Ann & Natalie's Compliance Corner
Welcome back to Ann & Natalie's Compliance Corner! This month, we report on the Department of Health and Human Services' (DHHS) response to the President's August executive order on improving transparency and quality in healthcare (the topic of our September athenaPulse article). Missed last month's guidance on updating your compliance plan in response to the 2007 Work Plan of the Office of the Inspector General (OIG)? Click here.
In response to an executive order signed by President Bush this past August committing federal healthcare programs to four "cornerstone" goals, DHHS Secretary Michael Leavitt recently called on employers to commit to healthcare quality and cost reporting for employees.
Consumers, payers, and providers currently lack fundamental information about healthcare quality and costs of services, which impact their ability to make informed choices and seek better quality of care at more affordable prices.
During a meeting of large and small company business leaders on November 17, Secretary Leavitt indicated that improved quality of care and lower costs could be achieved by committing to four specific "cornerstone" goals:
- Encouraging the Adoption Health Information Technology Standards by enabling the availability and secure exchange of information through support for interoperable health information systems and products.
- Increasing Transparency in Quality by creating programs to measure the quality of services provided by doctors, hospitals, and other healthcare providers and making this information available to health-plan enrollees.
- Increasing Transparency in Pricing by creating programs to provide health-plan enrollees information about the overall cost or price of their care.
- Promoting Quality and Efficiency of Care by facilitating high-quality and cost-effective healthcare through appropriate incentives.
Leavitt indicated that standards to measure quality of care should be led by the medical community while standards to measure quality and cost should be directed by a consensus process involving stakeholders within the healthcare sector.
The most reliable and broad-based information would be produced by employers sharing quality and price information with regional collaborative groups, where information could be aggregated. Enrollees in the plan would receive quality information from the employer or health plan, which would include specific costs the enrollee could expect to pay under the plan.
"This approach is about providing better information for everyone, up and down the healthcare system," says Leavitt. "Consumers and payers need this information, but physicians and hospitals need it just as much. That's where quality and value improvement will really take place."
The 11/17/06 DHHS press release is available at: www.hhs.gov/news/press/2006pres/20061117.html
Disclaimer: The content of Compliance Corner is for general informational purposes only and should not be interpreted as compliance guidance or advice. Consult your compliance advisor or attorney for compliance or legal advice on specific issues related to your practice or compliance program.
