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FTC Looks At Health Quality Comparisons

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The Federal Trade Commission is asking the public for comments about efforts to rate the quality of health care providers.

The FTC also will be holding a roundtable workshop on the topic, the agency says.

Here are the FTC questions about provider quality measurement efforts published today in the Federal Register:

A. Purchaser Decision Making and Quality Information

1. What decisions do quality information help different types of purchasers make?

2. What are the relevant times at which purchasers make health care decisions? What quality information about health care services and providers should be presented at these critical junctures?

3. What quality information is the most competitively significant for different types of purchasers? Are different types of data (e.g., licensing information, compliance with process measures, customer satisfaction, outcomes, outcomes per dollar spent) appropriate for different purchasers and purchaser decisions? How should any differences in measurement of the same provider or service (over the same time frame) be reconciled?

4. Does health care quality vary based by medical condition, provider, and patient? Does it vary over time? If so, how should quality measures be adjusted to take these differences into account?

5. What information is needed to measure the efficiency of a provider? What is the proper weighting of quality and resource use in an efficiency measure?

6. How broad a range of differences among health care providers and services is needed to motivate purchasers to switch service providers?

7. How should regional variations be accounted for in showing the results of quality measures? Should local, state, regional, or national benchmarks be used to show differences among service providers? Why or why not?

8. How does the framing of quality information affect the purchasers’ decisions? Do symbols and summaries affect purchaser understanding of health care quality information?

9. What has been learned from public and private quality reporting initiatives that can aid the competitive process?

10. What are the tradeoffs between quality-based competition and the availability of health care?

B. Barriers To Developing and Implementing Quality Measures

1. What barriers–clinical, marketplace, regulatory, or other– restrict the measurement, collection, and reporting of health care quality information? Can health care quality be measured such that it is of value to purchasers in their decision making?

2. Do providers and insurers have business reasons to develop and implement public reporting of quality measures?

3. How should quality measurements deal with organizational variation on the supply side (e.g., solo physician practitioners, small physician groups, integrated physician groups, etc.). If so, how should the measures be adjusted to consider this variation?

4. How does the development of reimbursement and payment reform affect the development of quality measurements?

5. Several private and public entities have developed standards to measure health care quality. Are concerns about provider capture of these organizations relevant in this context?

C. Federal Policies To Facilitate Quality Information Collection and Reporting

1. What federal policies can help overcome any marketplace barriers to the measurement, collection, and reporting of quality information?

2. How can government use its role as a payer (e.g., Medicare, Medicaid) to facilitate the development and use of quality information more broadly?

3. What are the costs and benefits of a single entity developing the quality measures, collecting and analyzing the data, and reporting the results? What are the costs and benefits of governmental involvement in these activities?

4. How should federal, state, and private sector efforts to measure and report on health care quality be harmonized so that purchasers obtain the benefits of cost and quality information?

Responses to the questions are due Sept. 30.


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