Abstract
This article describes the evolution of a collaborative model of quality improvement between an HMO and six contracted home health agencies using OASIS items to measure patient outcomes. The results showed that when agencies completed quality improvement activities independently, HMO patients' outcomes did not improve substantially. In contrast, when the HMO and agencies collaborated, patient outcomes improved as much as 19% in 1 year. This collaborative model can help purchasers and providers to share responsibility for improvement in patient outcomes.