As the cost of health care in the United States continues to rise, of utmost concern are reports that medical bills are creating substantial hardships for patients and that the cost of health care is now the biggest financial concern facing American families. Healthcare debt is a leading driver of personal bankruptcy and home foreclosure. Both insured and uninsured patients are burdened by medical bills. Confounding these issues is evidence that patients avoid necessary care (prescription refills, doctors appointments) because of cost. Care avoidance will compromise diagnosis and management and potentially result in an emergency department visit or hospitalization, which are the 2 biggest contributors to burdensome health care debt.

In response to these challenges, providers across the country are reflecting on their practice to identify opportunities and implement initiatives that improve patient care quality and safety while reducing costs. To efficiently and effectively advance this work on a national scale, the High Value Practice Academic Alliance was established in 2017, and faculty leaders from 100 partner institutions representing >30 different medical specialties & subspecialties have joined the organization. Through cross-institutional collaboration, successful value improvement work safely piloted in one academic center can be advanced nationally to lead large-scale improvements in health care value. Monthly webinars showcase successful value-based quality improvement initiatives, and the alliance directs a national high value care conference each fall, in partnership with the American Hospital Association and sponsored by the Johns Hopkins University School of Medicine.

Member centers also work together to design new value-based quality improvement initiatives and disseminate results in the medical journals for broad impact. Teams of faculty and house staff have created a compendium of peer-reviewed implementation guides published in JAMA Internal Medicine, designed to assist others embarking on new value-based improvement within their medical center. The 1st 6 guides were published as Special Communications in JAMA Internal Medicine, and others are in progress.

Engaging medical students, resident physicians, and fellows is critical for longstanding improvements in practice, and this a founding principle of the organization. 

The HVPAA Future Leaders Program is a free year-long professional development curriculum for residents and fellows, designed to recognize high potential house staff and advance their understanding of high value care and how to lead value-related quality improvement. The curriculum includes carefully selected didactics and direct mentoring by 7 faculty champions from academic medical centers committed to high value care.

By joining forces, academic institutions can efficiently and effectively advance performance improvement to refine health care on a national scale and demonstrate to patients that their medical providers are accountable for the quality of health care they deliver, as well as the quality of the U.S. health care delivery system.

The alliance provides a forum for academic medical institutions to collaborate on best practice performance improvement initiatives and peer reviewed publications related to health care value. The alliance does not provide medical advice.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPAA on Health Affairs Blog