About the AF4Q Evaluation

The Aligning Forces for Quality (AF4Q) initiative is the Robert Wood Johnson Foundation’s signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities and provide models for national reform.

The AF4Q Evaluation conducts impartial mixed methods research to provide inferences about the effect of AF4Q, identify key lessons about the AF4Q program design and implementation, and expand the knowledge base around health care reform at the local level. To measure the impact of the AF4Q initiative, we place particular emphasis on measurable progress in five key areas:

  • Consumer Engagement
  • Quality Improvement
  • Performance Measurement and Public Reporting
  • Payment Reform
  • Disparities Reduction

Learn more about our evaluation design in a 2012 special edition of the American Journal of Managed Care:

Evaluating a Community-Based Program to Improve Healthcare Quality: Research Design for the Aligning Forces for Quality Initiative

AF4Q Evaluation Investigator Honored By AcademyHealth

Jeff Alexander, the Richard Carl Jelinek Professor of Health Management and Policy in the U-M School of Public Health, professor emeritus, and co-investigator for the Aligning Forces for Quality Evaluation (AF4Q), was recently honored with the 2014 AcademyHealth Distinguished Investigator Award. This award recognizes investigators who have made significant and lasting contributions to the field of health services research through scholarship, teaching, advancement of science and methods, and leadership.

Alexander was been a member of the AF4Q Evaluation since 2006, leading research and evaluation in the areas of multi-stakeholder governance and organizational factors that impact AF4Q alliances’ efforts to improve health care.

Recent Publications

Why and How Six Aligning Forces for Quality Communities Have Focused on Reducing Disparities

The Aligning Forces for Quality initiative aims to increase consumer awareness and use of health care quality information. For six AF4Q communities the low rates of awareness and use among racial/ethnic minorities is of particular concern. With a focus on these six communities, we explore the activities implemented by AF4Q alliances to reduce disparities in the awareness of publicly available quality information and the ways in which alliances use the power of collaboration to enhance these efforts. By looking at the experience of these alliances we see evidence that community partnerships are a promising mechanism for increasing awareness of quality information in minority communities. This study provides one example for how AF4Q is creating models for health care improvement and disparities reduction in the United States. To read more, see this article online here.

What Influences the Awareness of Physician Quality Information? Implications for Medicare

Many organizations and initiatives, including AF4Q and Medicare’s Physician Compare effort, are working to report physician performance and raise awareness of physician quality among health care consumers. In this study we used data collected as part of the AF4Q evaluation effort to examine awareness of physician quality reports among people 65 and older who have chronic illnesses.

We found that awareness of physician quality information among this population is relatively low, similar to awareness in the general population. Furthermore, there is little difference in awareness across demographic subgroups. For this and other reasons, Medicare is not likely to be able to raise the overall awareness of beneficiaries significantly through targeted outreach programs. However, it is worth noting that awareness of physician performance information on the part of even a minority of Medicare beneficiaries, combined with a willingness to act on the information they contain, may be sufficient to drive quality improvement efforts on the part of physicians. To read more, find this article online here.