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Four Cornerstones

The Executive Order is intended to ensure that health care programs administered or sponsored by the federal government build on collaborative efforts to promote four cornerstones for health care improvement:

  1. Interoperable Health Information Technology (Health IT Standards): Interoperable health information technology has the potential to create greater efficiency in health care delivery.  Significant progress has been made to develop standards that enable health information systems to communicate and exchange data quickly and securely to protect patient privacy.  Additional standards must be developed and all health care systems and products should meet these standards as they are acquired or upgraded.  

  2. Measure and Publish Quality Information (Quality Standards): To make confident decisions about their health care providers and treatment options, consumers need quality of care information.  Similarly, this information is important to providers who are interested in improving the quality of care they deliver.  Quality measurement should be based on measures that are developed through consensus-based processes involving all stakeholders, such as the processes used by the AQA (multi-stakeholder group focused on physician quality measurement) and the Hospital Quality Alliance.

  3. Measure and Publish Price Information (Price Standards): To make confident decisions about their health care providers and treatment options, consumers also need price information.  Efforts are underway to develop uniform approaches to measuring and reporting price information for the benefit of consumers.  In addition, strategies are being developed to measure the overall cost of services for common episodes of care and the treatment of common chronic diseases. 

  4. Promote Quality and Efficiency of Care (Incentives): All parties - providers, patients, insurance plans, and payers - should participate in arrangements that reward both those who offer and those who purchase high-quality, competitively-priced health care.  Such arrangements may include implementation of pay-for-performance methods of reimbursement for providers or the offering of consumer-directed health plan products, such as account-based plans for enrollees in employer-sponsored health benefit plans.