Last November,
I endorsed the Patient Bill of Rights recommended by the Advisory
Commission on Consumer Protection and Quality in the Health Care Industry
(the Quality Commission). On February 20, 1998, after receiving your
encouraging reports from the Vice President about the degree to which
your agencies are in compliance with these rights, I directed you
to take all administrative actions under your authority to come into
compliance. As a result of my February 20 memorandum and your commitment
to implement the Patient Bill of Rights, the Federal Government will
be taking the lead in ensuring patient protections. By holding the
Federal Government accountable, we are strengthening our call on the
Congress to pass patient rights legislation that extends these protections
to all Americans.
Yesterday,
in their report to me through the Vice President, the Quality Commission
took the next logical step. Building on the Patient Bill of Rights,
which is explicitly designed to ensure quality, the Commissions
final report includes recommendations that I am confident will actually
improve quality care. Specifically, the Commission called for the
development of national health care quality improvement goals and
the use of measurement standards that will empower consumers and
businesses to make informed purchasing decisions based on health
plans' quality performance records.
The Quality
Commission recommends establishing two complementary entities, one
public and one private, to provide ongoing national leadership in
health care quality improvement. The Commission recommends the creation
of a broadly represented, publicly administered -Advisory Council
for Health Care Quality- and a privately administered - Forum for
Health Care Quality Measurement and Reporting. The Commission's
approach represents a creative balance to achieve constructive involvement
from all the parties that have important expertise and experience
in this area.
It is my strong
belief that we must ensure that all relevant agencies within the
Federal Government build on their leadership role in health care
quality. As the Quality Commission report makes clear, the lack
of coordination and uniform quality standards in both the public
and private sectors has created conditions that fall short of fully
meeting users needs, and often are duplicative and unduly burdensome
on health care providers, plans, and others. To that end, the Federal
Government must use improved standards and goals to better inform
and empower health care consumers and purchasers under Federal jurisdiction.
Moreover, we must do a better job of collaborating within and across
the Federal Government to most efficiently and effectively ensure
we achieve the national goal of improving quality and health outcomes.
Therefore,
I am directing the Secretary of Health and Human Services to immediately
establish a Quality Interagency Coordination - (QuIC) task force
to ensure better coordination among the executive agencies with
jurisdiction over health programs. I hereby direct you to take the
following actions consistent with your authority and the mission
of your agency to meet or exceed the recommendations of the Quality
Commission.
First, I direct
that all participating agencies shall have equal standing on the
QuIC task force.
Second, I direct
the task force to, wherever feasible, collaborate on goals, models,
and timetables that are consistent with the Quality Commissions
six - National Aims for Improvement: reducing the underlying causes
of illness, injury, and disability; reducing health care errors;
ensuring the appropriate use of health care service; expanding research
on effectiveness of treatments; addressing oversupply and under
supply of health care resources; and increasing patient participation
in their own care.
Third, I direct
the Secretary of Health and Human Services to serve as the convener
of the QuIC task force and to schedule the first task force meeting
to order by no later than March 27, 1998.
Fourth, I direct
the task force to improve cooperation by the participating agencies
on the development and utilization of quality measurement mechanisms
for public sector programs; these efforts should be flexible enough
to respond to changing needs, technology, and information, while
being sufficiently standardized to be comparably measured.
Fifth, I direct
the task force to work to increase the development and dissemination
of evidence-based health care information to help guide practitioners
actions in ways that will improve quality and potentially constrain
costs.
Sixth, I direct
the task force to consult with health care workers and their representatives,
as well as other affected parties, in developing models for quality
improvement.
Seventh, I
direct the task force to enhance efforts to develop user-friendly
information for both consumer and business purchasers that facilitates
meaningful comparisons of quality performances of plans, facilities,
and practitioners.
Eighth, I direct
all participating agencies, where feasible and appropriate, to seek
to avoid inefficient duplication of ongoing quality improvement
efforts and resources.
Finally, I
direct the task force, to every extent possible, to endeavor to
coordinate the Federal programs quality reporting and compliance
requirements to reduce administrative burdens on private entities
who administer, oversee, or participate in the Nations Federal health
programs.
WILLIAM J.
CLINTON
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