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Consumers, Employers and Labor Groups Unite to Establish Guidelines on Physician and Hospital Performance

Washington, DC (January 12, 2005) - An uncommon coalition of more than 25 of the nation's leading consumer, employer and labor organizations – the Consumer-Purchaser Disclosure Project – today announced guidelines to promote rapid, industry-wide adoption of performance measures to help patients compare the relative quality and cost of care provided by the nation's hospitals, physicians and health care systems.

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Download: Guidelines for Purchaser, Consumer and Health Plan Measurement of Provider Performance

Download: Endorsing Organizations

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"We know care varies significantly from provider to provider, and often these are life and death decisions," said Debra Ness, president of the National Partnership for Women & Families and Disclosure Project co-chair. "A lot of public and private organizations are moving to develop and institute measures of provider performance. It is imperative that consumers have access to reliable, standardized information – just like we currently have to guide our decisions about purchasing cars or home appliances – that can help them compare health care providers and make better health care decisions. These guidelines are intended to get organizations that are developing measures on the same page."

The Disclosure Project's Guidelines for Purchaser, Consumer and Health Plan Measurement of Provider Performance call for:

• Scientifically-Valid Performance Measures endorsed by the National Quality Forum's consensus process: The National Quality Forum's (NQF) performance indicators should serve as primary measures. Among NQF-endorsed measures, preference should be given to those measures adopted by the AQA, Hospital Quality Alliance, or other quality alliances that engage in consensus measure selection. If NQF has not endorsed a measure for an aspect of health care performance, measures endorsed by national accrediting organizations should be used. If supplemental measures are implemented, they must be scientifically grounded, regularly updated and reviewed by provider and consumer groups.
• Transparency of Provider Rating Methods: Provider rating methods, including detailed measurement specifications and algorithms used to combine scores and/or group providers into performance tiers, should be publicly disclosed.
• Coordinated Data Collection: If collection of data about performance creates a significant burden for providers, data collection should be coordinated across health plans and other purchasers who share hospitals and physicians within their contracted networks.

"We appreciate the hard work the Disclosure Project is taking to promote better health care in America by measuring and reporting the quality of care among our nation's hospitals, doctors, nurses and other health care providers," said Mark B. McClellan, M.D., Ph.D., Centers for Medicare & Medicaid Services administrator. "This will serve as one more tool available to consumers while helping improve the quality of health care all across the nation."

In developing the guidelines, the Disclosure Project considered issues that currently challenge standardization of performance assessment: defining uniform performance measures, making ratings useful and accessible to the public and ensuring efficient collection of provider-level data with minimum burden for providers. These factors are important as hospitals and physicians often are burdened by evaluations from numerous sources that determine performance scores in very different ways.

"It's crucial to establish a standard, valid approach to measure quality of care so patients, doctors, hospitals, employers and insurers can understand and trust the data that are collected," said Jordan J. Cohen, president, Association of American Medical Colleges (AAMC), representing the nation's major teaching hospitals, health systems and accredited medical schools. "These guidelines address an important need to improve the available knowledge base and to provide a framework for incorporating this information into medical education and research."

Comparative data on hospital and physician performance is urgently needed. Research shows Americans receive recommended care less than 55 percent of the time (RAND, 2003). As the public becomes more aware of the shortfalls and variation in quality of care, consumers are actively seeking out information they can use to make health care decisions. In 2004, more than 11 million Americans actively used comparative quality information to choose their doctors and more than 17 million utilized quality information to make hospital choices (Kaiser Family Foundation et al., National Survey of Consumer Experiences, 2004). Today, however, there is little standardization of the information that is being used by millions of Americans.

"A consistent approach to measuring providers is an essential part of employers and health plans' efforts to reign in costs and obtain better value," said Peter Lee, president and CEO of the Pacific Business Group on Health and co-chair of the Disclosure Project. "These guidelines illustrate a shared commitment across groups who don't always see eye-to-eye, but are coming together to be a catalyst for performance improvement. Standardized information is the key to fostering provider accountability and to rewarding better performers."

For more information go to: www.healthcaredisclosure.org

About the Disclosure Project

The Consumer-Purchaser Disclosure Project is a group of leading employer, consumer, and labor organizations working toward a common goal to ensure that all Americans have access to publicly reported health care performance information by January 1, 2007. Our shared vision is that Americans will be able to select hospitals, physicians, and treatments based on nationally standardized measures for clinical quality, consumer experience, equity, and efficiency. The Disclosure Project is supported by a grant from the Robert Wood Johnson Foundation and the Leapfrog Group.