Aside from the substance of the work that is needed, there are certain strategic or procedural constraints that may impede progress. The following three suggestions could enhance the success of efforts and the availability of information.
- Suggestion #8. In today’s competitive climate, HHS would be wise not to necessarily assume that information available under voluntary private efforts will continue to be available. We were struck by the fact that several groups had eliminated efforts to collect provider data. Historically, provider groups may have stopped collecting data when market changes influenced revenue or when sensitivities of members changed. HHS may want to commission a study to assess where it is dependent on such information, how important the information is, whether there is a need to develop or consider alternatives, or whether an independent capacity should be viewed as important.
- Suggestion #9. In today’s environment, public-private partnerships to collect data -- such as those developed in states like Minnesota -- are likely to be increasingly important to successful data initiatives. This assumption is incorporated into the suggestions made here. In light of the emerging need for such partnerships, HHS may wish to commission a review of both the operational issues these partnerships create and the experience in states or elsewhere that might inform this effort.
- Suggestion #10. HHS should assume that funding will be a constraint for all stakeholders concerned with the issues discussed here. The agency should consider convening a “summit” of public and foundation funders to discuss cooperative strategies that might finance data collection efforts. This is particularly critical, as historical experience suggests that states are severely limited both by the financing available for new data systems and by the resources and authority to attract and support technically proficient staff. Our study suggests that competition also may be reducing resources in the private sector. While more may be invested in data collection, there may be less willingness to engage in data collection for cooperative, as opposed to competitive, concerns. This summit can be a forum for considering not only what partnerships and innovations may be feasible but also the terms on which they may be feasible.
In sum, the information needs associated with the changing health system are extensive. Gaps in available information are widely perceived by stakeholders as impeding their ability to effectively serve their constituents. While some activity is underway to improve data and better address gaps, these activities are viewed by their sponsors as severely limited. The federal government can play an important role with stakeholders to better address the current and anticipated future information needs. While data improvement is a long term process and there are many challenges to be faced, stakeholder perceptions suggest some important areas where concrete steps can immediately be taken to begin this process.