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National Plan for ‘Value Exchanges’ Uses
Local Collaboratives to Report Quality, Cost Data Ad Campaign Urges Patients
to Ask Questions to Improve Care Study: Quality Interventions Improve
Processes but Not Outcomes Second Annual Safe-Rx Awards Recognize Use
of Electronic Prescribing Technology CMS Extends Premier Hospital
Quality Incentive Demonstration HHS Establishes Collaborative Program
to Improve Hospital Communication AHIMA, eHI and HIMSS to Develop and
Disseminate Successful Practices for State HIEs AoA Announces Theme
for 2007 Older Americans Month Department of Health and Human Services ( HHS ) Secretary Michael Leavitt
recently announced a new component of his Value-Driven Health Care Initiative
(VDHC) – a national plan to charter local collaborative organizations
that support quality improvement through public reporting of cost and
quality data. Secretary Leavitt is visiting communities across the country
to encourage local business and health care leaders to support VDHC and
work together to create the local collaboratives. The Secretary’s plan is not a government mandate – it’s
a voluntary effort that enhances the four cornerstones of the Value-Driven
Health Care Initiative, which he announced last fall: health IT, quality
reporting, cost reporting, and incentives for quality and value. The plan calls for development of “Value Exchanges,” which
are nationally chartered, local collaboratives that would become part
of a nationwide system using nationally- recognized standards to measure
and improve quality of care at the community level. The new system includes
two types of collaboratives: Value Exchanges that meet additional criteria may qualify to pool their
local data with Medicare data for more robust measurement of provider
performance and quality outcomes. HHS expects that the core of initial Value Exchanges will come from
collaboratives that already exist in communities across the country. The
Secretary’s plan is to bring these existing collaboratives into
a national system and spur development of new collaboratives in other
communities. The goal of Value Exchanges, “is to achieve both national coordination
in developing standards and local control in applying them,” said
Secretary Leavitt in an HHS press release. “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.” In addition to the Value Exchanges, last year HHS developed the “Better
Quality Information to Improve Care for Medicare Beneficiaries” or “BQI” program
to pioneer the pooling of local and Medicare data. There are six BQI sites
in the following states: Minnesota , Wisconsin , Massachusetts , Indiana
, California , and Arizona . These sites will continue to function as
special Medicare demonstrations. The first four have signed subcontracts
with the Delmarva Foundation and will receive QIO program funding. Value Exchanges The HHS Web site defines a Value Exchange as an organization “that
has taken clear action in its community to convene industry stakeholders
and advance the four cornerstones of Value-Driven Health Care.” To
receive a Value Exchange charter, organizations must be independent,
non-profit, local organizations that are: Value Exchanges will also be eligible to take part in a national Learning
Network to support quick expansion and sharing of quality improvement
techniques. The Agency for Healthcare Research and Quality will administer
and maintain the Learning Network, which will provide expert faculty,
tools, resources, and Web-based communications to members. “Without question, QIOs can play a key role in these Value Exchanges.
Communities would be hard pressed to find a local non-profit organization
with the breadth of health care relationships, technical know-how, and
data handling capabilities that QIOs can offer,” said David Schulke,
AHQA Executive Vice President. “Many QIOs are signing up to support
the Secretary’s new plan and are actively engaging with business
and health care leaders in their communities to develop meaningful collaboratives.” For more information on VBHC or how to become a chartered Value Exchange,
visit the HHS transparency Web site: www.hhs.gov/transparency. The Agency for Healthcare Research and Quality (AHRQ) and The Advertising
Council launched a national public service advertising (PSA) campaign
to encourage Americans to take a more proactive role in their health care.
