PBGH Pushes for Nationally Standardized Performance Measures
With help from PBGH, a coalition of consumer, labor and purchaser organizations has made significant progress toward the goal of enabling Americans to select hospitals, physicians and treatments on the basis of standardized measures. Dubbed the Consumer/Purchaser Disclosure Project, the coalition wants to have the measures in place by 2007. Thanks in part to coalition efforts, an initial set of standardized hospital quality measures has been adopted by the National Quality Forum, a not-for-profit organization developing a national strategy for health care quality measurement. Furthermore, the Centers for Medicare and Medicaid Services has embarked on an effort to create a standardized hospital patient experience survey. The Disclosure Project will assure that provider performance measurement is central to the growing national health care agenda. Learn more about the Disclosure Project at the PBGH Web site.

PBGH Calls for Functioning Hospital Markets in California
PBGH has continued its efforts to focus attention on wide variations in hospital cost and quality. On February 6, PBGH board member Sally Welborn, CEBS, vice president of corporate benefits for Wells Fargo & Company, testified before the California Assembly Committee on Health. She addressed three industry-wide issues-staggering cost increases, huge variations in the cost and quality of hospital care, and failure of the market to address these issues and need for change. To learn how the variation in hospital quality and costs impacts consumers and purchasers, read Ms. Welborn's testimony.

Also in California, PBGH has issued a call to health plans to be more diligent in their review of hospital cost increases. Meanwhile, PBGH is engaging California hospital leadership in an effort to craft "Hospital Accountability Principles." These principles would establish agreement among all major stakeholders on the importance of transparency in hospital performance, the rewarding of better providers, and adequate and fair reimbursement.

Two Projects Launched To Develop Physician Performance Information
EA select group of California medical groups is helping to develop individual physician quality performance measures, as PBGH launches a pilot survey of patients' experience with their physicians. The purpose of the project is to test approaches to collect and report physician performance using patient-reported information. Ultimately, our hope is that this kind of information will be publicly available to help consumers choose a doctor.

In a parallel project to assess quality based on claims, PBGH has launched a pilot to develop measures and measurement systems on the quality and efficiency of individual physicians. Using Medicare and health plan claims data, the project will also seek user-friendly ways to present information to consumers, so they can choose better doctors, and to health plans, so they can develop benefit designs and payment models that reward quality at the level of the individual physician. The federal Agency for Healthcare Research and Quality recently funded the project. To learn more, read the Physician Performance Projects Summary.

Negotiating Alliance, UC Improve Performance Measures
The PBGH Negotiating Alliance, a large group purchasing pool of 17 employers, and the University of California have worked to consolidate and standardize their HMO and self-funded health plan performance measures. In addition to setting administrative and HEDIS targets, the measures now create a framework for collaboration with health plans in promoting health and disease management outcomes measurement and such long-term initiatives as Leapfrog patient safety standards and provider pay-for-performance. For more information on "2003 Performance Measures," read the overview.

For its Fall California Market Report, HealthLeaders Magazine profiled the efforts by PBGH and UC to expand outcomes measures. The article quoted Michele French, UC executive director of workforce planning: "Employers want clear measures of health plan and provider accountability." To learn more, read "Employers want focus on outcomes in health plan quality measures."

New Research Uncovers Huge Waste, Links Incentives with Quality Improvements
New research on two fronts reveals huge waste in the American health care system and indicates that public reporting of quality measures may hold the key to better and more efficient care. Studies published in the Annals of Internal Medicine divided 306 geographic areas of the U.S. into five groups based on Medicare costs. Researchers found that patients fare just as well-if not better-in the low-cost group as in the high-cost group. If all the areas delivered care as efficiently as the low-cost group, the Medicare budget could be reduced 30 percent. The study has profound implications for the entire health care system because Medicare providers are also serving the general population. PBGH distributed a PBGH media alert on the study. Read the full article.

Meanwhile, a PBGH media alert called attention to a new study by the Center for Studying Health System Change that surveyed more than 1,000 physician organizations, each with at least 20 doctors, to correlate the use of four established "care management processes," or systematic ways of caring for patients with chronic illness, with report cards and other external incentives to improve care. Researchers reported that medical groups with external incentives, especially report cards on their performance, used more of the organized processes.

The Big (But Invisible) Problem of Poor Clinical Quality
In the March/April issue of Health Affairs, PBGH Medical Director Arnie Milstein, MD explores the blindness of American society toward poor clinical quality. Using research on cognitive and motivational psychology, Dr. Milstein and co-author Nancy E. Adler, PhD, describe major "impediments to perception of quality failure." Visit Health Affairs to read an abstract of the article and order the full text. For an overview of "Out Of Sight, Out Of Mind: Why Doesn't Widespread Clinical Quality Failure Command Our Attention?" read the article synopsis.

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