Quality is going to be job one for providers next year-whether they like it or not.
Thanks to the recently released report on medical errors by the Institute of Medicine, quality improvement and outcomes management have never been more important to the public. Not to mention President Clinton and many members of Congress, who have ranked quality high on their legislative wish lists for 2000 (Dec. 20-27, 1999, p. 2).
"This report received lot of attention because the public identified a lot with that," says Christopher Jennings, White House healthcare adviser. "Progress is never as quick as we want it to be, but the IOM amplifies the problem and moves us to address it."
The White House is hoping that health plans will lead the way. Clinton ordered the 300 plans that cover federal employees nationwide to develop and implement patient-safety initiatives. Clinton is hoping other health plans will follow suit, with providers falling in line behind them.
Already, the managed-care lobby has embraced this role and is relishing the idea of shedding its tarnished image.
If providers don't like the idea of health plans' running the quality-improvement parade, they should roll up their sleeves and work with Congress, which seems intent on passing some type of quality legislation this year.
And don't underestimate the power of healthcare consumers. The taste of World Wide Web sites loaded with healthcare information has whetted the public's appetite for more and better data on quality, and they just might get it in the near future.
There is a movement afoot in Congress to open up to the public the National Practitioner Data Bank, which tracks disciplinary actions and large malpractice judgments against physicians. While providers would argue that the data do not necessarily indicate quality, several patient advocacy groups support making it public.
The push to open the data bank got a big boost from the furor generated by the IOM report.
Providers have successfully killed such maneuvers in the past. They can head off this one, too, if they cooperate with all interested parties in finding an alternative solution. The key is working with patient advocates, who in the past have not always been included in provider quality-improvement efforts.
The IOM report, released in late November, is only the first of several reports the institute plans to release on healthcare quality. So brace yourselves: Quality will be the hot issue for 2000.