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Medicare News
President Orders Medicare, Other Federal Agencies to
Share Health Care Quality and Cost Reports
Medicare plans to post payment rates
to physicians this fall
 August 23, 2006 – All federal agencies, including
Medicare, have been ordered by President George W. Bush to share
information about the quality of care delivered by doctors and
hospitals, as well as the prices paid to these providers. The goal is to
provide consumers with a vast array of data that will help them make
better decisions in choosing hospitals and doctors for their healthcare.
Federal agencies provide coverage to nearly one in
every four Americans with health insurance.
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 August 23, 2006 – The Medicare drug program,
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The Executive Order directs agencies that
administer or support health insurance programs to take steps that will
result in more complete and open information for consumers. The
President said he hopes the Federal action will be followed by similar
commitments in the private sector, and in state and local government.
He directed Health and Human Services Secretary
Mike Leavitt to work collaboratively with the health care sector to
ensure that information provided to consumers is reliable and accurate.
The steps required by today's order include the
sharing of information about the quality of care delivered by doctors
and hospitals, as well as the prices paid to these providers. The order
also requires agencies and their health care contractors to promote the
use of interoperable health information technology products, so that
data can be easily shared. In addition, it requires agencies to offer
insurance options that reward consumers who exercise choice among health
providers based on value and quality of care.
Programs administered and sponsored by the federal
government represent a significant portion of the nation's health care
market, but until recently these programs have not been collaborating
extensively with privately-led efforts to improve the availability of
information to consumers.
Today's Executive Order will result in increased
quality and price information for all Medicare beneficiaries, those
covered by Department of Defense health programs, Veterans Affairs
Administration beneficiaries, and employees and their families covered
under the Federal Health Benefits Program. Action by states will be
needed to commit federally-supported Medicaid programs to the goals of
the Executive Order.
A news release by HHS said the order will not only
help consumers but "it will help support doctors and hospitals that
deliver high-quality care and avoid unnecessary health care costs,
creating opportunities to improve care and lower its costs."
The President said the action is a first step in a
larger plan to provide open health quality and price information for all
American consumers. He invited other employers to make similar
commitments on behalf of their employees, including major private
employers and states and local governments. And he pledged that the
administration will work with health care providers as well as labor
unions, the insurance industry and others to support a reliable and
comprehensive system of health quality and price information.
"People deserve to know what their health care
costs, how good it is, and the choices available to them," HHS Secretary
Mike Leavitt said. "The President's action today is a major step forward
in giving consumers easy-to-use information about the quality and price
of their health care. This is fundamental to achieving a health care
system that delivers good value."
Secretary Leavitt said the effort will begin with
information available now and will grow in volume and sophistication
over time. National "alliance" organizations bringing together payers
and health care provider organizations have been at work for several
years developing quality measures for ambulatory care (especially
physician care), hospitals and other institutions.
The goal of the President's initiative is to
strengthen and build on these efforts and ultimately present consumers
with information in a single, easy-to-use spreadsheet format.
Medicare's Program
In Medicare, early measures of quality have been
available for hospitals, nursing homes and other institutions for
several years. These quality measures are in the process of being
expanded through the collaborative "alliance" process. Some quality
information is also available at present through insurers and other
sources. In addition, Medicare began this year posting information on
the Web about the prices it pays for hospital care.
Medicare plans to begin posting information about
payment rates to physicians this fall.
Ultimately, under the President's plan, local
information on the quality and cost of care for most Americans would be
available from the collaboration of health care providers, public and
private payers, and other stakeholders in different regions of the
country. The collaboration by providers and payers would create an
unprecedented broad and reliable foundation of information on the
quality and price of services delivered by each health care provider.
Quality and cost measures developed through this process would be made
available to consumers.
A federally-sponsored program is currently underway
in six geographic areas that will examine best practices for aggregating
and sharing information.
Under today's Executive Order, price and quality
information would be made available for the particular benefit of those
enrolled in the federally-administered or sponsored programs. However,
much of this information will also be available in Web formats available
to the general public.
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.
The Federal Government Is A Major Participant In
The Health Care Market.
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.
Consumers Will Receive Information Through A
Collaborative Process.
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.
The President's Health Care Agenda Includes:
● Allowing Small Businesses To Form
Association Health Plans (AHPs). The President has called on
Congress to allow small businesses and civic and community groups to
form Association Health Plans (AHPs), which would allow these groups to
join together across State lines to purchase health insurance. This
would give them the same advantages, administrative efficiencies, and
negotiating clout enjoyed by big companies and labor unions.
● Passing Medical Liability Reforms. The
President has called on Congress to pass medical liability reforms that
would help injured patients get quick compensation for economic losses
while reducing frivolous lawsuits. Frivolous lawsuits and excessive jury
awards limit access to health care by driving providers out of many
communities. They also increase patients' costs by forcing doctors to
practice defensive medicine.
● Expanding Health IT. In 2004, the
President launched an initiative to make electronic health records
available to most Americans within the next 10 years. The Administration
is working to expand the use of health IT to increase efficiency, reduce
medical errors, and improve quality of care while protecting patients'
privacy and personal information.
● Expanding Health Savings Accounts (HSAs).
In December 2003, the President signed legislation establishing HSAs
that allow Americans to save tax-free dollars to pay for out-of-pocket
medical expenses and save for future longer-term costs. HSAs give
Americans more control over their health care spending, leading to
better treatment at lower costs.
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