There is a great deal of current activity to develop standardized performance measures for provider groups and health plans particularly in response to HIPAA and under HEDIS. Yet these efforts are limited by gaps in data and limitations in data quality, as well as by the effects of the competitive marketplace.
Suggestion #6. HHS staff should meet with NCQA, FAACT, and representatives of appropriate provider and insurer organizations to identify whether current activity addresses key priority needs and where additional federal help could be useful. One starting place for identifying needs could be the recently issued “Roadmap” to health care data prepared by NCQA.
Suggestion #7a. HHS should similarly consult with representatives of states (NAHDO and related members), payers, purchasers, and others to identify where gaps may exist in current efforts and where federal help would be useful.
Suggestion #7b. To encourage communication between user and producer communities, HHS should build on previous work and meet with representatives from both groups to discuss areas in which there may be any mismatches in priorities or unmet needs. One area flagged during our project was the ability to aggregate information to provide estimates for subpopulations, geographically defined resident entities, condition groups, and accountable entities of health plans or providers. Other areas include the inability to associate expenses with particular outcomes or to track care across changing settings of practice.