Seeking National Standards to Measure Quality of Health Care Providers
The Consumer-Purchaser Disclosure Project, a coalition of more than 30 leading consumer, purchaser and labor organizations, seeks to make information from standardized measures readily available to employers, consumers and other purchasers of health care so that they can select high-quality providers and treatments.
Staff from AcademyHealth (formerly known as the Academy for Health Services Research and Health Policy) administered the project. AcademyHealth is a professional organization of health services researchers, policy analysts and health care practitioners in Washington.
During the grant period, the Consumer and Purchaser Disclosure Project:
- Forged a new partnership among consumer, labor and purchaser organizations to advance the goal of performance transparency within the health care marketplace.
- Developed a framework for assessing performance measures from a consumer and purchaser perspective.
- Proposed an additional 27 performance measures for the hospital setting and increased the number ultimately adopted by the National Quality Forum. (The National Quality Forum is a public-private partnership formed in 1999 to develop and implement a national strategy for health care quality measurement and reporting.)
- Submitted comments to the National Quality Forum on various performance measures and implementation issues.
- Supported use of the national measurement set by stakeholders and identified key leverage points to initiate performance reporting.
The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $55,240.
At the time the project was funded, employers, consumers, and other purchasers of health care lack well-defined and standardized measures of performance and quality that they can use to understand the performance of hospitals, medical treatments, physicians and other health care providers. There was no agency or function in the health care marketplace that provides a comprehensive, consumer friendly set of performance measures.
The intent of the project was to rapidly advance the definition and implementation of a comprehensive set of performance measures across the six Institute of Medicine (IOM) quality domains safety, timeliness, effectiveness, efficiency, equity and patient-centeredness. The project staff believes that improvements in the health care system will be driven by:
- consumers using valid performance information to choose providers and treatments
- purchasers building performance expectations into their contracts and benefit designs
- providers acting on their desire to improve, supported with better information.
This project was consistent with RWJF's goal of creating demand for high-quality care among purchasers and consumers. RWJF has funded a number of other initiatives consistent with this goal (grant ID# 032002), including the National Health Care Purchasing Institute, an RWJF national program (now folded into Rewarding Results: Aligning Incentives with High-Quality Health Care) that worked to improve health care quality by advancing the purchasing practices of major corporations, government agencies and public employers (for more information see Grant Results). Another RWJF-funded initiative in this area is its support of the Leapfrog Group, a consortium of public and private health care purchasers that works to harness the purchasing clout of these groups to improve the safety and overall value of health care (see Grant Results on ID# 040728 on a grant to promote patient safety through health care purchasing tools.) The Leap Frog Group heads up Rewarding Results.
The goals of the Consumer and Purchaser Disclosure Project were to:
- Unite a critical mass of consumers and purchasers around the Disclosure Goal.
- Promote the rapid definition of a comprehensive set of standardized performance measures for hospitals, physicians and other providers, treatments and health plans addressing all six quality improvement aims set forth by the IOM in Crossing Quality Chasm.
- Support adoption of the measures issued by the National Quality Forum.
The National Quality Forum is a public-private partnership formed in 1999 to develop and implement a national strategy for health care quality measurement and reporting.
If the National Quality Forum endorsed the scope of measures promoted under this grant, project organizers believed chances were also good that the Centers for Medicare & Medicaid Services would adopt them for the purpose of public reporting.
Combined with support among large employers, consumer organizations and other health care purchasers, demand for widespread adoption of the measures would be even greater.
Additional financial and in-kind support came from three employer coalitions Employer Health Care Alliance Cooperative, Pacific Business Group on Health, and the Midwest Business Group on Health ($16,000, total) and the California HealthCare Foundation ($60,000).
In-kind contributions came from various other consumer and employer organizations participating in the project.
The Consumer and Purchaser Disclosure Project:
Project staff produced official comments addressing hospital performance measures under consideration by the National Quality Forum. Project leadership presented the consumer and purchaser perspective on performance measures during a July 2002 National Quality Forum Board meeting. They also produced a newsletter, Disclosure, in October 2002 for dissemination by participating organizations. Plenary meetings were held in July and October for all participating and supporting organizations to share progress and solicit ideas on future priorities.
AFTER THE GRANT
In collaboration with the National Quality Forum, the project sponsored a February 2003 meeting of 74 leaders of hospital, consumer and research groups, as well as public- and private sector purchasers to devise a plan for implementing the broad set of hospital performance measures. Administration of the project has since moved from AcademyHealth to the Leapfrog Group.
Project staff plans to continue a dialogue with the federal government to develop a plan for full implementation of the hospital measurement set. They also will push for further expansion of the hospital measures, particularly those that address efficiency and equity and cut across hospital departments. They will work to promote the development of measurement systems to support public reporting of the national measurement set.
GRANT DETAILS & CONTACT INFORMATION
Improving Public Reporting of Standardized Performance Measures of Health Care Quality
AcademyHealth (Washington, DC)
Dates: June 2002 to November 2002
Organizations Represented in the Consumer and Purchaser Disclosure Project
St. Paul, Minn.
American Benefits Council
American Hospice Foundation
Buyers Health Care Action Group
California HealthCare Foundation
Center for Medical Consumers
New York, N.Y.
Consumer Coalition for Quality Health Care
The Employer Health Care Alliance Cooperative
ERISA Industry Committee
Ford Motor Company
Foundation for Accountability
General Electric Company
General Motors Corporation
The Leapfrog Group
March of Dimes
Midwest Business Group on Health
National Association of Manufacturers
National Breast Cancer Coalition
National Business Coalition on Health
North Canton, Ohio
National Citizens' Coalition for Nursing Home Reform
National Coalition for Cancer Survivorship
Silver Spring, Md.
Niagara Health Quality Coalition
National Partnership for Women and Families
Pacific Business Group on Health
San Francisco, Calif.
State Medicaid Directors Association
Union Pacific Railroad
U.S. Chamber of Commerce
Washington Business Group on Health
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Disclosure. Washington, D.C.: National Health Care Purchasing Institute. One issue in 2002.
Presentations and Testimony
Debra Ness and Arnie Milstein, M.D., "Consumer and Purchaser Perspectives on Hospital Quality Measures," at a meeting of the National Quality Forum, July 15, 2002.
Report prepared by: Linda O. Prager
Reviewed by: Richard Camer
Reviewed by: Marian Bass
Program Officer: Paul Tarini