Experts testifying before Senate panel extol incentives, standardization as means to improve quality of care

Offering incentives to health care providers who deliver higher quality care and requiring that they comply with national quality standards would help improve patient care, witnesses said at a Senate Finance Committee hearing on Tuesday, CQ HealthBeat reports.

The hearing was one of several held by the panel to discuss issues related to overhauling the nation's health care system. Previous sessions have looked at controlling health care costs and expanding access to care.

Committee Chair Max Baucus (D-Mont.) said that the U.S. "simply cannot afford to continue paying for inappropriate or inadequate medical care," adding, "We need to encourage high-quality and high-value care," and "we need to reward health care providers who deliver it." He noted that health care costs are increasing by about 7% annually. Committee ranking member Chuck Grassley (R-Iowa) said, "We need incentives for quality versus quantity" (Carey, CQ HealthBeat, 9/9).

Peter Lee, executive director of national health policy for Pacific Business Group on Health, said, "We need to step back and say fee-for-service doesn't reward the right thing" (CongressDaily, 9/9). National Quality Forum Chair William Roper said he would tie as much as 5% to 10% of a provider's payment to the quality of care they provide. He said changing the industry's attitude about quality will take time but will be worth the effort.

Lee said a national initiative should be established to measure and compare the effectiveness of drugs, devices and procedures using a process "that can be trusted by all stakeholders by being transparent and rigorous." Baucus and Senate Budget Committee Chair Kent Conrad (D-N.D.) have introduced a bill (S 3408) that would create a public-private institute that would conduct comparative-effectiveness research. Lee also recommended creating "robust, independent systems" for gathering and publicizing performance results on patients, outcomes, cost and patient opinions of care, as well as "whether the right processes of care are being delivered."

Witnesses also emphasized the need for consensus among providers about how to measure quality, with such methods tested through pilot projects. Financial incentives can provide important encouragement for facilities to comply, but mandates for participation also are needed to ensure changes take place, they said. Roper suggested having Medicare require participating providers to implement standardized health information technology. He said, "Without that kind of vigorous push by people in Washington leading the charge, it's not going to happen" (CQ HealthBeat, 9/9).