As I travel home from the nation’s capital on my delayed Amtrak train, I’m reminded that summer 2017 has been labeled the “summer of hell” for commuters in the Northeast Corridor. Much-needed fixes to our transportation infrastructure are causing agonizing delays, but the long-term repercussions of doing nothing will be far worse.
That sounds close to where we are in health care. Implementing improvement can be difficult, time consuming work — but the consequences of low quality health care and, as a result, an unhealthy population, are far worse.
I traveled to DC for a meeting of the Consensus Standards Approval Committee of the National Quality Forum. This committee includes representatives of consumer and purchaser groups, such as the Quality Institute, The Leapfrog Group, and AARP, as well as provider organizations, including ACOG, Health Partners and the University of Pennsylvania.
We regularly come together to consider whether we should endorse submitted quality and efficiency measures. These measures focus on cost and resource use along with both process and outcome quality measures. National Quality Forum endorsement is highly influential. Health systems, public and private purchasers, including CMS, consumer groups and researchers use endorsed measures to improve performance.
Our committee looks to endorse valid measures that matter — measures that lead to better patient outcomes and better patient experiences, and measures that help reduce unnecessary and low-value care.
At this week’s meeting, our agenda was packed with measures that truly matter, especially to a high cost state like New Jersey. We endorsed three resource use measures. Recent federal legislation requires the use of these measures to drive payment reform. Providers use both quality and resource use measures to understand, in concrete ways, how they compare to peers caring for similar patients. The measures can catalyze changes in how providers practice, improving quality and reducing costs.
We also endorsed two measures of hospital performance on quickly intervening when sepsis is detected. This is a timely topic in New Jersey. A recent proposal by the New Jersey Department of Health for addressing sepsis cases is open for public comment. We also endorsed a quality measure for a holistic approach to hospice care. This is another area where New Jersey needs to improve, and the Quality Institute seeks to work with all of you to help more people in our state have their wishes honored at the end of their lives.
The committee also endorsed a measure to track and compare how well state Medicaid programs do in keeping eligible children enrolled in the program. We don’t want to see children from low-income families churning in and out of Medicaid because of excessive and complex bureaucracy, causing delays and gaps in their care.
Ironically, state and federal policymakers are going in the opposite direction and proposing additional hurdles to eligibility review and enrollment. Having a meaningful way to measure the impact of these changes — on both overall enrollment and the health of the population — will be important to consider as states redesign their Medicaid programs.
Overshadowing our work is uncertainty about the future of the Affordable Care Act and other changes taking place in Washington, and we hope 2017 will not be a “Summer of Hell” for people who rely on the ACA for health care.
But regardless of who pays for health care — ACA, ACHA, employers, states, individuals — we must reduce costs and improve quality. That mission drives us all at the Quality Institute. It’s why we get up in the morning. As our members, your input, experience and insight are invaluable and I look forward to our partnership through the challenges of Summer of 2017 and beyond.