1. Use the contractor budget to set realistic priorities by establishing task-specific resource estimates and expectations. Use detailed agendas to identify up front the expected outcomes from meetings (and not just the meeting process and logistics).  Each task force should be expected to have a very specific and scientifically/operationally grounded plan by March 2007.

2. Set aside the amount of resources expected to be needed to provide general opportunities for the Collaborative to meet with the goal of reinforcing individual firm commitment and work in this area. These should cover a specified number of meetings/calls with whatever preparation in between is decided is warranted. Set detailed agendas for these meetings in ways that support sharing of ongoing work and discussions of shared concerns, as well as reporting on task force progress.

3. Set specific goals for what each task force is to accomplish and devote resources only to these goals. Use the available resources to help staff the task forces with analysis on options, the state of the art, etc. Identify two or three specific things (not sets of things) that will be "NHPC general goals" for concrete accomplishments. 

4. Primary data collection: Learn from the hospital industry model  (described by AHA/HRET at the CHCS Quality Summit in December 2006) to build consensus strategies on how to collect these data in ways that are scientifically grounded, consistent with external user demands (e.g. OMB, Medicare, NQCA), and flexible enough that firms can decide how much detail to collect. Focus on approaches to collecting data that are likely to work for most plans and are well tied into the evolving techniques.  Be cautious about making compromises that deal expediently with integrating some leading plan practices but may constrain appropriate national solutions.  Given that firms wanted to pursue primary data collection primarily for the purposes of standardization, best practices, and perhaps even promoting national policy in this area, the use of pilot testing under this topic area seems superfluous.  Therefore, drop the concept of pilots—individual firms may pursue pilot testing of concepts on a purchaser or market basis if it makes sense to them. 

5. Language access lines:  Use a fixed amount of the budget (e.g. $20,000) to commission a synthesis paper on the existing requirements/models/state of the art that can be shared broadly with plans. Use the Collaborative to work in 1-2 local markets (if a local strategy makes sense) to test out better ways of applying evidence to make concrete improvements.

6. "Big B/Little B": This project means different things to different people.  Probably the most reasonable thing that the NHPC can do as a whole is to spend $20,000 commissioning a paper that makes the case for why working on this area has payoffs for purchasers and health plans.  Share with firms materials, if they exist, on plan-based strategies for judging return on investment, but do not make these a focus of the Collaborative because each firm is likely to vary in its needs and approach and could consume resources better used for the collective good.