HealthReformGPS is made possible through generous financial support from the RCHN Community Health Foundation. Visit them at

AF4Q brief reviews public reporting measures

Posted on August 7, 2012 | No Comments

PDF Version
Implementation Briefs

Aligning Forces for Quality (AF4Q), the Robert Wood Johnson Foundation’s signature effort to lift the overall quality of care in 16 targeted communities, has been a pioneer in collecting and publicly reporting data on the care provided by local physicians and hospitals. Measuring and publicly reporting on the quality and cost of care helps to improve quality and lower health care costs nationwide, and serves three important purposes: 1) it enables patients to make informed choices about their care and be better partners with their doctors; 2) it allows health care professionals to see where they can improve and motivates them to improve their performance; and 3) it allows consumers and purchasers to see the value they are getting for their money. Lessons and resources from AF4Q have been combined in a new brief that offers an overview on selecting performance metrics, engaging stakeholders, making performance reports consumer-friendly, and using performance measures to improve quality.

No Comments

Public comments are closed.

A provision of the Affordable Care Act (ACA) requires health plans to submit reports each year demonstrating how they reward health care quality through market-based incentives in benefit design and provider reimbursement structures. By spring 2012, the U.S. Secretary of Health and Human Services (HHS) is expected to develop requirements for health plans to report on their efforts to: improve health outcomes, prevent hospital readmissions, ensure patient safety and reduce medical errors, and implement wellness and health promotion activities. Both employer group health plans, including self-insured plans, individual market plans, and qualified health plans sold through the insurance exchanges are required to submit such reports. A report recently published by The Commonwealth Fund outlines key considerations...
In a study published in the March issue of Health Affairs, researchers found that Medicare’s seven-year public reporting initiative for hospitals, Hospital Compare, had no impact on reducing death rates for two key health conditions and just a modest effect on a third. These conclusions raise raises questions about the initiative’s ability to improve the quality of care provided by the nation’s hospitals. Hospital Compare produced no reductions beyond the existing trends in improvement of care of heart attacks and pneumonia. Authors found that hospitals might have improved on thirty-day mortality rates during the study, but attribute the change to ongoing innovations in clinical care, and not to any effect related to public reporting. At the same time, the researchers found a modest improvement in mortality rates for heart failure; though, they can’t prove that this was related to the public reporting initiative. The findings help inform the ongoing debate about Hospital Compare...
As required by the Patient Protection and Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) launched Physician Compare in December 2010, where Americans can find information on physicians. The website provides information ranging from the gender of the physician to whether doctors have foreign language proficiencies, if they accept Medicare patients, and where they completed their degrees and training. A new Robert Wood Johnson Foundation brief, "Reform in Action: Can Measuring Physician Performance Improve Health Care Quality?" explores examples of public reporting websites that have caused hospitals and physicians to improve their practice patterns and the quality of care they provide.
Section 9006 of the Affordable Care Act (ACA) would have required businesses to issue 1099 forms for transactions over $600 with other corporations, such as vendors and suppliers. This was a significant expansion of the reporting requirements and was seen by many as a huge burden on businesses, particularly small businesses. On April 14, 2011, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011 was signed into law, repealing the ACA Section 9006 reporting requirements.
Health care quality represents a constantly recurring theme in U.S. health policy. Traditionally, the Medicare program has paid for health care services on a fee-for-service basis with the exception of inpatient hospital services, which are paid based on Diagnosis Related Groups (DRGs) under the prospective payment system (PPS), and the Medicare Advantage and Prescription Drug plans, which are paid on a capitated basis. All payment systems tend to incentivize something; in the case of fee-for-service, it is indiscriminant increases in volume of services provided, while in case-based or capitation systems it is indiscriminant reductions in volume. The challenge is to promote both quality and value while also apportioning financial risk appropriately. Because Medicare has relied principally on a fee-for-service approach to payment for physician and other services (and even while hospital payments are case-based under the PPS, it does not discourage multiple admissions and readmissions), the program has experienced incredible growth in the volume of services. At the same time, Medicare lacks a program-wide and deliberate approach to promoting quality and value.