HHS pushes pilots to rein in health care costs

Executive order outlines move to IT standards

Carolyn Clancy, director of HHS' Agency for Healthcare Research and Quality, says that the pilots will provide data about the performance of physicians.

Olivier Douliery

Federal agencies pay more than 40 percent of all health care costs in the United States, and their share is going up.
With no end in sight, federal health IT projects are targeting ways to lower costs by making data on quality of health care and costs more easily available , said Mike Leavitt, secretary of the Health and Human Services Department.

'Health care costs have the capacity to erode the economy,' Leavitt said at the recent annual Health IT Summit in Washington, sponsored by the eHealth Initiative, a collaborative health care industry group.

The federal government's share mostly comes from programs in the Defense and Veterans Affairs departments, the Office of Personnel Management and HHS'which administers Medicare and Medicaid'he said.

But through a set of pilots being run at the state level and funded by HHS, consumers, insurance companies and government payers will have the ability to compare quality measures and prices, which should drive costs down if consumers flock to the highest-quality and most efficient health care.

HHS is sponsoring six regional pilots composed of physicians, hospitals, insurance plans and employers to make the quality and prices of certain procedures accessible. The announcement of the test programs comes on the heels of an executive order that President Bush issued in August that will change how the government procures health care.

The pilots will provide data about the performance of physicians based on a starter set of 26 quality measures, said Carolyn Clancy, director of HHS' Agency for Healthcare Research and Quality.
'People in those six communities will be able to see the quality of care provided by practitioners in their community, which for the most part is not now possible,' Clancy said.


The quality pilots, located in Boston, Indianapolis, Madison, Wis., Minneapolis, Phoenix and San Francisco, will each create a network, harmonize standards and share best practices.

For example, some Wisconsin health care companies are assembling cost and quality information based on data that the Madison pilot has developed.

In Indianapolis, the pilot produces report cards on physicians who participate in the program, Clancy said.

VA has begun a quality program in which physicians get monthly reports on their performance, including information about individual cases that reduced their score. The physician can click on a manager button for help on the next steps to improve performance.

'Most of health care doesn't look like VA, but it begins to show us what is possible when you can link incentives and a common set of rules for the road,' Clancy said.

The ability to make quality and price data accessible on a wide scale depends on establishing interoperability standards and adopting health IT practices that can exchange information, both of which are initiatives that HHS' Office of the National Coordinator for Health IT is leading.

The executive order sets the stage for these agencies to provide health care differently, Clancy said.

'The federal government will put some skin in the game, and agencies will work together in unprecedented collaboration,' she said.

Interoperability standards

As agencies acquire and update health IT systems for data exchange, they are required to use recognized interoperability standards, according to the executive order.

'If you're going to do business with the federal government, your software has to be compliant with adopted standards,' Clancy said.

Milestones that will advance quality and price transparency also will push HHS' overall health IT efforts to promote electronic health records that can exchange data.

The Health IT Standards Collaborative, through a contract with HHS, is developing interoperability standards. The public-private American Health Information Community will make recommendations on those standards. Another HHS-contracted group, the Certification Commission for Health IT, is to incorporate those standards in its product certification process.

About the Author

Mary Mosquera is a reporter for Federal Computer Week.

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