The “Questions Are the Answer: Get More Involved With Your Health
Care” PSA campaign kicks off during national Patient Safety Awareness
Week, March 4-10. “The goal of this new campaign is to get patients more involved
and to ultimately improve the safety of health care for all Americans,” said
Secretary of Health and Human Services Michael Leavitt. The Institute
of Medicine estimates that medical mistakes in hospitals account for 44,000
to 98,000 deaths each year -- more than those attributed to motor vehicle
accidents, breast cancer, or AIDS. Even though research shows that health
care safety improves when consumers are more involved, patients are generally
unaware of how they can help prevent medical mistakes. “We hope that these new public service advertisements will show
millions of Americans that they shouldn’t be afraid to ask questions
related to their health care and that their clinicians are interested
in answering them,” said AHRQ Director Carolyn Clancy, MD. “The
campaign is a natural outgrowth of AHRQ’s ongoing efforts to improve
the safety and quality of health care,” continued Dr. Clancy. Other
AHRQ efforts include such efforts as 5 Steps to Safer health Care, a joint
initiative with the American Hospital Association and the American Medical
Association, and numerous grants funded to support projects that improve
the safety of health care through health information technology and teamwork
among health care providers. The campaign includes television, radio, print, and Web advertising
directing audiences to call a toll-free number, (1-800-931-AHRQ). A comprehensive
Web site is available (http://www.ahrq.gov/questionsaretheanswer)
for tips on how to help prevent medical mistakes and become a partner
in their health care as well as resources and a glossary. Some of the
tips include: The Web site also features an interactive “Question Builder” that
allows consumers to generate a customized list of questions for their
health care providers that they can bring to each medical appointment. “We are proud to partner with AHRQ to shed light on this critical
issue and provide consumers with very simple steps that they can take
to improve their health care. The ads are entertaining and memorable,
while motivating, and I believe they will have a great impact on the health
of our country,” said Peggy Conlon, President & CEO of the Ad
Council. The new campaign was created pro bono by ad agency McCann Erickson Detroit.
PSAs are being distributed to 28,000 media stations nationwide this week.
Another campaign created specifically for the Hispanic community will
launch in late 2007. Per the Ad Council’s donated media model, all
of the new PSAs will air and run in advertising time and space donated
by the media. A study published in the March 1 New England Journal of
Medicine , found that interventions for chronic conditions in the
Health Disparities Collaboratives led to improvements in processes of
care but could not document improvement in clinical outcomes. The Health Disparities Collaborative was designed to improve care in
community health centers where many minority and uninsured patients receive
care. The program, which is administered by the Health Resources and Services
Administration (HRSA), brings together health centers to learn and disseminate
quality improvement techniques developed by the Institute for Healthcare
Improvement and adapted to the health center program. The collaborative
improvement interventions in the study, “Improving the Management
of Chronic Disease at Community Health Centers,” focused on diabetes,
asthma, and hypertension, which together affect more than 25 percent of
the U.S. adult population. “Our study showed that participating in a collaborative improved
the processes of care related to prevention and screening and disease
monitoring and treatment for diabetes and asthma, but participating in
a collaborative did not improve these processes for hypertension,” wrote
lead author Bruce E. Landon, MD, MBA, of the Department of Health Care
Policy at Harvard Medical School and colleagues. To conduct the study, the researchers used nationally validated quality
measures that were collected from medical record reviews conducted over
a one year period before the intervention and the same period after the
intervention. Then, they judged them against external control centers
for comparison. A number of process improvements were found: However, even though processes were improved, the researchers found
no improvement in intermediate outcomes, including: “This study indicates that focused quality improvement interventions
can enhance how we deliver care and we need to do more to improve clinical
outcomes,” said Carolyn M. Clancy, MD, Agency for Healthcare Research
and Quality (AHRQ) director. “These findings will guide our quality
improvement efforts in the overall health care system and at health centers,
which are a critically important component of a national strategy to deliver
quality care to the medically vulnerable.” The study was collaboratively supported by AHRQ and HRSA with a grant
from The Commonwealth Fund. Ten states were recently honored with the second annual Safe-Rx award
for their efforts to promote and support the adoption of electronic prescribing
(ePrescribing). The National Association of Chain Drug Stores (NACDS), the National Community
Pharmacists Association (NCPA) and SureScripts created the Safe-Rx award
to recognize how e-Prescribing enhances patient safety by providing a
more secure, accurate, and informed prescribing process. The award goes
to the top 10 e-Prescribing states in the nation and three physicians
within those states who have demonstrated outstanding leadership through
their use of e-Prescribing technology. The states, and their rankings,
are: Both New Jersey and Washington are new to the top ten this year. The Safe-Rx awards are based on an analysis of data from new prescriptions
and refill responses electronically transmitted over the Pharmacy Health
Information Exchange, operated by SureScripts. States are ranked by the
number of prescriptions routed electronically in 2006 as a percentage
of the total number of prescriptions eligible for electronic routing.
