National Themes, Issues, and Aims
Understanding national priorities and issues related to quality and safety can help health care organizations when it comes to defining their own strategic goals. National-level priorities and issues can serve as guide posts or may be imperative, driving strategic direction. In addition to the National Quality Strategy aims and the key themes for the Medicare Quality Improvement Organization, quality and disparity themes from Agency for Healthcare Research and Quality (AHRQ) and issues for Medicare provide insights into the concerns driving national health reform.
AHRQ themes from 2010 analysis
AHRQ called out four themes in its 2010 National Healthcare Quality Report and 2010 National Healthcare Disparities Report.
- Health care quality and access are suboptimal, especially for minority and low-income groups.
- Quality is improving; access and disparities are not improving.
- Urgent attention is warranted to ensure improvements in quality and progress on reducing disparities with respect to certain services, geographic areas, and populations, including:
- Cancer screening and management of diabetes
- States in the central part of the country
- Residents of inner-city and rural areas
- Disparities in preventive services and access to care
- Progress is uneven with respect to eight national priority areas:
• Two are improving in quality: palliative and end-of-life care, and patient and family engagement
• Three are lagging: population health, safety, and access
• Three require more data to assess: care coordination, overuse, and health system infrastructure
• All eight priority areas showed disparities related to race, ethnicity, and socioeconomic status
Top 10 Medicare issues in 2011
The Bureau of National Affairs Medicare Report listed the following items as the top 10 Medicare issues for this year.
- Regulations to determine shape and scope of accountable care organizations
- Testing different payment methods by the Centers for Medicare and Medicaid Innovation
- Potential cuts in Medicare payments
- Changes in Medicare Advantage enrollment periods and a payment freeze
- Reducing Part D plan enrollees' share of drug costs in the coverage gap until eliminated in 2020
- Physician quality reporting system and electronic prescribing incentive programs
- Provider penalties for failing to participate successfully in program
- Beneficiaries required to obtain their competitively bid items only from CMS-contracted suppliers with successful bids in 2010
- Continued litigation of whether general assistance days should be included among Medicaid-eligible days
- Litigation over use of collection agencies and concurrent write-offs for bad debts
1. National Healthcare Quality Report, Agency for Healthcare Research and Quality, March 2011. (224-page PDF)
2. Bureau of National Affairs, Medicare Report, January 7, 2011. .
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