Four witnesses made recommendations to improve quality in testimony at the U.S. Senate Committee on Finance's hearing, "Health Care Quality: The Path Forward," June 26.
Mark B. McClellan, MD, PhD, director of the Engelberg Center for Health Care Reform and a senior fellow at the Brookings Institution, shared four next steps on the journey to high-quality healthcare:
1. "Take further steps to transition payment systems in public programs to case- and person-level payments."
2. "Take further steps to implement case- and person-level quality measures in public programs."
3. "Support the [National Quality Forum] and a streamlined process for developing, endorsing and incorporating more meaningful quality measures into public programs."
4. "Support collaborations to implement quality measures using existing and emerging electronic data systems."
Christine K. Cassel, MD, president and CEO of the National Quality Forum, shared five activities healthcare quality leaders should take to continue improvement:
5. Increase "upstream, strategic and coordinated measure development that is focused on filling high-priority gaps."
6. Use "electronic systems to facilitate measure development and endorsement processes."
7. Adapt the "current review and endorsement process to meet changing needs."
8. Focus on measures that matter to providers, patients and purchasers.
9. Garner "continued support in both the public and private sectors for the measurement and quality improvement enterprise."
David Lansky, PhD, president and CEO of the Pacific Business Group on Health, made four recommendations on behalf of healthcare purchasers:
10. "Ensure the quality measurement enterprise reflects the needs of patients and purchasers."
11. "Develop and require collection of better performance measures."
12. "Develop needed information infrastructure" for performance data.
13. "Require the HHS secretary to meet Congressional intent" around providing healthcare quality information to the public.
Elizabeth A. McGlynn, PhD, director of the Kaiser Permanente Center for Effectiveness and Safety Research in Pasadena, Calif., suggested five steps to make progress on healthcare quality:
14. Measure meaningful outcomes and use lessons learned to improve care delivery.
15. Define clear goals for healthcare quality.
16. Invest in clinical and analytical expertise, testing and continued refinement of quality measures.
17. "Consider quality measurement in the context of emerging systems, new data sources, measures that are meaningful, different applications of measurement and expectations about what the delivery system can achieve."
18. "The federal government has a critical role to play in bringing the right stakeholders and experts together, coming to consensus with them on goals and co-developing a strategy for action."
The American Hospital Association also submitted a statement to the committee that included many changes needed to enhance quality measures, including the following two:
19. Use a consistent set of principles to align measures across payment and public reporting programs.
20. "The HHS secretary should identify the top three to five priority areas for measurement each year and implement them aggressively across the department's measurement programs."
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