The National Quality Strategy: Why We Should Care

During my perusal of existing bodies of literature such as the Stage 2 final rule and the physician value-based modifier section of the proposed rule for the 2013 Medicare PFS, I frequently come across the National Quality Strategy. Many nephrologists are not familiar with this concept, but it is part of what guides the direction of many CMS programs.

 

Origins

 

The quality strategy is a product of the Department of Health and Human Services. Our old friend the Affordable Care Act required the development of a national strategy to promote improved health care quality. In March of 2011, HHS published the National Strategy for Quality Improvement in Health Care (National Quality Strategy). The actual report  is worth a look as it provides background and examples that reflect the direction HHS plans to take in order to execute this strategy.

 

Aims

 

The quality strategy consists of three overarching aims:

1. Better Care: Improve the overall quality by making health care more patient-centered, reliable, accessible and safe.
2. Healthy People/Healthy Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social and environmental determinants of health in addition to delivering higher-quality care.
3. Affordable Care: Reduce the cost of quality health care for individuals, families, employers and government.

These aims will serve as guides to measure success at the local, state and national levels.

 

Priorities

 

The quality strategy further establishes six priorities, which have become the initial focus for this effort:

1. Making care safer by reducing harm caused in the delivery of care.
2. Ensuring that each person and family is engaged as partners in care.
3. Promoting effective communication and coordination of care.
4. Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.
5. Working with communities to promote wide use of best practices to enable healthy living.
6. Making quality care more affordable for individuals, families, employers and governments by developing and spreading new health care delivery models.

I have added emphasis to each of these priorities as these concepts are clearly emerging at every turn within the CMS programs we frequently address in this blog.

 

Impact on Nephrology

 

Why does the nation’s quality strategy warrant our attention? This strategy has a fundamental role in shaping policy. As time passes we are increasingly facing a shift in the “business as usual” approach to health care. Value-based purchasing, accountable care organizations and medical homes are no longer simply buzz words; they are living and, in some cases, breathing entities in various parts of the country. Transparency and quality reporting are becoming much more common than they were just a few years ago. As I mentioned at the outset, I see the quality strategy referenced throughout many of the programs I write about. The initial report to Congress will take you about 10 minutes to read. It will be 10 minutes well spent.