Although performance measurement efforts have made a positive impact on quality, only so much can be done when healthcare payment systems penalize improvement and the fragmentation of providers impedes coordination. Significant changes in the way healthcare is paid for, the way providers are organized, and the way consumer benefits are structured will be needed to achieve greater value in healthcare. To be successful, these changes must be made in a coordinated way.
Regional Health Improvement Collaboratives can serve as catalysts for payment and delivery system reforms, as neutral planning and problem-solving forums where win-win multi-payer, multi-provider payment and delivery reforms can be designed, and as sources of both leadership and technical assistance in implementing needed reforms.