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AQA Invitational Meeting Summary
Report of the Pilot Expansion Workgroup
Peter Lee, Pacific Business Group on Health
Peter Lee, who chairs the pilot expansion workgroup, said the workgroup
looked at four very large issues:
- The need to balance innovation with standardization and consistency.
- Funding (What is the ongoing mode of funding the infrastructure?).
- How to migrate quickly to electronic data collection.
- The collection function of these pilots (Should collection ultimately
be national or local?).
Lee noted that his workgroup had looked at three different collection models
(decentralized, centralized, hybrid), each based on the assumption that there
would be a blending of Medicare, commercial, and other data. He noted that
the cost of doing something nationally was lower than the cost of collecting
data in multiple communities. At the same time, he said, there are benefits
from a local-level model (including fostering innovation).
Lee reported that the workgroup concluded that the best option was a hybrid
model that would include a national collection mechanism for core consensus
measures supplemented by both local and additional national measurements.
There are implications for better quality information for Medicare beneficiaries,
said Lee. He stressed that the six AQA pilot sites have a central role to
play in assessing how best to manage national collection and address supplementary
Lee highlighted several uses for the value exchanges:
- Public/consumer reporting (with cost information)
- Rewarding and fostering better performance
- Supporting improvement directly by providers
In order to achieve these goals, Lee continued, we need to foster collaboration
across multiple stakeholders and use interoperative health information technologies
for measurement as appropriate. Lee concluded that it was also important
to evaluate these efforts.
Following Lee's remarks, one participant said that his workgroup had provided
a roadmap for addressing the challenges of:
- Pilot projects that do not have the technical skills to aggregate data.
- The need to have uniformity regarding aggregation.
She then asked for his thoughts on next steps for
moving the process along. What is the critical path? How do we get where
we are going?
In response, Lee said that while his workgroup had not yet
charted a timeline, clearly a roadmap was needed that sets out what will
happen in 2007, 2008, 2009, and beyond.
Carolyn Clancy added that the Robert Wood Johnson Foundation has funded
four communities that resemble the AQA pilots, and is about to fund up to
six more. She indicated that the Agency for Healthcare Research and Quality (AHRQ) has had discussions with the Foundation
about how to align AQA and Foundation efforts.