National Health Care Quality Strategy and Plan

1. National Health Care Quality Strategy and Plan AHRQ Annual Meeting September 27, 2010

2. The Affordable Care Act (P.L.111-148) Calls on the Secretary of the Department of Health and Human Services (HHS) to establish a national strategy, plan, and priorities to improve: the delivery of health care services patient health outcomes, and population health

3. The Affordable Care Act • Requires: • Agency-specific plans and benchmarks to achieve the national priorities • Alignment with meaningful use of HIT • strategies to align private and public payers • collaboration, coordination, and consultation with state agencies • Input from multi-stakeholder entities including NQF

4. The Affordable Care Act HHS welcomes comments and suggestions on all aspects of the proposed framework, principles, and other details of National Quality Strategy Narrative describing work to date is posted on the HHS.gov includes questions to gather valuable feedback in specified areas is open for public comment until Oct.15

5. National Quality Strategy – Context and Current Landscape • Multiple provisions of the Affordable Care Act describe programs that: • build on and expand existing efforts to assess and improve quality of care and population health • seek to foster higher quality, more affordable care • span hospitals, physicians, nursing homes, and various other providers

6. National Quality Strategy – Context and Current Landscape A wide array of key efforts are already underway in the private sector, states, and local communities Federal, state, and private-sector quality initiatives have all identified challenges and opportunities to improve nation’s health care

7. Crossing the Quality Chasm’s “Quality Framework National Priority Partnership’s “National Priorities and Goals” HHS National Prevention Strategy HHS Health People 2020 AHRQ National Quality Disparities Report “Let’s Move” Initiative National HIV/AIDS Strategy National Commission on Workforce Development Legislatively mandated Medicare quality programs (e.g. RHQDAPU, PQRI, e-prescribing) Meaningful use of health IT National, regional and State-based initiatives Sample Public and Private Strategic Initiatives and Frameworks

8. National Quality Strategy Will seek to promote alignment and common focus across the public and private sectors at all levels Will foster strong private/public partnership Will seek shared commitment to make sure that Americans receive consistent, high-quality, safe, and affordable care

9. National Quality Strategy: Core Principles • Guide the framework and development of goals, targets, and plans: • person-centeredness and family engagement • address all ages, populations, service locations, and sources of coverage • eliminate disparities in care • alignment of efforts of public and private sectors

10. National Quality Strategy: Core Principles Feed Back Questions Are the proposed principles for the National Quality Strategy appropriate? What is missing or how could the principles be better guides for the Framework, Principles, and Goals?

11. National Quality Strategy:Draft Framework • Better Care • Affordable Care • Healthy People and Healthy Communities

12. National Quality Strategy:Draft Framework Better Care person-centered addresses the quality, safety, access, and reliability of care delivery actively engages patients and families renders best possible care at all stages of health and disease

13. National Quality Strategy:Draft Framework Affordable Care reins in unsustainable costs for families government private sector

14. National Quality Strategy:Draft Framework • Healthy People/Healthy Communities • promotes health and wellness at all levels through strong partnerships between health care providers, individuals, and community resources

15. National Quality Strategy: Draft Framework Feedback Questions Is the proposed Framework for the National Quality Strategy sound and easily understood? Does the Framework set the right initial direction for the National Quality Strategy and Plan? How can it be improved?

16. National Quality Strategy: Legislative Criteria for Priorities • Demonstrates the greatest potential for improving health outcomes, efficiency, and patient-centeredness of health care for all populations, including children and vulnerable populations • Shows potential for rapid improvement in quality and efficiency • Addresses gaps in quality, efficiency, comparative effectiveness information, health outcomes measures, and data aggregation techniques • Improves federal payment policy to emphasize quality and efficiency

17. National Quality Strategy: Legislative Criteria for Priorities • Enhances the use of health care data to improve quality, efficiency, transparency, and outcomes • Addresses the health care provided to patients with high-cost chronic diseases • Improves research and dissemination of strategies and best practices to improve patient safety and reduce medical errors, preventable admissions and readmissions, and healthcare- associated infections • Reduces health disparities across health disparities populations and geographic areas

18. National Quality Strategy: Priorities Feed Back Question Using the legislative criteria for identifying national priorities, what priorities for improvement should be addressed for: Better Care Affordable Care Healthy People/Healthy Communities

19. National Quality Strategy: Goals Aspirational, actionable, and aligned across the Nation EXAMPLE: Reduce by XX% the overall rate of preventable instances of XX healthcare acquired conditions in XX years

20. National Quality Strategy: Goals Feed Back Question What aspirational goals should be set for the next 5 years, and to what extent should goals be identified for a shorter timeframe?

21. National Quality Strategy: Measures of Progress There may not be a one to one correlation between a broadly stated goal and a single measure Where possible, we should use or build on existing and widely-used measures or measure sets that have been reviewed and endorsed by multiple stakeholders Future measure development should be prioritized and aligned to the national goals and framework

22. National Quality Strategy: Measures of Progress Feed Back Questions Are there existing, well-established, and widely used measures that can be used or adapted to assess progress? What measures would best guide public and private sector action, as well as support assessing the nation’s progress to meeting the goals in the National Quality Strategy?

23. Additional Feedback Questions The success of the National Quality Strategy is, in large part, dependent on the ability of diverse stakeholders across both the public and private sectors to work together. Do you have recommendations on how key entities, sectors, or stakeholders can best be engaged to drive progress based on the National Quality Strategy and Plan?

24. Additional Feedback Questions Given the role that States can play in organizing health care delivery for vulnerable populations, do the principles and framework address the needs and issues of these populations? Are there priorities and goals that should be considered specifically to address State needs?

25. Additional Feedback Questions What measures or measure sets should be considered to reflect States’ activities, priorities, and concerns? What are some key recommendations on how to engage with States and ensure continued alignment with the National Quality Strategy?

26. To Submit Comments • Click button on HHS.gov homepage • Email national_quality_strategy@hhs.gov • Write or fax comments to: • Agency for Research and Quality • Attention Nancy Wilson • Room 3216 • 540 Gaither Road • Rockville MD 20850 • Fax: 301.427.1210 • Deadline for input October 15, 2010

27. Questions?