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In many cases, a quality reporting project is more effective when multiple organizations come together to make decisions, tackle the logistics, and combine money, talent, and other resources. This page discusses the benefits and challenges of collaboration and suggests ways to find appropriate partners.

Benefits of Collaboration

Collaboration offers benefits for sponsoring organizations, audiences, and the organizations whose performance is being reported.

Benefits for report sponsors:

• Larger audiences. Sponsoring organizations can benefit from the expanded audience they can reach through partners, who likely have their own communication channels and networks.
• Lower financial burden. A partnership strategy also lets the sponsors distribute the costs of the project across multiple funders, thus making the initiative more affordable for everyone.
• Greater credibility. When collaborative projects combine the objectives of health care purchasers with those of other organizations (such as consumer advocates and providers), consumers and patients tend to see the reports as more objective and thus more credible than materials produced by a single organization. Collaboration also allows sponsors to pool data, which increases the validity, and thus the credibility of quality scores.

Benefits for audiences:

• Greater consistency in information and messages. Collaboration among sponsoring organizations is an effective way of minimizing the inconsistencies often seen when multiple report cards are distributed to health care consumers in the same market. In areas where several sponsors produce performance reports on overlapping sets of plans or providers, those reports often use a variety of measures and measurement categories, data sources, definitions, and methodologies. As a result, consumers often see conflicting information on the same plans or providers, further adding to confusion and skepticism in the health care marketplace:
  • A comparison of five Web sites that displayed information on hospital quality found a lack of agreement in their rankings of the same local hospitals for four diagnoses.^[1]
  • A study of four public reports on provider groups in California found significant differences in content and methodology and illustrated the challenges that consumers would face if they tried to use competing data sources to choose a provider network.^[2]
  • An earlier study found similar problems with health plan performance reports distributed by Ford and General Motors.^[3]

Benefits for health care organizations:

• Reduced burden. Collaboration within a market also helps to ensure that local health plans and providers are not overly burdened by multiple demands for information. This can lower both the costs associated with generating reporting information for consumers, as well as the level of frustration for plans and providers that have to report slightly different information to different groups.

Challenges of Collaboration

Collaboration also has a few disadvantages:

• More time. Working with other organizations means taking the time to recruit and cultivate partners; negotiate goals, decisions, and strategies; and maintain communication and relationships over the course of the project. This time requirement needs to be incorporated into the project schedule.
• More compromises. One potential downside of a collaborative project is that the partners who can’t agree on a strategy (e.g., for displaying data) may settle for the “lowest common denominator,” which may not meet the needs of the audience or any of the partners. Collaborators must be mindful of this possibility and put the audience’s needs first.
• Fewer opportunities to experiment. While collaboration among organizations in a given market helps to reduce confusion and redundancy, it also limits opportunities to explore alternative approaches. 

Partnering With Health Care Organizations

One basic principle of health care quality reporting is that the subject of your report should be aware of the information before it is released to the public and, ideally, given an opportunity to respond in some way to the data (e.g., by seeking further details, initiating appropriate quality improvement activities, or offering an explanation for the results). Many sponsors take this principle a step further by seeking the active involvement of health care organizations in their projects.

Review key considerations when partnering with health care organizations.

Also visit: How Will You Gain the Trust of Providers or Plans?

Caveat: If health care organizations do participate in your project in some way, be careful how you refer to them in the report that goes out to the public. People are often suspicious of quality reports that appear to be produced by the providers or plans rather than an objective source that has no stake in the results.

Partnering With Consumer Advocates

Some report card sponsors pursue partnerships with organizations that function as advocates for consumers or patients. Advocates can offer a fresh perspective on the information needs and habits of consumers as well as well-established channels for communicating with those consumers.

To learn more about partnering with advocacy organizations, go to .

Finding Partners

Experienced sponsors suggest two ways to seek out potential partners:

Focus on those organizations with which you have something in common 

Some partnerships seem obvious because the participants clearly share common concerns. In the 1990’s, the U.S. auto manufacturers collaborated on quality reporting. While they may have been competitors, they also contracted with many of the same plans, had employees in many of the same States, already participated in similar quality measurement and reporting activities, and negotiated with the same unions.

Many private sector companies never even think to talk with purchasers or other agencies in the public sector and vice versa. But those who do have been surprised by how much they have in common and how much they can learn from each other.

• Public sponsors include the many agencies that purchase health care benefits on behalf of State employees; Medicaid beneficiaries; school, university, and local government employees; and the beneficiaries of State insurance programs for children and others. Other State agencies often involved in health care quality reporting include health departments, insurance departments, offices on aging, human services agencies, and government-sponsored health care commissions.
  
  What they offer. Due to its size, its influence, and the strength of its contractual relationships, a public purchaser or agency can lend substantial clout to a project. For instance, some States designate a single agency to contract for many, if not all, health care services for governmental organizations, including counties and schools; as a result, they can be a major purchaser in the State or in specific counties, often surpassing the biggest private employers. Moreover, public entities—especially regulatory agencies—imply the promise (or threat) of a political mandate, which can compel the cooperation of health plans or provider organizations. 
   
• Private sponsors include employers, purchaser coalitions, mixed-model coalitions of employers and health care organizations, proprietary companies, consumer advocacy groups, and other nonprofit organizations that focus on health care quality.
  
  What they offer. Private-sector sponsors of quality reporting projects often offer several years of experience with quality measurement and reporting as well as the flexibility to move quickly to make things happen. Many large employers and business coalitions have been actively engaged in such projects in various markets around the country since the 1990s. While they may not have all the answers, the experiences of private-sector sponsors give them a good sense of the right questions and the best paths to pursue.

Judging compatibility. When weighing the compatibility of potential co-sponsors, consider factors such as the following:

• Do you share an interest in performance at the same level of the health care system?
• Do you have similar reasons for wanting to measure quality?
• Do you have the same high level of commitment to measuring health care quality and informing consumers?
• Will it be possible to keep the number of decision makers involved down to a manageable number?

^[1] Rothberg MB, Morsi E, Benjamin EM, Pekow PS, Lindenauer PK. Choosing the best hospital: the limitations of public quality reporting. Health Aff (Millwood) 2008 Nov-Dec;27(6):1680-7
^[2] Simon LP and Monroe AF. California Provider Group Report Cards: What Do They Tell Us? American Journal of Medical Quality Mar/Apr 2001 16(2):61-70. For more information on this issue, see: U.S. General Accounting Office (GAO). Physician Performance: Report Cards Under Development but Challenges Remain. September 1999. GAO/HEHS-99-178. To order, go to GAO Web site at .
^[3] McGlynn EA, Adams JL, Hicks J, et al. Creating a Coordinated Autos/UAW Reporting System (CARS) for Evaluating Health Plan Performance. Santa Monica, California: RAND; September 1999. DRU-2123-FMC. Available at