The development of data that will enable employers and other healthcare purchasers to measure and compare treatment outcomes is akin to the search for healthcare's Holy Grail.
Eventually systems will exist to allow payers to compare the quality of individual physicians practicing in America's hospitals. But for now efforts focus on creating standard measures of quality and services offered by competing health plans covering a growing number of Americans.
Given the urgency of the need for comparative quality information, it's hard to criticize any endeavor to move the effort along. But why all the ballyhoo surrounding a venture into this arena by organizers of the Jackson Hole group?
Granted the announcement occurred during the long Fourth of July holiday, a notoriously slow news time. But several organizations-principally the National Committee for Quality Assurance-already are deeply involved in evaluating health plan performance. So further efforts may only increase the data collection burdens on providers.
Under the leadership of Executive Director Margaret O'Kane, the NCQA has toiled for almost a decade to bring standardization to commercial managed-care performance measurement. The third version of its Health Plan Employer Data and Information Set performance measures, scheduled for release in fall 1996, will seek to incorporate clinical risk-adjustment measures, an important step forward in the effort to make useful quality comparisons. Its working committee of representatives of business organizations, health plans and consumer groups recently has been joined by HCFA, a significant addition because it purchases care for many people.
The Joint Commission on Accreditation of Healthcare Organizations also has a performance measurement process for healthcare networks, which it's been trying to market for a year. Its entry into the health-plan business caused enough concern already about its potential to duplicate the NCQA's efforts.
We hope Jackson Holers resist the temptation to try to reinvent the wheel. As the team that popularized the concept of managed competition to address rising healthcare costs, they can provide valuable assistance in expanding the involvement of HCFA and other government agencies in improving quality measurement. They also are a valuable conduit to business organizations that previously haven't been active in the quality measurement effort.
Principally, their efforts should focus on facilitating research to develop tools that will take outcomes measurement, such as severity of illness, from theoretical to practical.