Key Issues > Health Care Quality and Access
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Health Care Quality and Access

Despite high health care spending levels, many preventable quality problems such as health-care-associated infections continue to persist. Access to health care also continues to be a problem for certain groups.

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The Department of Health and Human Services (HHS) is responsible for a variety of significant efforts that address health care quality and access.

  • Quality measurement and the meaningful use of electronic health records (EHR) each have the potential to improve quality of care and reduce spending. HHS needs to address problems with contractor performance in the development of quality measures and improve processes used to verify whether participating providers are meeting requirements to receive incentive payments for meaningful use of EHRs. HHS oversight of nursing home care has increased significantly in recent years, but continued attention is needed. To address issues related to quality of care in nursing homes, HHS can strengthen the Special Focus Facility program that focuses on poorly performing facilities, strengthen its oversight of complaint investigations, and improve its monitoring of nursing homes with records of serious care problems.

Figure 1: Number of Nursing Home Complaints Reported by Each State Survey Agency per 1,000 Nursing Home Residents, 2009

Number of Nursing Home Complaints Reported by Each State Survey Agency per 1,000 Nursing Home Residents, 2009

  • Unsafe health care practices occur despite HHS oversight and the existence of guidelines to prevent unsafe practices, and the extent of the problems is often unclear. To address these issues, HHS can improve data on unsafe injection practices and improve oversight of long-term care hospitals by improving oversight activities. HHS can also continue to identify priorities among recommended infection control practices established by the CDC and ensure consistency and compatibility of the data collected by HHS on health-care-associated infections.
  • Transparent and available information about health care services can assist consumers in making important health care decisions. For example, when accessing health care services, patients generally learn of the costs for provided services after receiving care even though they are increasingly responsible for paying these costs. To address this issue, HHS can take steps to make more price information for health care services available to consumers. HHS can also use strategic planning and develop milestones and timelines to ensure that its Five-Star System meets its goals in providing information on nursing home quality to consumers
  • Access to health care services for American Indians and Alaska Natives has been a long-standing concern. This issue could be addressed through the development and use of a new method to allocate contract health services funds for the provision of certain services to these populations.
Looking for our recommendations? Click on any report to find each associated recommendation and its current implementation status.

Patient Safety:

HHS Has Taken Steps to Address Unsafe Injection Practices, but More Action Is Needed
Published: Jul 13, 2012. Publicly Released: Aug 3, 2012.

Indian Health Service:

Action Needed to Ensure Equitable Allocation of Resources for the Contract Health Service Program
Published: Jun 15, 2012. Publicly Released: Jun 15, 2012.

Electronic Health Records:

Health Care Quality Measurement:

HHS Should Address Contractor Performance and Plan for Needed Measures
Published: Jan 13, 2012. Publicly Released: Jan 13, 2012.

Nursing Homes:

More Reports

Electronic Health Record Programs:

Participation Has Increased, but Action Needed to Achieve Goals, Including Improved Quality of Care
Published: Mar 6, 2014. Publicly Released: Mar 6, 2014.



Higher Use of Costly Prostate Cancer Treatment by Providers Who Self-Refer Warrants Scrutiny
Published: Jul 19, 2013. Publicly Released: Aug 1, 2013.

Patient Protection and Affordable Care Act:


Action Needed to Address Higher Use of Anatomic Pathology Services by Providers Who Self-Refer
Published: Jun 24, 2013. Publicly Released: Jul 15, 2013.

Patient Protection and Affordable Care Act:

Status of CMS Efforts to Establish Federally Facilitated Health Insurance Exchanges
Published: Jun 19, 2013. Publicly Released: Jun 19, 2013.

VA and IHS:

Further Action Needed to Collaborate on Providing Health Care to Native American Veterans
Published: Apr 26, 2013. Publicly Released: Apr 26, 2013.


Progress Made in Responding to Seasonal and Pandemic Outbreaks
Published: Feb 13, 2013. Publicly Released: Feb 13, 2013.

Health Care Fraud:

Types of Providers Involved in Medicare Cases, and CMS Efforts to Reduce Fraud
Published: Nov 28, 2012. Publicly Released: Nov 28, 2012.


States Reported Billions More in Supplemental Payments in Recent Years
Published: Jul 20, 2012. Publicly Released: Aug 20, 2012.