HHS unveils local quality reporting plan

The government hopes that local control will inspire physicians' trust and participation. However, some doctors worry about an overload of competing quality initiatives.

By David Glendinning, AMNews staff. March 19, 2007.

Washington -- When it comes to publicly reporting the quality and price of medical services, the Dept. of Health and Human Services wants to think nationally but act locally.

That's the driving concept behind the latest HHS quality and cost initiative, known as "value exchanges." Selected local, nonprofit collaboratives of health care professionals and purchasers will receive federal charters to issue report cards for participating physicians, nurses, hospitals and others.

By comparing information about multiple caregivers, health care consumers would be able to decide where to receive treatment based on the quality of care provided, its price or a combination of both. A physician who chooses not to participate would not be listed as an option on the consumer guides.

Although they will follow federal standards in measuring quality, the collaboratives will be self-governing. The voluntary effort, part of a broader quality and price transparency initiative that the Bush administration unveiled last year, aims to build on a Medicare public reporting pilot project operating in six states.

Within about 10 years, HHS hopes to establish a network of these value exchanges to give patients in many areas a tool for choosing where they receive care. Value exchanges will also be able to use the network to share successful innovations with each other.

Combining federal standards with local control is necessary to ensure that the initiative works, said HHS Secretary Michael Leavitt. Until a comprehensive national system of electronic medical records exists, much of this process will involve gleaning quality and cost information from paper claims -- which must be done at the local level.