PPACA: HHS Posts Quality Strategy Document

March 21, 2011 at 08:00 PM
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Drafters mention the cost of care briefly in the new National Strategy for Quality Improvement in Health Care, a document that is supposed to shape U.S. quality improvement efforts.

Congress included provisions requiring HHS to oversee the development of a National Quality Strategy in the Patient Protection and Affordable Care Act (PPACA).

Officials at the Agency for Healthcare Research and Quality, a well-establishedCaduceus arm of the U.S. Department of Health and Human Services (HHS), say the agency has developed the National Quality Strategy with "input from a wide range of stakeholders across the health care system."

The stakeholders who provided the information used to create the document include "federal and state agencies, local communities, provider organizations, clinicians, patients, businesses, employers, and payers," officials say.

A new Federal Interagency Working Group on Health Care Quality will begin working later this year to "collaborate, cooperate, and consult with departments and agencies that develop and disseminate the strategies, goals, models, and timetables that will advance the national priorities outlined in the National Quality Strategy," officials say. "The main goals of this effort are to avoid duplication of efforts, assure accountability, and, where possible, develop a streamlined approach for quality reporting."

The 3 stated aims of the strategy for the health care system are to:

  1. Better Care: Improve the overall quality of care, by making health care more patient-centered, reliable, accessible, and safe.
  2. Healthy People and Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care.
  3. Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government.

In a section on "Making Quality Care More Affordable," officials say "reducing costs must be considered hand-in-hand with the aims of expanding access, providing better care, and promoting population health."

To reduce costs, officials say, "the National Quality Strategy will foster care strategies that reduce redundant and harmful care, for example, by reducing health care-acquired conditions; establish common measures that will help assess the cost impact of new programs and payment systems

on families, employers, and the public sector, along with how well these programs support innovation and effective care; build measurement of cost and resource use–along with patient experience and outcomes–into the full range of public and private sector efforts to reform payment; reduce waste from undue administrative burdens; and make health care costs and quality more transparent to consumers and providers, so they can make better choices and decisions."

Officials say efforts to make care affordable include:

  • Establishing a new health insurance exchange distribution system.
  • Starting a new Center for Medicare and Medicaid Innovation to test new types of payment and service delivery models in Medicare, Medicaid, and the Children's Health Insurance Program.
  • Implementing PPACA administrative simplification provisions, such as the creation of a standard unique identifier for health plans and a new standard for electronic funds transfers.

Many commenters who responded to a request for ideas about a National Quality Strategy talked about the need to control the cost of managing chronic illnesses and the need to prevent misuse and overuse of diagnostic testing, officials say.

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