology company, QURE designed a study using Clinical Performance and Value™ vignettes to measure the effect of an innovative molecular blood test on clinical practice. QURE specifically measured:
- Variation in clinical practice among specialists caring for patients
- Physician characteristics, the presentation of patients, the stage of disease, and reported symptoms
- Therapeutic inadequacy and opportunities for earlier therapeutic adjustment. The results will focus on identifying effective therapy in a shorter time frame compared with current empiric (trial and error) practice.
QURE designed a three arm prospective randomized study design, collecting clinical practice data using Clinical Performance and Value (CPV™) vignettes. A group of recruited physicians were divided evenly between experienced users of the test, inexperienced users who were then introduced to the test through an intervention, and inexperienced users who had no experience with the test as a control arm.
QURE collected baseline data and re-sampled the same physicians after the introduction of the blood test, measuring how practice had changed in the three physician categories. These changes in clinical practice were quantified in a variety of dimensions, producing peer-review quality data for publication. Finally, QURE calibrated the changes in clinical practice, quantified the economic benefits of the test, and produced peer-review clinical practice data.
Policy, Government & International
QURE’s newest project is collaborating with the World Bank. With QURE’s assistance, the World Bank plans to conduct a healthcare provider survey in 6 Eastern Europe and Central Asian countries. The purpose of this consultancy is to:
- Design a healthcare provider facility survey, a brief patient survey and clinically based evaluation to assess quality of care for maternal, neonatal and non-communicable conditions
- Provide technical support, coordination and quality control for the implementation of the surveys in 6 Eastern Europe and Central Asian countries
- Provide analysis and reporting of the cross national data
The survey aims to provide standardized measurements of clinical performance in hospitals and primary care clinics that send patients to those hospitals. Within each hospital we will evaluate the quality of care among three specialties: cardiovascular disease care, obstetrical perinatal care, and for pediatric neonatal care. In each hospital and associated primary care providers, we will select physicians to complete CPV™ vignettes for the above mentioned specialties as well as cardiovascular disease and neonatal pneumonia in the primary care clinics.
U.S. National Institutes of Health
Quality Improvement Demonstration Study (QIDS), was a 5-year project funded by the U.S. National Institutes of Health. It was lead by University of California San Francisco’s Institute for Global Health and UPecon Foundation in collaboration with the Philippine Health Insurance Corporation and the Department of Health.
The primary objective of QIDS was to evaluate the impact of health sector reform initiatives on the health status and cognitive development of children. QIDS examined the link between clinical care and health status, including the cognitive ability of children so that inferences can be made on the relationship between policy interventions in health and ultimately, economic growth.
The study utilized an experimental design where the two interventions plus a control were randomized to matched blocks of hospital districts. Data was collected from public and private physicians via CPV™ vignettes, in addition to physician surveys, patient exit surveys, and household surveys.
Read more about QIDS here.