The current federal quality oversight programs represent a patchwork of requirements and processes that have evolved over the last 30 to 35 years. The purpose of this study was to re-examine the various federal quality improvement and oversight programs to assess whether changes are needed to:
- Provide adequate protection to beneficiaries.
- Provide strong incentives to providers to improve quality.
- Improve the efficiency of the oversight processes by reducing redundancy.
The committee that evaluated selected federal health care quality activities included members with backgrounds in different substantive fields of health care and health care services. Relevant fields included: quality care, quality measurement, information technology, health care delivery, and purchasing. Members also have knowledge of different government health care programs. Relevant government programs include Medicare, Medicaid, SCHIP, TRICARE, AHRQ quality research programs, and VA quality health care programs.
The committee drew on these areas to address key study objectives. In particular, the committee had to develop a conceptual framework for health care quality, which entailed the identification of goals and/or ideal characteristics for government quality programs. It then assessed the ways in which existing programs do and do not measure up to those criteria. Lastly, it recommended ways in which those programs could be strengthened.
This project was funded by the Department of Health and Human Services (http://www.os.dhhs.gov/), The California HealthCare Foundation (http://www.chcf.org), and The Commonwealth Fund (http://www.cmwf.org).
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