Quality key for public programs

The Institute of Medicine urges the government to start measuring and paying for quality improvements in its health care programs.

By Markian Hawryluk, AMNews staff. Nov. 18, 2002.

Washington -- The federal government could go a long way toward improving the nation's health care quality if it would lead by example, a new Institute of Medicine report says.

About 100 million people are served by the government's six health care programs -- Medicare, Medicaid, the State Children's Health Insurance Program, the Defense Dept.'s TRICARE, Veterans Health Administration and Indian Health Services. That represents one in three Americans. The vast majority of the nation's physicians care for patients in one or more of these programs.

So improving quality in these programs should generate significant momentum to better the entire health care delivery system, the IOM said.

"The federal government has enormous leverage to influence health care. It is the largest purchaser of health care services and the most influential regulator," said Gilbert Omenn, MD, PhD, professor of internal medicine, human genetics and public health at the University of Michigan Health System, Ann Arbor, and chair of the IOM's Committee on Enhancing Federal Health Care Quality Programs. "The federal government has a responsibility to provide leadership in addressing the serious quality-of-care and safety concerns confronting our nation."

According to the report, the federal programs have taken steps to enhance quality, but efforts have been uncoordinated and insufficient to drive the type of change needed.

"The committee is not recommending that ... the health care professionals involved in these programs work harder," Dr. Omenn said. "What we are recommending is a different approach to quality enhancement and a different portfolio of quality enhancement activities that we believe will be much more effective in improving safety and quality, and that will also result in a lighter burden on health care providers." [...]