New forum will boost demands for care data

Alliance will set agenda for accountability

In an effort to turn up the heat on health care accountability and performance measurement, a new national Forum for Healthcare Quality Measurement and Reporting is forming and will meet for the first time this spring or summer.

Creation of such a forum was one of the recommendations of the President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry, which issued a final report last July. The forum board will include representatives of major health care purchasers, health plans, provider groups, and consumer organizations.

One of the most "compelling" findings of the President’s commission involved the need for greater quality improvement in health care, says Chris Queram, MHA, CEO of The Alliance, a purchaser coalition based in Madison, WI, and a member of the President’s commission and the forum planning committee.

For example, the report cited studies of medication errors and hospital-based adverse events, underused lifesaving therapies such as beta blockers, and overused procedures such as hysterectomies.

Meanwhile, quality measurement currently is inconsistent, the report states. While various accrediting bodies, state agencies, and purchaser coalitions require performance measurement, those efforts aren’t coordinated, says Queram, who is also chairman of the board of the National Business Coalition on Health, a Washington, DC-based alliance of business coalitions.

"Provider organizations and health plans are pulled in any number of directions by different reporting standards and requirements," says Queram. "It’s costly, inefficient, and it makes it very difficult to compare providers and plans across communities.

"We need a common platform for quality measurement," he says. "The forum is designed to be the vehicle to do that."

The need for reporting comparative data on health care quality was at the heart of the report and recommendations of the President’s commission. "All participants in the health care industry must be accountable for improving the quality of health care in the United States," the report says.

Specifically, the commission favored a "health care error reporting system to identify errors and prevent their recurrence," as well as a comprehensive plan for quality measurement and data collection at all levels of health care.

"As much attention as the Patient’s Bill of Rights has received, which is important and politically attractive to legislators, the real important recommendations of the commission’s work are in the area of quality," says Queram. "They have the potential to transform the way health care services are delivered around the country."

The "Patient’s Bill of Rights" refers to a list of "consumer rights and responsibilities" that the commission outlined, covering such issues as access to providers, appeals of denial of coverage, and confidentiality.

As a private sector initiative, the forum will endorse standardized measures of quality and encourage their adoption at all levels of health care and by health care purchasers. It would seek to educate consumers about health care quality. The forum will report to the Advisory Council for Health Care Quality, a public body that would set improvement goals and monitor progress.

"The visibility of this whole area [of health care quality measurement] is going to be heightened," says Pat Powers, executive director of the Pacific Business Group on Health, a California purchaser coalition that has been active in reporting quality measures for medical groups, hospitals, and health plans. "Most of our employers are [located] in multiple states, and they’re very eager to see the kinds of activities we’re doing in California spread to other communities."

Christina Bethell, PhD, director of research for the Foundation for Accountability in Portland, OR, echoes those sentiments. "It adds an important leadership and visibility to the cause. The forum can help frame an agenda and push it harder than others can on their own."

New pressures on docs to prove quality?

For medical groups, the forum may mean new pressures to collect and report on a set of quality indicators and to upgrade information systems to make outcomes reporting more efficient. But it also should lead to less duplication of effort as medical groups provide quality information to different health plans and purchasers.

Major accrediting bodies, the American Medical Association, and the Foundation for Accountability have been involved in the creation of the forum.

"One of the great opportunities of the quality forum is to bring about greater alignment on a quality platform," says Queram. "Consumers and employers are all across the board in how much they use quality information in their decision making.

"We’ve focused a lot of cost and premium because it’s easier to measure and influence across a bargaining table," he says. "The great opportunity is to integrate quality information to make sure you’re focusing on value as opposed to just cost."

[A copy of the President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry is available on-line at http://www.hcqualitycommission.gov. Or you can contact Consumer Bill of Rights, Box 2429, Columbia, MD 21045-1429. Telephone: (800) 732-8200.]