More than 95 percent of the nation’s pharmacies are enabled to connect
to this secure network. For more information on the Safe-Rx awards, please visit www.surescripts.com/saferx. The Centers for Medicare & Medicaid Services (CMS) recently approved
a three-year extension of the Premier Hospital Quality Incentive Demonstration
(HQID). Second-year results from the project released earlier this
year show substantial improvement in quality of care across five clinical
focus areas with total gains of 11.8 percentage points. HQID is the first national pay-for-performance project designed to determine
the effectiveness of using financial incentives to foster improvements
in the quality of hospital care. The initial program, in which more than
260 hospitals voluntarily participated, included p rocess and outcome
measures in five clinical areas: During the three year extension, CMS will continue to track hospital
performance in these five clinical areas but will add new quality measures
and clinical conditions in the fifth and sixth years. New mortality
and patient safety measures are among those that may be included. The Agency will also use HQID to test the effectiveness of offering
incentive payments to hospitals achieving a defined level of quality,
or quality threshold, and to hospitals achieving the greatest improvement
in quality that also achieve the quality threshold. During the initial
phase, only the top performing hospitals were eligible for incentive payments. For more information, visit: http://www.cms.hhs.gov/HospitalQualityInits/35_HospitalPremier.asp or http://www.premierinc.com/quality-safety/tools-services/p4p/hqi/index.jsp The Department of Health and Human Services
(HHS) has announced a new program to assist hospitals in meeting the
communication needs of individuals who do not speak English as their
primary language or who are deaf or hard of hearing. The two-pronged
effort called “Effective Communication in Hospitals” will
have national and state-based components. For state-based efforts, HHS’ Office for
Civil Rights (OCR) will collaborate with state hospital associations
to develop and implement activities that address local issues. Hospital
associations in the following nine states have already committed to
working on this initiative: Kentucky, Missouri, New Jersey,
New York, Oklahoma, Pennsylvania, Rhode Island, Utah, and Washington. “This collaboration ensures that each
project partnership will have the flexibility to develop and conduct
the program that best meets the needs of the hospitals in that state,
rather than be a ‘one-size-fits-all’ effort,” said
Winston Wilkinson, director of OCR. The state-based effort is expected to tackle
such issues as: On the national level, a joint effort by OCR
headquarters and the American Hospital Association will ensure that
the project participants have access to resource materials, share the
results of the initiative with other hospitals, and address related
issues of national concern. A new Web page is available to provide hospitals
educational material and resources related to civil rights and effective
communication: http://www.hhs.gov/ocr/hospitalcommunication.html. “An increasingly diverse population has
created new challenges for health care providers. Ma ny hospitals
are actively taking steps to promote better communication with patients
and families,” Secretary Mike Leavitt said. “This initiative
will help hospitals move toward this critical goal -- ensuring that
all individuals have an equal opportunity to access quality health care.” The Office of the National Coordinator for Health Information Technology
(ONC) awarded a one-year, $800,000 contract to the American Health Information
Management Association’s (AHIMA) Foundation of Research and Education
(FORE) to foster collaboration among state leaders in health information
exchange (HIE) to identify and share emerging best practices. Work on
the contract will begin this month. The project will identify successful governance models that include defined
operations, resources and finances to generate, support and amplify health
information exchange. Delivering guidance to state and local HIE efforts
will help support the development of a nationwide network to enable health
care transformation and lower costs. During 2006, FORE was under contract to provide practical guidance tools
for state-level HIE organizations. This new contract builds on that work
and includes subcontracts with two additional organizations: eHealth Initiative
(eHI) and the Healthcare Information and Management Systems Society (HIMSS). Information produced from this project is available at www.staterhio.org. “Older Americans: Making Choices for a Healthier Future” will
be the 2007 theme for May’s Older Americans Month, the Administration
on Aging (AoA) says. Last year’s theme was “Choices for Independence.” Established in 1963, Older Americans Month is a time to acknowledge the
contributions of older persons. Each year, the President issues a formal
proclamation asking that the nation pay tribute to older persons residing
in their communities. Resources to help organizations and individuals participate in Older
Americans Month are available on the AoA Web site. These include such
items as: promotion strategies, logos, posters, and template press releases
and flyers. Materials specific to each year’s theme are also available. For more information, visit: http://www.aoa.gov/press/oam/oam.asp  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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