NCHS, the IOM, HCFA, and ANSI have a long history of establishing committees of prominent and talented individuals to propose ways to address the issues related to system performance and outcomes from different vantage points. On a more decentralized basis, NAHDO and NCQA have performed important similar work with states, health plans, and purchasers. The questions is: why are many documented recommendations not acted upon, and what can be done about this? Have the recommendations been flawed, the groups not optimally constituted, the implementation process lacking, or is the process or change just inherently slow? And if it is the latter, what does this imply for realistic policy implementation? The issue here is not to point fingers. Clearly, there are a number of obstacles that limit implementation and there may also be differences of opinion about how practical or valuable different recommendations or alternative strategies may be. Yet, there is an important opportunity to learn from these past efforts.
- Suggestion #5. HHS should commission an independent study to evaluate the process that followed the release of the NCHVS report on standardization, the HCFA expenditure panel chaired by Joe Newhouse, and potentially other efforts. The idea would be to hear the perspectives of a group of diverse stakeholders about the value of recommendations and barriers to implementation or consideration. The purpose of the study would be to identify appropriate lessons for future activity.