It's cliffhanger time again for the Malcolm Baldrige National Quality Award for healthcare, as providers watch and wonder whether Congress will finally fund an expansion of the prestigious business honor.
"It's always a guess until the end," said Michael Newman, spokesman for the National Institute of Standards and Technology, the branch of the U.S. Commerce Department that runs the Baldrige award competition.
The award, named after former Commerce Secretary Malcolm Baldrige, recognizes U.S. companies that use total quality management techniques to improve their products or services. It began in 1987 and now recognizes companies in three categories: manufacturing, services and small businesses. For the past several years, Congress has nixed funding to add the categories of healthcare and education.
The House and Senate have both finished their appropriations bills and are in recess until September. The bills diverge in their approach and degree of commitment to expanding the awards program.
The Senate bill earmarks $3 million for the Baldrige program, representing no increase in funding over last year. The Senate would prefer to let the departments of HHS and Education create their own quality awards.
The House bill sets aside $4.1 million for the program and recommends that the NIST seek full reimbursement for new Baldrige awards from the departments of HHS and Education.
President Clinton has asked for $5.3 million. Of that, $3 million would continue the existing program and $2.3 million would crank up the healthcare and education awards.
A new healthcare category would open the awards competition to not-for-profit healthcare providers. For-profit healthcare companies already are eligible in the service category.
New applicants wouldn't be restricted to hospitals, said Harry Hertz, director of the awards program. "It's any healthcare provider-nursing homes, rehab facilities, dialysis centers, home-health agencies, physician practices, HMOs. They'd all be eligible," he said.
"It's way too early to speculate on any of this at this point. The budget is so changeable between now and the final," said the NIST's Newman. "The hope is, we will receive what the president is requesting. We've done pilot programs in both of these. They were successful. They showed that these areas, healthcare and education, want to have a Baldrige program. Everything is go for it, except the funding."
At the Joint Commission on Accreditation of Healthcare Organizations, people are keeping their fingers crossed that the funding will pass.
"I am optimistic," said Paul Schyve, M.D., JCAHO senior vice president. "There is reasonable consensus that this would be good for healthcare. It would provide a set of widely accepted guidelines for improving performance in healthcare organizations."