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Medicare News
National Network of Local Groups to Monitor Health
Care is Launched by HHS
'Value Exchanges' will make quality and cost
findings public
 Feb. 28, 2007 Health & Human Services today
announced an ambitious program to establish local "collaborative
organizations," which will be call "Value Exchanges," to assess the
performance of local health care providers and make the findings public.
They will use "nationally-recognized standards" to measure and improve
quality of care in their areas and will eventually form a
nation-wide network, according to HHS Secretary Mike Leavitt. It is the
latest move in the government's effort to make health care cost and
performance more transparent.
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"This plan is about giving consumers good
information to make decisions about their health care, and giving
providers information to help them improve care," Leavitt said. "It's
also about hard work and trust. At the local level, providers and
purchasers can meet eye-to-eye and achieve the trust that must underlie
a system of improvement based on more open information."
Under the plan, HHS would select qualified regional
collaboratives to be chartered as Value Exchanges.
In these collaboratives, says HHS, local area
physicians, nurses, hospitals and other health care providers will work
collaboratively with health plans, employers, unions and other health
care purchasers to achieve reliable public reporting on quality and cost
of care.
As HHS-chartered Value Exchanges, they would
continue to focus on quality improvement and would provide public
reports on the performance of providers in their area.
The Value Exchanges would be independent,
non-profit organizations.
HHS says that in recent years, a number of
collaboratives of this kind have been created independently in
communities throughout the country. The new plan would help bring such
collaboratives into a national system, as well as stimulating more
communities to create such collaboratives. It would also create a
national Learning Network to help the chartered Value Exchanges move
quickly to expand and improve quality assessment.
Secretary Leavitt said that HHS will invite initial
applicants to be chartered as Value Exchanges. HHS will also stimulate
development of more collaboratives by formally recognizing early
community efforts to bring stakeholders together for quality improvement
and reporting.
The system would include two types of
collaboratives:
Community Leaders -- Less-developed
collaboratives, especially those aiming at growth in stakeholder
participation and quality measurement capacity.
Value Exchanges -- Collaboratives that best
meet criteria and are selected by HHS to be chartered and carry out
quality improvement and public reporting.
Advanced collaboratives that meet additional
criteria may qualify to pool their data with Medicare data for
broadest-based measurement of provider performance and quality outcomes.
Existing local and regional collaboratives that
have developed independently in recent years would be expected to form
the initial core of Value Exchanges receiving HHS charters. In addition,
six existing collaboratives were selected last year to pioneer the
process of pooling local and Medicare data, under Medicare's Better
Quality Information to Improve Care for Medicare Beneficiaries program.
The six pilots will continue to function as special Medicare
demonstrations.
In measuring providers' performance and publicly
reporting the findings, the Value Exchanges would use
nationally-recognized standards. These standards, developed through
public-private efforts, also form the basis for ongoing Medicare quality
and performance reporting. The Exchanges could also pioneer new quality
improvement strategies and share results through the Learning Network.
The new system would be administered by HHS' Agency
for Healthcare Research and Quality (AHRQ). AHRQ Director Carolyn M.
Clancy, M.D., said providers would lead in the development of standards.
"The goal is to achieve both national coordination
in developing standards and local control in applying them," Secretary
Leavitt said. "The Value-Driven Health Care Initiative is aiming at both
of these goals -- and at the same time, aiming to keep control in the
private and professional sectors. The federal government can help
organize -- but providers, purchasers and consumers themselves must be
in charge and make the system work."
The plan for Value Exchanges is part of the
Value-Driven Health Care Initiative, a public-private effort launched by
Leavitt last year to improve quality and lower costs in health care
delivery.
The first element of this initiative, which is
still on-going, aims at national coordination by calling on all health
care stakeholders to commit to public reporting on quality and costs,
including recognition of consensus standards of care. The initiative
also supports health information technology and incentives for value
purchasing in health care.
>> For more information:
www.hhs.gov/transparency.
Background on Mandate by President Bush
President's Executive Order Drives Effort to Make
Health Care Transparent
 Last August, President Bush signed an Executive
Order aimed at increasing the transparency of the health care system. A
White House statement said, " Americans need to know their options in
advance, know the quality of doctors and hospitals in their area, and
know what procedures will cost.
"When Americans buy new cars, they have access to
consumer research on safety, reliability, price, and performance - and
they should be able to expect the same when they purchase health care."
Bush said, "Health care policy ought to be aimed at
bolstering the consumer, empowering individuals to be responsible for
health care decisions."
Consumers Will Receive Information Through A
Collaborative Process
The White House statement on the order said, "The
Federal government will work collaboratively in this process, building
on efforts by quality alliances that include a broad range of health
care stakeholders to improve quality and cost information. Measures of
quality at the provider and health plan level will be developed from
private and government sources and will not involve developing or
releasing data at the individual patient level.
"Participation in this process in each area will be
governed by various regional stakeholders, including local providers,
employers, and health plans and insurers. Consumers will be able to
access information from a variety of potential sources, including
insurance companies, employers, and Medicare-sponsored websites."
This executive order directs federal agencies that
administer or sponsor federal health insurance programs to:
1. Increase Transparency In Pricing. The
Executive Order directs Federal agencies to share with beneficiaries
information about prices paid to health care providers for procedures.
2. Increase Transparency In Quality. The
Executive Order directs Federal agencies to share with beneficiaries
information on the quality of services provided by doctors, hospitals,
and other health care providers.
3. Encourage Adoption Of Health Information
Technology (IT) Standards. The Executive Order directs Federal
agencies to use improved health IT systems to facilitate the rapid
exchange of health information.
4. Provide Options That Promote Quality And
Efficiency In Health Care. The Executive Order directs Federal
agencies to develop and identify approaches that facilitate high quality
and efficient care.
Medicare beneficiaries, health insurance
beneficiaries at the Department of Defense and Department of Veterans
Affairs, and Federal employees represent about one-quarter of Americans
covered by health insurance. This Executive Order builds on the Federal
government's existing efforts to release Medicare payment information
for individual health care providers.
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