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.
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
- 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.