Greater Cincinnati’s success in leading health care transformation initiatives is featured in a new book, Bridging the Value Gap, written by Chuck Reynolds and Jack Nightingale.

The authors looked nationwide for specific programs or locations where employers, health care providers, and health insurance plans, are working together to control health care costs and improve quality. They found a compelling case study in the Tri-state.

Prominently featured in the book’s narrative and graphic display is the role of the Health Collaborative and its ability to provide a neutral forum where all health care stakeholders have equal footing to influence change. The book goes into great detail about the resolve of the Greater Cincinnati community, including the willingness of the hospitals to work together and the strong business support for health care transformation. Both contributed to Cincinnati being selected as one of 16 Aligning Forces for Quality (AF4Q) communities, with the Health Collaborative receiving just over two million dollars from the Robert Wood Johnson Foundation over a six year period.

“At first, we were drawn to the Cincinnati AF4Q story because the Health Collaborative was pursuing a remarkably comprehensive set of programs to achieve successful transformation,” says co-author Jack Nightingale. “But as we studied the initiative, we came to see just how deep the spirit of collaboration had carried. The area’s major employers, hospital systems, and health plans, all shared a commitment to jointly develop new approaches that will lead to better care for patients while controlling the overall cost trend.”

Much of the case study is devoted to the early development of various programs led by the Health Collaborative. This includes the support the Health Collaborative provides to assist primary care doctors as they transform their practices into Patient Centered Medical Homes (PCMH). In this emerging practice model the primary care physician takes a larger role in the coordination of each patient’s care and overall health. Early measures show this model has potential to reduce costs and improve wellness.

The authors also give credit to the work the Health Collaborative did to enlist the support of physicians as it established a system that encourages doctors to report their clinical outcomes for display on the website This unprecedented commitment to quality improvement and transparency by the physician community delivered to patients in Cincinnati their first, and only, scientifically based measure of physician performance. First developed for diabetes outcomes, the Health Collaborative continues to expand the number of conditions reported on the website.

The authors also cited the business community’s ability to become involved and support a business plan around a health care transformation initiative. General Electric, Procter & Gamble and Ethicon Endo-Surgery were among those who took the reins, lending resources and direction. Also noted was the willingness of the health plans to provide data and try new reimbursement models.

The authors were also greatly impressed with the consumer research led by the Health Collaborative. The patient insight developed from qualitative studies is helping health care administrators around the nation understand how patients respond to new initiatives around cost and quality. It is becoming a blueprint for identifying the work that needs to be done to better engage patients as responsible consumers of health care resources.

The book is published and distributed by Johnson and Johnson Health Care Systems Inc. and is available in limited quantities online at


The Health Collaborative assembles diverse community stakeholders; hospitals, physicians, insurers, patients, business, education, government and community members, with the goal of generating measurable, sustainable health improvement. The work of the Collaborative has been recognized by the U.S. Department of Health & Human Services, the Agency for Healthcare Research and Quality, and the Robert Wood Johnson Foundation. For more information, visit

To view as a PDF, click here.