AQA Invitational Meeting Summary

Report of the Pilot Expansion Workgroup

Peter Lee, Pacific Business Group on Health

Peter Lee, who chairs the pilot expansion workgroup, said the workgroup looked at four very large issues:

• The need to balance innovation with standardization and consistency.
• Funding (What is the ongoing mode of funding the infrastructure?).
• How to migrate quickly to electronic data collection.
• The collection function of these pilots (Should collection ultimately be national or local?).

Lee noted that his workgroup had looked at three different collection models (decentralized, centralized, hybrid), each based on the assumption that there would be a blending of Medicare, commercial, and other data. He noted that the cost of doing something nationally was lower than the cost of collecting data in multiple communities. At the same time, he said, there are benefits from a local-level model (including fostering innovation).

Lee reported that the workgroup concluded that the best option was a hybrid model that would include a national collection mechanism for core consensus measures supplemented by both local and additional national measurements.

There are implications for better quality information for Medicare beneficiaries, said Lee. He stressed that the six AQA pilot sites have a central role to play in assessing how best to manage national collection and address supplementary efforts.

Lee highlighted several uses for the value exchanges:

• Public/consumer reporting (with cost information)
• Rewarding and fostering better performance
• Supporting improvement directly by providers

In order to achieve these goals, Lee continued, we need to foster collaboration across multiple stakeholders and use interoperative health information technologies for measurement as appropriate. Lee concluded that it was also important to evaluate these efforts.

Discussion

Following Lee's remarks, one participant said that his workgroup had provided a roadmap for addressing the challenges of:

1. Pilot projects that do not have the technical skills to aggregate data.
2. The need to have uniformity regarding aggregation.

She then asked for his thoughts on next steps for moving the process along. What is the critical path? How do we get where we are going?

In response, Lee said that while his workgroup had not yet charted a timeline, clearly a roadmap was needed that sets out what will happen in 2007, 2008, 2009, and beyond.

Carolyn Clancy added that the Robert Wood Johnson Foundation has funded four communities that resemble the AQA pilots, and is about to fund up to six more. She indicated that the Agency for Healthcare Research and Quality (AHRQ) has had discussions with the Foundation about how to align AQA and Foundation efforts.

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