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Quality Standards

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Measuring Quality

Health care is like any other service; some providers are better than others. Quality of care is of critical interest to patients; their health, even their lives, can be at stake. They need and deserve to know. Doctors want to know too.

Measuring health care quality is complex. As a medical discipline, it is still in the pioneering phase. Some professional health groups are already doing it.

Organizations of insurers and health care providers have joined forces to create standards and measures for health care quality. Organizations involved include:

  • AQA (formerly the Ambulatory Quality Care Alliance), which has steering committees focused on performance measurement, data aggregation and reporting External Links Disclaimer
  • Hospital Quality Alliance (HQA), a reporting initiative providing information on the quality of care in hospitals External Links Disclaimer
  • Quality Alliance Steering Committee , a new national committee that combines the efforts of AQA and HQA to expand on them External Links Disclaimer

Initial standards focus on ambulatory care (physician services) and hospital care. Claims and other data will be aggregated and used to measure specific providers against the standards.

Under a Medicare initiative in six pilot cities - Boston, Indianapolis, Minneapolis, Madison, San Francisco, and Phoenix - community collaborations will apply and expand these measures. The Quality Alliance Steering Committee is now working to broaden the pilot efforts. For more on the pilots, see Pilot Communities & Programs.

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Comparing Hospitals

One of the first steps toward providing consumers with data on quality was created by the Centers for Medicare & Medicaid Services (CMS) and the HQA. The Hospital Compare site provides quality information from more than 4,000 hospitals on an initial set of conditions - heart attack, heart failure, pneumonia, and surgical infection prevention.

Hospital Compare shows how often hospitals provided the recommended care to get the best results for most patients. For instance, the site describes the recommended care for a heart attack, and consumers can see how often hospitals they are considering provided that care. New information, on patient satisfaction, treating asthma in children, and intensive care unit services, will be added to the Hospital Compare site as it becomes available.

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Physician Services Standards

The AQA began in 2004 as an effort to create a method for measuring physician performance in ambulatory care and provide consumers with this information to help them make better choices. The original alliance members from the American Academy of Family Physicians, the American College of Physicians, America's Health Insurance Plans, and the Agency for Healthcare Research and Quality have now been joined by other supporting organizations, and the scope of the alliance's efforts has expanded to include all areas of physician care.

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Hospital Care Standards

The Hospital Quality Alliance is a public-private collaboration to improve the quality of care provided by the nation's hospitals by measuring and publicly reporting on that care. This collaboration includes the Centers for Medicare & Medicaid Services, the American Hospital Association, the Federation of American Hospitals, and the Association of American Medical Colleges, and is supported by many other organizations.

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