President Clinton's quality task force is likely to recommend that Congress create two new voluntary commissions that would oversee ongoing quality measurement, improvement and reporting efforts for the entire healthcare industry.
At the same time, the managed-care industry is considering a number of options for overseeing its own flock and is leaning toward a voluntary program and away from more regulatory models.
The two commissions proposed by the 34-member task force would be similar to the American National Standards Institute, which has voluntary membership and does not have regulatory authority. Instead of creating a government agency, health plans, providers and purchasers would voluntarily join the commission and agree to abide by its recommendations. The quality task force met last week in Washington.
If accepted by the full panel, the proposal will be part of the final report of the president's Advisory Commission on Consumer Protection and Quality in the Health Care Industry due out early next year. Last month, the quality task force released a "consumer bill of rights" that President Clinton has vowed to translate into legislation next year.
One of the proposed commissions, which would likely be appointed jointly by Congress and the White House, would set a national quality strategy. It would advise Congress and the executive branch on quality issues but would not have regulatory authority.
The second commission, comprising various healthcare quality stakeholders, would implement the strategies created by the first commission. Membership in the implementation commission would be voluntary and would be open to providers, health plans, insurers, purchasers, unions and quality experts.
In choosing a voluntary structure, the quality task force rejected other models, including one similar to the Securities and Exchange Commission. It said such models are too regulatory.
States also are grappling with new ways to regulate the managed-care industry (See related story, p. 21)
In an effort to avoid clinical mandates and possibly unify various state HMO laws, the American Association of Health Plans also has been looking at changes in the way health plans are regulated. The association hired Steven Wallman, a recently retired SEC commissioner, to perform the review.
Like the president's quality task force, the AAHP considered models such as the SEC and the Financial Accounting Standards Board that have regulatory authority over an industry. But the AAHP appears to have rejected those models as too regulatory.
In a Dec. 1 draft memo to the AAHP obtained by MODERN HEALTHCARE, Wallman argues that a voluntary, nonregulatory body would give the industry the most flexibility and "insulate the regulatory structure from the immediacy of politics."