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What actions will the Federal government be taking to make value-driven health care a reality?


The Executive Order directs, to the extent permitted by law, health care programs administered or sponsored by the Federal government to promote quality and efficient delivery of health care through the use of interoperable health information technology, transparency regarding health care quality and price, and better incentives for program beneficiaries, enrollees, and providers.  This includes actions taken by the Centers for Medicare & Medicaid (CMS), and other Federal health benefits programs, such as Federal Employees Health Benefit Program (FEHBP) and TRICARE.  For example, the Office of Personnel Management (OPM) which administers FEHBP is working with its carriers to provide quality and price information to enrollees and to ensure that FEHBP enrollees are able to access innovative health insurance options.  The Federal government anticipates that the full implementation and use of all the measures and standards will be phased in over time.  As all purchasers begin to align expectations, these efforts should expand and move more quickly. 

Each agency that administers such a program is directed to utilize, where available, health information technology systems and products that meet recognized interoperability standards and to require such use in contracts or agreements with health insurance plans, third party administrators, providers, and others with which they contract.  The Federal government is expanding its efforts to make available relevant quality and price information using national consensus measures as a foundation for beneficiaries, providers, and our own insureds in a useable manner and to work in collaboration with broad-based national public-private initiatives in the private sector and non-Federal public sector.  To promote higher quality and efficiency of care, CMS is making available Medicare Savings Accounts (MSAs) and has initiated an MSA demonstration project for Medicare beneficiaries and is also exploring pay-for-performance and other value-based purchasing options for hospitals and other settings of care. 

CMS reports publicly on consensus quality measures for hospitals, nursing homes, dialysis facilities, home health agencies, and Medicare Advantage plans.  CMS also provides confidential quality performance reports to physicians voluntarily participating in the Physician Voluntary Reporting Program (PVRP).  With regard to price information, CMS is also reporting publicly on Medicare payments to hospitals and ambulatory surgery centers, and this Fall, outpatient and physician fee schedule payments.  In addition, CMS has provided an unprecedented amount of information for Medicare beneficiaries to use to make decisions on prescription drug plans.


Last Updated: 4/25/2008