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What Will Healthcare Reform Mean to the Healthcare Quality Professional?
Now that both the U.S. Senate and House of Representatives have passed their own versions of sweeping healthcare reform legislation, the healthcare industry has its eyes and ears on lawmakers as they negotiate the details of a final, compromise measure. Congressional leaders have stated they would like to consider that bill for passage sometime before the President’s State of the Union Address in mid-February.
At this time, it is hard to predict what that final bill will look like and what components will be included, but experts agree that healthcare quality measures will be a key element of the ultimate plan. Recently, NAHQ e-news had the chance to talk with American Hospital Association’s Dr. Maulik Joshi and Nancy Foster about how healthcare reform will affect the healthcare quality professional. Joshi is president of AHA's Health Research & Educational Trust and editor of NAHQ’s Journal for Healthcare Quality, and Foster is AHA’s vice president of quality and patient safety policy.
Q: What is the role of healthcare quality efforts in healthcare reform?
Joshi: It is clear that quality will be an important piece of the emerging legislation. In both the House and Senate bills, lawmakers have recognized that reform isn’t just about getting more people covered—it is also about making our system better. There are two strong themes coming out of those measures—execution and innovation.
In terms of execution, quality professionals have been leading the way for a number of years in public reporting; expanding standardized, endorsed quality measures; and implementing improvements and value-based purchasing. With innovation, they will be |
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asking for more pilot and demonstration projects to help expand upon current quality measures and the information that these efforts have unleashed. For example, they may be looking at potential demonstrations on bundled payment or new ways of testing and delivering quality care.
Q: What are some of the specific healthcare quality issues that we can expect to see addressed in the final bill?
| Foster: Both bills include provisions dealing with the excessive number of unnecessary readmissions, transitioning of patient care across the continuum of care, and preventing hospital infections. In addition, there are three provisions on experimenting with different payment methods, including bundled payments, medical homes, and accountable care organizations. The Senate bill included the implementation of a [Centers for Medicare and Medicaid Services] proposal on value-based purchasing. Overall, these provisions encourage healthcare professionals to use science as a way to become transparent and do the best for patients. |
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Q: How will reform affect the healthcare quality professional?
Joshi: The quality leader has already been doing much of this work. But with healthcare reform, we can expand our knowledge to provide better, more efficient, higher quality care.
Foster: As a result of this important debate, public policy makers have recognized that improving quality and preventing complications in care make the healthcare system more efficient, thereby helping to pay for expansion of coverage. Healthcare quality is an important theme in reform as it will help enable payment strategies to deliver better care.
But reform is not the only vehicle for changes in healthcare. Look for the implementation of regulations on the use of electronic health records for reporting data on health measures by hospitals and other providers as a result of the Economic Recovery Act. These proposed regulations call for numerous safety measures such as checking for drug/drug interactions.
Click here for a side-by-side comparison of the House and Senate healthcare reform bills.
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