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AQA Invitational Meeting Summary
HHS Transparency Initiative
Andrew Croshaw, Transparency Health Care Initiative, U.S. Department of Health and Human Services (HHS)
Andrew Croshaw discussed HHS's Transparency Health Care Initiative. The initiative is based on the idea that building a value-driven health care system requires four cornerstones:
- Connecting the system—the need to identify standards so that all
health information systems can quickly and securely communicate and exchange data.
- Measuring and publishing quality—the need to define benchmarks for what constitutes quality care.
- Measuring and publishing price—the need to reach agreement on what procedures and services are
covered in each episode of care.
- Creating positive incentives—the need to create incentives to reward both those who offer and
those who purchase high-quality, competitively priced health care.
indicated that a large number of companies (and one major labor union) have signed statements of support for the four
cornerstones, including approximately 50 of the top 200 companies in the United States. In addition, about a half-dozen States have either signed a statement of support
or crafted their own executive orders to begin to move forward on the four
cornerstones. Croshaw said the hope was to get to a tipping point so that
purchasers all around the United States are asking that the four cornerstones
that he was pleased to see that the Quality Alliance Steering Committee had
come up with some criteria for how to take standards and measures and implement
them locally. He said that HHS has developed a Community Leader for Value in Health
Care credential to identify organizations that are working to achieve the four
cornerstones at the local level.
discussion, Carolyn Clancy asked how strong the commitment was of the groups
who are signing on to the initiative. Croshaw responded that the commitment
wasn't legally binding but was a public statement of an organization's
commitment to work toward the four cornerstones of a value-driven health care
system. He added that he believed it is important to signal to the market that companies
are increasingly engaged in this effort.
participant asked what would happen when a new administration takes office in 2
years. How do we ensure the legacy of this important work? In response, Croshaw
said that he believed the work being done was of interest to a broad range of
stakeholders and not limited to one political party.
spoke about the need for national aggregation standards. He pointed out that
health plans are facing the prospect of having to respond to as many as 35
separate State aggregation measures. In response, Croshaw noted that the States
are generating a number of innovative solutions. As part of that process, he
said, the Federal Government will have an opportunity to influence the States.
He added that the goal is to continue to focus on quality improvement and
value—to promote innovation while also ensuring that we are aligning with
the four cornerstones.
participant asked whether the HHS transparency initiative offered an opportunity
to highlight and start to address health disparities. Croshaw indicated that
the Robert Wood Johnson Foundation has been very focused on quality-of-care
initiatives, and has been working to align its efforts with others in order to
speak with one voice. Clancy added that AHRQ is looking for opportunities to
align with the Robert Wood Johnson Foundation. She also indicated that AHRQ is
trying to integrate quality improvement assessment initiatives with the goal of
reducing health disparities.